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Home > Scientific articles
Aug 2020
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Characterizing the non-linear pharmacokinetics of miltefosine in paediatric visceral leishmaniasis patients from Eastern Africa

Journal of Antimicrobial Chemotherapy

by Palic S, Kip AE, Beijnen JH, Mbui J, Musa A, Solomos A, Wasunna M, Olobo J, Alves F, Dorlo TPC. Journal of Antimicrobial Chemotherapy 2020; doi: 10.1093/jac/dkaa314

Summary: Conventional miltefosine dosing (2.5 mg/kg/day) for treatment of visceral leishmaniasis is less effective in children than in adults. Results of a trial on a higher allometric dose (median 3.2 mg/kg/day) in paediatric visceral leishmaniasis patients in Eastern Africa showed an unforeseen, lower than dose-proportional increase in exposure. The authors describe a pooled model-based analysis of the paediatric data available from both dosing regimens to characterize the non-linearities in miltefosine pharmacokinetics. The bioavailability of miltefosine appeared to be affected by the cumulative dose, possibly as a consequence of impaired absorption. Despite this, allometric dosing led to a faster target achievement and increased exposure compared with conventional dosing.

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Children Visceral leishmaniasis Africa

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