Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium
Abstract Background Intravenous (IV) artesunate is the treatment of choice for severe malaria. In Europe, however, no GMP-manufactured product is available and treatment data in European travellers are scarce. Fortunately, artesunate became available in the Netherlands and Belgium through a named pa...
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ftdoajarticles:oai:doaj.org/article:778ba945cac44674aff4bbc7df4dd3ac 2023-05-15T15:12:25+02:00 Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium Kreeftmeijer-Vegter Annemarie R van Genderen Perry J Visser Leo G Bierman Wouter FW Clerinx Jan van Veldhuizen Cees KW de Vries Peter J 2012-03-01T00:00:00Z https://doi.org/10.1186/1475-2875-11-102 https://doaj.org/article/778ba945cac44674aff4bbc7df4dd3ac EN eng BMC http://www.malariajournal.com/content/11/1/102 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-11-102 1475-2875 https://doaj.org/article/778ba945cac44674aff4bbc7df4dd3ac Malaria Journal, Vol 11, Iss 1, p 102 (2012) Intravenous artesunate Severe malaria Parasite clearance Named patient program European traveller Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2012 ftdoajarticles https://doi.org/10.1186/1475-2875-11-102 2022-12-31T00:45:12Z Abstract Background Intravenous (IV) artesunate is the treatment of choice for severe malaria. In Europe, however, no GMP-manufactured product is available and treatment data in European travellers are scarce. Fortunately, artesunate became available in the Netherlands and Belgium through a named patient programme. This is the largest case series of artesunate treated patients with severe malaria in Europe. Methods Hospitalized patients treated with IV artesunate between November 2007 and December 2010 in the Netherlands and Belgium were retrospectively evaluated. Patient characteristics, treatment and clinical outcome were recorded on a standardized form and mortality, parasite clearance times and the occurrence of adverse events were evaluated. Results Of the 68 treated patients, including 55 with severe malaria, two patients died (2/55 = 3.6%). The mean time to 50% parasite clearance (PCT50), 90% and 99% were 4.4 hours (3.9 - 5.2), 14.8 hours (13.0 - 17.2), and 29.5 hours (25.9 - 34.4) respectively. Artesunate was well tolerated. However, an unusual form of haemolytic anaemia was observed in seven patients. The relationship with artesunate remains uncertain. Conclusions Data from the named patient programme demonstrate that IV artesunate is effective and well-tolerated in European travellers lacking immunity. However, increased attention needs to be paid to the possible development of haemolytic anaemia 2-3 weeks after start of treatment. Treatment of IV artesunate should be limited to the period that IV treatment is required and should be followed by a full oral course of an appropriate anti-malarial drug. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Traveller ENVELOPE(-48.533,-48.533,61.133,61.133) Malaria Journal 11 1 |
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Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Intravenous artesunate Severe malaria Parasite clearance Named patient program European traveller Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Intravenous artesunate Severe malaria Parasite clearance Named patient program European traveller Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Kreeftmeijer-Vegter Annemarie R van Genderen Perry J Visser Leo G Bierman Wouter FW Clerinx Jan van Veldhuizen Cees KW de Vries Peter J Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium |
topic_facet |
Intravenous artesunate Severe malaria Parasite clearance Named patient program European traveller Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Intravenous (IV) artesunate is the treatment of choice for severe malaria. In Europe, however, no GMP-manufactured product is available and treatment data in European travellers are scarce. Fortunately, artesunate became available in the Netherlands and Belgium through a named patient programme. This is the largest case series of artesunate treated patients with severe malaria in Europe. Methods Hospitalized patients treated with IV artesunate between November 2007 and December 2010 in the Netherlands and Belgium were retrospectively evaluated. Patient characteristics, treatment and clinical outcome were recorded on a standardized form and mortality, parasite clearance times and the occurrence of adverse events were evaluated. Results Of the 68 treated patients, including 55 with severe malaria, two patients died (2/55 = 3.6%). The mean time to 50% parasite clearance (PCT50), 90% and 99% were 4.4 hours (3.9 - 5.2), 14.8 hours (13.0 - 17.2), and 29.5 hours (25.9 - 34.4) respectively. Artesunate was well tolerated. However, an unusual form of haemolytic anaemia was observed in seven patients. The relationship with artesunate remains uncertain. Conclusions Data from the named patient programme demonstrate that IV artesunate is effective and well-tolerated in European travellers lacking immunity. However, increased attention needs to be paid to the possible development of haemolytic anaemia 2-3 weeks after start of treatment. Treatment of IV artesunate should be limited to the period that IV treatment is required and should be followed by a full oral course of an appropriate anti-malarial drug. |
format |
Article in Journal/Newspaper |
author |
Kreeftmeijer-Vegter Annemarie R van Genderen Perry J Visser Leo G Bierman Wouter FW Clerinx Jan van Veldhuizen Cees KW de Vries Peter J |
author_facet |
Kreeftmeijer-Vegter Annemarie R van Genderen Perry J Visser Leo G Bierman Wouter FW Clerinx Jan van Veldhuizen Cees KW de Vries Peter J |
author_sort |
Kreeftmeijer-Vegter Annemarie R |
title |
Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium |
title_short |
Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium |
title_full |
Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium |
title_fullStr |
Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium |
title_full_unstemmed |
Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium |
title_sort |
treatment outcome of intravenous artesunate in patients with severe malaria in the netherlands and belgium |
publisher |
BMC |
publishDate |
2012 |
url |
https://doi.org/10.1186/1475-2875-11-102 https://doaj.org/article/778ba945cac44674aff4bbc7df4dd3ac |
long_lat |
ENVELOPE(-48.533,-48.533,61.133,61.133) |
geographic |
Arctic Traveller |
geographic_facet |
Arctic Traveller |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 11, Iss 1, p 102 (2012) |
op_relation |
http://www.malariajournal.com/content/11/1/102 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-11-102 1475-2875 https://doaj.org/article/778ba945cac44674aff4bbc7df4dd3ac |
op_doi |
https://doi.org/10.1186/1475-2875-11-102 |
container_title |
Malaria Journal |
container_volume |
11 |
container_issue |
1 |
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1766343097737805824 |