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氯喹-伯氨喹治疗疗效、安全性及在哥伦比亚太平洋地区无并发症疟疾患者中的血浆水平。

Chloroquine-Primaquine Therapeutic Efficacy, Safety, and Plasma Levels in Patients with Uncomplicated Malaria in a Colombian Pacific Region.

机构信息

Malaria Group, School of Medicine, Universidad de Antioquia, Medellin, Colombia.

出版信息

Am J Trop Med Hyg. 2019 Jan;100(1):72-77. doi: 10.4269/ajtmh.18-0655.

Abstract

In Colombia, published studies for the treatment of uncomplicated malaria with chloroquine-primaquine (CQ-PQ) are scarce. The aim of the study was to evaluate the therapeutic efficacy and safety profile of this combination. A clinical trial was performed in adults with uncomplicated malaria using the 28-day World Health Organization validated protocol. Patients received supervised antimalarial treatment and the primary efficacy end point was the clinical and parasitological response. Safety was assessed through adverse events surveillance, and plasma levels of antimalarial drugs were measured. A total of 77 patients were included. Adequate clinical and parasitological response rate diagnosed by thick blood smear examination was achieved in 72 of 73 patients (98.6%) with a complete 28-day follow-up. There were two parasitological therapeutic failures (TFs) (2.9%) on day 28, established by polymerase chain reaction among 68 patients, one of them with a positive film. No adverse events were detected. After completing the antimalarial treatment, all patients reached adequate plasma concentrations of CQ and desethylchloroquine (DECQ), with medians of 302.9 and 104.0 ng/mL, respectively. Uncomplicated malaria treatment with CQ-PQ standard treatment was effective and safe in the study population; TFs were not associated with low plasma levels of CQ and DECQ.

摘要

在哥伦比亚,针对氯喹-伯氨喹(CQ-PQ)治疗无并发症疟疾的已发表研究较为匮乏。本研究旨在评估该联合疗法的疗效和安全性。一项针对无并发症疟疾的成年人开展的临床试验采用了 28 天世界卫生组织(WHO)验证的方案。患者接受了监督下的抗疟治疗,主要疗效终点是临床和寄生虫学应答。通过不良事件监测评估安全性,并测量抗疟药物的血浆水平。共纳入 77 例患者。在完成 28 天的随访后,73 例患者中有 72 例(98.6%)经厚血涂片检查诊断为充分的临床和寄生虫学应答。68 例患者中有 2 例(2.9%)在第 28 天发生寄生虫学治疗失败(TF),其中 1 例血片阳性。未发现不良事件。完成抗疟治疗后,所有患者均达到 CQ 和去乙基氯喹(DECQ)的充分血浆浓度,中位数分别为 302.9 和 104.0ng/mL。在研究人群中,CQ-PQ 标准治疗治疗无并发症疟疾是有效且安全的;TF 与 CQ 和 DECQ 的低血浆水平无关。

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