预防抗疟疾药物耐药性,使用基于三次阿美西宁的组合疗法
Tran Dang Nguyen1, Bo Gao2, Chanaki Amaratunga2,3
1Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA, USA.
Nature communications
|July 29, 2023
概括
基于三重甲素的组合疗法 (TACT) 可以延迟甲素耐药性的出现. 早期采用TACT可以改善疟疾治疗结果,并有助于消除疟疾的努力.
科学领域:
- 疟疾学 疟疾学
- 寄生虫学的寄生虫学
- 药物耐药性的演变 药物耐药性的演变
背景情况:
- 素耐药性和伴侣耐药性对全球疟疾控制构成重大威胁.
- 在临床试验中,基于三次美素的组合疗法 (TACTs) 证明了有效性和耐受性,即使是在患有多药耐药疟疾的地区.
研究的目的:
- 评估TACT的早期采用是否可以延迟抗疟疾药物耐药性的出现和传播.
- 为了比较TACT和当前基于艺术素的组合疗法 (ACT) 之间的长期艺术素抵抗水平和治疗失败率.
主要方法:
- 利用两个独立的基于个体的模型模拟Plasmodium falciparum流行病学和演变.
- 评估了引入特定的TACT (artsunate-mefloquine-piperaquine或artemether-lumefantrine-amodiaquine) 与继续使用ACT的影响.
主要成果:
- 引入TACT显著延迟了抗素耐药性的出现和传播.
- 与继续使用ACT相比,TACT可以降低长期治疗失败率.
- 这种延迟延长了当前抗疟疾药物的治疗寿命,并提高了消除疟疾的前景.
结论:
- 建议决策者立即考虑TACT的引入,在新出现的素抗药性地区.
- 达克技术是维持有效疟疾治疗和实现消除目标的关键策略.
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