Pooled Multicenter Analysis of Cardiovascular Safety and Population Pharmacokinetic Properties of Piperaquine in African Patients with Uncomplicated Falciparum Malaria
Copyright © 2020 Wattanakul et al..
Dihydroartemisinin-piperaquine has shown excellent efficacy and tolerability in malaria treatment. However, concerns have been raised of potentially harmful cardiotoxic effects associated with piperaquine. The population pharmacokinetics and cardiac effects of piperaquine were evaluated in 1,000 patients, mostly children enrolled in a multicenter trial from 10 sites in Africa. A linear relationship described the QTc-prolonging effect of piperaquine, estimating a 5.90-ms mean QTc prolongation per 100-ng/ml increase in piperaquine concentration. The effect of piperaquine on absolute QTc interval estimated a mean maximum QTc interval of 456 ms (50% effective concentration of 209 ng/ml). Simulations from the pharmacokinetic-pharmacodynamic models predicted 1.98 to 2.46% risk of having QTc prolongation of >60 ms in all treatment settings. Although piperaquine administration resulted in QTc prolongation, no cardiovascular adverse events were found in these patients. Thus, the use of dihydroartemisinin-piperaquine should not be limited by this concern. (This study has been registered at ClinicalTrials.gov under identifier NCT02199951.).
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:64 |
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| Enthalten in: |
Antimicrobial agents and chemotherapy - 64(2020), 7 vom: 23. Juni |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wattanakul, Thanaporn [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 17.06.2021 Date Revised 17.06.2021 published: Electronic-Print ClinicalTrials.gov: NCT02199951 Citation Status MEDLINE |
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| doi: |
10.1128/AAC.01848-19 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM308972627 |
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| 245 | 1 | 0 | |a Pooled Multicenter Analysis of Cardiovascular Safety and Population Pharmacokinetic Properties of Piperaquine in African Patients with Uncomplicated Falciparum Malaria |
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| 500 | |a ClinicalTrials.gov: NCT02199951 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Wattanakul et al. | ||
| 520 | |a Dihydroartemisinin-piperaquine has shown excellent efficacy and tolerability in malaria treatment. However, concerns have been raised of potentially harmful cardiotoxic effects associated with piperaquine. The population pharmacokinetics and cardiac effects of piperaquine were evaluated in 1,000 patients, mostly children enrolled in a multicenter trial from 10 sites in Africa. A linear relationship described the QTc-prolonging effect of piperaquine, estimating a 5.90-ms mean QTc prolongation per 100-ng/ml increase in piperaquine concentration. The effect of piperaquine on absolute QTc interval estimated a mean maximum QTc interval of 456 ms (50% effective concentration of 209 ng/ml). Simulations from the pharmacokinetic-pharmacodynamic models predicted 1.98 to 2.46% risk of having QTc prolongation of >60 ms in all treatment settings. Although piperaquine administration resulted in QTc prolongation, no cardiovascular adverse events were found in these patients. Thus, the use of dihydroartemisinin-piperaquine should not be limited by this concern. (This study has been registered at ClinicalTrials.gov under identifier NCT02199951.) | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a QT prolongation | |
| 650 | 4 | |a antimalarial agents | |
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| 700 | 1 | |a Adjei, Alex |e verfasserin |4 aut | |
| 700 | 1 | |a Sie, Ali |e verfasserin |4 aut | |
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| 700 | 1 | |a Macete, Eusebio |e verfasserin |4 aut | |
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| 700 | 1 | |a Winterberg, Markus |e verfasserin |4 aut | |
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| 700 | 1 | |a Adjuik, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Abdulla, Salim |e verfasserin |4 aut | |
| 700 | 1 | |a Owusu-Agyei, Seth |e verfasserin |4 aut | |
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