ArtemetherLumefantrine As Effective As Quinine

Artemisinin combination also better tolerated than quinine in pregnant women with malaria
By Beth Gilbert
HealthDay Reporter

THURSDAY, Oct. 7 (HealthDay News) -- The combination of artemether and lumefantrine appears to be better tolerated than, and as effective as, oral quinine for the treatment of uncomplicated malaria in the second and third trimesters of pregnancy, according to a study published online Oct. 6 in The Lancet Infectious Diseases.

In an open-label, non-inferiority trial, Patrice Piola, M.D., of Epicentre in Paris, and colleagues randomized 304 pregnant women in Uganda to receive either quinine hydrochloride or artemether-lumefantrine between October 2006 and May 2009. Participants were followed up weekly until delivery.

At day 42, the investigators found that 137 of 138 patients (99.3 percent) undergoing treatment with artemether-lumefantrine and 122 of 125 (97.6 percent) receiving quinine were cured, a difference of 1.7 percent. In terms of gametocyte and parasite clearance, the artemether-lumefantrine fixed-dose regimen was more effective than quinine. The data also revealed 290 adverse events among those receiving quinine and 141 among those receiving artemether-lumefantrine. The most common adverse events among those receiving quinine were tinnitus, nausea, vomiting, and anorexia, while abdominal pain, headaches, and influenza-like syndrome were the most common adverse events among those receiving artemether-lumefantrine.

"Our study suggests that artemisinin derivatives, depending on the companion drug, could be preferable to oral quinine for the treatment of uncomplicated malaria in pregnancy, because they are better tolerated with reassuring safety results and not inferior to quinine in efficacy," the authors write.

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