Efficacy, Tolerability, PK of OZ439 in Adults With Acute, Uncomplicated P.Falciparum or Vivax Malaria Mono-infection
Primary Purpose
Malaria, Falciparum, Malaria, Vivax
Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
OZ439
Sponsored by
About this trial
This is an interventional treatment trial for Malaria, Falciparum focused on measuring Acute uncomplicated Plasmodium Falciparum malaria, Blood stage Plasmodium Vivax malaria
Eligibility Criteria
Inclusion Criteria:
- Male or female patients between the age of 18 and 60 years, inclusive
- Body weight between 40 kg and 90 kg inclusive
Presence of mono-infection of P. falciparum or P. vivax confirmed by:
- Fever, as defined by axillary temperature ≥ 37.5°C or oral/rectal/tympanic temperature ≥ 38°C, or history of fever in the previous 24 hours (history of fever must be documented) and,
- Microscopically confirmed parasite infection, 5,000 to 50,000 asexual parasite count/µl of blood
- Written informed consent, in accordance with local practice, provided by patient. If the patient is unable to write, witnessed consent is permitted according to local ethical considerations
- Ability to swallow oral medication
- Ability and willingness to participate and access the health facility
- Agree to minimum of 4 days hospitalisation for drug administration and pharmacokinetic sampling
Exclusion Criteria:
- Patients with signs and symptoms of severe/complicated malaria requiring parenteral treatment according to the World Health Organisation Criteria 2010 (Attachment 2)
- Mixed Plasmodium infection
- Severe vomiting, defined as more than three times in the 24 hours prior to inclusion in the study or inability to tolerate oral treatment, or severe diarrhoea defined as 3 or more watery stools per day
- Presence of other serious or chronic clinical condition requiring hospitalisation.
- Severe malnutrition (defined as the weight-for-height being below -3 standard deviation or less than 70% of median of the NCHS/WHO normalised reference values).
- Known history or evidence of clinically significant disorders such as cardiovascular (including arrhythmia, QTc interval greater than or equal to 450 msec), respiratory (including active tuberculosis), history of jaundice, hepatic, renal, gastrointestinal, immunological (including active HIV-AIDS), neurological (including auditory), endocrine, infectious, malignancy, psychiatric, history of convulsions or other abnormality (including head trauma).
- Known history of hypersensitivity, allergic or adverse reactions to artemisinin containing compounds or mefloquine or drug in the national guidelines for P. vivax.
- Known active Hepatitis A IgM (HAV-IgM), Hepatitis B surface antigen (HBsAg) or Hepatitis C antibody (HCV Ab).
- Have received any antimalarial treatment in the preceding 14 days, as determined by history and screening test.
- Have received antibacterial with known antimalarial activity in the preceding 14 days.
- Have received an investigational drug within the past 4 weeks.
- Liver function tests (ASAT/ALAT levels) more than 2 x ULN
- Hb level below 10 g/dL.
- Bilirubin levels greater than 40 µmol/L.
- Serum creatinine levels more than 2 times the upper limit of normal range in absence of dehydration. In case of important dehydration the creatinine should be lower than 2X ULN after oral/parenteral rehydration.
- Female patients must be neither pregnant (as demonstrated by a negative serum pregnancy test) nor lactating, and must be willing to take measures not to become pregnant during the study period and safety follow-up period
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Experimental
Experimental
Experimental
Arm Label
800 mg OZ439 po single dose
400 mg OZ439 p.o. single dose
200mg OZ439 p.o. single dose
1200 mg OZ439 po single dose
Arm Description
800 mg OZ439 po single dose
400 mg OZ439 p.o. single dose
200mg OZ439 p.o. single dose
1200 mg OZ439 po single dose
Outcomes
Primary Outcome Measures
Derived Parasite Reduction Rate at 24 Hours (PPR24)
PRR24 is the log10 change in parasitemia over 24 hours estimated from a regression model fit separately for each patient. The relationship between parasite counts and time was analyzed by fitting a variable lag phase, then a linear decline to the natural log of parasite count versus time relationship. The slope of this log linear relationship is the primary end-point.
