Drug-drug Interactions between Lumefantrine and Commonly-used Antiretroviral Treatment: An Individual Participant Data Population Pharmacokinetic Meta-Analysis.

Drug-drug Interactions between Lumefantrine and Commonly-used Antiretroviral Treatment: An Individual Participant Data Population Pharmacokinetic Meta-Analysis. Antimicrob Agents Chemother. 2020 Feb 18;: Authors: Francis J, Barnes KI, Workman L, Kredo T, Vestergaard LS, Hoglund RM, Byakika-Kibwika P, Lamorde M, Walimbwa SI, Chijioke-Nwauche I, Sutherland CJ, Merry C, Scarsi KK, Nyagonde N, Lemnge MM, Khoo SH, Bygbjerg IC, Parikh S, Aweeka FT, Tarning J, Denti P Abstract Treating malaria in HIV co-infected 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 ten studies, with 6,100 lumefantrine concentrations from 793 non-pregnant adult participants (41% HIV-malaria co-infected, 36% malaria-infected, 20% HIV-infected, and 3% healthy volunteers). Lumefantrine exposure increased 3.4-fold with co-administration of lopinavir/ritonavir-based antiretroviral therapy (ART), while it decreased by 47% with efavirenz-based ART and by 59% in the patients with rifampicin-based anti-tuberculosis treatment. Nevirapine- or dolutegravir-based ART and malaria- or HIV-infection were not associated with significant effects. Monte Carlo simulatio...
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research