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Comparative safety of artemether-lumefantrine and other artemisinin-based combinations in children: a systematic

Oluwaseun Egunsola1, Kazeem A Oshikoya

  • 1Academic Division of Child Health, University of Nottingham, Derbyshire Children's Hospital, Derby DE22 3DT, UK. mzxoe@nottingham.ac.uk.

Malaria Journal
|November 2, 2013
PubMed

Insights

Artemether-lumefantrine (AL) is safe for children, with common side effects like cough and gastrointestinal issues. It shows comparable safety to other artemisinin-based combinations, though more research is needed for specific comparisons.

Area of Science:

  • Pediatric Pharmacology
  • Infectious Disease Treatment
  • Drug Safety and Efficacy

Background:

  • Artemisinin-based combination therapies (ACTs) are crucial for treating malaria in children.
  • Evaluating the safety profile of artemether-lumefantrine (AL) against other ACTs is essential for pediatric malaria management.

Purpose of the Study:

  • To compare the safety of artemether-lumefantrine (AL) with alternative artemisinin-based combination therapies in pediatric populations.
  • To identify and quantify adverse events associated with AL use in children.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) published up to April 2013.
  • Searches conducted in EMBASE, MEDLINE, and the Cochrane Library, including studies with pediatric participants (≤ 17 years) where AL safety was an outcome.
  • Inclusion criteria focused on comparative safety data for AL.

Main Results:

  • Over 6,000 patients receiving AL reported 4,726 adverse events (AEs).
  • Common AEs for AL included coryza, vomiting, anemia, and diarrhea; cough was very common.
  • AL showed a higher risk of body weakness compared to artesunate-mefloquine but a lower risk of vomiting compared to artesunate-amodiaquine and chlorproguanil-dapsone-artesunate (ACD).
  • Serious adverse events were significantly lower with AL compared to ACD.

Conclusions:

  • Artemether-lumefantrine (AL) demonstrates comparable safety to artesunate-amodiaquine (ASAQ) and dihydroartemisinin-piperaquine (DP) in children.
  • The most frequent adverse events associated with AL are cough and gastrointestinal symptoms.
  • Further research is recommended to compare AL safety with artesunate-mefloquine and artesunate-azithromycin.
Abstract

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