The time points chosen for the regression are those that yield the highest degree of significance when assessing the regression when the number of time points are greater than or equal to 3. No extrapolation was performed.
Secondary Outcome Measures
Full Information
NCT ID
NCT01213966
First Posted
October 1, 2010
Last Updated
November 17, 2014
Sponsor
Medicines for Malaria Venture
Collaborators
Mahidol University
1. Study Identification
Unique Protocol Identification Number
NCT01213966
Brief Title
Efficacy, Tolerability, PK of OZ439 in Adults With Acute, Uncomplicated P.Falciparum or Vivax Malaria Mono-infection
Official Title
Phase IIa Exploratory, Open Label, Single/Multiple Dose Testing Clinical Study to Assess the Preliminary Efficacy, Tolerability and PK of OZ439 in Adult Patients With Acute, Uncomplicated P. Falciparum or Vivax Malaria Mono-infection
Study Type
Interventional
2. Study Status
Record Verification Date
November 2014
Overall Recruitment Status
Completed
Study Start Date
October 2010 (undefined)
Primary Completion Date
May 2012 (Actual)
Study Completion Date
May 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medicines for Malaria Venture
Collaborators
Mahidol University
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
A Phase IIa Exploratory, Open label, Single Dose Regimen, Multiple Dose Testing Clinical Study to Assess the Preliminary Efficacy, Tolerability and Pharmacokinetics of OZ439 in adult patients with acute, uncomplicated Plasmodium falciparum or vivax malaria mono-infection.
Detailed Description
This exploratory Phase IIa study aims to investigate the preliminary efficacy in terms of parasite reduction and clearance in malaria patients, and the tolerability of OZ439 administered as single dose regimen at 3 different doses in parallel cohorts of patients with either acute uncomplicated Plasmodium falciparum or Plasmodium vivax malaria mono-infection (10 patients per plasmodium species per dose level).
Treatment with OZ439 will be given as a single dose on Day 0, starting in the first cohort at a dose of 800 mg. Established antimalarial therapy will be given at the latest at 36 hours post dosing.
The primary endpoint will be the derived parasite reduction rate (PRR) at 24 hours after study drug administration.
A review of each individual study cohort (dose/species) will be conducted with the Principal Investigator and the Sponsor and a decision will be reached on whether the dose for the next cohort should increase or decrease (within 200mg-1600mg range). This decision will be based on parasite reduction rate over the first 24 hours following administration of OZ439, tolerability and exposure.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malaria, Falciparum, Malaria, Vivax
Keywords
Acute uncomplicated Plasmodium Falciparum malaria, Blood stage Plasmodium Vivax malaria
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
82 (Actual)
8. Arms, Groups, and Interventions
Arm Title
800 mg OZ439 po single dose
Arm Type
Experimental
Arm Description
800 mg OZ439 po single dose
Arm Title
400 mg OZ439 p.o. single dose
Arm Type
Experimental
Arm Description
400 mg OZ439 p.o. single dose
Arm Title
200mg OZ439 p.o. single dose
Arm Type
Experimental
Arm Description
200mg OZ439 p.o. single dose
Arm Title
1200 mg OZ439 po single dose
Arm Type
Experimental
Arm Description
1200 mg OZ439 po single dose
Intervention Type
Drug
Intervention Name(s)
OZ439
Other Intervention Name(s)
Artefenomel
Intervention Description
po, single dose
Primary Outcome Measure Information:
Title
Derived Parasite Reduction Rate at 24 Hours (PPR24)
Description
PRR24 is the log10 change in parasitemia over 24 hours estimated from a regression model fit separately for each patient. The relationship between parasite counts and time was analyzed by fitting a variable lag phase, then a linear decline to the natural log of parasite count versus time relationship. The slope of this log linear relationship is the primary end-point.
