Comparison of chlorproguanil-dapsone with sulfadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in young African children: double-blind randomised controlled trial

Alloueche, Ali; Bailey, W. S.; Barton, Sarah; Bwika, Juma; Chimpeni, Phillips; Falade, CO; Fehintola, F. A.; Horton, John; Jaffar, Shabbar; Kanyok, Thomas P.; Kremsner, P. G.; Kublin, James G.; Lang, Trudie; Missinou, MA; Mkandala, Christopher; Premji, Z; Robertson, Lindsay; Sowunmi, A.; Ward, Stephen A.; Winstanley, PA; Oduola, A. M. J.

doi:10.1016/s0140-6736(04)16350-2

Cited by 94 publications

(84 citation statements)

References 22 publications

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“…A standard single dose of SP was also well tolerated and achieved the same degree of efficacy as FC. This level of efficacy was notably higher than that expected from previous studies (1,13,14).…”

contrasting

confidence: 65%

Randomized Controlled Trial of Fosmidomycin-Clindamycin versus Sulfadoxine-Pyrimethamine in the Treatment of Plasmodium falciparum Malaria

Oyakhirome

Issifou

Pongratz

et al. 2007

Antimicrob Agents Chemother

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Fosmidomycin-clindamycin therapy given every 12 h for 3 days was compared with a standard single oral dose of sulfadoxine-pyrimethamine. The two treatments showed comparably good tolerabilities and had an identical high degree of efficacy of 94% in a randomized trial carried out with 105 Gabonese children aged 3 to 14 years with uncomplicated malaria. These antimalarials merit further clinical exploration.

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contrasting

confidence: 65%

Randomized Controlled Trial of Fosmidomycin-Clindamycin versus Sulfadoxine-Pyrimethamine in the Treatment of Plasmodium falciparum Malaria

Oyakhirome

Issifou

Pongratz

et al. 2007

Antimicrob Agents Chemother

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“…The major CPG-DDS safety study by Alloueche and others 4 retrospectively genotyped some patients with hemoglobin drops of ≥ 20 g/L versus baseline and compared them to controls. However, because of sample bias and hemoglobin readings not being collected at the appropriate time points, the hemolytic potential of CPG-DDS in G6PD-deficient patients could not be fully determined.…”

Section: Discussionmentioning

confidence: 99%

“…In a pivotal study of 1,850 children, CPG-DDS had Day 14 cure rates of 93-99% and was more effective than sulfadoxinepyrimethamine (SP) in three of five African countries. 4 Artemisinin derivatives are active against multidrug-resistant P. falciparum , 5,6 rapidly reduce asexual parasitemia, 7,8 and are gametocytocidal, potentially reducing transmission. [9][10][11][12][13] However, the short half-life of these agents precludes their use as monotherapy for uncomplicated malaria.…”

Section: Introductionmentioning

confidence: 99%

“…A clinical safety trial of CPG-DDS suggested that the hemolytic effect of dapsone might be compounded in malaria patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency, though data were insufficient to fully assess the clinical significance of the findings. 4,16 G6PD deficiency is X-linked, therefore more common in males. 17 In hemizygous males, the most common African variant, G6PD A−, results in 10-15% of normal enzyme activity.…”

Section: Introductionmentioning

confidence: 99%

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Chlorproguanil–Dapsone–Artesunate versus Chlorproguanil–Dapsone: A Randomized, Double-Blind, Phase III Trial in African Children, Adolescents, and Adults with Uncomplicated Plasmodium falciparum Malaria

Tiono¹,

Dicko²,

Ndububa³

et al. 2009

The American Journal of Tropical Medicine and Hygiene

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Abstract. This multi-center, randomized, parallel-group, double-blind, double-dummy study compared the efficacy and safety of chlorproguanil-dapsone-artesunate (CDA) and chlorproguanil-dapsone (CPG-DDS) in the treatment of falciparum malaria in Africa (Burkina Faso, Ghana, Mali, Nigeria). Six hundred patients (≥ 1 year of age) received CDA 2.0/2.5/4.0 mg/kg, and 292 CPG-DDS 2.0/2.5 mg/kg, once daily for 3 days. Day 28 parasitologic cure rate (polymerase chain reaction [PCR]-corrected, per-protocol population) was 89.1% (416/467) for CDA, non-inferior but also superior to CPG-DDS, 83.0% (176/212) (treatment difference 6.1%; 95% confidence interval [CI] 0.3, 11.9). Glucose-6-phosphate dehydrogenase (G6PD) genotype was available for 844/892 (95%) patients. Occurrences of a composite hemoglobin safety endpoint (hemoglobin drop ≥ 40 g/L or ≥ 40% versus baseline, hemoglobin < 50 g/L, or blood transfusion) were CDA 13/44 (30%), CPG-DDS 7/24 (29%) in G6PD-deficient patients versus CDA 4/448 (< 1%), CPG-DDS 6/221 (3%) in G6PD-normal patients. No deaths occurred. CDA was more efficacious than CPG-DDS. However, the hemolytic potential in G6PD-deficient patients does not support further development of CDA.

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“…In fact, Lapdap has been efficacious in recent clinical trials in children in Blantyre (2,16), suggesting that the DHFR-164 mutation remains rare. Nevertheless, continued surveillance for these mutations is needed, as is confirmation that these mutations are associated with high levels of clinical SP and Lapdap resistance.…”

mentioning

confidence: 99%

Mutations Associated with Sulfadoxine-Pyrimethamine and Chlorproguanil Resistance in Plasmodium falciparum Isolates from Blantyre, Malawi

Alker

Mwapasa

Purfield

et al. 2005

Antimicrob Agents Chemother

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Comparison of chlorproguanil-dapsone with sulfadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in young African children: double-blind randomised controlled trial

Cited by 94 publications

References 22 publications

Randomized Controlled Trial of Fosmidomycin-Clindamycin versus Sulfadoxine-Pyrimethamine in the Treatment of Plasmodium falciparum Malaria

Randomized Controlled Trial of Fosmidomycin-Clindamycin versus Sulfadoxine-Pyrimethamine in the Treatment of Plasmodium falciparum Malaria

Chlorproguanil–Dapsone–Artesunate versus Chlorproguanil–Dapsone: A Randomized, Double-Blind, Phase III Trial in African Children, Adolescents, and Adults with Uncomplicated Plasmodium falciparum Malaria

Mutations Associated with Sulfadoxine-Pyrimethamine and Chlorproguanil Resistance in Plasmodium falciparum Isolates from Blantyre, Malawi

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