皮罗纳里丁-阿尔特苏纳酸用于治疗没有并发症的Plasmodium falciparum疟疾
Tilly Fox1, Jenifer A Otieno2, Joseph Pryce3
1Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
皮罗纳里丁-阿尔特苏纳酸在治疗无并发症的Plasmodium falciparum疟疾方面是有效的,其疗效与其他基于素的组合疗法相比相当或更好. 然而,它与肝酶升高的风险增加有关.
科学领域:
- 疟疾学与热带传染病
- 药理学和药物有效性研究研究.
- 公共卫生和全球卫生干预措施
背景情况:
- 世界卫生组织建议在没有并发症的Plasmodium falciparum疟疾中使用基于美素的组合疗法 (ACT).
- 由于人们担心甲美西宁耐药性,因此需要开发新的ACT合作伙伴药物.
- 铁二甲酸 (PY-AS) 是世卫组织在2022年推的一种新型ACT.
研究的目的:
- 为了评估与非复杂的P. falciparum疟疾的替代ACT相比,pyronaridine-artesunate的疗效和安全性.
- 评估pyronaridine-artesunate和其他pyronaridine治疗的益处和危害.
主要方法:
- 随机对照试验 (RCT) 和非随机研究的系统审查和元分析.
- 搜索了多个数据库,包括CENTRAL,MEDLINE,Embase,LILACS和临床试验注册表.
- 包括15项研究 (14项RCT,1项准实验) 关于疗效和10项NRS关于安全,共分别有7295名和11783名参与者.
主要成果:
- 皮罗纳里丁-阿尔特苏纳酸在28天的PCR调整和未调整治疗失败中显示出可能更好的疗效,而不是阿尔特梅瑟-卢梅方特林 (中等确定性证据).
- 对阿尔特苏纳特-阿莫迪亚奎因和阿尔特苏纳特-梅弗洛奎因的疗效显示出混合的结果,证据的确定性中等至低.
- 与其他抗疟疾药物相比,皮罗纳里丁-阿特苏纳酸与氨酸转移酶 (ALT) 和酸氨酸转移酶 (AST) 升高的风险显著增加有关 (高确定性证据).
结论:
- 皮罗纳里丁-阿尔特苏纳酸对不复杂的P. falciparum疟疾有效,其性能可能与世卫组织推的其他ACT相比或优于它.
- 皮罗纳里丁-阿尔特苏纳酸的使用观察到肝酶 (ALT和AST) 升高的风险显著增加.
- 需要进一步的研究,特别是关于成本效益和特定人群的代表性,如亚洲的幼儿.
更多相关视频
10:50Detection and Quantification of Plasmodium falciparum in Aqueous Red Blood Cells by Attenuated Total Reflection Infrared Spectroscopy and Multivariate Data Analysis
Published on: November 2, 2018
10:38High Yield Purification of Plasmodium falciparum Merozoites For Use in Opsonizing Antibody Assays
Published on: July 17, 2014
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