{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:50:55Z","timestamp":1792698655423,"version":"4.5.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["VR 2022-01251"],"award-info":[{"award-number":["VR 2022-01251"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>An allometric miltefosine regimen dosed based on fat-free mass (FFM) is effective and safe in treating children with visceral leishmaniasis (VL). However, its complexity hinders successful implementation in endemic areas. We aimed to develop a simplified dosing based on weight bands (WBs) that achieves equivalent miltefosine exposure in a paediatric VL population using a simulation-based approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Utilizing demographic data from 9379 Eastern African paediatric VL patients, WHO\u2013CDC growth curves were adjusted to create a realistic virtual paediatric VL population. The virtual children were given either an allometric FFM-based, a WB-based or a 2.5\u2005mg\/kg dosing of miltefosine per day. To compare the regimens, two pharmacokinetic metrics were derived from the simulated patient population receiving the allometric FFM-based regimen: the 5th percentile of the time above the concentration associated with 90% in vitro intracellular parasite killing for efficacy and the 95th percentile of the AUC for safety. The performance of the dosing regimens was evaluated for both 14- and 28-day regimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A virtual population was constructed that closely resembled real-world paediatric Eastern African VL patients\u2019 height- and weight-for-age distributions. Target attainment rates for the two pharmacokinetic metrics tested differed by less than 1.5% between the final WB- and FFM-based dosing regimens. The final doses in mg were 20 for children under 6\u2005kg, 30 for 6.0\u20139.9\u2005kg, 50 for 10.0\u201314.9\u2005kg, 60 for 15.0\u201319.9\u2005kg, 70 for 20.0\u201324.9\u2005kg and 80 for 25.0\u201329.9\u2005kg, for both 14- and 28-day regimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our simplified WB-based dosing strategy offers a practical alternative for allometric miltefosine dosing in children, yielding satisfactory exposure levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag014","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T12:47:58Z","timestamp":1767962878000},"source":"Crossref","is-referenced-by-count":3,"title":["Weight-band-based simplification of oral allometric miltefosine dosing in paediatric patients with visceral leishmaniasis"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0397-8761","authenticated-orcid":false,"given":"Andres","family":"Mazariegos Herrera","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Uppsala University , Uppsala ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats O","family":"Karlsson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Uppsala University , Uppsala ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elin M","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Uppsala University , Uppsala ,","place":["Sweden"]},{"name":"Department of Pharmacy, Pharmacology and Toxicology, Radboud University Medical Center , Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas P 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