The effect of mefloquine dose on outcome of uncomplicated falciparum malaria treated with artesunate-mefloquine: a WWARN systematic review and individual patient data meta-analysis
Malaria Journal·
- DOI
- 10.1186/s12936-026-05963-4
- PMID
- 42638106
- PMCID
- —
- OpenAlex
- —
- Study type
- Systematic review
- Publisher
- Springer Science and Business Media LLC
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The results indicate that while the regimen remains effective, age-specific tolerability issues may constrain dosing adjustments in young children.
Structured evidence summary
Research question
What impact does varying mefloquine dosage have on clinical outcomes and tolerability in patients receiving artesunate-mefloquine therapy?
Study design
The investigation utilizes an individual patient data meta-analysis combined with a systematic review of thirty-one clinical trials.
Population and setting
The cohort comprises 6,761 individuals diagnosed with uncomplicated falciparum malaria, primarily recruited from Asian sites, with a median participant age of eighteen years.
Main findings
Three-day combination therapy achieved low parasite recurrence rates prior to the emergence of drug resistance. Pediatric patients in Asia experienced a substantially greater likelihood of treatment failure than adults, whereas increased mefloquine quantities corresponded to improved outcomes in that region. Gastrointestinal adverse events following administration were most prevalent among children between one and five years old.
Public-health relevance
The results indicate that while the regimen remains effective, age-specific tolerability issues may constrain dosing adjustments in young children.
Important limitations
The dataset aggregates historical trial results gathered before widespread drug resistance developed, potentially reducing contemporary relevance. Geographic representation heavily favors Asian populations, limiting broader extrapolation.
GIDS interpretation
This synthesis consolidates historical trial data into a searchable format, facilitating literature mapping for researchers investigating antimalarial pharmacokinetics and pediatric safety thresholds.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 11 auditable classifier relationships to diseases, places, topics, and study design.