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Am. J. Trop. Med. Hyg., 77(6), 2007, pp. 1005-1009
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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Assessment of the Relative Advantage of Various Artesunate-Based Combination Therapies by a Multi-Treatment Bayesian Random-Effects Meta-Analysis

Frans Herwig Jansen*, Emmanuel Lesaffre, Louis Kone Penali, Maria-Jose Garcia Zattera, Henri Die-Kakou, AND Emmanuel Bissagnene
Fondation ACT-ion Afrique, Bruxelles, Belgium; Biostatistical Centre, University of Leuven, Belgium

Over the years, multiple articles on Artemisinin-based Combination Therapies (ACTs) were published, highlighting the relative advantages or drawbacks of these combinations. Many studies were comparative. Because none of the studies compare all combinations and methodology varies between studies, there is no homogeneity. A multi-treatment Bayesian random-effects meta-analysis was designed to assess the relative effect of each combination therapy to artesunate + sulfadoxine-pyrimethamine (4 mg/kg/day for 3 days). By far the most attractive result for the variable adequate clinical and parasitological response at day 28 PCR corrected is given by the combination artemether-lumefantrine. Annual follow-up on the data published is intended to reveal the changes in the relative drug efficacy values of ACTs.

Received January 18, 2007. Accepted for publication August 1, 2007.

* Address correspondence to Frans Herwig Jansen, Witte Bremlaan 30, 2360 Oud-Turnhout, Belgium. E-mail: fh.jansen{at}actionafrique.org, fhj{at}dafra.be

Authors’ addresses: Frans Herwig Jansen, Witte Bremlaan 30, 2360 Oud-Turnhout, Belgium, E-mail: fh.jansen{at}actionafrique.org. Em-manuel Lesaffre and Maria-Jose Garcia Zattera, Biostatistical Centre, U.Z. St. Rafaël, Catholic University of Leuven, Kapucijnenvoer 35, B-3000 Leuven, Belgium, E-mails: emmanuel.lesaffre{at}med.kuleuven.be and mjgarcia{at}uc.cl. Louis Kone Penali, Logements Lycée Classique, Boulevard de France 6, Abidjan- Cocody, Côte d’Ivoire, 22 BP 80 Abidjan 22, E-mail: lpenali{at}yahoo.fr. Henri Die-Kakou, BP 1544, Abidjan 06, Côte d’Ivoir, E-mail: diekakouhenri{at}yahoo.fr. Emmanuel Bissagnene, 15 BP 804, Abidjan 15, Côte d’Ivoir, E-mail: bissagnene{at}yahoo.fr.

SP + AS3 = standard dose of SP plus 3 days of AS’s dose (4 mk/kg/day for 3 days).

SP + AS1 = standard dose of SP plus only 1 day of AS’s dose (4 mk/kg for 1 day).






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