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pubmed-article:16126619pubmed:abstractTextArtesunate (AS) is being developed as a potential agent for the treatment of severe and complicated malaria. A risk assessment of the therapeutic index and related hematological changes of AS and artelinate (AL) following daily intravenous injection for 3 days was conducted in Plasmodium berghei-infected and uninfected rats. The minimum doses of AS and AL for parasitemia suppression were 2.3 and 2.5 mg/kg, respectively, and the suppressive doses for half parasitemia (SD50) were 7.4 and 8.6 mg/kg, respectively. The maximum tolerated dose (MTD) for AS was 240 mg/kg with a therapeutic index of 32.6. The MTD for AL was 80 mg/kg with a therapeutic index of 9.3. Hematological changes were studied on days 1 and 8 after the final dosing. In both AS- and AL-treated rats, dose-dependent and rapidly reversible hematological changes (significant reductions in RBC, HCT, Hb, and reticulocyte levels) were seen in the peripheral blood. Bone marrow evaluation revealed a statistically significant reduction in the myeloid/erythroid ratio only at the highest dose of AS (240 mg/kg), albeit still within the normal ratio range (1.0-1.5:1.0). Looking at the respective therapeutic indices the authors have concluded that AS is much safer than AL. Both drugs induced hematological changes in rats that parallel the dose-dependent, reversible anemia and reticulocytopenia previously reported in animals and humans. However, no significant bone marrow depression was seen for either agent.lld:pubmed
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pubmed-article:16126619pubmed:pagination251-64lld:pubmed
pubmed-article:16126619pubmed:dateRevised2006-11-15lld:pubmed
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pubmed-article:16126619pubmed:articleTitleRisk assessment and therapeutic indices of artesunate and artelinate in Plasmodium berghei-infected and uninfected rats.lld:pubmed
pubmed-article:16126619pubmed:affiliationDivision of Experimental Therapeutics, Walter Reed Army Institute of Research, Silver Spring, Maryland 20307-5100, USA.lld:pubmed
pubmed-article:16126619pubmed:publicationTypeJournal Articlelld:pubmed
pubmed-article:16126619pubmed:publicationTypeComparative Studylld:pubmed
pubmed-article:16126619pubmed:publicationTypeResearch Support, U.S. Gov't, Non-P.H.S.lld:pubmed