Response to comment on 'The clinical pharmacology of tafenoquine in the radical cure of Plasmodium vivax malaria: An individual patient data meta-analysis'

被引:1
|
作者
Watson, James A. [1 ,2 ,3 ]
Commons, Robert J. [3 ,4 ]
Tarning, Joel [2 ,5 ]
Simpson, Julie A. [6 ]
Cuentas, Alejandro Llanos [7 ]
Lacerda, Marcus V. G. [8 ]
Green, Justin A. [9 ,12 ]
Koh, Gavin C. K. W. [10 ]
Chu, Cindy S. [2 ,11 ]
Nosten, Francois H. [2 ,11 ]
Price, Richard N. [2 ,3 ,4 ]
Day, Nicholas P. J. [2 ,5 ]
White, Nicholas J. [2 ,5 ]
机构
[1] Univ Oxford, Hosp Trop Dis, Clin Res Unit, Ho Chi Minh, Vietnam
[2] Univ Oxford, Ctr Trop Med & Global Hlth, Nuffield Dept Med, Oxford, England
[3] WorldWide Antimalarial Resistance Network, Oxford, England
[4] Charles Darwin Univ, Menzies Sch Hlth Res, Global Hlth Div, Darwin, NT, Australia
[5] Mahidol Univ, Fac Trop Med, Mahidol Oxford Trop Med Res Unit, Bangkok, Thailand
[6] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Ctr Epidemiol & Biostat, Melbourne, Australia
[7] Univ Peruana Cayetano Heredia, Unit Leishmaniasis & Malaria, Inst Med Trop Alexander Von Humboldt, San Martin De Porres, Peru
[8] Fundacao Med Trop Dr Heitor Vieira Dourado, Manaus, AM, Brazil
[9] GSK, Brentford, England
[10] Northwick Pk Hosp & Clin Res Ctr, Dept Infect Dis, Harrow, England
[11] Shoklo Malaria Res Unit, Mae Sot, Thailand
[12] AstraZeneca, Cambridge, England
来源
ELIFE | 2024年 / 13卷
基金
英国惠康基金;
关键词
tafenoquine; Plasmodium vivax malaria; radical cure; haemolysis; Human; Other;
D O I
10.7554/eLife.91283
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
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.
引用
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页数:7
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