Use of weight-for-age data to optimize tablet strength and dosing regimens for a new fixed-dose artesunate-amodiaquine combination for treating falciparum malaria

Taylor, W. R. J., Terlouw, Anja ORCID: https://orcid.org/0000-0001-5327-8995, Olliaro, P. L., White, N. J., Brasseur, P. and terKuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617 (2006) 'Use of weight-for-age data to optimize tablet strength and dosing regimens for a new fixed-dose artesunate-amodiaquine combination for treating falciparum malaria'. Bulletin of the World Health Organization, Vol 84, Issue 12, pp. 956-964.

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Abstract

Objective. To testa novel methodology to define age-based dosing regimens for the treatment of malaria with anew, user-friendly, blister-packaged fixed-dose combination of artesunate and amodiaquine.
Methods. A weight-for-age reference database of 88 054 individuals from sub-Saharan Africa was compiled using data from Demographic Health Surveys, observational and intervention studies, and standardized for sex, age and malaria risk. We then determined the optimal tablet strength (milligram (mg) per tablet) and age-dose categories for the combination of artesunate and amodiaquine, The proportions of patients predicted to receive doses within newly defined therapeutic ranges for amodiaquine (7-15 mg/kg/day) and artesunate (2-10 mg/kg/day), were estimated for different age categories and mg tablet strengths using models based on the weight-for-age reference database.
Findings. The optimal paediatric (p) and adult (a) strength tablets contained 25/67.5 and 100/270 mg artesunate/amodiaquine, respectively. A regimen with five age categories: 0-1 months (1/2 p), 2-11 months (1 p), 1-5 years (2 p), 6-13 years (1 a), and >= 14 years (2 a) had an overall dosing accuracy of 83.4% and 99.9% for amodiaduine and artesunate, respectively.
Conclusion.The proposed method to use weight-for-age reference data from countries where malaria is endemic is a useful tool for designing age-based dosing regimens for antimalarial drugs for drug registration and field use.

Item Type:	Article
Uncontrolled Keywords:	artemether-lumefantrine uncomplicated malaria oral artesunate artemisinin derivatives antimalarial-drugs improve adherence randomized-trial home treatment western kenya rural kenya
Subjects:	QV Pharmacology > Anti-Inflammatory Agents. Anti-Infective Agents. Antineoplastic Agents > QV 256 Antimalarials WC Communicable Diseases > Tropical and Parasitic Diseases > WC 770 Therapy
Digital Object Identifer (DOI):	https://doi.org/10.2471/BLT.06.031492
Depositing User:	Ms Julia Martin
Date Deposited:	19 Jan 2011 10:17
Last Modified:	13 Sep 2019 13:10
URI:	https://archive.lstmed.ac.uk/id/eprint/1609

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