The effect of dosing strategies on the therapeutic efficacy of artesunate-amodiaquine for uncomplicated malaria a meta-analysis of individual patient data

doi:10.1186/s12916-015-0301-z

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Fältnamn	Indikatorer	Metadata
000		08371naa a22017653a 4500
001		20194308
003		SE-LIBR
005		20170323182046.0
007		cr\|\|\|\|\|\|\|\|\|\|\|\|
008		170323s2015 sw \|\|\|\| o \|\|\|\| \|\|eng c
024	7	a http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-2530812 uri
024	7	a urn:nbn:se:uu:diva-2530812 urn
024	7	a 10.1186/s12916-015-0301-z2 doi
040		a S
041	0	a eng
042		9 EPLK
100	1	a Adjuik, Martin A.4 aut
245	1 0	a The effect of dosing strategies on the therapeutic efficacy of artesunate-amodiaquine for uncomplicated malariah [Elektronisk resurs]b a meta-analysis of individual patient data
260		c 2015
500		a Published
506	0	a gratis
520		a Background: Artesunate-amodiaquine (AS-AQ) is one of the most widely used artemisinin-based combination therapies (ACTs) to treat uncomplicated Plasmodium falciparum malaria in Africa. We investigated the impact of different dosing strategies on the efficacy of this combination for the treatment of falciparum malaria. Methods: Individual patient data from AS-AQ clinical trials were pooled using the WorldWide Antimalarial Resistance Network (WWARN) standardised methodology. Risk factors for treatment failure were identified using a Cox regression model with shared frailty across study sites. Results: Forty-three studies representing 9,106 treatments from 1999-2012 were included in the analysis; 4,138 (45.4%) treatments were with a fixed dose combination with an AQ target dose of 30 mg/kg (FDC), 1,293 (14.2%) with a non-fixed dose combination with an AQ target dose of 25 mg/kg (loose NFDC-25), 2,418 (26.6%) with a non-fixed dose combination with an AQ target dose of 30 mg/kg (loose NFDC-30), and the remaining 1,257 (13.8%) with a co-blistered non-fixed dose combination with an AQ target dose of 30 mg/kg (co-blistered NFDC). The median dose of AQ administered was 32.1 mg/kg [IQR: 25.9-38.2], the highest dose being administered to patients treated with co-blistered NFDC (median = 35.3 mg/kg [IQR: 30.6-43.7]) and the lowest to those treated with loose NFDC-25 (median = 25.0 mg/kg [IQR: 22.7-25.0]). Patients treated with FDC received a median dose of 32.4 mg/kg [IQR: 27-39.0]. After adjusting for reinfections, the corrected antimalarial efficacy on day 28 after treatment was similar for co-blistered NFDC (97.9% [95% confidence interval (CI): 97.0-98.8%]) and FDC (98.1% [95% CI: 97.6%-98.5%]; P = 0.799), but significantly lower for the loose NFDC-25 (93.4% [95% CI: 91.9%-94.9%]), and loose NFDC-30 (95.0% [95% CI: 94.1%-95.9%]) (P < 0.001 for all comparisons). After controlling for age, AQ dose, baseline parasitemia and region; treatment with loose NFDC-25 was associated with a 3.5-fold greater risk of recrudescence by day 28 (adjusted hazard ratio, AHR = 3.51 [95% CI: 2.02-6.12], P < 0.001) compared to FDC, and treatment with loose NFDC-30 was associated with a higher risk of recrudescence at only three sites. Conclusions: There was substantial variation in the total dose of amodiaquine administered in different AS-AQ combination regimens. Fixed dose AS-AQ combinations ensure optimal dosing and provide higher antimalarial treatment efficacy than the loose individual tablets in all age categories.
