An Individual Participant Data Population Pharmacokinetic Meta-analysis of Drug-Drug Interactions between Lumefantrine and Commonly Used Antiretroviral Treatment

Author:

Francis Jose12,Barnes Karen I.12ORCID,Workman Lesley12,Kredo Tamara13,Vestergaard Lasse S.456,Hoglund Richard M.78,Byakika-Kibwika Pauline910,Lamorde Mohammed10,Walimbwa Stephen I.10,Chijioke-Nwauche Ifeyinwa11,Sutherland Colin J.12ORCID,Merry Concepta13,Scarsi Kimberley K.14,Nyagonde Nyagonde415,Lemnge Martha M.15,Khoo Saye H.16,Bygbjerg Ib C.5,Parikh Sunil17,Aweeka Francesca T.18,Tarning Joel7819ORCID,Denti Paolo12ORCID

Affiliation:

1. Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa

2. WorldWide Antimalarial Resistance Network (WWARN) Pharmacology/Southern African Regional Centre, University of Cape Town, Cape Town, South Africa

3. Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa

4. Muheza District Hospital, Muheza, Tanzania

5. Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark

6. Department of Infectious Disease Epidemiology and Prevention, and Parasitology Laboratory, Statens Serum Institut, Copenhagen, Denmark

7. Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

8. Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom

9. Department of Medicine, Makerere University, Kampala, Uganda

10. Infectious Diseases Institute, Makerere University, Kampala, Uganda

11. Department of Clinical Pharmacy and Management, Faculty of Pharmaceutical Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria

12. Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom

13. Department of Clinical Medicine, Trinity College, Dublin, Ireland

14. Department of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, Nebraska, USA

15. Tanga Research Centre, National Institute for Medical Research (NIMR), Tanga, Tanzania

16. Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom

17. Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA

18. Drug Research Unit, University of California, San Francisco, San Francisco, California, USA

19. WorldWide Antimalarial Resistance Network (WWARN) Pharmacometrics/Asia Regional Centre, Mahidol University, Bangkok, Thailand

Abstract

Treating malaria in HIV-coinfected individuals should consider potential drug-drug interactions. Artemether-lumefantrine is the most widely recommended treatment for uncomplicated malaria globally. Lumefantrine is metabolized by CYP3A4, an enzyme that commonly used antiretrovirals often induce or inhibit. A population pharmacokinetic meta-analysis was conducted using individual participant data from 10 studies with 6,100 lumefantrine concentrations from 793 nonpregnant adult participants (41% HIV-malaria-coinfected, 36% malaria-infected, 20% HIV-infected, and 3% healthy volunteers).

Funder

South African National Research Foundation

Bill and Melinda Gates Foundation

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology

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