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Title: Modelling primaquine-induced haemolysis in G6PD deficiency
Authors: James Watson
Walter R.J. Taylor
Didier Menard
Sim Kheng
Nicholas J. White
Mahidol University
Nuffield Department of Clinical Medicine
Institut Pasteur du Cambodge
National Center for Parasitology, Entomology and Malaria Control
Keywords: Biochemistry, Genetics and Molecular Biology;Immunology and Microbiology
Issue Date: 4-Feb-2017
Citation: eLife. Vol.6, (2017)
Abstract: © Watson et al. Primaquine is the only drug available to prevent relapse in vivax malaria. The main adverse effect of primaquine is erythrocyte age and dose-dependent acute haemolytic anaemia in individuals with glucose-6-phosphate dehydrogenase deficiency (G6PDd). As testing for G6PDd is often unavailable, this limits the use of primaquine for radical cure. A compartmental model of the dynamics of red blood cell production and destruction was designed to characterise primaquine-induced haemolysis using a holistic Bayesian analysis of all published data and was used to predict a safer alternative to the currently recommended once weekly 0.75 mg/kg regimen for G6PDd. The model suggests that a step-wise increase in daily administered primaquine dose would be relatively safe in G6PDd. If this is confirmed, then were this regimen to be recommended for radical cure patients would not require testing for G6PDd in areas where G6PDd Viangchan or milder variants are prevalent.
ISSN: 2050084X
Appears in Collections:Scopus 2016-2017

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