Deux hépatites fulminantes survenues au cours d’un traitement curatif par l’association artésunate–amodiaquine

Guévart, E.; Aguemon, A. R.

doi:10.1016/j.medmal.2008.09.024

Cited by 15 publications

(9 citation statements)

References 8 publications

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“…Changes in renal and hepatic biochemical makers were not clinically significant. These results are in accordance with those reported before [25,35], but in contrast with recent results where ASAT and ALAT levels were elevated during treatment with oral AS + AQ, AQ was incriminated for the outcome [39,40]. Throughout the treatment, an increase in WBC counts was observed in three patients from the group receiving AS + AQ and two from the PR 259 CT1 group.…”

supporting

confidence: 92%

Antimalarial Efficacy of a Quantified Extract of Nauclea pobeguinii Stem Bark in Human Adult Volunteers with Diagnosed Uncomplicated falciparum Malaria. Part 2: A Clinical Phase IIB Trial

et al. 2012

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According to the promising results of the Phase I and Phase IIA clinical trials with the herbal medicinal product PR 259 CT1 consisting of an 80 % ethanolic extract of the stem bark of Nauclea pobeguinii containing 5.6 % strictosamide, a Phase IIB study was conducted as a single blind prospective trial in 65 patients with proven Plasmodium falciparum malaria to evaluate the effectiveness and safety of this herbal drug. The study was carried out simultaneously using an artesunate-amodiaquine combination (Coarsucam®) as a positive control. This combination is the standard first-line treatment for uncomplicated malaria recommended by the National Programme of Malaria Control in the Democratic Republic of Congo (DR Congo). With regard to PR 259 CT1, patients were treated with a drug regimen of two 500-mg capsules three times daily for three days in the inpatient clinic, followed by out-patient treatment of one 500-mg capsule three times daily during the next four days; the positive control group received two tablets containing 100 mg artesunate and 270 mg amodiaquine (fixed-dose) once daily during three consecutive days. Antimalarial responses were evaluated according to the WHO 2003 guideline for a 14-day test. The results from the physical and laboratory examinations did not show any significant changes in values of vital signs, ECG, biochemical, and haematological parameters. The study showed a significant decreased parasitaemia in patients treated with PR 29 CT1 and artesunate-amodiaquine with adequate clinical parasitological responses (APCR) at day 14 of 87.9 and 96.9 %, respectively. The former product was better tolerated than the latter since more side effects were observed for the artesunate-amodiaquine combination. These results indicated that PR 259 CT1 can be considered as a promising candidate for the development of a herbal medicine for the treatment of uncomplicated falciparum malaria.

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supporting

confidence: 92%

Antimalarial Efficacy of a Quantified Extract of Nauclea pobeguinii Stem Bark in Human Adult Volunteers with Diagnosed Uncomplicated falciparum Malaria. Part 2: A Clinical Phase IIB Trial

et al. 2012

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“…Artemisinin-derivatives are a cornerstone for the treatment but not chemoprevention of malaria (2). Despite their extensive use, artemisinin-derivative liver injury has rarely been described (8, 10). As far as we know, this is the first case report of an acute cholestatic hepatitis due to the intake of Artemisia annua tea.…”

Section: Discussionmentioning

confidence: 99%

“…Herbal and dietary supplements (HDS) are increasingly used worldwide and HDS-induced liver injury is becoming a growing concern (7). Despite the extensive use of ACTs in malaria-endemic areas, artemisinin-derivative liver injury is rare (8, 9). Kumar reported a case of a patient who developed a cholestatic liver injury 6 weeks after taking a herbal supplement containing artemisinin orally for general health maintenance (10).…”

Section: Introductionmentioning

confidence: 99%

Danger of Herbal Tea: A Case of Acute Cholestatic Hepatitis Due to Artemisia annua Tea

