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Safety and Efficacy Study of IV Artesunate to Treat Malaria

Primary Purpose

Malaria

Status
Completed
Phase
Phase 2
Locations
Kenya
Study Type
Interventional
Intervention
Artesunate
Malarone
Sponsored by
U.S. Army Medical Research and Development Command
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Malaria focused on measuring Uncomplicated Malaria, GMP artesunate

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Adult male & non-pregnant females, 18-65 years Fever, defined as >37.5ºC, during the current illness, or history (within the last 48 hours) of fever. Diagnosis of falciparum malaria, greater than or equal to 200 parasites/uL Able to communicate well with the investigator and to comply with the requirements of the entire study. Willing to be admitted for the period of drug administration and/or to follow up (return to hospital) Provision of the written informed consent to participate as shown by a signature on the informed consent form. Exclusion Criteria: Administration of any investigational drug in the period 0 to 16 weeks before entry to the study. The use of any medication during the period 0 to 14 days (prescribed drugs) or 0 to 5 days (OTC) before entry to the study (including herbal or dietary supplements), except those deemed by the principal investigator / clinical investigator not to interfere with the outcome of the study. Existence of any surgical or medical condition that, in the judgment of the clinical investigator, might interfere with the distribution, metabolism or excretion of the drug. History of serious adverse reaction or hypersensitivity to study drug or follow on treatment. Mixed malaria infection (malaria other than falciparum malaria mono-infection as detected by screening blood smear) Severe falciparum malaria (as defined by the WHO; Attachment 1). Donation or loss of greater than 400 ml of blood in the period 0 to 12 weeks before entry to the study, Transfusion of blood within past 30 days. Refusal to prevent pregnancy during the 14 days of the trial Pregnancy as defined clinically or by a positive urine BHCG at the time of screening, or nursing mothers. Laboratory evidence or history of significant cardiovascular, liver or renal functional abnormality, which in the opinion of the investigator would place them at increased risk. Specifically, the following will serve as exclusionary lab values: Creatinine >1.4 x ULN (>2.0 mg/dL) Glucose <LLN (65mg/dL) AST, ALT >3x ULN (120 U/L)

Sites / Locations

  • New Nyanza Provincial Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Artesunate and Malarone

Arm Description

Subject are given intravenous Artesunate once a day for 3 days. Following completion of Artesunate treatment, all subjects received Malarone follow-on therapy to ensure parasitologic cure.

Outcomes

Primary Outcome Measures

Change in Percentage of Parasites Detected at 48 Hours
Change in Percentage of Parasites Detected at 48 Hours. With positive numbers to represent increases and negative numbers to represent decreases

Secondary Outcome Measures

Percentage of Parasite Clearance
The target variable is detection (percentage) of asexual stage parasites of Plasmodium falciparum malaria in bloodstream by Giemsa - stained microscopy of thick and thin blood smears
Number of Subjects With Fever Clearance
Temperature is measured by oral digital thermometers, and fever clearance time is defined as the first time with resolution of fever (<37.5C) sustained for 24 hours
Safety - Severity of Adverse Events
Determine the safety (defined as severity of AE's using the Common Toxicity Criteria)
Safety - Adverse Events Relationship to Study Drug
Determine the safety (defined as relationship to study drug of AE's and SAE's)
Safety - Severity of Serious Adverse Events (SAE's)
Determine the safety (defined as severity of SAE's using the Common Toxicity Criteria)
Safety - Serious Adverse Event (SAE) Relationship to Study Drug
Determine the safety (defined as relationship to study drug of SAE's)

Full Information

First Posted
March 1, 2006
Last Updated
September 20, 2019
Sponsor
U.S. Army Medical Research and Development Command
Collaborators
Military Infectious Diseases Research Program (MIDRP)
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1. Study Identification

Unique Protocol Identification Number
NCT00298610
Brief Title
Safety and Efficacy Study of IV Artesunate to Treat Malaria
Official Title
A Phase II, Open Label, Study of the Safety, Tolerability, Efficacy and Pharmacokinetics of Intravenous Artesunate in Adults With Uncomplicated Malaria
Study Type
Interventional

2. Study Status

Record Verification Date
November 2016
Overall Recruitment Status
Completed
Study Start Date
March 2006 (undefined)
Primary Completion Date
October 2007 (Actual)
Study Completion Date
October 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
U.S. Army Medical Research and Development Command
Collaborators
Military Infectious Diseases Research Program (MIDRP)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine how GMP IV Artesunate is metabolized and cleared by individuals with uncomplicated malaria infection and to determine how fast it eliminates malaria infection from the body.
Detailed Description
This is an unblinded non-randomized phase II pharmacokinetic study of a new GMP formulation of intravenous artesunate. Artesunate has been used throughout Asia and Africa for many years. Its overall efficacy associated with the ability to lower parasitemia is well established. To date, pharmacokinetic studies have not been done in Africa using GMP (Good Manufacturing Practices)-produced drug. The objective of this study is to show that GMP IV artesunate rapidly clears parasites in Adult Kenyan populations with malaria and that the pharmacokinetic profile of the drug approximates other populations of adults tested (Asians and North Americans).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malaria
Keywords
Uncomplicated Malaria, GMP artesunate

