Effect of Artesunate–Amodiaquine on Mortality Related to Ebola Virus Disease
| العنوان: | Effect of Artesunate–Amodiaquine on Mortality Related to Ebola Virus Disease |
|---|---|
| المؤلفون: | Esther Sterk, Jean Clement Cabrol, Motoi Suzuki, Philippe Azuma, Anne Bocquin, Martin De Smet, Etienne Gignoux, Constanze Yue, Andrew S. Azman, Roberta Petrucci, Christopher H. Logue, Iza Ciglenecki, Angela Cannas, Thomas Pottage, Andreas Kurth, Dorian Job, Moses Massaquoi, Amanda Tiffany, Micaela Serafini, Julien Potet, Thomas Strecker |
| المصدر: | New England Journal of Medicine. 374:23-32 |
| بيانات النشر: | Massachusetts Medical Society, 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Adult, Male, Risk, 0301 basic medicine, medicine.medical_specialty, Adolescent, Amodiaquine, Suspected Ebola virus disease, medicine.disease_cause, Antimalarials, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Artemether, Child, Fluorenes, Ebola virus, business.industry, Artemether, Lumefantrine Drug Combination, Artesunate/amodiaquine, Infant, General Medicine, Hemorrhagic Fever, Ebola, Middle Aged, Liberia, medicine.disease, Artemisinins, Anti-Bacterial Agents, Malaria, Surgery, Drug Combinations, 030104 developmental biology, Ethanolamines, Child, Preschool, Relative risk, Regression Analysis, Female, business, medicine.drug, Combination drug |
| الوصف: | Malaria treatment is recommended for patients with suspected Ebola virus disease (EVD) in West Africa, whether systeomatically or based on confirmed malaria diagnosis. At the Ebola treatment center in Foya, Lofa County, Liberia, the supply of artemether-lumefantrine, a first-line antimalarial combination drug, ran out for a 12-day period in August 2014. During this time, patients received the combination drug artesunate-amodiaquine; amodiaquine is a compound with anti-Ebola virus activity in vitro. No other obvious change in the care of patients occurred during this period.We fit unadjusted and adjusted regression models to standardized patient-level data to estimate the risk ratio for death among patients with confirmed EVD who were prescribed artesunate-amodiaquine (artesunate-amodiaquine group), as compared with those who were prescribed artemether-lumefantrine (artemether-lumefantrine group) and those who were not prescribed any antimalarial drug (no-antimalarial group).Between June 5 and October 24, 2014, a total of 382 patients with confirmed EVD were admitted to the Ebola treatment center in Foya. At admission, 194 patients were prescribed artemether-lumefantrine and 71 were prescribed artesunate-amodiaquine. The characteristics of the patients in the artesunate-amodiaquine group were similar to those in the artemether-lumefantrine group and those in the no-antimalarial group. A total of 125 of the 194 patients in the artemether-lumefantrine group (64.4%) died, as compared with 36 of the 71 patients in the artesunate-amodiaquine group (50.7%). In adjusted analyses, the artesunate-amodiaquine group had a 31% lower risk of death than the artemether-lumefantrine group (risk ratio, 0.69; 95% confidence interval, 0.54 to 0.89), with a stronger effect observed among patients without malaria.Patients who were prescribed artesunate-amodiaquine had a lower risk of death from EVD than did patients who were prescribed artemether-lumefantrine. However, our analyses cannot exclude the possibility that artemether-lumefantrine is associated with an increased risk of death or that the use of artesunate-amodiaquine was associated with unmeasured patient characteristics that directly altered the risk of death. |
| تدمد: | 1533-4406 0028-4793 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3fc505ab2c1a8a284c7ce708a347d548 https://doi.org/10.1056/nejmoa1504605 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....3fc505ab2c1a8a284c7ce708a347d548 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15334406 00284793 |
|---|