World Antimalarial Resistance Network (WARN) IV: Clinical pharmacology

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World Antimalarial Resistance Network (WARN) IV: Clinical pharmacology

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dc.contributor.author Barnes, Karen I. en_US
dc.contributor.author Lindegardh, Niklas en_US
dc.contributor.author Ogundahunsi, Olumide en_US
dc.contributor.author Olliaro, Piero en_US
dc.contributor.author Plowe, Christopher V. en_US
dc.contributor.author Randrianarievelojosia, Milijaona en_US
dc.contributor.author Gbotosho, Grace O. en_US
dc.contributor.author Watkins, William M. en_US
dc.contributor.author Sibley, Carol Hopkins en_US
dc.contributor.author White, Nicholas J. en_US
dc.date.accessioned 2010-05-06T20:06:11Z
dc.date.available 2010-05-06T20:06:11Z
dc.date.issued 2007 en_US
dc.identifier.citation Barnes K, Lindegardh N, Ogundahunsi O, et al. World Antimalarial Resistance Network (WARN) IV: Clinical pharmacology. Malaria Journal. 2007;6(1):122. en_US
dc.identifier.other 10.1186/1475-2875-6-122 en_US
dc.identifier.uri http://www.malariajournal.com/content/6/1/122 en_US
dc.identifier.uri http://hdl.handle.net/1773/15845
dc.description.abstract A World Antimalarial Resistance Network (WARN) database has the potential to improve the treatment of malaria, through informing current drug selection and use and providing a prompt warning of when treatment policies need changing. This manuscript outlines the contribution and structure of the clinical pharmacology component of this database. The determinants of treatment response are multi-factorial, but clearly providing adequate blood concentrations is pivotal to curing malaria. The ability of available antimalarial pharmacokinetic data to inform optimal dosing is constrained by the small number of patients studied, with even fewer (if any) studies conducted in the most vulnerable populations. There are even less data relating blood concentration data to the therapeutic response (pharmacodynamics). By pooling all available pharmacokinetic data, while paying careful attention to the analytical methodologies used, the limitations of small (and thus underpowered) individual studies may be overcome and factors that contribute to inter-individual variability in pharmacokinetic parameters defined. Key variables for pharmacokinetic studies are defined in terms of patient (or study subject) characteristics, the formulation and route of administration of the antimalarial studied, the sampling and assay methodology, and the approach taken to data analysis. Better defining these information needs and criteria of acceptability of pharmacokinetic-pharmacodynamic (PK-PD) studies should contribute to improving the quantity, relevance and quality of these studies. A better understanding of the pharmacokinetic properties of antimalarials and a more clear definition of what constitutes "therapeutic drug levels" would allow more precise use of the term "antimalarial resistance", as it would indicate when treatment failure is not caused by intrinsic parasite resistance but is instead the result of inadequate drug levels. The clinical pharmacology component of the WARN database can play a pivotal role in monitoring accurately for true antimalarial drug resistance and promptly correcting sub-optimal dosage regimens to prevent these contributing to the emergence and spread of antimalarial resistance. en_US
dc.description.sponsorship Bill and Melinda Gates Foundation. en_US
dc.language.iso en_US en_US
dc.title World Antimalarial Resistance Network (WARN) IV: Clinical pharmacology en_US
dc.type Article en_US


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