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Artesunate and Malarone
Arm Type
Experimental
Arm Description
Subject are given intravenous Artesunate once a day for 3 days. Following completion of Artesunate treatment, all subjects received Malarone follow-on therapy to ensure parasitologic cure.
Intervention Type
Drug
Intervention Name(s)
Artesunate
Other Intervention Name(s)
quinidine
Intervention Description
Intravenous Artesunate (2.4 mg/kg) once a day for three days
Intervention Type
Drug
Intervention Name(s)
Malarone
Other Intervention Name(s)
atovaquone and proguanil hydrochloride
Intervention Description
(proguanil/atovaquone) follow-on therapy (4 tablets once daily for three days)
Primary Outcome Measure Information:
Title
Change in Percentage of Parasites Detected at 48 Hours
Description
Change in Percentage of Parasites Detected at 48 Hours. With positive numbers to represent increases and negative numbers to represent decreases
Time Frame
48 hours
Secondary Outcome Measure Information:
Title
Percentage of Parasite Clearance
Description
The target variable is detection (percentage) of asexual stage parasites of Plasmodium falciparum malaria in bloodstream by Giemsa - stained microscopy of thick and thin blood smears
Time Frame
24 and 48 hours post dose
Title
Number of Subjects With Fever Clearance
Description
Temperature is measured by oral digital thermometers, and fever clearance time is defined as the first time with resolution of fever (<37.5C) sustained for 24 hours
Time Frame
Within 48 hours post dose
Title
Safety - Severity of Adverse Events
Description
Determine the safety (defined as severity of AE's using the Common Toxicity Criteria)
Time Frame
up to 14 days
Title
Safety - Adverse Events Relationship to Study Drug
Description
Determine the safety (defined as relationship to study drug of AE's and SAE's)
Time Frame
up to 14 days
Title
Safety - Severity of Serious Adverse Events (SAE's)
Description
Determine the safety (defined as severity of SAE's using the Common Toxicity Criteria)
Time Frame
up to 14 days
Title
Safety - Serious Adverse Event (SAE) Relationship to Study Drug
Description
Determine the safety (defined as relationship to study drug of SAE's)
Time Frame
Up to 14 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult male & non-pregnant females, 18-65 years Fever, defined as >37.5ºC, during the current illness, or history (within the last 48 hours) of fever. Diagnosis of falciparum malaria, greater than or equal to 200 parasites/uL Able to communicate well with the investigator and to comply with the requirements of the entire study. Willing to be admitted for the period of drug administration and/or to follow up (return to hospital) Provision of the written informed consent to participate as shown by a signature on the informed consent form. Exclusion Criteria: Administration of any investigational drug in the period 0 to 16 weeks before entry to the study. The use of any medication during the period 0 to 14 days (prescribed drugs) or 0 to 5 days (OTC) before entry to the study (including herbal or dietary supplements), except those deemed by the principal investigator / clinical investigator not to interfere with the outcome of the study. Existence of any surgical or medical condition that, in the judgment of the clinical investigator, might interfere with the distribution, metabolism or excretion of the drug. History of serious adverse reaction or hypersensitivity to study drug or follow on treatment. Mixed malaria infection (malaria other than falciparum malaria mono-infection as detected by screening blood smear) Severe falciparum malaria (as defined by the WHO; Attachment 1). Donation or loss of greater than 400 ml of blood in the period 0 to 12 weeks before entry to the study, Transfusion of blood within past 30 days. Refusal to prevent pregnancy during the 14 days of the trial Pregnancy as defined clinically or by a positive urine BHCG at the time of screening, or nursing mothers. Laboratory evidence or history of significant cardiovascular, liver or renal functional abnormality, which in the opinion of the investigator would place them at increased risk. Specifically, the following will serve as exclusionary lab values: Creatinine >1.4 x ULN (>2.0 mg/dL) Glucose <LLN (65mg/dL) AST, ALT >3x ULN (120 U/L)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shon A Remich, MD
Organizational Affiliation
Walter Reed Army Institute of Research (WRAIR)
Official's Role
Principal Investigator
Facility Information:
Facility Name
New Nyanza Provincial Hospital
City
Kisumu
State/Province
New Nyanza
Country
Kenya

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety and Efficacy Study of IV Artesunate to Treat Malaria

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