Primaquine for Plasmodium vivax malaria treatment - Authors' reply.
Primaquine for Plasmodium vivax malaria treatment - Authors' reply.
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伯氨喹用于治疗间日疟原虫疟疾 - 作者的回复。
DOI：
10.1016/s0140-6736(20)30217-8
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发表时间：
2020
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：
Price RN
我们同意 Harin Karunajeewa 和 Robert James 的观点，即需要更广泛地推广间日疟原虫疟疾的根治方法。问题是，我们如何实现这一目标？缩短疗程并提高依从性是朝着正确方向迈出的重要一步。 1 伯氨喹治疗方案通常延长 14 天以上，以减少每日剂量，从而提高耐受性和安全性。主要不良事件风险是葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症患者的溶血。仍建议延长治疗方案的主要原因是间日疟流行国家缺乏 G6PD 检测。 2 新颖的即时 G6PD 测试预示着一个新时代的到来，可以探索不同给药方案的使用。 3, 4 我们也同意不应轻视 8-氨基喹啉的不利影响，但同样也不应夸大其影响。 IMPROV 研究 5 中 7 天伯氨喹治疗方案后的不良事件引起警惕；然而，我们认为，可以通过对 G6PD 缺乏症进行即时筛查、与食物一起服用伯氨喹以减轻腹痛以及提高对溶血风险的认识和理解来减轻这些风险，以便患者
We agree with Harin Karunajeewa and Robert James that radical cure of Plasmodium vivax malaria needs to be deployed more widely. The question is, how do we achieve this? Shortening the treatment course and thereby improving adherence is an important step in the right direction. 1 Primaquine regimens are usually extended over 14 days to reduce the daily dose and thereby improve tolerability and safety. The main adverse event risk is haemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The primary reason why the prolonged regimen is still recommended is the lack of G6PD testing in vivax-endemic countries. 2 Novel point-of-care G6PD tests herald a new era, in which the use of different dosing regimens can be explored. 3, 4 We also agree that the adverse effects of 8-aminoquinolines should not be trivialised, but equally they should not be exaggerated. The adverse events following the 7 day primaquine regimen in the IMPROV study5 give rise to caution; however, we believe that they can be mitigated by pointof-care screening for G6PD deficiency, administering primaquine with food to reduce abdominal pain, and promoting awareness and understanding of the haemolytic risk so that patients