Population pharmacokinetics of piperaquine after two different treatment regimens with dihydroartemisinin-piperaquine in patients with Plasmodium falciparum malaria in Thailand.

The population pharmacokinetics of piperaquine in adults and children with uncomplicated Plasmodium falciparum malaria treated with two different dosage regimens of dihydroartemisinin-piperaquine were characterized. Piperaquine pharmacokinetics in 98 Burmese and Karen patients aged 3 to 55 years wer...

Full description

Bibliographic Details
Main Authors: Tarning, J, Ashley, E, Lindegardh, N, Stepniewska, K, Phaiphun, L, Day, N, Mcgready, R, Ashton, M, Nosten, F, White, N
Format: Journal article
Language:English
Published: 2008
_version_ 1826306723735928832
author Tarning, J
Ashley, E
Lindegardh, N
Stepniewska, K
Phaiphun, L
Day, N
Mcgready, R
Ashton, M
Nosten, F
White, N
author_facet Tarning, J
Ashley, E
Lindegardh, N
Stepniewska, K
Phaiphun, L
Day, N
Mcgready, R
Ashton, M
Nosten, F
White, N
author_sort Tarning, J
collection OXFORD
description The population pharmacokinetics of piperaquine in adults and children with uncomplicated Plasmodium falciparum malaria treated with two different dosage regimens of dihydroartemisinin-piperaquine were characterized. Piperaquine pharmacokinetics in 98 Burmese and Karen patients aged 3 to 55 years were described by a two-compartment disposition model with first-order absorption and interindividual random variability on all parameters and were similar with the three- and four-dose regimens. Children had a lower body weight-normalized oral clearance than adults, resulting in longer terminal elimination half-lives and higher total exposure to piperaquine (area under the concentration-time curve from 0 to 63 days [AUC day 0-63]). However, children had lower plasma concentrations in the therapeutically relevant posttreatment prophylactic period (AUC day 3-20) because of smaller body weight-normalized central volumes of distribution and shorter distribution half-lives. Our data lend further support to a simplified once-daily treatment regimen to improve treatment adherence and efficacy and indicate that weight-adjusted piperaquine doses in children may need to be higher than in adults.
first_indexed 2024-03-07T06:52:16Z
format Journal article
id oxford-uuid:fcef24d2-8295-41f3-a69e-c563c1c981f8
institution University of Oxford
language English
last_indexed 2024-03-07T06:52:16Z
publishDate 2008
record_format dspace
spelling oxford-uuid:fcef24d2-8295-41f3-a69e-c563c1c981f82022-03-27T13:25:01ZPopulation pharmacokinetics of piperaquine after two different treatment regimens with dihydroartemisinin-piperaquine in patients with Plasmodium falciparum malaria in Thailand.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fcef24d2-8295-41f3-a69e-c563c1c981f8EnglishSymplectic Elements at Oxford2008Tarning, JAshley, ELindegardh, NStepniewska, KPhaiphun, LDay, NMcgready, RAshton, MNosten, FWhite, NThe population pharmacokinetics of piperaquine in adults and children with uncomplicated Plasmodium falciparum malaria treated with two different dosage regimens of dihydroartemisinin-piperaquine were characterized. Piperaquine pharmacokinetics in 98 Burmese and Karen patients aged 3 to 55 years were described by a two-compartment disposition model with first-order absorption and interindividual random variability on all parameters and were similar with the three- and four-dose regimens. Children had a lower body weight-normalized oral clearance than adults, resulting in longer terminal elimination half-lives and higher total exposure to piperaquine (area under the concentration-time curve from 0 to 63 days [AUC day 0-63]). However, children had lower plasma concentrations in the therapeutically relevant posttreatment prophylactic period (AUC day 3-20) because of smaller body weight-normalized central volumes of distribution and shorter distribution half-lives. Our data lend further support to a simplified once-daily treatment regimen to improve treatment adherence and efficacy and indicate that weight-adjusted piperaquine doses in children may need to be higher than in adults.
spellingShingle Tarning, J
Ashley, E
Lindegardh, N
Stepniewska, K
Phaiphun, L
Day, N
Mcgready, R
Ashton, M
Nosten, F
White, N
Population pharmacokinetics of piperaquine after two different treatment regimens with dihydroartemisinin-piperaquine in patients with Plasmodium falciparum malaria in Thailand.
title Population pharmacokinetics of piperaquine after two different treatment regimens with dihydroartemisinin-piperaquine in patients with Plasmodium falciparum malaria in Thailand.
title_full Population pharmacokinetics of piperaquine after two different treatment regimens with dihydroartemisinin-piperaquine in patients with Plasmodium falciparum malaria in Thailand.
title_fullStr Population pharmacokinetics of piperaquine after two different treatment regimens with dihydroartemisinin-piperaquine in patients with Plasmodium falciparum malaria in Thailand.
title_full_unstemmed Population pharmacokinetics of piperaquine after two different treatment regimens with dihydroartemisinin-piperaquine in patients with Plasmodium falciparum malaria in Thailand.
title_short Population pharmacokinetics of piperaquine after two different treatment regimens with dihydroartemisinin-piperaquine in patients with Plasmodium falciparum malaria in Thailand.
title_sort population pharmacokinetics of piperaquine after two different treatment regimens with dihydroartemisinin piperaquine in patients with plasmodium falciparum malaria in thailand
work_keys_str_mv AT tarningj populationpharmacokineticsofpiperaquineaftertwodifferenttreatmentregimenswithdihydroartemisininpiperaquineinpatientswithplasmodiumfalciparummalariainthailand
AT ashleye populationpharmacokineticsofpiperaquineaftertwodifferenttreatmentregimenswithdihydroartemisininpiperaquineinpatientswithplasmodiumfalciparummalariainthailand
AT lindegardhn populationpharmacokineticsofpiperaquineaftertwodifferenttreatmentregimenswithdihydroartemisininpiperaquineinpatientswithplasmodiumfalciparummalariainthailand
AT stepniewskak populationpharmacokineticsofpiperaquineaftertwodifferenttreatmentregimenswithdihydroartemisininpiperaquineinpatientswithplasmodiumfalciparummalariainthailand
AT phaiphunl populationpharmacokineticsofpiperaquineaftertwodifferenttreatmentregimenswithdihydroartemisininpiperaquineinpatientswithplasmodiumfalciparummalariainthailand
AT dayn populationpharmacokineticsofpiperaquineaftertwodifferenttreatmentregimenswithdihydroartemisininpiperaquineinpatientswithplasmodiumfalciparummalariainthailand
AT mcgreadyr populationpharmacokineticsofpiperaquineaftertwodifferenttreatmentregimenswithdihydroartemisininpiperaquineinpatientswithplasmodiumfalciparummalariainthailand
AT ashtonm populationpharmacokineticsofpiperaquineaftertwodifferenttreatmentregimenswithdihydroartemisininpiperaquineinpatientswithplasmodiumfalciparummalariainthailand
AT nostenf populationpharmacokineticsofpiperaquineaftertwodifferenttreatmentregimenswithdihydroartemisininpiperaquineinpatientswithplasmodiumfalciparummalariainthailand
AT whiten populationpharmacokineticsofpiperaquineaftertwodifferenttreatmentregimenswithdihydroartemisininpiperaquineinpatientswithplasmodiumfalciparummalariainthailand