An Individual Participant Data Population Pharmacokinetic Meta-analysis of Drug-Drug Interactions between Lumefantrine and Commonly Used Antiretroviral Treatment
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 in...
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| Veröffentlicht in: | Antimicrobial agents and chemotherapy 2020-04, Vol.64 (5), Article 02394 |
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| creator | Francis, Jose Barnes, Karen I. Workman, Lesley Kredo, Tamara Vestergaard, Lasse S. Hoglund, Richard M. Byakika-Kibwika, Pauline Lamorde, Mohammed Walimbwa, Stephen I. Chijioke-Nwauche, Ifeyinwa Sutherland, Colin J. Merry, Concepta Scarsi, Kimberley K. Nyagonde, Nyagonde Lemnge, Martha M. Khoo, Saye H. Bygbjerg, Ib C. Parikh, Sunil Aweeka, Francesca T. Tarning, Joel Denti, Paolo |
| description | 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). Lumefantrine exposure increased 3.4-fold with coadministration of lopinavir-ritonavir-based antiretroviral therapy (ART), while it decreased by 47% with efavirenz-based ART and by 59% in the patients with rifampin-based antituberculosis treatment. Nevirapine- or dolutegravir-based ART and malaria or HIV infection were not associated with significant effects. Monte Carlo simulations showed that those on concomitant efavirenz or rifampin have 49% and 80% probability of day 7 concentrations < 200 ng/ml, respectively, a threshold associated with an increased risk of treatment failure. The risk of achieving subtherapeutic concentrations increases with larger body weight. An extended 5-day and 6-day artemether-lumefantrine regimen is predicted to overcome these drug-drug interactions with efavirenz and rifampin, respectively. |
| doi_str_mv | 10.1128/AAC.02394-19 |
| format | Article |
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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). Lumefantrine exposure increased 3.4-fold with coadministration of lopinavir-ritonavir-based antiretroviral therapy (ART), while it decreased by 47% with efavirenz-based ART and by 59% in the patients with rifampin-based antituberculosis treatment. Nevirapine- or dolutegravir-based ART and malaria or HIV infection were not associated with significant effects. Monte Carlo simulations showed that those on concomitant efavirenz or rifampin have 49% and 80% probability of day 7 concentrations < 200 ng/ml, respectively, a threshold associated with an increased risk of treatment failure. The risk of achieving subtherapeutic concentrations increases with larger body weight. An extended 5-day and 6-day artemether-lumefantrine regimen is predicted to overcome these drug-drug interactions with efavirenz and rifampin, respectively.</description><identifier>ISSN: 0066-4804</identifier><identifier>EISSN: 1098-6596</identifier><identifier>DOI: 10.1128/AAC.02394-19</identifier><identifier>PMID: 32071050</identifier><language>eng</language><publisher>WASHINGTON: Amer Soc Microbiology</publisher><subject>Adolescent ; Adult ; Aged ; Anti-HIV Agents - pharmacokinetics ; Anti-HIV Agents - therapeutic use ; Antimalarials - pharmacokinetics ; Antimalarials - therapeutic use ; Antiretroviral Therapy, Highly Active ; Artemether, Lumefantrine Drug Combination - pharmacokinetics ; Artemether, Lumefantrine Drug Combination - therapeutic use ; Body Weight ; Clinical Therapeutics ; Computer Simulation ; Drug Interactions ; Female ; HIV Infections - complications ; HIV Infections - drug therapy ; Humans ; Life Sciences & Biomedicine ; Lopinavir - pharmacokinetics ; Lopinavir - therapeutic use ; Lumefantrine - pharmacokinetics ; Lumefantrine - therapeutic use ; Malaria - complications ; Malaria - drug therapy ; Male ; Microbiology ; Middle Aged ; Monte Carlo Method ; Pharmacology & Pharmacy ; Ritonavir - pharmacokinetics ; Ritonavir - therapeutic use ; Science & Technology ; Young Adult</subject><ispartof>Antimicrobial agents and chemotherapy, 2020-04, Vol.64 (5), Article 02394</ispartof><rights>Copyright © 2020 Francis et al.</rights><rights>Copyright © 2020 Francis et al. 2020 Francis et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>9</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000528256200061</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-a418t-b81352def985d76c5168ad8bbe9c4fe9e0075353c3067fdd691eacc0d6e0a23f3</citedby><cites>FETCH-LOGICAL-a418t-b81352def985d76c5168ad8bbe9c4fe9e0075353c3067fdd691eacc0d6e0a23f3</cites><orcidid>0000-0002-2769-0967 ; 0000-0001-7494-079X ; 0000-0003-1592-6407 ; 0000-0001-9100-2754 ; 0000-0003-4566-4030 ; 0000-0002-3825-3260 ; 0000-0002-5547-820X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7179577/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7179577/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,886,27929,27930,28253,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32071050$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Francis, Jose</creatorcontrib><creatorcontrib>Barnes, Karen I.