The Vivax Surveyor: Online mapping database for Plasmodium vivax clinical trials.
The Vivax Surveyor: Online mapping database for Plasmodium vivax clinical trials.
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DOI：
10.1016/j.ijpddr.2017.03.003
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发表时间：
2017-08
期刊：
影响因子：
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通讯作者：
Price RN
中科院分区：
文献类型：
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作者：
Commons RJ;Thriemer K;Humphreys G;Suay I;Sibley CH;Guerin PJ;Price RN
反复的间日疟原虫感染与显著的发病率和死亡率相关。虽然根治可以减少复发性感染，但它受到抗疟药耐药性和缺乏安全有效的催眠术治疗的困扰。本研究记录了间日疟原虫已发表的临床试验的现有文献，提供了一个最新的在线开放获取工具来查看和下载可用信息。根据PRISMA指南进行了系统评价，以确定1960年1月1日至2016年10月12日期间发表的具有至少28天随访的前瞻性间日疟原虫治疗性临床试验。将治疗组和氯喹耐药证据映射到试验地点。自1960年以来，共发表了1152项至少随访28天的抗疟临床试验，其中230项（20.0%）纳入间日疟患者，并被纳入研究。试验在38个国家进行：亚太地区168个（73.0%），非洲13个（5.7%），美洲43个（18.7%）。评估间日疟原虫的抗疟试验比例从1991-1995年的10.7%（12/112）上升至2011-2015年的24.9%（56/225）。总体而言，188个（81.7%）间日疟原虫试验包括氯喹治疗组，单独或联合伯氨喹，107个（46.5%）试验包括氯喹治疗组和早期伯氨喹治疗组，以评估根治效果。最近，使用青蒿素衍生物的治疗组有所增加。在可量化氯喹耐药的131个地点中，在15个流行国家的59个（45.0%）地点存在耐药。在过去20年中，关于间日疟原虫治疗的临床研究有了大幅增加，这使人们对全球范围的氯喹耐药性有了更大的认识。WWARN开放获取的在线互动地图提供了耐药间日疟正在出现地区的最新信息。正在进行越来越多的间日疟原虫抗疟疗效试验。耐氯喹间日疟存在于许多间日疟流行国家。很少有试验评估适当的催眠杀虫治疗方案。提出了一个在线开放获取工具，用于审查已发表的间日疟疗效试验。
Recurrent P. vivax infections are associated with significant morbidity and mortality. Although radical cure can reduce recurrent infection, it is confounded by antimalarial resistance and the lack of safe and effective hypnozoitocidal treatment. This study documents the available literature of published clinical trials of P. vivax, providing an up to date, online, open access tool to view and download available information. A systematic review was conducted according to PRISMA guidelines to identify prospective P. vivax therapeutic clinical trials with at least 28 days follow-up published between 1st January 1960 and 12th October 2016. Treatment arms and evidence of chloroquine resistance were mapped to trial sites. Since 1960, a total of 1152 antimalarial clinical trials with a minimum 28 days follow-up have been published, of which 230 (20.0%) enrolled patients with P. vivax and were included. Trials were conducted in 38 countries: 168 (73.0%) in the Asia-Pacific, 13 (5.7%) in Africa and 43 (18.7%) in the Americas. The proportion of antimalarial trials assessing P. vivax rose from 10.7% (12/112) in 1991–1995, to 24.9% (56/225) in 2011–2015. Overall, 188 (81.7%) P. vivax trials included a chloroquine treatment arm, either alone or in combination with primaquine, and 107 (46.5%) trials included a chloroquine treatment arm with early primaquine to assess radical cure. There has been a recent increase in treatment arms with artemisinin derivatives. Of the 131 sites in which chloroquine resistance could be quantified, resistance was present in 59 (45.0%) sites in 15 endemic countries. Over the last 20 years there has been a substantial increase in clinical research on the treatment of P. vivax, which has generated a greater awareness of the global extent of chloroquine resistance. The WWARN open access, online interactive map provides up to date information of areas where drug resistant P. vivax is emerging. Increasing numbers of antimalarial efficacy trials for P. vivax are being conducted. Chloroquine resistant P. vivax is present in many vivax endemic countries. Few trials have assessed appropriate hypnozoitocidal treatment regimens. An online open access tool is presented to review published vivax efficacy trials.