Use of Area Under the Curve to Evaluate the Effects of Antimalarial Drugs on Malaria-Associated Anemia After Treatment

• DOI: 10.1097/mjt.0b013e3181d169c9
• Publication Date: 2010-07-30T09:54:49Z
• Authors: Akintunde Sowunmi; Grace Olusola Gbo...; Christian Tientch...; Onikepe Folarin; Titilope Okuboyejo; Obaro Michael; Bayo Fatunmbi
• Keywords: Artesunate; Artemether; Amodiaquine; Lumefantrine

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