650	7	a Medical and Health Sciences2 hsv
650	7	a Clinical Medicine2 hsv
650	7	a Infectious Medicine2 hsv
650	7	a Medicin och hälsovetenskap2 hsv
650	7	a Klinisk medicin2 hsv
650	7	a Infektionsmedicin2 hsv
653	0	a Malaria
653	0	a Plasmodium falciparum
653	0	a Drug resistance
653	0	a Artesunate
653	0	a Amodiaquine
653	0	a Dosing
653	0	a Efficacy
700	1	a Allan, Richard4 aut
700	1	a Anvikar, Anupkumar R.4 aut
700	1	a Ashley, Elizabeth A.4 aut
700	1	a Ba, Mamadou S.4 aut
700	1	a Barennes, Hubert4 aut
700	1	a Barnes, Karen I.4 aut
700	1	a Bassat, Quique4 aut
700	1	a Baudin, Elisabeth4 aut
700	1	a Bjorkman, Anders4 aut
700	1	a Bompart, Francois4 aut
700	1	a Bonnet, Maryline4 aut
700	1	a Borrmann, Steffen4 aut
700	1	a Brasseur, Philippe4 aut
700	1	a Bukirwa, Hasifa4 aut
700	1	a Checchi, Francesco4 aut
700	1	a Cot, Michel4 aut
700	1	a Dahal, Prabin4 aut
700	1	a D'Alessandro, Umberto4 aut
700	1	a Deloron, Philippe4 aut
700	1	a Desai, Meghna4 aut
700	1	a Diap, Graciela4 aut
700	1	a Djimde, Abdoulaye A.4 aut
700	1	a Dorsey, Grant4 aut
700	1	a Doumbo, Ogobara K.4 aut
700	1	a Espie, Emmanuelle4 aut
700	1	a Etard, Jean-Francois4 aut
700	1	a Fanello, Caterina I.4 aut
700	1	a Faucher, Jean-Francois4 aut
700	1	a Faye, Babacar4 aut
700	1	a Flegg, Jennifer A.4 aut
700	1	a Gaye, Oumar4 aut
700	1	a Gething, Peter W.4 aut
700	1	a Gonzalez, Raquel4 aut
700	1	a Grandesso, Francesco4 aut
700	1	a Guerin, Philippe J.4 aut
700	1	a Guthmann, Jean-Paul4 aut
700	1	a Hamour, Sally4 aut
700	1	a Hasugian, Armedy Ronny4 aut
700	1	a Hay, Simon I.4 aut
700	1	a Humphreys, Georgina S.4 aut
700	1	a Jullien, Vincent4 aut
700	1	a Juma, Elizabeth4 aut
700	1	a Kamya, Moses R.4 aut
700	1	a Karema, Corine4 aut
700	1	a Kiechel, Jean R.4 aut
700	1	a Kremsner, Peter G.4 aut
700	1	a Krishna, Sanjeev4 aut
700	1	a Lameyre, Valerie4 aut
700	1	a Ibrahim, Laminou M.4 aut
700	1	a Lee, Sue J.4 aut
700	1	a Lell, Bertrand4 aut
700	1	a Martensson, Andreas4 aut
700	1	a Massougbodji, Achille4 aut
700	1	a Menan, Herve4 aut
700	1	a Menard, Didier4 aut
700	1	a Menendez, Clara4 aut
700	1	a Meremikwu, Martin4 aut
700	1	a Moreira, Clarissa4 aut
700	1	a Nabasumba, Carolyn4 aut
700	1	a Nambozi, Michael4 aut
700	1	a Ndiaye, Jean-Louis4 aut
700	1	a Nikiema, Frederic4 aut
700	1	a Nsanzabana, Christian4 aut
700	1	a Ntoumi, Francine4 aut
700	1	a Ogutu, Bernhards R.4 aut
700	1	a Olliaro, Piero4 aut
700	1	a Osorio, Lyda4 aut
700	1	a Ouedraogo, Jean-Bosco4 aut
700	1	a Penali, Louis K.4 aut
700	1	a Pene, Mbaye4 aut
700	1	a Pinoges, Loretxu4 aut
700	1	a Piola, Patrice4 aut
700	1	a Price, Ric N.4 aut
700	1	a Roper, Cally4 aut
700	1	a Rosenthal, Philip J.4 aut
700	1	a Rwagacondo, Claude Emile4 aut
700	1	a Same-Ekobo, Albert4 aut
700	1	a Schramm, Birgit4 aut
700	1	a Seck, Amadou4 aut
700	1	a Sharma, Bhawna4 aut
700	1	a Sibley, Carol Hopkins4 aut
700	1	a Sinou, Veronique4 aut
700	1	a Sirima, Sodiomon B.4 aut
700	1	a Smith, Jeffery J.4 aut
700	1	a Smithuis, Frank4 aut
700	1	a Some, Fabrice A.4 aut
700	1	a Sow, Doudou4 aut
700	1	a Staedke, Sarah G.4 aut
700	1	a Stepniewska, Kasia4 aut
700	1	a Swarthout, Todd D.4 aut
700	1	a Sylla, Khadime4 aut
700	1	a Talisuna, Ambrose O.4 aut
