Safety of epoietin beta-quinine drug combination in children with cerebral malaria in Mali
Open Access
- 24 July 2009
- journal article
- clinical trial
- Published by Springer Nature in Malaria Journal
- Vol. 8 (1), 169
- https://doi.org/10.1186/1475-2875-8-169
Abstract
Cerebral malaria carries an unacceptable case fatality rate in children despite timely and adequate chemotherapy. To improve the survival rate, adjunctive therapies previously tested mainly focused on the modulation of the inflammatory response, without definitive effect in humans. In this context, a new adjunctive strategy using a neuroprotective drug: erythropoietin (epoietin-beta, Epo) was proposed. An open-labelled study including cerebral malaria children (Blantyre coma score below 3) was conducted in Mali. The objective was to assess the short-term safety (seven days) of erythropoietin at high doses (1,500 U/kg/day during three days) combined to quinine. 35 patients with unrousable coma were included in the study. None of expected side effects of erythropoietin were observed during the seven days follow-up. No significant increase in the case fatality rate (7/35 patients) was observed compared to other studies with mortality rates ranging from 16 to 22% in similar endemic areas. These data provide the first evidence of the short-term safety of erythropoietin at high doses combined to quinine. A multicentre study is needed to assess the potential of Epo as an adjunctive therapy to increase the survival during cerebral malaria. ClinicalTrials.gov ID: NCT00697164Keywords
This publication has 37 references indexed in Scilit:
- Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic reviewMalaria Journal, 2008
- Life-Threatening Malaria in African ChildrenThe Pediatric Infectious Disease Journal, 2008
- Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trialMalaria Journal, 2007
- Burden, Features, and Outcome of Neurological Involvement in Acute Falciparum Malaria in Kenyan ChildrenPublished by American Medical Association (AMA) ,2007
- Neurorestorative treatment of stroke: Cell and pharmacological approachesNeuroRX, 2006
- Discovering erythropoietin's extra-hematopoietic functions: Biology and clinical promiseKidney International, 2006
- Emerging biological roles for erythropoietin in the nervous systemNature Reviews Neuroscience, 2005
- Erythropoietin as an antiapoptotic, tissue-protective cytokineCell Death & Differentiation, 2004
- The decision to prematurely terminate a trial of R-HuEPO due to thrombotic eventsJournal of Pain and Symptom Management, 2004
- Dexamethasone Proves Deleterious in Cerebral MalariaNew England Journal of Medicine, 1982