@article{fdi:010064636,
  title = {{T}he effect of dose on the antimalarial efficacy of artemether-lumefantrine : a systematic review and pooled analysis of individual patient data},
  author = {{A}nstey, {N}. {M}. and {P}rice, {R}. {N}. and {D}avis, {T}. {M}. {E}. and {K}arunajeewa, {H}. {A}. and {M}ueller, {I}. and {D}'{A}lessandro, {U}. and {M}assougbodji, {A}. and {N}ikiema, {F}. and {O}uedraogo, {J}. {B}. and {T}into, {H}. and {Z}ongo, {I}. and {S}ame-{E}kobo, {A}. and {K}one, {M}. and {M}enan, {H}. and {T}oure, {A}. {O}. and {Y}avo, {W}. and {K}ofoed, {P}. {E}. and {A}lemayehu, {B}. {H}. and {J}ima, {D}. and {B}audin, {E}. and {E}spie, {E}. and {N}abasumba, {C}. and {P}inoges, {L}. and {S}chramm, {B}. and {C}ot, {M}ichel and {D}eloron, {P}hilippe and et al.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {A}rtemether-lumefantrine is the most widely used artemisinin-based combination therapy for malaria, although treatment failures occur in some regions. {W}e investigated the effect of dosing strategy on efficacy in a pooled analysis from trials done in a wide range of malaria-endemic settings. {M}ethods {W}e searched {P}ub{M}ed for clinical trials that enrolled and treated patients with artemether-lumefantrine and were published from 1960 to {D}ecember, 2012. {W}e merged individual patient data from these trials by use of standardised methods. {T}he primary endpoint was the {PCR}-adjusted risk of {P}lasmodium falciparum recrudescence by day 28. {S}econdary endpoints consisted of the {PCR}-adjusted risk of {P} falciparum recurrence by day 42, {PCR}-unadjusted risk of {P} falciparum recurrence by day 42, early parasite clearance, and gametocyte carriage. {R}isk factors for {PCR}-adjusted recrudescence were identified using {C}ox's regression model with frailty shared across the study sites. {F}indings {W}e included 61 studies done between {J}anuary, 1998, and {D}ecember, 2012, and included 14 327 patients in our analyses. {T}he {PCR}-adjusted therapeutic efficacy was 97.6% (95% {CI} 97.4-97.9) at day 28 and 96.0% (95.6-96.5) at day 42. {A}fter controlling for age and parasitaemia, patients prescribed a higher dose of artemether had a lower risk of having parasitaemia on day 1 (adjusted odds ratio [{OR}] 0.92, 95% {CI} 0.86-0.99 for every 1 mg/kg increase in daily artemether dose; p=0.024), but not on day 2 (p=0.69) or day 3 (0.087). {I}n {A}sia, children weighing 10-15 kg who received a total lumefantrine dose less than 60 mg/kg had the lowest {PCR}-adjusted efficacy (91.7%, 95% {CI} 86.5-96.9). {I}n {A}frica, the risk of treatment failure was greatest in malnourished children aged 1-3 years ({PCR}-adjusted efficacy 94.3%, 95% {CI} 92.3-96.3). {A} higher artemether dose was associated with a lower gametocyte presence within 14 days of treatment (adjusted {OR} 0.92, 95% {CI} 0.85-0.99; p=0.037 for every 1 mg/kg increase in total artemether dose). {I}nterpretation {T}he recommended dose of artemether-lumefantrine provides reliable efficacy in most patients with uncomplicated malaria. {H}owever, therapeutic efficacy was lowest in young children from {A}sia and young underweight children from {A}frica; a higher dose regimen should be assessed in these groups.},
  keywords = {{AFRIQUE} ; {ASIE} ; {AMERIQUE} {DU} {SUD}},
  booktitle = {},
  journal = {{L}ancet {I}nfectious {D}iseases},
  volume = {15},
  numero = {6},
  pages = {692--702},
  ISSN = {1473-3099},
  year = {2015},
  DOI = {10.1016/s1473-3099(15)70024-1},
  URL = {https://www.documentation.ird.fr/hor/fdi:010064636},
}