Systemic drug exposure | Case No. | Parasite slope half-life (h)a | In vitro sensitivity (IC50: nM)b | Pfmdr1 copy number | MQ/DHA Systemic exposure | Conclusion on cause(s) of treatment failure | ||
---|---|---|---|---|---|---|---|---|
 |  |  | AS | MQ |  | AUC0-7d/ AUC0-24h/ | Day Re |  |
Adequate DHA exposure alone (n=5) | 1 | 3.12 | Reduced (3.5±0.42) | Resistant (58.8±5.1) | >1 | 7.55c | 610 (day 21) | -Possible AS resistant |
-MQ resistant + Inadequate MQ exposure | ||||||||
-Predicted by increased in pfmdr1 copy number | ||||||||
2 | 3.56 | Reduced (4.8±1.07) | Resistant (69.5±4.7) | >1 | 8.02c | 100 (day 28) | -Possible AS resistant | |
-MQ resistant + Inadequate MQ exposure | ||||||||
-Predicted by increased in pfmdr1 copy number | ||||||||
3 | 4.23 | Sensitive (1.2±0.27) | Sensitive (10.6±1.9) | 1 | 6.98c | 300 (day 28) | -Inadequate MQ exposure | |
4 | 3.88 | Sensitive (0.7±0.13) | Sensitive (6.6±0.4) | 1 | 7.99c | 600 (day 33) | -Inadequate MQ exposure | |
5 | 3.42 | Sensitive (0.9±0.10) | Sensitive (19.4±0.7) | >1 | 8.07c | 720 (day 14) | -Inadequate MQ exposure | |
-Predicted by increased in pfmdr1 copy number | ||||||||
Adequate MQ exposure alone (n=5) | 6 | 3.55 | Reduced (3.0±0.06) | Resistant (45.3±3.1) | >1 | 320d | 324 (day 27) | -Possible AS resistant + Inadequate DHA exposure |
-MQ resistant | ||||||||
-Predicted by increased in pfmdr1 copy number | ||||||||
7 | 3.39 | Reduced (3.1±0.05) | Resistant (70.3±6.3) | >1 | 208d | 212 (day 28) | -Possible AS resistant + Inadequate DHA exposure | |
-MQ resistant | ||||||||
-Predicted by increased in pfmdr1 copy number | ||||||||
8 | 3.56 | Reduced (4.2±0.07) | Resistant (50.0±4.2) | >1 | 309d | 489 (day 21) | -Possible AS resistant + Inadequate DHA exposure | |
-Mefloquine resistant | ||||||||
-Predicted by increased in pfmdr1 copy number | ||||||||
 | 9 | 3.64 | Sensitive (1.8±0.30) | Resistant (55.3±4.4) | >1 | 378d | 510 (day 28) | - Inadequate DHA concentration |
-MQ resistant | ||||||||
-Predicted by pfmdr1 copy number | ||||||||
10 | 3.22 | Sensitive (1.4) | Resistant (35.0±2.9) | >1 | 489d | 402 (day 21) | - Inadequate DHA exposure | |
-MQ resistant | ||||||||
-Predicted by pfmdr1 copy number | ||||||||
Adequate DHA and MQ exposure (n=7) | 11 | 3.97 | Reduced (2.9±0.01) | Resistant (118.4±6.1) | >1 | - | 1,250 (day 17) | -Possible AS resistant |
-MQ resistant, | ||||||||
-Predicted by increased in Pfmdr1 copy number | ||||||||
12 | 3.45 | Reduced (3.7±0.32) | Resistant (95.8±5.4) | >1 | - | 578 (day 14) | -Possible AS resistant | |
-MQ resistant | ||||||||
-Predicted by increased in Pfmdr1 copy number | ||||||||
13 | 3.33 | Sensitive (1.7±0.16) | Resistant (28.8±5.5) | >1 | - | 102 (day 35) | -MQ resistant | |
-Predicted by pfmdr1 copy number | ||||||||
14 | 3.56 | Sensitive (1.9±0.10) | Resistant (60.8±7.1) | >1 | - | 620 (day 14) | -MQ resistant | |
-Predicted by pfmdr1 copy number | ||||||||
15 | 3.65 | Reduced (3.7±0.21) | Resistant (25.5±0.2) | 1 | - | 610 (day 24) | -Possible AS resistant | |
-MQ resistant | ||||||||
16 | 3.56 | Reduced (5.2±0.85) | Sensitive (16.6±0.8 | 1 | - | 107 (day 35) | -Possible AS resistant | |
 | 17 | 3.44 | Sensitive (0.9±0.08) | Sensitive (16.5±2.4) | 1 | - | 67 (day 42) | -Other host-related factors |