Response to comment on 'The clinical pharmacology of tafenoquine in the radical cure of Plasmodium vivax malaria: an individual patient data meta-analysis'
In our recent paper on the clinical pharmacology of tafenoquine (Watson et al., 2022), we used all available individual patient pharmacometric data from the tafenoquine pre-registration clinical efficacy trials to characterise the determinants of anti-relapse efficacy in tropical vivax malaria. We c...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
eLife Sciences Publications
2024
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| _version_ | 1797112647160692736 |
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| author | Watson, JA Commons, RJ Tarning, J Simpson, JA Llanos Cuentas, A Lacerda, MVG Green, JA Koh, GCKW Chu, CS Nosten, FH Price, RN Day, NPJ White, NJ |
| author_facet | Watson, JA Commons, RJ Tarning, J Simpson, JA Llanos Cuentas, A Lacerda, MVG Green, JA Koh, GCKW Chu, CS Nosten, FH Price, RN Day, NPJ White, NJ |
| author_sort | Watson, JA |
| collection | OXFORD |
| description | In our recent paper on the clinical pharmacology of tafenoquine (Watson et al., 2022), we used all available individual patient pharmacometric data from the tafenoquine pre-registration clinical efficacy trials to characterise the determinants of anti-relapse efficacy in tropical vivax malaria. We concluded that the currently recommended dose of tafenoquine (300 mg in adults, average dose of 5 mg/kg) is insufficient for cure in all adults, and a 50% increase to 450 mg (7.5 mg/kg) would halve the risk of vivax recurrence by four months. We recommended that clinical trials of higher doses should be carried out to assess their safety and tolerability. Sharma and colleagues at the pharmaceutical company GSK defend the currently recommended adult dose of 300 mg as the optimum balance between radical curative efficacy and haemolytic toxicity (Sharma et al., 2024). We contend that the relative haemolytic risks of the 300 mg and 450 mg doses have not been sufficiently well characterised to justify this opinion. In contrast, we provided evidence that the currently recommended 300 mg dose results in sub-maximal efficacy, and that prospective clinical trials of higher doses are warranted to assess their risks and benefits. |
| first_indexed | 2024-03-07T08:27:00Z |
| format | Journal article |
| id | oxford-uuid:f82de108-98d2-44d9-afde-9a464eaa6ba1 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:27:00Z |
| publishDate | 2024 |
| publisher | eLife Sciences Publications |
| record_format | dspace |
| spelling | oxford-uuid:f82de108-98d2-44d9-afde-9a464eaa6ba12024-02-19T17:14:16ZResponse to comment on 'The clinical pharmacology of tafenoquine in the radical cure of Plasmodium vivax malaria: an individual patient data meta-analysis'Journal articlehttp://purl.org/coar/resource_type/c_1843uuid:f82de108-98d2-44d9-afde-9a464eaa6ba1EnglishSymplectic ElementseLife Sciences Publications2024Watson, JACommons, RJTarning, JSimpson, JALlanos Cuentas, ALacerda, MVGGreen, JAKoh, GCKWChu, CSNosten, FHPrice, RNDay, NPJWhite, NJIn our recent paper on the clinical pharmacology of tafenoquine (Watson et al., 2022), we used all available individual patient pharmacometric data from the tafenoquine pre-registration clinical efficacy trials to characterise the determinants of anti-relapse efficacy in tropical vivax malaria. We concluded that the currently recommended dose of tafenoquine (300 mg in adults, average dose of 5 mg/kg) is insufficient for cure in all adults, and a 50% increase to 450 mg (7.5 mg/kg) would halve the risk of vivax recurrence by four months. We recommended that clinical trials of higher doses should be carried out to assess their safety and tolerability. Sharma and colleagues at the pharmaceutical company GSK defend the currently recommended adult dose of 300 mg as the optimum balance between radical curative efficacy and haemolytic toxicity (Sharma et al., 2024). We contend that the relative haemolytic risks of the 300 mg and 450 mg doses have not been sufficiently well characterised to justify this opinion. In contrast, we provided evidence that the currently recommended 300 mg dose results in sub-maximal efficacy, and that prospective clinical trials of higher doses are warranted to assess their risks and benefits. |
| spellingShingle | Watson, JA Commons, RJ Tarning, J Simpson, JA Llanos Cuentas, A Lacerda, MVG Green, JA Koh, GCKW Chu, CS Nosten, FH Price, RN Day, NPJ White, NJ Response to comment on 'The clinical pharmacology of tafenoquine in the radical cure of Plasmodium vivax malaria: an individual patient data meta-analysis' |
| title | Response to comment on 'The clinical pharmacology of tafenoquine in the radical cure of Plasmodium vivax malaria: an individual patient data meta-analysis' |
| title_full | Response to comment on 'The clinical pharmacology of tafenoquine in the radical cure of Plasmodium vivax malaria: an individual patient data meta-analysis' |
| title_fullStr | Response to comment on 'The clinical pharmacology of tafenoquine in the radical cure of Plasmodium vivax malaria: an individual patient data meta-analysis' |
| title_full_unstemmed | Response to comment on 'The clinical pharmacology of tafenoquine in the radical cure of Plasmodium vivax malaria: an individual patient data meta-analysis' |
| title_short | Response to comment on 'The clinical pharmacology of tafenoquine in the radical cure of Plasmodium vivax malaria: an individual patient data meta-analysis' |
| title_sort | response to comment on the clinical pharmacology of tafenoquine in the radical cure of plasmodium vivax malaria an individual patient data meta analysis |
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