{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T20:12:28Z","timestamp":1785355948349,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,7,22]],"date-time":"2015-07-22T00:00:00Z","timestamp":1437523200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["089275\/Z\/09\/2"],"award-info":[{"award-number":["089275\/Z\/09\/2"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim was to compare the pharmacokinetic properties of artesunate and dihydroartemisinin in the same women: i) pregnant with acute uncomplicated malaria on day 1 and 2, ii) pregnant with convalescent malaria on day 7 and iii) in a healthy state 3\u2009months post\u2010partum on day 1, 2 and 7.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Non\u2010linear mixed\u2010effects modelling was used to compare plasma concentration\u2013time profiles of artesunate and dihydroartemisinin over 7\u2009days of treatment following oral and intravenous artesunate administration to pregnant women with uncomplicated <jats:italic>Plasmodium falciparum<\/jats:italic> malaria during their second or third trimesters of pregnancy. The same women were restudied 3 months after delivery when fully recovered. Non\u2010compartmental results of the same study have been published previously.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty pregnant patients on the Thailand\u2010Myanmar border were studied and 15 volunteered to be restudied 3 months post\u2010partum. Malaria and pregnancy had no effect on the pharmacokinetic properties of artesunate or dihydroartemisinin after intravenous artesunate administration. However, malaria and pregnancy had opposite effects on the absorption of orally administered artesunate. Malaria increased the absolute oral bioavailability of artesunate by 87%, presumably by inhibiting first pass effect, whereas pregnancy decreased oral bioavailability by 23%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The population pharmacokinetic analysis demonstrated opposite effects of malaria and pregnancy on the bioavailability of orally administered artesunate. Lower drug exposures during the second and third trimesters of pregnancy may contribute to lower cure rates and thus the development of drug resistance. Dose optimization studies are required for artesunate containing artemisinin\u2010based combination therapies (ACTs) in later pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.12660","type":"journal-article","created":{"date-parts":[[2015,4,15]],"date-time":"2015-04-15T20:19:10Z","timestamp":1429129150000},"page":"642-653","source":"Crossref","is-referenced-by-count":34,"title":["Opposite malaria and pregnancy effect on oral bioavailability of artesunate \u2013 a population pharmacokinetic evaluation"],"prefix":"10.1111","volume":"80","author":[{"given":"Frank","family":"Kloprogge","sequence":"first","affiliation":[{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine University of Oxford  United Kingdom"},{"name":"Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine Mahidol University  Bangkok"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"McGready","sequence":"additional","affiliation":[{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine University of Oxford  United Kingdom"},{"name":"Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine Mahidol University  Bangkok"},{"name":"Shoklo Malaria Research Unit, Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine Mahidol University  Mae Sot Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aung Pyae","family":"Phyo","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine Mahidol University  Mae Sot Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus J.","family":"Rijken","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine Mahidol University  Mae Sot Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warunee","family":"Hanpithakpon","sequence":"additional","affiliation":[{"name":"Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine Mahidol University  Bangkok"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hla Hla","family":"Than","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine Mahidol University  Mae Sot Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathar","family":"Hlaing","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine Mahidol University  Mae Sot Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naw Thida","family":"Zin","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine Mahidol University  Mae Sot Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas P. 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