et al. 2019

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Background: Artemisia annua is a Chinese medicinal herb. Artemisinin-derivatives are recommended as part of a combination treatment for uncomplicated malaria. Herbal and dietary supplements (HDS) are increasingly used worldwide and HDS-induced liver injury is becoming a growing concern.Case Report: We present the first case of severe acute cholestatic hepatitis due to the intake of Artemisia annua tea as chemoprophylaxis for malaria in a patient returning from Ethiopia. The patients presented with jaundice, elevated transaminases, and parameters of cholestasis (total bilirubin 186.6 μmol/L, conjugated bilirubin 168.5 μmol/L). A liver biopsy showed a portal hepatitis with lymphocytic infiltration of the bile ducts and diffuse intra-canalicular and intra-cytoplasmic bilirubinostasis. The toxicologic analysis of the Artemisia tea revealed the ingredients arteannuin b, deoxyartemisin, campher, and scopoletin. There were no other identifiable etiologies of liver disease. The Roussel Uclaf Causality Assessment Method (RUCAM) score assessed a “probably” causal relationship. Sequencing of genes encoding for hepatic transporters for bile acid homeostasis (BSEP, MDR3, and FIC1) found no genetic variants typically associated with hereditary cholestasis syndromes. Normalization of bilirubin occurred 3 months after the onset of disease.Conclusion: The use of artemisinin-derivatives for malaria prevention is ineffective and potentially harmful and should thus be discouraged. Moreover, the case demonstrates our as yet inadequate understanding of the pathophysiology and susceptibility to HDS induced liver injury.

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“…According to WHO, first-line treatment for uncomplicated malaria in high-endemicity areas consists of a combination of either artemether plus lumefantrine or artesunate plus one of the following drugs: amodiaquine, mefloquine, or sulfadoxine–pyrimethamine, or dihydroartemisinin–piperaquine 1. Interactions between amodiaquine and efavirenz has been reported reflecting in higher amodiquine concentrations;70 these evidences may have a clinical impact, as a significant number of HIV-infected patients in sub-Saharan Africa receive an efavirenz-based treatment57 and WHO contraindicates this co-administration;27 furthermore, given that these drugs are both potentially hepatotoxic71,72 patients prescribing this combination have to be strictly monitored. Finally, we know that quinine, halofantrine, and lumefantrine are all antimalarial drugs metabolized through the cytochrome P-450 enzyme system;73,74 so that, these drugs may potentially interact with the non-nucleoside reverse transcriptase inhibitors (NNRTIs) resulting in reduced bioavailability of the antimalarial drugs 75.…”

Section: Interactions Between Antiretrovirals and Antimalarial Agentsmentioning

confidence: 99%

MALARIA AND HIV IN ADULTS: When The Parasite runs into The Virus

Focà

Odolini

Brianese

et al. 2012

Mediterr J Hematol Infect Dis

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Malaria and HIV/AIDS are among the principal causes of morbidity and mortality worldwide, particularly in resource-limited settings such as sub-Saharan Africa. Despite the international community’s efforts to reduce incidence and prevalence of these diseases, they remain a global public health problem. Clinical manifestations of malaria may be more severe in HIV infected patients, which have higher risks of severe malaria and malaria related death. Co-infected pregnant women, children and international travelers from non-malaria endemic countries are at higher risk of clinical complications. However, there is a paucity and conflicting data regarding malaria and HIV co-infection, particularly on how HIV infection can modify the response to antimalarial drugs and about drug-interactions between antiretroviral agents and artemisinin-based combined regimens. Moreover, consulting HIV-infected international travelers and physicians specialized in HIV care and travel medicine should prescribe an adequate chemoprophylaxis in patients travelling towards malaria endemic areas and pay attention on interactions between antiretrovirals and antimalarial prophylaxis drugs in order to prevent clinical complications of this co-infection.This review aims to evaluate the available international literature on malaria and HIV co-infection in adults providing a critical comprehensive review of nowadays knowledge.

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Deux hépatites fulminantes survenues au cours d’un traitement curatif par l’association artésunate–amodiaquine

Cited by 15 publications

References 8 publications

Antimalarial Efficacy of a Quantified Extract of Nauclea pobeguinii Stem Bark in Human Adult Volunteers with Diagnosed Uncomplicated falciparum Malaria. Part 2: A Clinical Phase IIB Trial

Antimalarial Efficacy of a Quantified Extract of Nauclea pobeguinii Stem Bark in Human Adult Volunteers with Diagnosed Uncomplicated falciparum Malaria. Part 2: A Clinical Phase IIB Trial

Danger of Herbal Tea: A Case of Acute Cholestatic Hepatitis Due to Artemisia annua Tea

MALARIA AND HIV IN ADULTS: When The Parasite runs into The Virus

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