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

Frans Herwig Jansen Fondation ACT-ion Afrique, Bruxelles, Belgium; Biostatistical Centre, University of Leuven, Belgium

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Emmanuel Lesaffre Fondation ACT-ion Afrique, Bruxelles, Belgium; Biostatistical Centre, University of Leuven, Belgium

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Louis Kone Penali Fondation ACT-ion Afrique, Bruxelles, Belgium; Biostatistical Centre, University of Leuven, Belgium

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Maria-Jose Garcia Zattera Fondation ACT-ion Afrique, Bruxelles, Belgium; Biostatistical Centre, University of Leuven, Belgium

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Henri Die-Kakou Fondation ACT-ion Afrique, Bruxelles, Belgium; Biostatistical Centre, University of Leuven, Belgium

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Emmanuel Bissagnene Fondation ACT-ion Afrique, Bruxelles, Belgium; Biostatistical Centre, University of Leuven, Belgium

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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.

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