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Modelling the optimal dosing schedule for artemether-lumefantrine chemoprophylaxis against malaria
OBJECTIVE: Antimalarial chemoprophylaxis for high risk groups in endemic areas of Southeast Asia has the potential to reduce malaria transmission and accelerate elimination. However, the optimal choice of medication and dosing for many potential candidates is not clear. For a planned randomised cont...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9528175/ https://www.ncbi.nlm.nih.gov/pubmed/36184602 http://dx.doi.org/10.1186/s13104-022-06212-y |
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author | Tarning, Joel von Seidlein, Lorenz Dondorp, Arjen M. White, Nicholas J. Maude, Richard J. |
author_facet | Tarning, Joel von Seidlein, Lorenz Dondorp, Arjen M. White, Nicholas J. Maude, Richard J. |
author_sort | Tarning, Joel |
collection | PubMed |
description | OBJECTIVE: Antimalarial chemoprophylaxis for high risk groups in endemic areas of Southeast Asia has the potential to reduce malaria transmission and accelerate elimination. However, the optimal choice of medication and dosing for many potential candidates is not clear. For a planned randomised controlled trial of prophylaxis for forest goers in Cambodia, artemether-lumefantrine (AL) was selected because of its ongoing efficacy and excellent tolerability and safety. As AL had not been used before for this purpose, a previously published pooled pharmacometric meta-model was used to determine the optimal dosing schedule. RESULTS: A full 3 day AL treatment course given twice a month, and twice daily treatment given once a week, resulted in trough concentrations consistently above the therapeutic threshold of 200 ng/mL. However, the most favourable exposure profile, and arguably most practical dosing scenario, was an initial 3 day full AL treatment course followed by twice daily dosing given once a week for the duration of chemoprevention. The latter was adopted as the dosing schedule for the trial. |
format | Online Article Text |
id | pubmed-9528175 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-95281752022-10-04 Modelling the optimal dosing schedule for artemether-lumefantrine chemoprophylaxis against malaria Tarning, Joel von Seidlein, Lorenz Dondorp, Arjen M. White, Nicholas J. Maude, Richard J. BMC Res Notes Research Note OBJECTIVE: Antimalarial chemoprophylaxis for high risk groups in endemic areas of Southeast Asia has the potential to reduce malaria transmission and accelerate elimination. However, the optimal choice of medication and dosing for many potential candidates is not clear. For a planned randomised controlled trial of prophylaxis for forest goers in Cambodia, artemether-lumefantrine (AL) was selected because of its ongoing efficacy and excellent tolerability and safety. As AL had not been used before for this purpose, a previously published pooled pharmacometric meta-model was used to determine the optimal dosing schedule. RESULTS: A full 3 day AL treatment course given twice a month, and twice daily treatment given once a week, resulted in trough concentrations consistently above the therapeutic threshold of 200 ng/mL. However, the most favourable exposure profile, and arguably most practical dosing scenario, was an initial 3 day full AL treatment course followed by twice daily dosing given once a week for the duration of chemoprevention. The latter was adopted as the dosing schedule for the trial. BioMed Central 2022-10-02 /pmc/articles/PMC9528175/ /pubmed/36184602 http://dx.doi.org/10.1186/s13104-022-06212-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Note Tarning, Joel von Seidlein, Lorenz Dondorp, Arjen M. White, Nicholas J. Maude, Richard J. Modelling the optimal dosing schedule for artemether-lumefantrine chemoprophylaxis against malaria |
title | Modelling the optimal dosing schedule for artemether-lumefantrine chemoprophylaxis against malaria |
title_full | Modelling the optimal dosing schedule for artemether-lumefantrine chemoprophylaxis against malaria |
title_fullStr | Modelling the optimal dosing schedule for artemether-lumefantrine chemoprophylaxis against malaria |
title_full_unstemmed | Modelling the optimal dosing schedule for artemether-lumefantrine chemoprophylaxis against malaria |
title_short | Modelling the optimal dosing schedule for artemether-lumefantrine chemoprophylaxis against malaria |
title_sort | modelling the optimal dosing schedule for artemether-lumefantrine chemoprophylaxis against malaria |
topic | Research Note |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9528175/ https://www.ncbi.nlm.nih.gov/pubmed/36184602 http://dx.doi.org/10.1186/s13104-022-06212-y |
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