Pharmacokinetics of Artesunate Alone and in Combination with Sulfadoxine/Pyrimethamine in Healthy Sudanese Volunteers

Matar, Kamal M.; Awad, Abdelmoneim; Elamin, Sakina B.

doi:10.4269/ajtmh.13-0283

Cited by 10 publications

(6 citation statements)

References 39 publications

(37 reference statements)

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“…One alternative regimen constitutes the use of a highly efficacious artemisinine (AS) derivative in association with AQ. Artesunate is a soluble derivative quickly adsorbed orally, the highest concentration in blood is achieved 1 h following an oral intake and the half-life is between 20 and 72 min ( Orrell et al, 2008 ; Saunders et al, 2012 ; Matar et al, 2014 ). AS pharmacokinetics parameters are similar when AS is given alone and when AS is combined with AQ ( Orrell et al, 2008 ).…”

Section: Introductionmentioning

confidence: 99%

School-aged children based seasonal malaria chemoprevention using artesunate-amodiaquine in Mali

Thera

Koné

Tangara

et al. 2018

Parasite Epidemiology and Control

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IntroductionMalaria is still a public health problem in Africa. Seasonal Malaria Chemoprevention (SMC) is an efficient control strategy recommended by WHO that targets children under five year old living in areas of seasonal malaria transmission. SMC uses the combination amodiaquine (AQ) – sulfadoxine-pyrimethamine (SP). However SP selects rapidly drug resistant parasites. And malaria burden may increase in older children where SMC is implemented. We initiated a pilot study to assess an alternative approach to SMC in older children in Mali.MethodsA randomized open-label clinical trial was conducted to test the efficacy and safety of SMC using artesunate – amodiaquine in school aged children in Mali. Two hundred pupils aged 6–15 years old were enrolled and randomized into two arms of 100 each, to receive either artesunate–amodiaquine (ASAQ) monthly or no intervention. Both arms were followed and clinical malaria were diagnosed and treated with arthemeter-lumefanthrine as recommended by Mali National Malaria Control Program. ASAQ was administered 3 days under study team direct observation and during 4 consecutive months starting in October 2013. Follow up was continued until April 2014.ResultsOverall, 20 cases of uncomplicated clinical malaria were encountered in the Control arm and three cases in the ASAQ arm, showing a protective efficacy of 85% 95% CI [80.1–89.9] against clinical malaria. Protective efficacy against malaria infection was 69.6% 95% CI [58.6–21.4]. No effect on anemia was observed. ASAQ was well tolerated. Most common solicited adverse events were abdominal pain and headaches of mild intensity in respectively 64% and 44% of children that swallowed ASAQ.ConclusionASAQ is effective and well tolerated as SMC targeting older children in a peri urban setting in Mali. Its administration at schools is a feasible and accepted strategy to deliver the intervention.

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Section: Introductionmentioning

confidence: 99%

School-aged children based seasonal malaria chemoprevention using artesunate-amodiaquine in Mali

Thera

Koné

Tangara

et al. 2018

Parasite Epidemiology and Control

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“…When animals reached parasitaemia of 50-60% the first group was administered AAN as single dose (35 mg/kg equivalent amount of artemether) intravenous injection. Artemether free drug being insoluble in water its solution was prepared by dissolving it in non clinical hydroaholic vehicle (ATM) [35] and administered intravenously to the second group while third group acted as control. At stipulated time interval of 10min, 30min, 1, 2, 4, 8, 10, and 24h, the animals were exposed to inhalation of anaesthetic ether and blood samples were withdrawn using retro-orbital puncture.…”

Section: Pharmacokinetics In P Berghei Infected Micementioning

confidence: 99%

Bio-inspired artemether-loaded human serum albumin nanoparticles for effective control of malaria-infected erythrocytes

Sidhaye¹,

Bhuran²,

Zambare³

et al. 2016

Nanomedicine

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Aim: The intra-erythrocytic development of the malarial parasite is dependent on active uptake of nutrients, including human serum albumin (HSA), into parasitized red blood cells (pRBCs). We have designed HSA-based nanoparticles as a potential drug-delivery option for antimalarials. Methods: Artemether-loaded nanoparticles (AAN) were designed and antimalarial activity evaluated in-vitro/in-vivo using Plasmodium falciparum/Plasmodium berghei species, respectively. Results: Selective internalisation of AAN into Plasmodiuminfected RBCs in preference to healthy erythrocytes was observed using confocal-imaging.In-vitro studies showed 50% dose reduction for AAN as compared to drug-only controls to achieve IC50 levels of inhibition. The nanoparticles exhibited 2-fold higher peak drug concentrations in RBCs with antimalarial activity at 50% of therapeutic doses in P.bergeiinfected mice. Conclusion: HSA-based nanoparticles offer safe and effective approach for selective targeting of antimalarial drugs.

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“…Nonetheless, sulfadoxine has been linked to serious to fatal cases of erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, and serum sickness syndromes. Pyrimethamine, first formulated in the 1950s, prevents the conversion of folic acid and dihydrofolic acid to the active tetrahydrofolate coenzyme form, which is required for amino acid and nucleic acid synthesis [91]. This combination is recommended for the prevention and treatment of P. falciparum chloroquine resistance and can be used in conjunction with quinine.…”

Section: Sulfadoxine and Pyrimethaminementioning

confidence: 99%

Molecular Approaches for Malaria Therapy

Mishra¹,

Mishra²,

Kashaw³

et al. 2021

Plasmodium Species and Drug Resistance

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Malaria is a potentially fatal blood disease spread by mosquitos. Malaria is preventable, but it is more prevalent in developing countries where prevention is difficult and prophylaxis is often inaccessible. Malaria remains one of the world’s most serious public health problems, according to the World Health Organisation (WHO). The development of resistance is a current problem that poses a danger to the environment. Resistance is a current problem that could jeopardise the use of well-established and cost-effective antimalarials. The World Health Organisation recommends an artemisinin-based drug combination (ACT) to avoid or postpone the development of resistance. This book’s chapter discusses current medicines as well as potential and rational possibilities for finding new drugs to treat malady. There were also WHO recommendations for both complicated and non-complicated malaria. Other preventive measures such as ITN and IPT are listed in the manuscript in addition to routine care. While a brief overview of the vaccine tested so far has been included, there is currently no vaccine available to treat malaria.

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Pharmacokinetics of Artesunate Alone and in Combination with Sulfadoxine/Pyrimethamine in Healthy Sudanese Volunteers

Cited by 10 publications

References 39 publications

School-aged children based seasonal malaria chemoprevention using artesunate-amodiaquine in Mali

School-aged children based seasonal malaria chemoprevention using artesunate-amodiaquine in Mali

Bio-inspired artemether-loaded human serum albumin nanoparticles for effective control of malaria-infected erythrocytes

Molecular Approaches for Malaria Therapy

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