Publication: Orally formulated artemisinin in healthy fasting vietnamese male subjects: A randomized, four-sequence, open-label, pharmacokinetic crossover study
Issued Date
2011-05-01
Resource Type
ISSN
1879114X
01492918
01492918
Other identifier(s)
2-s2.0-79958694501
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Mahidol University
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SCOPUS
Bibliographic Citation
Clinical Therapeutics. Vol.33, No.5 (2011), 644-654
Suggested Citation
Tran Tinh Hien, Warunee Hanpithakpong, Nguyen Thanh Truong, Nguyen Thi Dung, Pham Van Toi, Jeremy Farrar, Niklas Lindegardh, Joel Tarning, Michael Ashton Orally formulated artemisinin in healthy fasting vietnamese male subjects: A randomized, four-sequence, open-label, pharmacokinetic crossover study. Clinical Therapeutics. Vol.33, No.5 (2011), 644-654. doi:10.1016/j.clinthera.2011.04.017 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/12525
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Title
Orally formulated artemisinin in healthy fasting vietnamese male subjects: A randomized, four-sequence, open-label, pharmacokinetic crossover study
Abstract
Background: Artemisinin derivatives are used in antimalarial drug combination therapy. Artemisinin and piperaquine have recently been proven to be prospective candidates for combination therapy in the treatment of uncomplicated Plasmodium falciparum malaria. Objective: The goal of this study was to evaluate the relative bioavailability and to characterize the pharmacokinetic properties of a new micronized powder formulation of artemisinin against the previous standard Vietnamese formulation when administered as a single oral dose or in combination with piperaquine. Methods: This was a single-center, randomized, 4-sequence, open-label, crossover study conducted in 15 healthy male Vietnamese volunteers under fasting conditions with a washout period of 3 weeks between study visits. A single oral dose of 160 or 500 mg of artemisinin was administered alone or in combination with piperaquine. Potential adverse events were monitored daily by the clinician and by using laboratory test results. Frequent blood samples were drawn for 12 hours after dose. Artemisinin was quantified in plasma using LC-MS/MS. Pharmacokinetic parameters were computed from the plasma concentration-time profiles using a noncompartmental analysis method. Results: Pharmacokinetic parameters T max , C max , AUC 0-∞ , V d /F, CL/F, and t 1/2 (mean [SD]) for the new formulation of artemisinin were 1.83 (0.88) hours, 178 (97) ng/mL, 504 (210) h*ng/mL, 1270 (780) L, 401 (260) L/h, and 2.21 (0.29) hours, respectively. The mean percentage of the test/reference formulation ratio for the logarithmically transformed values of C max , AUC 0-last, and AUC 0-∞ were 121% (90% CI, 92.5-158), 122% (90% CI, 101-148), and 120% (90% CI, 98.0-146), respectively. Conclusions: This single-dose study found that the dose-normalized C max , AUC 0-last , and AUC 0-∞ mean geometric differences between the test and reference formulations were relatively small ( < 40%) and will probably not have a clinical impact in the treatment of malaria infections. © 2011.