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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Pharmacokinetics of co-formulated mefloquine and artesunate in pregnant and non-pregnant women with uncomplicated Plasmodium falciparum infection in Burkina Faso
Journal of Antimicrobial Chemotherapy, Volume 69, No. 9, Article dku154, Year 2014
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Description
Objectives: Mefloquine/artesunate has recently been developed as a fixed-dose combination, providing a promising rescue/alternative treatment for malaria during pregnancy. However, limited data are available on the effect of pregnancy on its pharmacokinetic properties. This study was conducted to assess the pharmacokinetic properties of mefloquine/carboxymefloquine and artesunate/dihydroartemisinin in pregnant and non-pregnant women with uncomplicated malaria. Methods: Twenty-four women in their second and third trimesters of pregnancy and 24 paired non-pregnant women were enrolled. All patients were treated for uncomplicated Plasmodium falciparum malaria with a standard fixed-dose combination of oral mefloquine and artesunate one daily over 3 days. Frequent blood samples were collected before treatment and at scheduled times post-dose for the drug measurements and pharmacokinetic analyses. The study was registered at www.clinicaltrials.gov (identifier: NCT00701961). Results: The total median exposure to mefloquine and dihydroartemisinin was not significantly different between the pregnant and non-pregnant women (P>0.05). Therewas a trend of higher exposure tomefloquine in the pregnant women, but this difference did not reach statistical significance (656700 versus 542400 h×ng/mL; P=0.059). However, the total exposure to carboxymefloquine was 49% lower during pregnancy (735600 versus 1499000 h×ng/mL; P<0.001) and the total drug exposure to artesunate was 42% higher during pregnancy (89.0 versus 62.9 h×ng/mL; P=0.039) compared with non-pregnant controls. Conclusions: The plasma levels ofmefloquine and dihydroartemisinin appeared to be similar in both pregnant and non-pregnant women, but there were significant differences in carboxymefloquine and artesunate exposure. The data presented here do not warrant a dose adjustment in pregnant patients, but an extensive analysis of the data could provide a better understanding of these findings. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Authors & Co-Authors
Valea, Innocent
Burkina Faso, Ouagadougou
Centre Muraz
Burkina Faso, Ouagadougou
Institut de Recherche en Sciences de la Santé
Tinto, Halidou
Burkina Faso, Ouagadougou
Centre Muraz
Burkina Faso, Ouagadougou
Institut de Recherche en Sciences de la Santé
Coulibaly, Maminata Traore
Burkina Faso, Ouagadougou
Institut de Recherche en Sciences de la Santé
Toe, Laeticia Celine
Burkina Faso, Ouagadougou
Centre Muraz
Lindegårdh, Niklas
Thailand, Bangkok
Faculty of Tropical Medicine, Mahidol University
United Kingdom, Oxford
Nuffield Department of Medicine
Tarning, Joel
Thailand, Bangkok
Faculty of Tropical Medicine, Mahidol University
United Kingdom, Oxford
Nuffield Department of Medicine
Van geertruyden, Jean Pierre
Belgium, Antwerpen
Universiteit Antwerpen
D'Alessandro, Umberto
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Gambia, Banjul
Medical Research Council Laboratories Gambia
Davies, Geraint Rhys
United Kingdom, Liverpool
University of Liverpool
Ward, Stephen Andrew
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Statistics
Citations: 34
Authors: 10
Affiliations: 9
Identifiers
Doi:
10.1093/jac/dku154
ISSN:
03057453
e-ISSN:
14602091
Research Areas
Cancer
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Locations
Burkina Faso
Participants Gender
Female