700	1	a Tarning, Joel4 aut
700	1	a Taylor, Walter R. J.4 aut
700	1	a Temu, Emmanuel A.4 aut
700	1	a Thwing, Julie I.4 aut
700	1	a Tjitra, Emiliana4 aut
700	1	a Tine, Roger C. K.4 aut
700	1	a Tinto, Halidou4 aut
700	1	a Vaillant, Michel T.4 aut
700	1	a Valecha, Neena4 aut
700	1	a Van den Broek, Ingrid4 aut
700	1	a White, Nicholas J.4 aut
700	1	a Yeka, Adoke4 aut
700	1	a Zongo, Issaka4 aut
710	1 2	a Uppsala universitetb Medicinska och farmaceutiska vetenskapsområdet4 pbl
772	1 8	i channel recordw 19753896
773	0 8	i Värdpublikationt BMC Medicineg 13x 1741-7015
856	4 0	u http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-253081
856	4 0	u http://dx.doi.org/10.1186/s12916-015-0301-z
856	4 0	u http://uu.diva-portal.org/smash/get/diva2:819496/FULLTEXT01
841		5 APISa x ab 170324\|\|0000\|\|\|\|\|001\|\|\|\|\|\|000000e 1
024	7	5 APISa urn:nbn:se:uu:diva-2530812 urn
852		5 APISb APIS
856	4 0	5 APISu http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-253081

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Av författaren/redakt...: Adjuik, Martin A ...; Allan, Richard; Anvikar, Anupkum ...; Ashley, Elizabet ...; Ba, Mamadou S.; Barennes, Hubert; visa fler...; Barnes, Karen I.; Bassat, Quique; Baudin, Elisabet ...; Bjorkman, Anders; Bompart, Francoi ...; Bonnet, Maryline; Borrmann, Steffe ...; Brasseur, Philip ...; Bukirwa, Hasifa; Checchi, Frances ...; Cot, Michel; Dahal, Prabin; D'Alessandro, Um ...; Deloron, Philipp ...; Desai, Meghna; Diap, Graciela; Djimde, Abdoulay ...; Dorsey, Grant; Doumbo, Ogobara ...; Espie, Emmanuell ...; Etard, Jean-Fran ...; Fanello, Caterin ...; Faucher, Jean-Fr ...; Faye, Babacar; Flegg, Jennifer ...; Gaye, Oumar; Gething, Peter W ...; Gonzalez, Raquel; Grandesso, Franc ...; Guerin, Philippe ...; Guthmann, Jean-P ...; Hamour, Sally; Hasugian, Armedy ...; Hay, Simon I.; Humphreys, Georg ...; Jullien, Vincent; Juma, Elizabeth; Kamya, Moses R.; Karema, Corine; Kiechel, Jean R.; Kremsner, Peter ...; Krishna, Sanjeev; Lameyre, Valerie; Ibrahim, Laminou ...; Lee, Sue J.; Lell, Bertrand; Martensson, Andr ...; Massougbodji, Ac ...; Menan, Herve; Menard, Didier; Menendez, Clara; Meremikwu, Marti ...; Moreira, Clariss ...; Nabasumba, Carol ...; Nambozi, Michael; Ndiaye, Jean-Lou ...; Nikiema, Frederi ...; Nsanzabana, Chri ...; Ntoumi, Francine; Ogutu, Bernhards ...; Olliaro, Piero; Osorio, Lyda; Ouedraogo, Jean- ...; Penali, Louis K.; Pene, Mbaye; Pinoges, Loretxu; Piola, Patrice; Price, Ric N.; Roper, Cally; Rosenthal, Phili ...; Rwagacondo, Clau ...; Same-Ekobo, Albe ...; Schramm, Birgit; Seck, Amadou; Sharma, Bhawna; Sibley, Carol Ho ...; Sinou, Veronique; Sirima, Sodiomon ...; Smith, Jeffery J ...; Smithuis, Frank; Some, Fabrice A.; Sow, Doudou; Staedke, Sarah G ...; Stepniewska, Kas ...; Swarthout, Todd ...; Sylla, Khadime; Talisuna, Ambros ...; Tarning, Joel; Taylor, Walter R ...; Temu, Emmanuel A ...; Thwing, Julie I.; Tjitra, Emiliana; Tine, Roger C. K ...; Tinto, Halidou; Vaillant, Michel ...; Valecha, Neena; Van den Broek, I ...; White, Nicholas ...; Yeka, Adoke; Zongo, Issaka; visa färre...

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