There is an urgent need to develop systems to assess the safety of antimalarials in early pregnancy, says a new essay in this week's PLoS Medicine .
Feiko ter Kuile (Liverpool School of Tropical Medicine, Liverpool, UK) and colleagues report that the anti-malarial drugs artemisinins are effective and commonly used, but they have been shown to be toxic to embryos in animal models. Their safety in early human pregnancies remains uncertain, despite up to 10% of embryos being exposed to anti-malarial drugs in malaria endemic countries.
Because most of the approaches used in wealthier countries to evaluate a drug's toxicity in pregnancy do not apply in low income countries, the authors argue that we must establish an international antimalarial pregnancy exposure registry. This would enable a "targeted prospective pharmacovigilance approach and timely assessment of the risk–benefit profile of antimalarials," say ter Kuile and colleagues.
Citation: Dellicour S, ter Kuile FO, Stergachis A (2008) Pregnancy exposure registries for assessing antimalarial drug safety in pregnancy in malaria-endemic countries. PLoS Med 5(9): e187. doi:10.1371/journal.pmed.0050187
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CONTACT:
Feiko O. ter Kuile
Liverpool School of Tropical Medicine
Child and Reproductive Health
Pembroke Place
Liverpool, merseyside l3 5qa
United Kingdom
0151 705 3287
0151 705 3329 (fax)
terkuile@liv.ac.uk
PLOS Medicine