artemesia (wormwood) warnings disputed

[Guest guest]

>>>someone quite astutely disputed the claim that artemesia annua

>>>(aka Wormwood, sometimes used to treat babesia) is neurotoxic.

>>>

>>>from lymenet.

>>>

>>><http://www.ajtmh.org/cgi/reprint/74/6/940.pdf>www.ajtmh.org/cgi/reprint/74/6\

/940.pdf

>>>

>>>

>>>Dear Sir,

>>>

>>>Dr. Toovey rings once again the alarm bell on the potential

>>>neurotoxicity of the artemisinin derivatives.

>>>

>>>These drugs are now

>>>the cornerstone for the treatment of falciparum malaria, and

>>>use throughout the tropics is increasing rapidly, so potentially

>>>serious adverse effects are of great concern.

>>>

>>>Dr. Toovey has suggested previously that coartemether

>>>(artemether-lumefantrine) causes irreversible hearing loss and has

>>>speculated that artesunate neurotoxicity contributed to fatal

>>>outcomes in

>>>

>>>(in) the recent SEAQUAMAT severe malaria trial in which artesunate

>>>reduced the mortality of severe malaria by 35%,1 and he now finds

>>>that the negative results from our study of the effects of

>>>artemether-lumefantrine on hearing are unconvincing.2

>>>

>>>

>>>The neurologic lesions observed in animals exposed to

>>>large doses of parenteral oil soluble artemether or artemether

>>>were localized to certain brain stem nuclei, in particular those

>>>involved with hearing and balance.3

>>>

>>>The lesions were associated with sustained drug exposure, which is

>>>why it was so difficult to produce them with oral drug

>>>administration (the artemisinin derivatives are rapidly absorbed

>>>and eliminated when given orally).

>>>

>>>Subsequent extensive clinical and patho-

>>>logic studies have naturally focused on determining whether

>>>

>>>similar lesions occur in humans treated with these drugs for

>>>

>>>malaria. Audiometric testing, with the exception of the study

>>>

>>>of Dr. Toovey and a single volunteer in Vietnam (who had a

>>>

>>>reported small drop in hearing threshold of 15-30 db at 12,000

>>>Hz),4,5 has not shown any effect of drug treatment.

>>>

>>>However, audiometric tests alone are not sufficient to study the

>>>potential effects of drugs on auditory function because they

>>>explore only the proximal end of the pathway.

>>>

>>>

>>>In our study,2 we measured auditory brainstem responses (ABRs)

>>>focusing on waves III-V to detect changes in the neuronal

>>>conduction between the caudal pons and the midbrain. This is the

>>>segment of the auditory pathway relevant to the location of

>>>lesions observed in animals.

>>>

>>>

>>>Our objective was not " ...to provide reassurance that artemether

>>>lumefantrine was not ototoxic, " but to investigate Dr. Toovey's

>>>allegation that otoxicity was irreversible.

>>>

>>>In this retrospective case-control study (by definition without

>>>baseline measurements), we found no differ-

>>>

>>>ences in the auditory wavelengths and their latencies between

>>>

>>>cases exposed to coartemether and the controls who were not.

>>>

>>>

>>>

>>>

>>>Thus, if artemether-lumefantrine is ototoxic, it is not irrevers-

>>>ible. Our results confirm the negative findings of two previous

>>>studies, which also combined ABR with audiometry.6,7

>>>

>>>Dr. Toovey is also unconvinced by the negative results of

>>>the neuropathological study of patients who died of severe

>>>malaria in a comparative trial of artemether and quinine.8

>>>

>>>

>>>

>>>However, it should also be noted that more than 100 survivors

>>>in this randomized and blinded study, in which patients re-

>>>ceived a high dose of parenteral artemether, underwent au-

>>>diometry at discharge from the hospital.9 There was no dif-

>>>ference between the two groups.

>>>

>>>

>>>Further prospective audio- metric studies are in progress, but the

>>>weight of evidence to date increasingly suggests that the

>>>artemisinin derivatives are safe and do not affect hearing.

>>>

>>>-

>>>

>>>Go to link to see the

>>>

>>>Nine citations as references. Five authors . . .from UK and Thailand.

>>>

>>>

>>>

>>>242 Vietnamese patients -

>>>

>>>excerpt: " In this population there was no clinical or

>>>neurophysiological evidence of brain-stem toxicity that could be

>>>attributed to exposure to artemisinin or artesunate. "

>>>

>>>-------

>>>

>>><http://www.ajtmh.org/cgi/content/abstract/63/1/48?ck=nck>www.ajtmh.org/cgi/c\

ontent/abstract/63/1/48?ck=nck

>>>

>>>

>>>Am J Trop Med Hyg (0) 63: 48-55.

>>>

>>>Clinical and neurophysiological study of the effects of multiple

>>>doses of artemisinin on brain-stem function in Vietnamese patients.

>>>

>>>

>>>E Kissinger, TT Hien, NT Hung, ND Nam, NL Tuyen, BV Dinh, C Mann,

>>>NH Phu, PP Loc, JA Simpson, NJ White, JJ Farrar

>>>

>>>Wellcome Trust Clinical Research Unit, Centre for Tropical

>>>Diseases, Ho Chi Minh City, Vietnam.

>>>

<http://flash.lymenet.org/scripts/ultimatebb.cgi?ubb=get_topic;f=1;t=062410>http\

://flash.lymenet.org/scripts/ultimatebb.cgi?ubb=get_topic;f=1;t=062410

[Guest guest]

***Artemesia annua WORKS to kill parasites.

It will only work once alot of the metals are out.

