PMID- 24175945
OWN - NLM
STAT- MEDLINE
DCOM- 20140820
LR  - 20211021
IS  - 1475-2875 (Electronic)
IS  - 1475-2875 (Linking)
VI  - 12
DP  - 2013 Nov 1
TI  - Comparative safety of artemether-lumefantrine and other artemisinin-based 
      combinations in children: a systematic review.
PG  - 385
LID - 10.1186/1475-2875-12-385 [doi]
AB  - BACKGROUND: The purpose of the study was to compare the safety of 
      artemether-lumefantrine (AL) with other artemisinin-based combinations in 
      children. METHODS: A search of EMBASE (from 1974 to April 2013), MEDLINE (from 
      1946 to April 2013) and the Cochrane library of registered controlled trials for 
      randomized controlled trials (RCTs) which compared AL with other 
      artemisinin-based combinations was done. Only studies involving children </= 17 
      years old in which safety of AL was an outcome measure were included. RESULTS: 
      Four thousand, seven hundred and twenty six adverse events (AEs) were recorded in 
      6,000 patients receiving AL. Common AEs (>/= 1/100 and <1/10) included: coryza, 
      vomiting, anaemia, diarrhoea, vomiting and abdominal pain; while cough was the 
      only very commonly reported AE (>/= 1/10). AL-treated children have a higher risk 
      of body weakness (64.9%) than those on artesunate-mefloquine (58.2%) (p = 0.004, 
      RR: 1.12 95% CI: 1.04-1.21). The risk of vomiting was significantly lower in 
      patients on AL (8.8%) than artesunate-amodiaquine (10.6%) (p = 0.002, RR: 0.76, 
      95% CI: 0.63-0.90). Similarly, children on AL had a lower risk of vomiting (1.2%) 
      than chlorproguanil-dapsone-artesunate (ACD) treated children (5.2%) (p = 0.002, 
      RR: 0.63, 95% CI: 0.47-0.85). The risk of serious adverse events was 
      significantly lower for AL (1.3%) than ACD (5.2%) (p = 0.002, RR: 0.45, 95% CI: 
      0.27-0.74). CONCLUSION: Artemether-lumefantrine combination is as safe as ASAQ 
      and DP for use in children. Common adverse events are cough and gastrointestinal 
      symptoms. More studies comparing AL with artesunate-mefloquine and 
      artesunate-azithromycin are needed to determine the comparative safety of these 
      drugs.
FAU - Egunsola, Oluwaseun
AU  - Egunsola O
AD  - Academic Division of Child Health, University of Nottingham, Derbyshire 
      Children's Hospital, Derby DE22 3DT, UK. mzxoe@nottingham.ac.uk.
FAU - Oshikoya, Kazeem A
AU  - Oshikoya KA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20131101
PL  - England
TA  - Malar J
JT  - Malaria journal
JID - 101139802
RN  - 0 (Antimalarials)
RN  - 0 (Artemether, Lumefantrine Drug Combination)
RN  - 0 (Artemisinins)
RN  - 0 (Drug Combinations)
RN  - 0 (Ethanolamines)
RN  - 0 (Fluorenes)
RN  - 9RMU91N5K2 (artemisinin)
SB  - IM
MH  - Adolescent
MH  - Antimalarials/*administration & dosage/*adverse effects
MH  - Artemether, Lumefantrine Drug Combination
MH  - Artemisinins/*administration & dosage/*adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Cough/chemically induced/pathology
MH  - Drug Combinations
MH  - Drug-Related Side Effects and Adverse Reactions/epidemiology/pathology
MH  - Dyspepsia/chemically induced/pathology
MH  - Ethanolamines/*administration & dosage/*adverse effects
MH  - Fluorenes/*administration & dosage/*adverse effects
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Randomized Controlled Trials as Topic
PMC - PMC3818443
EDAT- 2013/11/02 06:00
MHDA- 2014/08/21 06:00
PMCR- 2013/11/01
CRDT- 2013/11/02 06:00
PHST- 2013/07/10 00:00 [received]
PHST- 2013/10/28 00:00 [accepted]
PHST- 2013/11/02 06:00 [entrez]
PHST- 2013/11/02 06:00 [pubmed]
PHST- 2014/08/21 06:00 [medline]
PHST- 2013/11/01 00:00 [pmc-release]
AID - 1475-2875-12-385 [pii]
AID - 10.1186/1475-2875-12-385 [doi]
PST - epublish
SO  - Malar J. 2013 Nov 1;12:385. doi: 10.1186/1475-2875-12-385.