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

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 registere...

Full description

Saved in:

Bibliographic Details
Published in:	Malaria journal Vol. 4; no. 1; p. 46
Main Authors:	Hutagalung, Robert, Paiphun, Lucy, Ashley, Elizabeth A, McGready, Rose, Brockman, Alan, Thwai, Kaw L, Singhasivanon, Pratap, Jelinek, Thomas, White, Nicholas J, Nosten, François H
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 22-09-2005 BioMed Central BMC
Subjects:	Adolescent Adult Aged Animals Antimalarials - adverse effects Antimalarials - therapeutic use Artemether Artemisinins - adverse effects Artemisinins - therapeutic use Artesunate Child Child, Preschool Drug Resistance, Multiple Ethanolamines - adverse effects Ethanolamines - therapeutic use Female Fluorenes - adverse effects Fluorenes - therapeutic use Humans Lumefantrine Malaria, Falciparum - drug therapy Malaria, Falciparum - epidemiology Male Mefloquine - adverse effects Mefloquine - therapeutic use Middle Aged Plasmodium falciparum Plasmodium falciparum - drug effects Sesquiterpenes - adverse effects Sesquiterpenes - therapeutic use Thailand - epidemiology
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	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. 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. 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. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1475-2875 1475-2875
DOI:	10.1186/1475-2875-4-46