Evidence map›Paper›PMID 42234159›Full record

ArticleEuropean journal of clinical pharmacology2026

Population pharmacokinetics of lumefantrine in pregnant and non-pregnant Nigerian women receiving efavirenz-based antiretroviral therapy.

Tawakalt Olamide Akinrinade, Ibrahim Adebayo Hassan, Adebanjo Jonathan Adegbola, Adekemi Adeleke, Jacinta Nwamaka Nwogu-Attah, Oluwasegun Eniayewu, Ayorinde Adehin, Oluseye Oladotun Bolaji

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Article in European journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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5 · Who and what money

Authors and funding

8 authors.

Tawakalt Olamide AkinrinadeDepartment of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria.
Ibrahim Adebayo HassanDepartment of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria.
Adebanjo Jonathan AdegbolaDepartment of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria. adegbolaaj@oauife.edu.ng.ORCID http://orcid.org/0000-0002-6064-2641
Adekemi AdelekeDepartment of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria.
Jacinta Nwamaka Nwogu-AttahDepartment of Pharmaceutical Chemistry, Faculty of Pharmacy, Lead City University, Ibadan, Nigeria.
Oluwasegun EniayewuDepartment of Pharmaceutical and Medicinal Chemistry, Faculty of Pharmaceutical Sciences, University of Ilorin, Ilorin, Nigeria.
Ayorinde AdehinMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Oluseye Oladotun BolajiTranslational Pharmacokinetics Research Unit, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLumefantrine is a key partner drug in artemether-lumefantrine therapy, yet data describing its pharmacokinetics among women with efavirenz-based antiretroviral therapy remains limited. This study aimed to characterise the population pharmacokinetics of lumefantrine in pregnant and non-pregnant Nigerians living with HIV, evaluate the influence of pregnancy and CYP3A5 genotype, and assess the adequacy of current and alternative dosing regimens with respect to day-7 plasma concentration targets.

methodsPlasma lumefantrine concentrations were analysed using nonlinear mixed-effects modelling in Pumas. Structural models comprising one to three compartments, along with alternative absorption models, were evaluated. Pregnancy status and CYP3A5 expressor status, among other candidate covariates, were tested using a stepwise covariate modelling procedure. Model robustness was assessed using nonparametric bootstrap resampling and simulation-based diagnostics. Monte Carlo simulations were then performed to compare the probability of achieving a day-7 lumefantrine concentration of at least 0.2 µg/mL under current versus alternative dosing regimens.

resultsLumefantrine pharmacokinetics were adequately described by a two-compartment model with transit absorption. Pregnancy status and functionally relevant CYP3A5 genotype were not identified as significant covariates on lumefantrine pharmacokinetic parameters among the study population. At the currently recommended twice-daily dosing for 3 days, approximately 65% of simulated patients achieved the day-7 concentration target. Extending dosing to twice daily for 5 days increased target attainment to approximately 96%, while alternative intensified regimens also improved exposure.

conclusionsNo statistically significant effect of pregnancy on lumefantrine pharmacokinetics was identified in this EFV-treated population. However, the standard 3-day dosing regimen may result in suboptimal exposure in a substantial proportion of patients. Simulation results suggest that extended dosing regimens could markedly improve day-7 target attainment, supporting further evaluation of alternative dosing strategies to optimise the efficacy of artemether-lumefantrine among people with concurrent EFV-based ART.

Indexed as

Anti-HIV AgentsAntimalarialsBenzoxazinesHIV InfectionsLumefantrineAdultAlkynesCyclopropanesCytochrome P-450 CYP3AFemaleGenotypeHumansModels, BiologicalMonte Carlo MethodNigeriaPregnancyAlkynesAnti-HIV AgentsAntimalarialsBenzoxazinesCyclopropanesCYP3A5 protein, humanCytochrome P-450 CYP3AefavirenzLumefantrineAntimalarialEfavirenz-based ARTMalariaPopulation pharmacokineticsPregnancySimulation

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.