Clinical pharmacology of artemisinin-based combination therapies

被引:107
作者
Aweeka, Francesca T. [1 ]
German, Polina L. [1 ]
机构
[1] Univ Calif San Francisco, Drug Res Unit, San Francisco, CA 94143 USA
关键词
D O I
10.2165/00003088-200847020-00002
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Malaria, a disease transmitted by the female Anopheles mosquito, has had devastating effects on human populations for more than 4000 years. Treatment of the disease with single drugs, such as chloroquine, sulfadoxine/pyrimethamine or mefloquine, has led to the emergence of resistant Plasmodium falciparum parasites that lead to the most severe form of the illness. Artemisinin-based combination therapies are currently recommended by WHO for the treatment of uncomplicated P. falciparum malaria. Artemisinin and semisynthetic derivatives, including artesunate, artemether and dihydroartemisinin, are short-acting antimalarial agents that kill parasites more rapidly than conventional antimalarials, and are active against both the sexual and asexual stages of the parasite cycle. Artemisinin fever clearance time is shortened to 32 hours as compared with 2-3 days with older agents. To delay or prevent emergence of resistance, artemisinins are combined with one of several longer-acting drugs - amodiaquine, mefloquine, sulfadoxine/pyrimethamine or lumefantrine - which permit elimination of the residual malarial parasites. The clinical pharmacology of artemisinin-based combination therapies is highly complex. The short-acting artemisinins and their long-acting counterparts are metabolized and/or inhibit/induce cytochrome P450 enzymes, and may thus participate in drug-drug interactions with multiple drugs on the market. Alterations in antimalarial drug plasma concentrations may lead to either suboptimal efficacy or drug toxicity and may compromise treatment.
引用
收藏
页码:91 / 102
页数:12
相关论文
共 110 条
[41]   CLINICAL-APPLICATION OF MEFLOQUINE PHARMACOKINETICS IN THE TREATMENT OF PLASMODIUM-FALCIPARUM MALARIA [J].
KARBWANG, J ;
NABANGCHANG, K .
FUNDAMENTAL & CLINICAL PHARMACOLOGY, 1994, 8 (06) :491-502
[42]  
KARBWANG J, 1994, B WORLD HEALTH ORGAN, V72, P83
[43]   Safety and efficacy of dihydroartemisinin/piperaquine (Artekin®) for the treatment of uncomplicated Plasmodium falciparum malaria in Rwandan children [J].
Karema, Corine ;
Fanello, Caterina I. ;
Van Overmeir, Chantal ;
Van geertruyden, Jean-Pierre ;
van Doren, Walli ;
Ngamije, Daniel ;
D'Alessandro, Umberto .
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 2006, 100 (12) :1105-1111
[44]   Safety evaluation of fixed combination piperaquine plus dihydroartemisinin (Artekin®) in Cambodian children and adults with malaria [J].
Karunajeewa, H ;
Lim, C ;
Hung, TY ;
Ilett, KF ;
Denis, MB ;
Socheat, D ;
Davis, TME .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2004, 57 (01) :93-99
[45]   Disposition of artesunate and dihydroartemisinin after administration of artesunate suppositories in children from Papua New Guinea with uncomplicated malaria [J].
Karunajeewa, HA ;
Ilett, KF ;
Dufall, K ;
Kemiki, A ;
Bockarie, M ;
Alpers, MP ;
Barrett, PH ;
Vicini, P ;
Davis, TME .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2004, 48 (08) :2966-2972
[46]   Pharmacokinetic interaction between mefloquine and ritonavir in healthy volunteers [J].
Khaliq, Y ;
Gallicano, K ;
Tisdale, C ;
Carignan, G ;
Cooper, C ;
McCarthy, A .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2001, 51 (06) :591-600
[47]   Pharmacokinetics of quinine, chloroquine and amodiaquine - Clinical implications [J].
Krishna, S ;
White, NJ .
CLINICAL PHARMACOKINETICS, 1996, 30 (04) :263-299
[48]   Re-evaluation of how artemisinins work in light of emerging evidence of in vitro resistance [J].
Krishna, Sanjeev ;
Woodrow, Charles J. ;
Staines, Henry M. ;
Haynes, Richard K. ;
Mercereau-Puijalon, Odile .
TRENDS IN MOLECULAR MEDICINE, 2006, 12 (05) :200-205
[49]   Pharmacokinetic interaction trial between co-artemether and mefloquine [J].
Lefèvre, G ;
Bindschedler, M ;
Ezzet, F ;
Schaeffer, N ;
Meyer, I ;
Thomsen, MS .
EUROPEAN JOURNAL OF PHARMACEUTICAL SCIENCES, 2000, 10 (02) :141-151
[50]   Pharmacokinetics and electrocardiographic pharmacodynamics of artemether-lumefantrine (Riamet®) with concomitant administration of ketoconazole in healthy subjects [J].
Lefèvre, G ;
Carpenter, P ;
Souppart, C ;
Schmidli, H ;
McClean, M ;
Stypinski, D .
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2002, 54 (05) :485-492