The time points chosen for the regression are those that yield the highest degree of significance when assessing the regression when the number of time points are greater than or equal to 3. No extrapolation was performed.
Time Frame
24 hours after study drug administration
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female patients between the age of 18 and 60 years, inclusive
Body weight between 40 kg and 90 kg inclusive
Presence of mono-infection of P. falciparum or P. vivax confirmed by:
Fever, as defined by axillary temperature ≥ 37.5°C or oral/rectal/tympanic temperature ≥ 38°C, or history of fever in the previous 24 hours (history of fever must be documented) and,
Microscopically confirmed parasite infection, 5,000 to 50,000 asexual parasite count/µl of blood
Written informed consent, in accordance with local practice, provided by patient. If the patient is unable to write, witnessed consent is permitted according to local ethical considerations
Ability to swallow oral medication
Ability and willingness to participate and access the health facility
Agree to minimum of 4 days hospitalisation for drug administration and pharmacokinetic sampling
Exclusion Criteria:
Patients with signs and symptoms of severe/complicated malaria requiring parenteral treatment according to the World Health Organisation Criteria 2010 (Attachment 2)
Mixed Plasmodium infection
Severe vomiting, defined as more than three times in the 24 hours prior to inclusion in the study or inability to tolerate oral treatment, or severe diarrhoea defined as 3 or more watery stools per day
Presence of other serious or chronic clinical condition requiring hospitalisation.
Severe malnutrition (defined as the weight-for-height being below -3 standard deviation or less than 70% of median of the NCHS/WHO normalised reference values).
Known history or evidence of clinically significant disorders such as cardiovascular (including arrhythmia, QTc interval greater than or equal to 450 msec), respiratory (including active tuberculosis), history of jaundice, hepatic, renal, gastrointestinal, immunological (including active HIV-AIDS), neurological (including auditory), endocrine, infectious, malignancy, psychiatric, history of convulsions or other abnormality (including head trauma).
Known history of hypersensitivity, allergic or adverse reactions to artemisinin containing compounds or mefloquine or drug in the national guidelines for P. vivax.
Known active Hepatitis A IgM (HAV-IgM), Hepatitis B surface antigen (HBsAg) or Hepatitis C antibody (HCV Ab).
Have received any antimalarial treatment in the preceding 14 days, as determined by history and screening test.
Have received antibacterial with known antimalarial activity in the preceding 14 days.
Have received an investigational drug within the past 4 weeks.
Liver function tests (ASAT/ALAT levels) more than 2 x ULN
Hb level below 10 g/dL.
Bilirubin levels greater than 40 µmol/L.
Serum creatinine levels more than 2 times the upper limit of normal range in absence of dehydration. In case of important dehydration the creatinine should be lower than 2X ULN after oral/parenteral rehydration.
Female patients must be neither pregnant (as demonstrated by a negative serum pregnancy test) nor lactating, and must be willing to take measures not to become pregnant during the study period and safety follow-up period
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sasithon Pukrittayakamee, MD
Organizational Affiliation
Mahidol University
Official's Role
Principal Investigator
12. IPD Sharing Statement
Citations:
PubMed Identifier
26448141
Citation
Phyo AP, Jittamala P, Nosten FH, Pukrittayakamee S, Imwong M, White NJ, Duparc S, Macintyre F, Baker M, Mohrle JJ. Antimalarial activity of artefenomel (OZ439), a novel synthetic antimalarial endoperoxide, in patients with Plasmodium falciparum and Plasmodium vivax malaria: an open-label phase 2 trial. Lancet Infect Dis. 2016 Jan;16(1):61-69. doi: 10.1016/S1473-3099(15)00320-5. Epub 2015 Oct 5.
Results Reference
derived
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Efficacy, Tolerability, PK of OZ439 in Adults With Acute, Uncomplicated P.Falciparum or Vivax Malaria Mono-infection
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