Artemisinin-based combination therapy for ... - The Cochrane Library

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Analysis 9.6. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 6 Proportion anaemic (Haemoglobin < 11 g/dl). Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 9 Artemether-lumefantrine vs Artesunate plus amodiaquine Outcome: 6 Proportion anaemic (Haemoglobin < 11 g/dl) Study or subgroup AL6 AS+AQ Risk Ratio Risk Ratio 1 At baseline n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Guthmann 2004 AGO 33/61 34/64 1.02 [ 0.73, 1.41 ] 2 At day 28 Guthmann 2004 AGO 8/60 10/63 0.84 [ 0.36, 1.98 ] 0.01 0.1 1 10 100 Favours AL6 Favours AS+AQ Analysis 9.7. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 7 Serious adverse events (including deaths). Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 9 Artemether-lumefantrine vs Artesunate plus amodiaquine Outcome: 7 Serious adverse events (including deaths) Study or subgroup AL6 AS+AQ Risk Ratio Risk Ratio n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Faye 2003 SEN 0/149 0/360 0.0 [ 0.0, 0.0 ] Mutabingwa 2004 TZA 1/519 0/515 2.98 [ 0.12, 72.91 ] Falade 2005 NGA 0/66 0/66 0.0 [ 0.0, 0.0 ] Bukirwa 2005 UGA 1/202 1/201 1.00 [ 0.06, 15.80 ] Dorsey 2006 UGA 14/202 15/232 1.07 [ 0.53, 2.17 ] Kobbe 2007 GHA 2/120 2/117 0.98 [ 0.14, 6.81 ] Total (95% CI) 1258 1491 1.11 [ 0.59, 2.08 ] Total events: 18 (AL6), 18 (AS+AQ) Heterogeneity: Chi 2 = 0.40, df = 3 (P = 0.94); I 2 =0.0% Test for overall effect: Z = 0.33 (P = 0.74) Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 0.01 0.1 1 10 100 Favours AL6 Favours AS+AQ 170
Analysis 9.8. Comparison 9 Artemether-lumefantrine vs Artesunate plus amodiaquine, Outcome 8 Early vomiting. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 9 Artemether-lumefantrine vs Artesunate plus amodiaquine Outcome: 8 Early vomiting Study or subgroup AL6 AS+AQ Risk Ratio Weight Risk Ratio n/N n/N M-H,Fixed,95% CI M-H,Fixed,95% CI Guthmann 2004 AGO 1/68 2/69 4.3 % 0.51 [ 0.05, 5.47 ] Falade 2005 NGA 4/66 5/66 10.9 % 0.80 [ 0.22, 2.85 ] Owusu-Agyei 2006 GHA 22/177 22/178 47.8 % 1.01 [ 0.58, 1.75 ] Adjei 2006 GHA 2/111 2/116 4.3 % 1.05 [ 0.15, 7.29 ] Kobbe 2007 GHA 11/123 15/123 32.7 % 0.73 [ 0.35, 1.53 ] Total (95% CI) 545 552 100.0 % 0.87 [ 0.59, 1.31 ] Total events: 40 (AL6), 46 (AS+AQ) Heterogeneity: Chi 2 = 0.72, df = 4 (P = 0.95); I 2 =0.0% Test for overall effect: Z = 0.66 (P = 0.51) 0.01 0.1 1 10 100 Favours AL6 Favours AS+AQ Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 171
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Artemisinin-based combination thera
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Analysis 2.2. Comparison 2 Dihydroa
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Analysis 10.5. Comparison 10 Arteme
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[Intervention Review] Artemisinin-b
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B A C K G R O U N D Malaria is a di
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drugs and the treatment comparisons
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this analysis into participants who
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Figure 1. Methodological quality su
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confidence intervals of the estimat
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Anaemia Hasugian 2005 IDN found tha
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Three trials report significantly m
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or those treated for P. vivax at ba
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Early vomiting Not reported. D I S
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Figure 4. Olliaro-Vaillant plot. Da
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Figure 10. Olliaro-Vaillant plot. D
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of findings tables’. For these ta
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Huambo and Bie provinces, central A
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References to studies excluded from
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Adjuik 2004 Adjuik M, Babiker A, Ga
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C H A R A C T E R I S T I C S O F S
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Ashley 2003a THA (Continued) Outcom
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Ashley 2003b THA (Continued) Alloca
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Ashley 2005 THA (Continued) Exclusi
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Bonnet 2004 GIN (Continued) Item Au
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Bukirwa 2005 UGA Methods Trial desi
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Djimde 2004 MLI (Continued) • AS
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Dorsey 2006 UGA (Continued) Item Au
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Fanello 2004 RWA Methods Trial desi
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Faye 2003 SEN (Continued) Outcomes
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Grande 2005 PER (Continued) Allocat
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Guthmann 2004 AGO (Continued) All d
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Hasugian 2005 IDN Methods Trial des
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Hutagalung 2002 THA (Continued) 5.
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Janssens 2003 KHM (Continued) Free
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Karema 2004 RWA (Continued) Interve
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Karunajeewa 2007 PNG (Continued) Ri
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Kobbe 2007 GHA (Continued) Exclusio
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Koram 2003 GHA (Continued) Adequate
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Martensson 2003 TZA Methods Trial d
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Mayxay 2003 LAO (Continued) 1. Feve
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Menard 2006 MDG Methods Trial desig
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Mens 2007 KEN (Continued) Risk of b
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Mutabingwa 2004 TZA (Continued) •
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Owusu-Agyei 2006 GHA (Continued) Fr
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Sagara 2005b MLI (Continued) • 25
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Smithuis 2004 MMR (Continued) Risk
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Stohrer 2003 LAO Methods Trial desi
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Swarthout 2004 ZAR (Continued) Note
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Tran 2002 VNM Methods Trial design:
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Van den Broek 2003a BGD (Continued)
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Van Vugt 1998 THA Methods Trial des
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Yeka 2004 UGA (Continued) Risk of b
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Yeka 2007 UGA (Continued) Free of o
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Zongo 2007 BFA (Continued) Novartis
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(Continued) Fofana 2005 Conference
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D A T A A N D A N A L Y S E S Compa
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2.2 Asia 1 317 Risk Ratio (M-H, Fix
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Comparison 5. Dihydroartemisinin-pi
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Comparison 8. Artesunate plus meflo
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Comparison 10. Artemether-lumefantr
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Page 197 and 198: Analysis 12.2. Comparison 12 Artesu
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(Continued) Smithuis 2004 MMR (652
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Dihydroartemisinin-piperaquine vs A
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(Continued) Mayxay 2003 LAO (220 pa
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Artesunate plus mefloquine vs Amodi
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(Continued) Faye 2003 SEN (509 part
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Artemether-lumefantrine vs Artesuna
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(Continued) Zongo 2005 BFA (521 par
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(Continued) Faye 2003 SEN (521 part
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PCR = polymerase chain reaction PCV
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(Continued) Proportion with anaemia
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(Continued) Vivax efficacy: P. viva
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(Continued) Efficacy: Total Failure
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(Continued) Outcomes Illustrative c
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(Continued) GRADE Working Group gra
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Footnotes 1 Data were also availabl
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8 Very serious imprecision: There w
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(Continued) justed Vivax efficacy:
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(Continued) Harms: Serious adverse
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(Continued) Harms: Early vomiting -
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1 Dorsey 2006 UGA; Faye 2003 SEN; K
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