Open AccessStrong correlation of lumefantrine concentrations in capillary and venous plasma from malaria patients
Author(s) -
Liusheng Huang,
Norah Mwebaza,
Richard Kajubi,
Florence Marzan,
Camilla Forsman,
Sunil Parikh,
Francesca Aweeka
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0202082
Subject(s) - regimen , medicine , lumefantrine , confidence interval , linear regression , malaria , pharmacokinetics , plasmodium falciparum , immunology , mathematics , artemisinin , statistics
Background Lumefantrine is a long-acting antimalarial drug with an elimination half-life of over 3 days and protein binding of 99 percent. Correlation of lumefantrine concentrations from capillary plasma via fingerprick (C c ) versus venous plasma (C v ) remains to be defined. Methods Venous and capillary plasma samples were collected simultaneously from children, pregnant women, and non-pregnant adults at 2, 24, 120hr post last dose of a standard 3-day artemether-lumefantrine regimen they received for uncomplicated malaria. Some of the enrolled children and pregnant women were also HIV-infected. Samples were analyzed via liquid chromatography tandem mass spectrometry. Linear regression analysis was performed using the program Stata® SE12.1. Results In children, the linear regression equations for C c vs C v at 2, 24, and 120hr (day 7) post dose are [C c ] = 1.05*[C v ]+95.0 (n = 142, R 2 = 0.977), [C c ] = 0.995*[C v ]+56.7 (n = 147, R 2 = 0.990) and [C c ] = 0.958*[C v ]+18.6 (n = 139, R 2 = 0.994), respectively. For pregnant women, the equations are [C c ] = 1.04*[C v ]+68.1 (n = 43, R 2 = 0.990), [C c ] = 0.997*[C v ]+37.3 (n = 43, R 2 = 0.993) and [C c ] = 0.941*[C v ]+11.1 (n = 41, R 2 = 0.941), respectively. For non-pregnant adults, the equations are [C c ] = 1.05*[C v ]-117 (n = 32, R 2 = 0.958), [C c ] = 0.962*[C v ]+9.21 (n = 32, R 2 = 0.964) and [C c ] = 1.04*[C v ]-40.1 (n = 32, R 2 = 0.988), respectively. In summary, a linear relationship with a slope of ~1 was found for capillary and venous lumefantrine levels in children, pregnant women and non-pregnant adults at 2hr, 24hr and 120hr post last dose, representing absorption, distribution, and elimination phases. Conclusions Capillary and venous plasma concentration of lumefantrine can be used interchangeably at 1:1 ratio. Capillary sampling method via finger prick is a suitable alternative for sample collection in clinical studies.