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Clin Pharmacokinet 65 , 10871099 (2026)

The downregulation of PfEMP1 expression may be attributed to increased formation of methemoglobin, which disrupts actin remodeling and prevents the parasite from assembling its actin cytoskeletonwithin the host cytoplasm, thereby hindering the transport of PfEMP1 to the erythrocyte surface and ultimately reducing cytoadherence [27,28,29,30]

Additionally, several clinical trials have demonstrated that adherence to the MedDiet can effectively alleviate depressive symptoms and enhance the quality of life in patients (108, 109)

If additional benefit is desired and tolerated, a dose of 15 mg once weekly may be considered, continuing at that level as appropriate