School of Pharmacy, University of Mississippi, Jackson, MS, USA.
Ann Pharmacother. 2012 Apr;46(4):567-77. doi: 10.1345/aph.1Q539. Epub 2012 Apr 10.
To review the pharmacology, pharmacokinetics, safety, and efficacy of artemether-lumefantrine for the treatment of Plasmodium falciparum malaria.
English-language articles indexed in PubMed (1947-November 2011) were identified, using the search terms artemether-lumefantrine, artemether-lumefantrine AND malaria, Coartem, and Coartem AND malaria.
Available English-language articles were reviewed. In addition, the malaria treatment regimens recommended by region as provided by the World Health Organization and the treatment guidelines from the Centers for Disease Control and Prevention were reviewed.
Artemether-lumefantrine is an artemisinin-derived combination antimalarial approved by the Food and Drug Administration in 2009 for the treatment of P. falciparum malaria. The dual mechanisms of action of artemether-lumefantrine provide rapid and sustained parasite clearance. In the reviewed studies, the polymerase chain reaction (PCR)-corrected 28-day cure rates of artemether-lumefantrine were noninferior to the most common comparators, including chloroquine, dapsone, and other artemisinin derivatives (86-100% vs 51-100%, respectively). PCR-corrected day-42 cure rates were 92-99.3% for artemether-lumefantrine versus 62-100% for the comparator groups. The major adverse effects (gastrointestinal and central nervous system) were mild to moderate in severity and did not require a change in therapy. Although adherence to artemether-lumefantrine has been described as a potential problem due to the complicated dosing schedule, studies have described clinical cure rates similar to those of other antimalarials.
Artemether-lumefantrine is a safe and effective treatment for children and adults with P. falciparum malaria.
综述青蒿琥酯-咯萘啶治疗恶性疟原虫疟疾的药理学、药代动力学、安全性和疗效。
检索 PubMed 数据库（1947 年 11 月至 2011 年），使用的检索词包括青蒿琥酯-咯萘啶、青蒿琥酯-咯萘啶和疟疾、科泰新和科泰新和疟疾。
对现有的英文文献进行了回顾。此外，还查阅了世界卫生组织推荐的疟疾治疗方案和美国疾病控制与预防中心的治疗指南。
青蒿琥酯-咯萘啶是一种青蒿素类复方抗疟药物，2009 年经美国食品药品管理局批准用于治疗恶性疟原虫疟疾。青蒿琥酯-咯萘啶的双重作用机制可迅速持久地清除寄生虫。在已评价的研究中，青蒿琥酯-咯萘啶的聚合酶链反应（PCR）校正 28 天治愈率与最常用的对照药物（包括氯喹、氨苯砜和其他青蒿素衍生物）相似（分别为 86%-100%和 51%-100%）。PCR 校正的第 42 天治愈率分别为青蒿琥酯-咯萘啶 92%-99.3%和对照药物组 62%-100%。主要不良事件（胃肠道和中枢神经系统）为轻至中度，无需改变治疗方案。尽管青蒿琥酯-咯萘啶的服药方案较复杂，可能导致用药顺应性较差，但研究结果显示其临床治愈率与其他抗疟药物相似。
青蒿琥酯-咯萘啶是治疗儿童和成人恶性疟原虫疟疾的安全有效的药物。
