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Use of area under the curve to evaluate the effects of antimalarial drugs on malaria associated anemia after treatment

Sowunmi, Akintunde and Gbotosho, Grace O. and Happi, Christian T. and Folarin, Onikepe A and Okuboyejo, Titilope M and Michael, Obaro S and Fatunmbi, Bayo (2011) Use of area under the curve to evaluate the effects of antimalarial drugs on malaria associated anemia after treatment. American Journal of Ther., 18 (3). pp. 190-197.

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To evaluate the effects of antimalarial drugs on Plasmodium falciparum malaria associated anemia (MAA), we use the area under curve (AUC) of anemia levels after treatment as an approach to combine their duration and magnitude. The method involves numerical estimation, by trapezoidal rule, of AUC from a plot of deficit in hematocrit levels from 30% (the lower threshold of normal) versus time in anemic children. Using the method, we evaluated, in randomized trials, the effects of artesunate-mefloquine (AMQ) versus mefloquine alone (MQ), and artemether-lumefantrine (AL) versus amodiaquine-artesunate (AA) on the time-course of recovery from MAA in 109 children. Anemia resolution times were similar (10.9 ± 6.2 [SD] vs 13.3 ± 8.9 d, P = 0.2) but mean AUC was significantly lower in AMQ- compared to MQ- treated children (35.5 ± 7.1 [SEM] vs 49.8 ± 11.3 %.h, P = 0.02) indicating larger exposure to anemia in MQ-treated children. In ALand AA- treated children, both anemia resolution times (8.6 ± 5.3 [SD] vs 8.6 ± 4.8 d, P = 0.98) and mean AUC (57.1 ± 12.9 [SEM] vs 46.3 ± 8.7 %.h, P = 0.74) were similar. Estimation of AUC appears more robust than estimation of anemia resolution time in evaluating antimalarial drug effects and can be used in both observational studies and clinical trials assessing the effects of therapies on MAA.

Item Type: Article
Uncontrolled Keywords: area under curve (AUC);malarial anemia antimalarial drugs; children
Subjects: Q Science > QH Natural history > QH301 Biology
R Medicine > RM Therapeutics. Pharmacology
Divisions: Faculty of Medicine, Health and Life Sciences > School of Biological Sciences
Depositing User: Mrs Patricia Nwokealisi
Date Deposited: 02 Oct 2014 10:51
Last Modified: 02 Oct 2014 10:51

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