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

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Analysis 15.5. Comparison 15 Dihydroartemisinin-piperaquine dose analysis (versus Artesunate plus mefloquine), Outcome 5 Total Failure Day 28 PCR unadjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 15 Dihydroartemisinin-piperaquine dose analysis (versus Artesunate plus mefloquine) Outcome: 5 Total Failure Day 28 PCR unadjusted Study or subgroup DHA-P ASMQ Risk Ratio Risk Ratio 1 DHA-P 4 doses n/N n/N M-H,Random,95% CI M-H,Random,95% CI Ashley 2003a THA 1/59 0/59 3.00 [ 0.12, 72.18 ] Ashley 2004 THA 2/155 13/157 0.16 [ 0.04, 0.68 ] Janssens 2003 KHM 2/195 2/207 1.06 [ 0.15, 7.46 ] Tran 2002 VNM 0/166 0/77 0.0 [ 0.0, 0.0 ] Subtotal (95% CI) 575 500 0.56 [ 0.10, 3.14 ] Total events: 5 (DHA-P), 15 (ASMQ) Heterogeneity: Tau 2 = 1.18; Chi 2 = 4.12, df = 2 (P = 0.13); I 2 =52% Test for overall effect: Z = 0.66 (P = 0.51) 2 DHA-P 3 doses Ashley 2004 THA 3/163 13/157 0.22 [ 0.06, 0.77 ] Smithuis 2004 MMR 6/319 0/316 12.88 [ 0.73, 227.64 ] Tangpukdee 2005 THA 1/107 0/54 1.53 [ 0.06, 36.89 ] Subtotal (95% CI) 589 527 1.29 [ 0.09, 18.93 ] Total events: 10 (DHA-P), 13 (ASMQ) Heterogeneity: Tau 2 = 4.07; Chi 2 = 7.57, df = 2 (P = 0.02); I 2 =74% Test for overall effect: Z = 0.19 (P = 0.85) Total (95% CI) 1164 1027 0.74 [ 0.20, 2.65 ] Total events: 15 (DHA-P), 28 (ASMQ) Heterogeneity: Tau 2 = 1.32; Chi 2 = 11.38, df = 5 (P = 0.04); I 2 =56% Test for overall effect: Z = 0.47 (P = 0.64) Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 0.005 0.1 1 10 200 Favours DHA-P Favours ASMQ 206
Analysis 15.6. Comparison 15 Dihydroartemisinin-piperaquine dose analysis (versus Artesunate plus mefloquine), Outcome 6 Total Failure Day 28 PCR adjusted. Review: Artemisinin-based combination therapy for treating uncomplicated malaria Comparison: 15 Dihydroartemisinin-piperaquine dose analysis (versus Artesunate plus mefloquine) Outcome: 6 Total Failure Day 28 PCR adjusted Study or subgroup DHA-P ASMQ Risk Ratio Risk Ratio 1 DHA-P 4 doses n/N n/N M-H,Random,95% CI M-H,Random,95% CI Ashley 2003a THA 1/59 0/59 3.00 [ 0.12, 72.18 ] Ashley 2004 THA 1/154 7/151 0.14 [ 0.02, 1.12 ] Janssens 2003 KHM 2/195 1/206 2.11 [ 0.19, 23.11 ] Tran 2002 VNM 0/166 0/77 0.0 [ 0.0, 0.0 ] Subtotal (95% CI) 574 493 0.79 [ 0.10, 6.11 ] Total events: 4 (DHA-P), 8 (ASMQ) Heterogeneity: Tau 2 = 1.62; Chi 2 = 3.99, df = 2 (P = 0.14); I 2 =50% Test for overall effect: Z = 0.22 (P = 0.82) 2 DHA-P 3 doses Ashley 2004 THA 1/161 7/151 0.13 [ 0.02, 1.08 ] Smithuis 2004 MMR 2/315 0/316 5.02 [ 0.24, 104.06 ] Tangpukdee 2005 THA 1/107 0/54 1.53 [ 0.06, 36.89 ] Subtotal (95% CI) 583 521 0.79 [ 0.08, 7.82 ] Total events: 4 (DHA-P), 7 (ASMQ) Heterogeneity: Tau 2 = 2.15; Chi 2 = 4.21, df = 2 (P = 0.12); I 2 =52% Test for overall effect: Z = 0.20 (P = 0.84) Total (95% CI) 1157 1014 0.74 [ 0.19, 2.86 ] Total events: 8 (DHA-P), 15 (ASMQ) Heterogeneity: Tau 2 = 1.09; Chi 2 = 8.19, df = 5 (P = 0.15); I 2 =39% Test for overall effect: Z = 0.43 (P = 0.66) Artemisinin-based combination therapy for treating uncomplicated malaria (Review) Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. 0.002 0.1 1 10 500 Favours DHA-P Favours ASMQ 207
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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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Comparison 12. Artesunate plus amod
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5.2 DHA-P 3 doses 3 1116 Risk Ratio
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Comparison 21. How does Artesunate
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(... Continued) Study or subgroup D
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Analysis 1.12. Comparison 1 Dihydro
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(... Continued) Study or subgroup D
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Page 161 and 162: Analysis 5.7. Comparison 5 Dihydroa
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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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