A randomized trial of artemether-lumefantrine versus mefloquine-artesunate for the treatment of uncomplicated multi-drug resistant Plasmodium falciparum on the western border of Thailand
Abstract Background The use of antimalarial drug combinations with artemisinin derivatives is recommended to overcome drug resistance in Plasmodium falciparum . The fixed combination of oral artemether-lumefantrine, an artemisinin combination therapy (ACT) is highly effective and well tolerated. It...
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ftdoajarticles:oai:doaj.org/article:904c1e7bccee4f05a385586d7b8cfa25 2023-05-15T15:13:20+02:00 A randomized trial of artemether-lumefantrine versus mefloquine-artesunate for the treatment of uncomplicated multi-drug resistant Plasmodium falciparum on the western border of Thailand McGready Rose Ashley Elizabeth A Paiphun Lucy Hutagalung Robert Brockman Alan Thwai Kaw L Singhasivanon Pratap Jelinek Thomas White Nicholas J Nosten François H 2005-09-01T00:00:00Z https://doi.org/10.1186/1475-2875-4-46 https://doaj.org/article/904c1e7bccee4f05a385586d7b8cfa25 EN eng BMC http://www.malariajournal.com/content/4/1/46 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-4-46 1475-2875 https://doaj.org/article/904c1e7bccee4f05a385586d7b8cfa25 Malaria Journal, Vol 4, Iss 1, p 46 (2005) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2005 ftdoajarticles https://doi.org/10.1186/1475-2875-4-46 2022-12-30T22:41:10Z Abstract Background The use of antimalarial drug combinations with artemisinin derivatives is recommended to overcome drug resistance in Plasmodium falciparum . The fixed combination of oral artemether-lumefantrine, an artemisinin combination therapy (ACT) is highly effective and well tolerated. It is the only registered fixed combination containing an artemisinin. The trial presented here was conducted to monitor the efficacy of the six-dose regimen of artemether-lumefantrine (ALN) in an area of multi-drug resistance, along the Thai-Myanmar border. Methods The trial was an open-label, two-arm, randomized study comparing artemether-lumefantrine and mefloquine-artesunate for the treatment of uncomplicated falciparum malaria with 42 days of follow up. Parasite genotyping by polymerase chain reaction (PCR) was used to distinguish recrudescent from newly acquired P. falciparum infections. The PCR adjusted cure rates were evaluated by survival analysis. Results In 2001–2002 a total of 490 patients with slide confirmed uncomplicated P. falciparum malaria were randomly assigned to receive artemether-lumefantrine (n = 245) or artesunate and mefloquine (n = 245) and were followed for 42 days. All patients had rapid initial clinical and parasitological responses. In both groups, the PCR adjusted cure rates by day 42 were high: 98.8% (95% CI 96.4, 99.6%) for artemether-lumefantrine and 96.3% (95% CI 93.1, 98.0%) for artesunate-mefloquine. Both regimens were very well tolerated with no serious adverse events observed attributable to either combination. Conclusion Overall, this study confirms that these two artemisinin-based combinations remain highly effective and result in equivalent therapeutic responses in the treatment of highly drug-resistant falciparum malaria. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 4 1 46 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 McGready Rose Ashley Elizabeth A Paiphun Lucy Hutagalung Robert Brockman Alan Thwai Kaw L Singhasivanon Pratap Jelinek Thomas White Nicholas J Nosten François H A randomized trial of artemether-lumefantrine versus mefloquine-artesunate for the treatment of uncomplicated multi-drug resistant Plasmodium falciparum on the western border of Thailand |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background The use of antimalarial drug combinations with artemisinin derivatives is recommended to overcome drug resistance in Plasmodium falciparum . The fixed combination of oral artemether-lumefantrine, an artemisinin combination therapy (ACT) is highly effective and well tolerated. It is the only registered fixed combination containing an artemisinin. The trial presented here was conducted to monitor the efficacy of the six-dose regimen of artemether-lumefantrine (ALN) in an area of multi-drug resistance, along the Thai-Myanmar border. Methods The trial was an open-label, two-arm, randomized study comparing artemether-lumefantrine and mefloquine-artesunate for the treatment of uncomplicated falciparum malaria with 42 days of follow up. Parasite genotyping by polymerase chain reaction (PCR) was used to distinguish recrudescent from newly acquired P. falciparum infections. The PCR adjusted cure rates were evaluated by survival analysis. Results In 2001–2002 a total of 490 patients with slide confirmed uncomplicated P. falciparum malaria were randomly assigned to receive artemether-lumefantrine (n = 245) or artesunate and mefloquine (n = 245) and were followed for 42 days. All patients had rapid initial clinical and parasitological responses. In both groups, the PCR adjusted cure rates by day 42 were high: 98.8% (95% CI 96.4, 99.6%) for artemether-lumefantrine and 96.3% (95% CI 93.1, 98.0%) for artesunate-mefloquine. Both regimens were very well tolerated with no serious adverse events observed attributable to either combination. Conclusion Overall, this study confirms that these two artemisinin-based combinations remain highly effective and result in equivalent therapeutic responses in the treatment of highly drug-resistant falciparum malaria. |
format |
Article in Journal/Newspaper |
author |
McGready Rose Ashley Elizabeth A Paiphun Lucy Hutagalung Robert Brockman Alan Thwai Kaw L Singhasivanon Pratap Jelinek Thomas White Nicholas J Nosten François H |
author_facet |
McGready Rose Ashley Elizabeth A Paiphun Lucy Hutagalung Robert Brockman Alan Thwai Kaw L Singhasivanon Pratap Jelinek Thomas White Nicholas J Nosten François H |
author_sort |
McGready Rose |
title |
A randomized trial of artemether-lumefantrine versus mefloquine-artesunate for the treatment of uncomplicated multi-drug resistant Plasmodium falciparum on the western border of Thailand |
title_short |
A randomized trial of artemether-lumefantrine versus mefloquine-artesunate for the treatment of uncomplicated multi-drug resistant Plasmodium falciparum on the western border of Thailand |
title_full |
A randomized trial of artemether-lumefantrine versus mefloquine-artesunate for the treatment of uncomplicated multi-drug resistant Plasmodium falciparum on the western border of Thailand |
title_fullStr |
A randomized trial of artemether-lumefantrine versus mefloquine-artesunate for the treatment of uncomplicated multi-drug resistant Plasmodium falciparum on the western border of Thailand |
title_full_unstemmed |
A randomized trial of artemether-lumefantrine versus mefloquine-artesunate for the treatment of uncomplicated multi-drug resistant Plasmodium falciparum on the western border of Thailand |
title_sort |
randomized trial of artemether-lumefantrine versus mefloquine-artesunate for the treatment of uncomplicated multi-drug resistant plasmodium falciparum on the western border of thailand |
publisher |
BMC |
publishDate |
2005 |
url |
https://doi.org/10.1186/1475-2875-4-46 https://doaj.org/article/904c1e7bccee4f05a385586d7b8cfa25 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 4, Iss 1, p 46 (2005) |
op_relation |
http://www.malariajournal.com/content/4/1/46 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-4-46 1475-2875 https://doaj.org/article/904c1e7bccee4f05a385586d7b8cfa25 |
op_doi |
https://doi.org/10.1186/1475-2875-4-46 |
container_title |
Malaria Journal |
container_volume |
4 |
container_issue |
1 |
container_start_page |
46 |
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1766343902918344704 |