</creatorcontrib><creatorcontrib>Workman, Lesley</creatorcontrib><creatorcontrib>Kredo, Tamara</creatorcontrib><creatorcontrib>Vestergaard, Lasse S.</creatorcontrib><creatorcontrib>Hoglund, Richard M.</creatorcontrib><creatorcontrib>Byakika-Kibwika, Pauline</creatorcontrib><creatorcontrib>Lamorde, Mohammed</creatorcontrib><creatorcontrib>Walimbwa, Stephen I.</creatorcontrib><creatorcontrib>Chijioke-Nwauche, Ifeyinwa</creatorcontrib><creatorcontrib>Sutherland, Colin J.</creatorcontrib><creatorcontrib>Merry, Concepta</creatorcontrib><creatorcontrib>Scarsi, Kimberley K.</creatorcontrib><creatorcontrib>Nyagonde, Nyagonde</creatorcontrib><creatorcontrib>Lemnge, Martha M.</creatorcontrib><creatorcontrib>Khoo, Saye H.</creatorcontrib><creatorcontrib>Bygbjerg, Ib C.</creatorcontrib><creatorcontrib>Parikh, Sunil</creatorcontrib><creatorcontrib>Aweeka, Francesca T.</creatorcontrib><creatorcontrib>Tarning, Joel</creatorcontrib><creatorcontrib>Denti, Paolo</creatorcontrib><title>An Individual Participant Data Population Pharmacokinetic Meta-analysis of Drug-Drug Interactions between Lumefantrine and Commonly Used Antiretroviral Treatment</title><title>Antimicrobial agents and chemotherapy</title><addtitle>ANTIMICROB AGENTS CH</addtitle><addtitle>Antimicrob Agents Chemother</addtitle><addtitle>Antimicrob Agents Chemother</addtitle><description>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). Lumefantrine exposure increased 3.4-fold with coadministration of lopinavir-ritonavir-based antiretroviral therapy (ART), while it decreased by 47% with efavirenz-based ART and by 59% in the patients with rifampin-based antituberculosis treatment. Nevirapine- or dolutegravir-based ART and malaria or HIV infection were not associated with significant effects. Monte Carlo simulations showed that those on concomitant efavirenz or rifampin have 49% and 80% probability of day 7 concentrations < 200 ng/ml, respectively, a threshold associated with an increased risk of treatment failure. The risk of achieving subtherapeutic concentrations increases with larger body weight. An extended 5-day and 6-day artemether-lumefantrine regimen is predicted to overcome these drug-drug interactions with efavirenz and rifampin, respectively.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anti-HIV Agents - pharmacokinetics</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antimalarials - pharmacokinetics</subject><subject>Antimalarials - therapeutic use</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Artemether, Lumefantrine Drug Combination - pharmacokinetics</subject><subject>Artemether, Lumefantrine Drug Combination - therapeutic use</subject><subject>Body Weight</subject><subject>Clinical Therapeutics</subject><subject>Computer Simulation</subject><subject>Drug Interactions</subject><subject>Female</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>Humans</subject><subject>Life Sciences & Biomedicine</subject><subject>Lopinavir - pharmacokinetics</subject><subject>Lopinavir - therapeutic use</subject><subject>Lumefantrine - pharmacokinetics</subject><subject>Lumefantrine - therapeutic use</subject><subject>Malaria - complications</subject><subject>Malaria - drug therapy</subject><subject>Male</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Monte Carlo Method</subject><subject>Pharmacology & Pharmacy</subject><subject>Ritonavir - pharmacokinetics</subject><subject>Ritonavir - therapeutic use</subject><subject>Science & Technology</subject><subject>Young Adult</subject><issn>0066-4804</issn><issn>1098-6596</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><recordid>eNqNkkFv1DAUhCMEokvhxhn5itoUO4kT-4IUpQUqLWIP7Tl6sV9al429sp2t9ufwT_F2YQUHJC62LH8zb-Rxlr1l9IKxQnxo2-6CFqWsciafZQtGpchrLuvn2YLSus4rQauT7FUIDzSduaQvs5OyoA2jnC6yH60l11abrdEzrMkKfDTKbMBGcgkRyMpt5jVE4yxZ3YOfQLnvxmKCyFeMkIOF9S6YQNxILv18l--X5BjRg9rLAhkwPiJaspwnHJOxT3oCVpPOTZOz6x25DahJa6PxGL3bGp-S3HiEOKGNr7MXI6wDvvm1n2a3n65uui_58tvn665d5lAxEfNBsJIXGkcpuG5qxVktQIthQKmqESVS2vCSl6qkdTNqXUuGoBTVNVIoyrE8zT4efDfzMKFWaXTK0W-8mcDvegem__vGmvv-zm37hjWSN00yOD8YKO9C8DgetYz2-6r6VFX_VFXPZMLfH3AIU9E_uNmnpwz_Yt_9me1o_LvHBJwdgEcc3BiUQavwiKXieSEKXhf7L8ASLf6f7kx86r9zs43lT7oOwgM</recordid><startdate>20200421</startdate><enddate>20200421</enddate><creator>Francis, Jose</creator><creator>Barnes, Karen I.