@article{fdi:010082795,
  title = {{D}evelopment of weight and age-based dosing of daily primaquine for radical cure of vivax malaria},
  author = {{T}aylor, {W}. {R}. and {H}oglund, {R}. {M}. and {P}eerawaranun, {P}. and {N}guyen, {T}. {N}. and {H}ien, {T}. {T}. and {T}arantola, {A}. and von {S}eidlein, {L}. and {T}ripura, {R}. and {P}eto, {T}. {J}. and {D}ondorp, {A}. {M}. and {L}andier, {J}ordi and {N}osten, {F}. {H}. and {S}mithuis, {F}. and {P}hommasone, {K}. and {M}ayxay, {M}. and {K}heang, {S}. {T}. and {S}ay, {C}. and {N}eeraj, {K}. and {R}ithea, {L}. and {D}ysoley, {L}. and {K}heng, {S}. and {M}uth, {S}. and {R}oca-{F}eltrer, {A}. and {D}ebackere, {M}. and {F}airhurst, {R}. {M}. and {S}ong, {N}. and {B}uchy, {P}. and {M}enard, {D}. and {W}hite, {N}. {J}. and {T}arning, {J}. and {M}ukaka, {M}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {I}n many endemic areas, {P}lasmodium vivax malaria is predominantly a disease of young adults and children. {I}nternational recommendations for radical cure recommend fixed target doses of 0.25 or 0.5 mg/kg/day of primaquine for 14 days in glucose-6-phosphate dehydrogenase normal patients of all ages. {H}owever, for many anti-malarial drugs, including primaquine, there is evidence that children have lower exposures than adults for the same weight-adjusted dose. {T}he aim of the study was to develop 14-day weight-based and age-based primaquine regimens against high-frequency relapsing tropical {P}. vivax. {M}ethods {T}he recommended adult target dose of 0.5 mg/kg/day (30 mg in a 60 kg patient) is highly efficacious against tropical {P}. vivax and was assumed to produce optimal drug exposure. {P}rimaquine doses were calculated using allometric scaling to derive a weight-based primaquine regimen over a weight range from 5 to 100 kg. {G}rowth curves were constructed from an anthropometric database of 53,467 individuals from the {G}reater {M}ekong {S}ubregion ({GMS}) to define weight-for-age relationships. {T}he median age associated with each weight was used to derive an age-based dosing regimen from the weight-based regimen. {R}esults {T}he proposed weight-based regimen has 5 dosing bands: (i) 5-7 kg, 5 mg, resulting in 0.71-1.0 mg/kg/day; (ii) 8-16 kg, 7.5 mg, 0.47-0.94 mg/kg/day; (iii) 17-40 kg, 15 mg, 0.38-0.88 mg/kg/day; (iv) 41-80 kg, 30 mg, 0.37-0.73 mg/kg/day; and (v) 81-100 kg, 45 mg, 0.45-0.56 mg/kg/day. {T}he corresponding age-based regimen had 4 dosing bands: 6-11 months, 5 mg, 0.43-1.0 mg/kg/day; (ii) 1-5 years, 7.5 mg, 0.35-1.25 mg/kg/day; (iii) 6-14 years, 15 mg, 0.30-1.36 mg/kg/day; and (iv) >= 15 years, 30 mg, 0.35-1.07 mg/kg/day. {C}onclusion {T}he proposed weight-based regimen showed less variability around the primaquine dose within each dosing band compared to the age-based regimen and is preferred. {I}ncreased dose accuracy could be achieved by additional dosing bands for both regimens. {T}he age-based regimen might not be applicable to regions outside the {GMS}, which must be based on local anthropometric data. {P}harmacokinetic data in small children are needed urgently to inform the proposed regimens.},
  keywords = {{P}rimaquine ; {A}llometric scaling ; {A}ge-based dosing ; {W}eight-based dosing ; {P}lasmodium vivax ; {CAMBODGE} ; {MYANMAR} ; {VIET} {NAM} ; {LAOS} ; {GRAND} {MEKONG} {SOUS} {REGION}},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {20},
  numero = {1},
  pages = {366 [10 p.]},
  year = {2021},
  DOI = {10.1186/s12936-021-03886-w},
  URL = {https://www.documentation.ird.fr/hor/fdi:010082795},
}