Regards

CS

artemesia (wormwood) warnings disputed

>>>someone quite astutely disputed the claim that artemesia annua

>>>(aka Wormwood, sometimes used to treat babesia) is neurotoxic.

>>>

>>>from lymenet.

>>>

>>><http://www.ajtmh.org/cgi/reprint/74/6/940.pdf>www.ajtmh.org/cgi/reprint/74/6\

/940.pdf

>>>

>>>

>>>Dear Sir,

>>>

>>>Dr. Toovey rings once again the alarm bell on the potential

>>>neurotoxicity of the artemisinin derivatives.

>>>

>>>These drugs are now

>>>the cornerstone for the treatment of falciparum malaria, and

>>>use throughout the tropics is increasing rapidly, so potentially

>>>serious adverse effects are of great concern.

>>>

>>>Dr. Toovey has suggested previously that coartemether

>>>(artemether-lumefantrine) causes irreversible hearing loss and has

>>>speculated that artesunate neurotoxicity contributed to fatal

>>>outcomes in

>>>

>>>(in) the recent SEAQUAMAT severe malaria trial in which artesunate

>>>reduced the mortality of severe malaria by 35%,1 and he now finds

>>>that the negative results from our study of the effects of

>>>artemether-lumefantrine on hearing are unconvincing.2

>>>

>>>

>>>The neurologic lesions observed in animals exposed to

>>>large doses of parenteral oil soluble artemether or artemether

>>>were localized to certain brain stem nuclei, in particular those

>>>involved with hearing and balance.3

>>>

>>>The lesions were associated with sustained drug exposure, which is

>>>why it was so difficult to produce them with oral drug

>>>administration (the artemisinin derivatives are rapidly absorbed

>>>and eliminated when given orally).

>>>

>>>Subsequent extensive clinical and patho-

>>>logic studies have naturally focused on determining whether

>>>

>>>similar lesions occur in humans treated with these drugs for

>>>

>>>malaria. Audiometric testing, with the exception of the study

>>>

>>>of Dr. Toovey and a single volunteer in Vietnam (who had a

>>>

>>>reported small drop in hearing threshold of 15-30 db at 12,000

>>>Hz),4,5 has not shown any effect of drug treatment.

>>>

>>>However, audiometric tests alone are not sufficient to study the

>>>potential effects of drugs on auditory function because they

>>>explore only the proximal end of the pathway.

>>>

>>>

>>>In our study,2 we measured auditory brainstem responses (ABRs)

>>>focusing on waves III-V to detect changes in the neuronal

>>>conduction between the caudal pons and the midbrain. This is the

>>>segment of the auditory pathway relevant to the location of

>>>lesions observed in animals.

>>>

>>>

>>>Our objective was not " ...to provide reassurance that artemether

>>>lumefantrine was not ototoxic, " but to investigate Dr. Toovey's

>>>allegation that otoxicity was irreversible.

>>>

>>>In this retrospective case-control study (by definition without

>>>baseline measurements), we found no differ-

>>>

>>>ences in the auditory wavelengths and their latencies between

>>>

>>>cases exposed to coartemether and the controls who were not.

>>>

>>>

>>>

>>>

>>>Thus, if artemether-lumefantrine is ototoxic, it is not irrevers-

>>>ible. Our results confirm the negative findings of two previous

>>>studies, which also combined ABR with audiometry.6,7

>>>

>>>Dr. Toovey is also unconvinced by the negative results of

>>>the neuropathological study of patients who died of severe

>>>malaria in a comparative trial of artemether and quinine.8

>>>

>>>

>>>

>>>However, it should also be noted that more than 100 survivors

>>>in this randomized and blinded study, in which patients re-

>>>ceived a high dose of parenteral artemether, underwent au-

>>>diometry at discharge from the hospital.9 There was no dif-

>>>ference between the two groups.

>>>

>>>

>>>Further prospective audio- metric studies are in progress, but the

>>>weight of evidence to date increasingly suggests that the

>>>artemisinin derivatives are safe and do not affect hearing.

>>>

>>>-

>>>

>>>Go to link to see the

>>>

>>>Nine citations as references. Five authors . . .from UK and Thailand.

>>>

>>>

>>>

>>>242 Vietnamese patients -

>>>

>>>excerpt: " In this population there was no clinical or

>>>neurophysiological evidence of brain-stem toxicity that could be

>>>attributed to exposure to artemisinin or artesunate. "

>>>

>>>-------

>>>

>>><http://www.ajtmh.org/cgi/content/abstract/63/1/48?ck=nck>www.ajtmh.org/cgi/c\

ontent/abstract/63/1/48?ck=nck

>>>

>>>

>>>Am J Trop Med Hyg (0) 63: 48-55.

>>>

>>>Clinical and neurophysiological study of the effects of multiple

>>>doses of artemisinin on brain-stem function in Vietnamese patients.

>>>

>>>

>>>E Kissinger, TT Hien, NT Hung, ND Nam, NL Tuyen, BV Dinh, C Mann,

>>>NH Phu, PP Loc, JA Simpson, NJ White, JJ Farrar

>>>

>>>Wellcome Trust Clinical Research Unit, Centre for Tropical

>>>Diseases, Ho Chi Minh City, Vietnam.

>>>

<http://flash.lymenet.org/scripts/ultimatebb.cgi?ubb=get_topic;f=1;t=062410>http\

://flash.lymenet.org/scripts/ultimatebb.cgi?ubb=get_topic;f=1;t=062410