{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:12:09Z","timestamp":1791321129910,"version":"4.3.1"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,8,5]]},"abstract":"<jats:p>Since there is no ideal candidate to replace sulfadoxine\u2013pyrimethamine (SP) for intermittent preventive treatment (IPTp), alternatives need to be evaluated on basis of their benefit\u2013risk ratio. We reanalyzed the first Beninese trial on mefloquine (MQ) versus SP for IPTp using a multiple outcome approach, which allowed the joint assessment of efficacy and tolerability. Overall superiority of MQ to SP was defined as superiority on at least one efficacy outcome (low birth weight [LBW], placental malaria, or maternal anemia), non-inferiority on all of them as well as on tolerability defined as cutaneous or neuropsychiatric adverse events (AEs) or low compliance with the treatment. The analysis included 1,601 women. MQ was found to be overall superior to SP (<jats:italic>P<\/jats:italic> = 0.004). Performing several sensitivity analyses to handle both missing data and stillbirths provided similar results. Using MQ for IPTp as an example, we show that a multiple outcome analysis is a pragmatic way to assess the benefits\/disadvantages of one drug compared with another. In the current context of a lack of antimalarials that could be used for IPTp, such a statistical approach could be widely used by institutional policy makers for future recommendations regarding the prevention of malaria in pregnancy (MiP).<\/jats:p>","DOI":"10.4269\/ajtmh.14-0783","type":"journal-article","created":{"date-parts":[[2015,6,10]],"date-time":"2015-06-10T13:03:20Z","timestamp":1433941400000},"page":"300-304","source":"Crossref","is-referenced-by-count":9,"title":["Mefloquine Versus Sulfadoxine\u2013Pyrimethamine for Intermittent Preventive Treatment in Pregnancy: A Joint Analysis on Efficacy and Tolerability"],"prefix":"10.4269","volume":"93","author":[{"given":"Val\u00e9rie","family":"Briand","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Escolano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Journot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achille","family":"Massougbodji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Cot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascale","family":"Tubert-Bitter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Lancet Infect Dis","first-page":"93","article-title":"Epidemiology and burden of malaria in pregnancy","volume":"7","author":"Desai","year":"2007"},{"key":"ref2","series-title":"A Strategic Framework for Malaria Prevention and Control during Pregnancy in the Africa Region","author":"WHO","year":"2004"},{"key":"ref3","series-title":"Updated WHO Policy Recommendation: Intermittent Preventive Treatment of Malaria in Pregnancy Using Sulfadoxine\u2013Pyrimethamine (IPTp\u2013SP)","author":"WHO","year":"2012"},{"key":"ref4","series-title":"JAMA","first-page":"594","article-title":"Intermittent preventive therapy for malaria during pregnancy using 2 vs 3 or more doses of sulfadoxine\u2013pyrimethamine and risk of low birth weight in Africa: systematic review and meta-analysis","volume":"309","author":"Kayentao","year":"2013"},{"key":"ref5","series-title":"Lancet Infect Dis","first-page":"136","article-title":"Antimalarial drugs and pregnancy: safety, pharmacokinetics, and pharmacovigilance","volume":"7","author":"Ward","year":"2007"},{"key":"ref6","series-title":"J Infect Dis","first-page":"991","article-title":"Intermittent treatment for the prevention of malaria during pregnancy in Benin: a randomized, open-label equivalence trial comparing sulfadoxine\u2013pyrimethamine with mefloquine","volume":"200","author":"Briand","year":"2009"},{"key":"ref7","series-title":"PLoS Med","first-page":"e1001733","article-title":"Intermittent preventive treatment of malaria in pregnancy with mefloquine in HIV-negative women: a multicentre randomized controlled trial","volume":"11","author":"Gonz\u00e1lez","year":"2014"},{"key":"ref8","series-title":"J Acquir Immune Defic Syndr","first-page":"198","article-title":"Cotrimoxazole prophylaxis versus mefloquine intermittent preventive treatment to prevent malaria in HIV-infected pregnant women: two randomized controlled trials","volume":"65","author":"Denoeud-Ndam","year":"2014"},{"key":"ref9","series-title":"PLoS Med","first-page":"e1001735","article-title":"Intermittent preventive treatment of malaria in pregnancy with mefloquine in HIV-infected women receiving cotrimoxazole prophylaxis: a multicenter randomized placebo-controlled trial","volume":"11","author":"Gonz\u00e1lez","year":"2014"},{"key":"ref10","series-title":"Malar J","first-page":"456","article-title":"Conclusions and recommendations of September 2013 meeting","volume":"12","author":"Malaria Policy Advisory Committee to the WHO","year":"2013"},{"key":"ref11","series-title":"Stat Med","first-page":"1193","article-title":"A combined superiority and non-inferiority approach to multiple endpoints in clinical trials","volume":"26","author":"Bloch","year":"2007"},{"key":"ref12","series-title":"Biometrics","first-page":"1039","article-title":"One-sided tests in clinical trials with multiple endpoints","volume":"57","author":"Bloch","year":"2001"},{"key":"ref13","series-title":"Malar J","first-page":"196","article-title":"Molecular markers of resistance to sulphadoxine\u2013pyrimethamine during intermittent preventive treatment of pregnant women in Benin","volume":"10","author":"Bertin","year":"2011"},{"key":"ref14","series-title":"Malar J","first-page":"195","article-title":"High rates of parasite recrudescence following intermittent preventive treatment with sulphadoxine\u2013pyrimethamine during pregnancy in Benin","volume":"12","author":"Moussiliou","year":"2013"},{"key":"ref15","series-title":"Trop Med Int Health","first-page":"886","article-title":"Dramatically decreased therapeutic efficacy of chloroquine and sulfadoxine\u2013pyrimethamine, but not mefloquine, in southern Benin","volume":"12","author":"Aubouy","year":"2007"},{"key":"ref16","series-title":"Am J Trop Med Hyg","first-page":"979","article-title":"Therapeutic efficacy and effects of artesunate\u2013mefloquine and mefloquine alone on malaria-associated anemia in children with uncomplicated Plasmodium falciparum malaria in southwest Nigeria","volume":"81","author":"Sowunmi","year":"2009"},{"key":"ref17","series-title":"J Infect Dis","first-page":"594","article-title":"Efficacy of intermittent preventive treatment versus chloroquine prophylaxis to prevent malaria during pregnancy in Benin","volume":"198","author":"Briand","year":"2008"},{"key":"ref18","series-title":"Lancet Infect Dis","first-page":"388","article-title":"Adverse effects of falciparum and vivax malaria and the safety of antimalarial treatment in early pregnancy: a population-based study","volume":"12","author":"McGready","year":"2012"},{"key":"ref19","series-title":"Clin Infect Dis","first-page":"808","article-title":"The effects of mefloquine treatment in pregnancy","volume":"28","author":"Nosten","year":"1999"},{"key":"ref20","series-title":"Am J Trop Med Hyg","first-page":"33","article-title":"The effect of malaria and malaria prevention in pregnancy on offspring birthweight, prematurity, and intrauterine growth retardation in rural Malawi","volume":"55","author":"Steketee","year":"1996"},{"key":"ref21","series-title":"Clin Infect Dis","first-page":"e124","article-title":"Pregnancy and fetal outcomes after exposure to mefloquine in the pre- and periconception period and during pregnancy","volume":"54","author":"Schlagenhauf","year":"2012"}],"container-title":["The American Society of Tropical Medicine and 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