</creator><creator>Workman, Lesley</creator><creator>Kredo, Tamara</creator><creator>Vestergaard, Lasse S.</creator><creator>Hoglund, Richard M.</creator><creator>Byakika-Kibwika, Pauline</creator><creator>Lamorde, Mohammed</creator><creator>Walimbwa, Stephen I.</creator><creator>Chijioke-Nwauche, Ifeyinwa</creator><creator>Sutherland, Colin J.</creator><creator>Merry, Concepta</creator><creator>Scarsi, Kimberley K.</creator><creator>Nyagonde, Nyagonde</creator><creator>Lemnge, Martha M.</creator><creator>Khoo, Saye H.</creator><creator>Bygbjerg, Ib C.</creator><creator>Parikh, Sunil</creator><creator>Aweeka, Francesca T.</creator><creator>Tarning, Joel</creator><creator>Denti, Paolo</creator><general>Amer Soc Microbiology</general><general>American Society for Microbiology</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2769-0967</orcidid><orcidid>https://orcid.org/0000-0001-7494-079X</orcidid><orcidid>https://orcid.org/0000-0003-1592-6407</orcidid><orcidid>https://orcid.org/0000-0001-9100-2754</orcidid><orcidid>https://orcid.org/0000-0003-4566-4030</orcidid><orcidid>https://orcid.org/0000-0002-3825-3260</orcidid><orcidid>https://orcid.org/0000-0002-5547-820X</orcidid></search><sort><creationdate>20200421</creationdate><title>An Individual Participant Data Population Pharmacokinetic Meta-analysis of Drug-Drug Interactions between Lumefantrine and Commonly Used Antiretroviral Treatment</title><author>Francis, Jose ; 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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). Lumefantrine exposure increased 3.4-fold with coadministration of lopinavir-ritonavir-based antiretroviral therapy (ART), while it decreased by 47% with efavirenz-based ART and by 59% in the patients with rifampin-based antituberculosis treatment. Nevirapine- or dolutegravir-based ART and malaria or HIV infection were not associated with significant effects. Monte Carlo simulations showed that those on concomitant efavirenz or rifampin have 49% and 80% probability of day 7 concentrations < 200 ng/ml, respectively, a threshold associated with an increased risk of treatment failure. The risk of achieving subtherapeutic concentrations increases with larger body weight. 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| fulltext | fulltext |
| identifier | ISSN: 0066-4804 |
| ispartof | Antimicrobial agents and chemotherapy, 2020-04, Vol.64 (5), Article 02394 |
| issn | 0066-4804 1098-6596 |
| language | eng |
| recordid | cdi_asm2_journals_10_1128_AAC_02394_19 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; PubMed Central |
| subjects | Adolescent Adult Aged Anti-HIV Agents - pharmacokinetics Anti-HIV Agents - therapeutic use Antimalarials - pharmacokinetics Antimalarials - therapeutic use Antiretroviral Therapy, Highly Active Artemether, Lumefantrine Drug Combination - pharmacokinetics Artemether, Lumefantrine Drug Combination - therapeutic use Body Weight Clinical Therapeutics Computer Simulation Drug Interactions Female HIV Infections - complications HIV Infections - drug therapy Humans Life Sciences & Biomedicine Lopinavir - pharmacokinetics Lopinavir - therapeutic use Lumefantrine - pharmacokinetics Lumefantrine - therapeutic use Malaria - complications Malaria - drug therapy Male Microbiology Middle Aged Monte Carlo Method Pharmacology & Pharmacy Ritonavir - pharmacokinetics Ritonavir - therapeutic use Science & Technology Young Adult |
| title | An Individual Participant Data Population Pharmacokinetic Meta-analysis of Drug-Drug Interactions between Lumefantrine and Commonly Used Antiretroviral Treatment |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-11T23%3A35%3A37IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-pubmed_asm2_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=An%20Individual%20Participant%20Data%20Population%20Pharmacokinetic%20Meta-analysis%20of%20Drug-Drug%20Interactions%20between%20Lumefantrine%20and%20Commonly%20Used%20Antiretroviral%20Treatment&rft.jtitle=Antimicrobial%20agents%20and%20chemotherapy&rft.au=Francis,%20Jose&rft.date=2020-04-21&rft.volume=64&rft.issue=5&rft.artnum=02394&rft.issn=0066-4804&rft.eissn=1098-6596&rft_id=info:doi/10.1128/AAC.02394-19&rft_dat=%3Cpubmed_asm2_%3E32071050%3C/pubmed_asm2_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/32071050&rfr_iscdi=true |