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Population Pharmacokinetics of Praziquantel in Pregnant and Lactating Filipino Women Infected with Schistosoma japonicum

An estimated 40 million women of reproductive age are infected with one of three species of the waterborne parasite Schistosoma spp. Treatment with praziquantel (PZQ) via mass drug administration (MDA) campaigns is the mainstay of schistosomiasis control for populations living in areas of endemicity...

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Autores principales: Bustinduy, Amaya L., Kolamunnage-Dona, Ruwanthi, Mirochnick, Mark H., Capparelli, Edmund V., Tallo, Veronica, Acosta, Luz P., Olveda, Remigio M., Friedman, Jennifer F., Hope, William W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society for Microbiology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7449211/
https://www.ncbi.nlm.nih.gov/pubmed/32631820
http://dx.doi.org/10.1128/AAC.00566-20
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author Bustinduy, Amaya L.
Kolamunnage-Dona, Ruwanthi
Mirochnick, Mark H.
Capparelli, Edmund V.
Tallo, Veronica
Acosta, Luz P.
Olveda, Remigio M.
Friedman, Jennifer F.
Hope, William W.
author_facet Bustinduy, Amaya L.
Kolamunnage-Dona, Ruwanthi
Mirochnick, Mark H.
Capparelli, Edmund V.
Tallo, Veronica
Acosta, Luz P.
Olveda, Remigio M.
Friedman, Jennifer F.
Hope, William W.
author_sort Bustinduy, Amaya L.
collection PubMed
description An estimated 40 million women of reproductive age are infected with one of three species of the waterborne parasite Schistosoma spp. Treatment with praziquantel (PZQ) via mass drug administration (MDA) campaigns is the mainstay of schistosomiasis control for populations living in areas of endemicity. The World Health Organization recommends that pregnant and lactating women be included in schistosomiasis MDA programs, and several recent studies have evaluated the safety and efficacy of PZQ use during pregnancy. To date, there are no data describing PZQ pharmacokinetics (PK) during pregnancy or among lactating postpartum women. As part of a randomized controlled trial investigating the safety and efficacy of PZQ during human pregnancy, we examined the PK of this therapeutic drug among three distinct cohorts of women infected with S. japonicum in Leyte, Philippines. Specifically, we studied the PK properties of PZQ among early- and late-gestation pregnant women (n = 15 each) and lactating postpartum women (n = 15) with schistosomiasis. We found that women in early pregnancy had increased apparent clearance and lower area-under-the-curve (AUC(0–24)) values that may be related to physiological changes in drug clearance and/or changes in oral bioavailability. There was no relationship between body weight and apparent clearance. The mean ± standard deviation partition ratio of plasma to breast milk was 0.36. ± 0.13. The estimated median infant PZQ daily dose would be 0.037 mg/kg of body weight ingested from breast milk, which is significantly lower than the dosage required for antischistosomal activity and not known to be harmful to the infant. Our PK data do not support the suggestion to delay breastfeeding 72 h after taking PZQ. Results can help inform future drug efficacy studies in pregnant and lactating women with schistosomiasis.
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spelling pubmed-74492112020-09-09 Population Pharmacokinetics of Praziquantel in Pregnant and Lactating Filipino Women Infected with Schistosoma japonicum Bustinduy, Amaya L. Kolamunnage-Dona, Ruwanthi Mirochnick, Mark H. Capparelli, Edmund V. Tallo, Veronica Acosta, Luz P. Olveda, Remigio M. Friedman, Jennifer F. Hope, William W. Antimicrob Agents Chemother Pharmacology An estimated 40 million women of reproductive age are infected with one of three species of the waterborne parasite Schistosoma spp. Treatment with praziquantel (PZQ) via mass drug administration (MDA) campaigns is the mainstay of schistosomiasis control for populations living in areas of endemicity. The World Health Organization recommends that pregnant and lactating women be included in schistosomiasis MDA programs, and several recent studies have evaluated the safety and efficacy of PZQ use during pregnancy. To date, there are no data describing PZQ pharmacokinetics (PK) during pregnancy or among lactating postpartum women. As part of a randomized controlled trial investigating the safety and efficacy of PZQ during human pregnancy, we examined the PK of this therapeutic drug among three distinct cohorts of women infected with S. japonicum in Leyte, Philippines. Specifically, we studied the PK properties of PZQ among early- and late-gestation pregnant women (n = 15 each) and lactating postpartum women (n = 15) with schistosomiasis. We found that women in early pregnancy had increased apparent clearance and lower area-under-the-curve (AUC(0–24)) values that may be related to physiological changes in drug clearance and/or changes in oral bioavailability. There was no relationship between body weight and apparent clearance. The mean ± standard deviation partition ratio of plasma to breast milk was 0.36. ± 0.13. The estimated median infant PZQ daily dose would be 0.037 mg/kg of body weight ingested from breast milk, which is significantly lower than the dosage required for antischistosomal activity and not known to be harmful to the infant. Our PK data do not support the suggestion to delay breastfeeding 72 h after taking PZQ. Results can help inform future drug efficacy studies in pregnant and lactating women with schistosomiasis. American Society for Microbiology 2020-08-20 /pmc/articles/PMC7449211/ /pubmed/32631820 http://dx.doi.org/10.1128/AAC.00566-20 Text en Copyright © 2020 Bustinduy et al. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Pharmacology
Bustinduy, Amaya L.
Kolamunnage-Dona, Ruwanthi
Mirochnick, Mark H.
Capparelli, Edmund V.
Tallo, Veronica
Acosta, Luz P.
Olveda, Remigio M.
Friedman, Jennifer F.
Hope, William W.
Population Pharmacokinetics of Praziquantel in Pregnant and Lactating Filipino Women Infected with Schistosoma japonicum
title Population Pharmacokinetics of Praziquantel in Pregnant and Lactating Filipino Women Infected with Schistosoma japonicum
title_full Population Pharmacokinetics of Praziquantel in Pregnant and Lactating Filipino Women Infected with Schistosoma japonicum
title_fullStr Population Pharmacokinetics of Praziquantel in Pregnant and Lactating Filipino Women Infected with Schistosoma japonicum
title_full_unstemmed Population Pharmacokinetics of Praziquantel in Pregnant and Lactating Filipino Women Infected with Schistosoma japonicum
title_short Population Pharmacokinetics of Praziquantel in Pregnant and Lactating Filipino Women Infected with Schistosoma japonicum
title_sort population pharmacokinetics of praziquantel in pregnant and lactating filipino women infected with schistosoma japonicum
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7449211/
https://www.ncbi.nlm.nih.gov/pubmed/32631820
http://dx.doi.org/10.1128/AAC.00566-20
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