Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium
Background: Intravenous (IV) artesunate is the treatment of choice for severe malaria. In Europe, however, no GMP-manufactured product is available and treatment data in European travellers are scarce. Fortunately, artesunate became available in the Netherlands and Belgium through a named patient programme. This is the largest case series of artesunate treated patients with severe malaria in Europe. Methods: Hospitalized patients treated with IV artesunate between November 2007 and December 2010 in the Netherlands and Belgium were retrospectively evaluated. Patient characteristics, treatment a... Mehr ...
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Dokumenttyp: | Artikel |
Erscheinungsdatum: | 2012 |
Reihe/Periodikum: | Kreeftmeijer-Vegter , A R , van Genderen , P J , Visser , L G , Bierman , W F W , Clerinx , J , van Veldhuizen , C K W & de Vries , P J 2012 , ' Treatment outcome of intravenous artesunate in patients with severe malaria in the Netherlands and Belgium ' , Malaria journal , vol. 11 , 102 . https://doi.org/10.1186/1475-2875-11-102 |
Schlagwörter: | Intravenous artesunate / Severe malaria / Parasite clearance / Named patient program / European traveller / SEVERE FALCIPARUM-MALARIA / HEMOLYTIC-ANEMIA / RANDOMIZED-TRIAL / QUININE / ARTEMISININ / TRAVELERS / EFFICACY |
Sprache: | Englisch |
Permalink: | https://search.fid-benelux.de/Record/base-26825425 |
Datenquelle: | BASE; Originalkatalog |
Powered By: | BASE |
Link(s) : | https://hdl.handle.net/11370/645370ed-f0e5-4e65-a694-d4880256b059 |
Background: Intravenous (IV) artesunate is the treatment of choice for severe malaria. In Europe, however, no GMP-manufactured product is available and treatment data in European travellers are scarce. Fortunately, artesunate became available in the Netherlands and Belgium through a named patient programme. This is the largest case series of artesunate treated patients with severe malaria in Europe. Methods: Hospitalized patients treated with IV artesunate between November 2007 and December 2010 in the Netherlands and Belgium were retrospectively evaluated. Patient characteristics, treatment and clinical outcome were recorded on a standardized form and mortality, parasite clearance times and the occurrence of adverse events were evaluated. Results: Of the 68 treated patients, including 55 with severe malaria, two patients died (2/55 = 3.6%). The mean time to 50% parasite clearance (PCT50), 90% and 99% were 4.4 hours (3.9 - 5.2), 14.8 hours (13.0 - 17.2), and 29.5 hours (25.9 - 34.4) respectively. Artesunate was well tolerated. However, an unusual form of haemolytic anaemia was observed in seven patients. The relationship with artesunate remains uncertain. Conclusions: Data from the named patient programme demonstrate that IV artesunate is effective and well-tolerated in European travellers lacking immunity. However, increased attention needs to be paid to the possible development of haemolytic anaemia 2-3 weeks after start of treatment. Treatment of IV artesunate should be limited to the period that IV treatment is required and should be followed by a full oral course of an appropriate anti-malarial drug.