search
Back to results

Effect of Concomitant Mansonella Perstans Microfilaremia on Immune Responses Following Single Dose Praziquantel in People With Schistosomiasis

Primary Purpose

Schistosomiasis

Status
Withdrawn
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Praziquantel
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Schistosomiasis focused on measuring Filariasis, Schistosoma Mansoni, Coinfection

Eligibility Criteria

14 Years - 80 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers
  • INCLUSION CRITERIA (SCREENING):

    1. Male or non-pregnant female subjects
    2. Age 14-80 years (per participant self-report)
    3. Resident of Tienegubougou, Bougoudiana or surrounding villages

    5. Consent to a blood draw to screen for filarial infection and a urine exam to screen for schistosomiasis

    6. Must be willing to have blood samples stored.

EXCLUSION CRITERIA (SCREENING):

  1. Known to be pregnant (by history)
  2. Chronic medical conditions, including but not limited to diabetes, renal or hepatic insufficiency, immunodeficiency, psychiatric disorder, seizure, that in the investigators judgments are deemed to be clinically significant
  3. History of hypersensitivity reaction to PZQ.
  4. Weight less than 20 kg

INCLUSION CRITERIA (INTERVENTIONAL STUDY):

  1. S. haematobium infection documented at screening and within 14 days prior to the baseline visit
  2. The subject agrees to storage of samples for study.

EXCLUSION CRITERIA (INTERVENTIONAL STUDY):

  1. Pregnancy (by urine beta-HCG)
  2. Chronic kidney or liver disease
  3. Hgb <10 mg/dL
  4. PZQ treatment since the screening visit
  5. Concomitant Schistosoma mansoni, Wuchereria bancrofti (Wb) or Onchocerca volvulus infection
  6. Use of immunosuppressive therapies, including steroids, within the past month
  7. Any condition that in the investigator s opinion places the subject at undue risk by participating in the study.

EXCLUSION OF CHILDREN AND PREGNANT WOMEN:

Pregnant women will be excluded from this study since it involves administration of medications contraindicated in pregnancy. Children less than 14 years old will be excluded because of the amount of blood required for the immunologic studies. The age of consent in Mali is 18 years of age, so children aged 14 to 17 years will sign an assent form in addition to the consent form to be signed by a parent or tutor. However, married women between the ages of 14 and 17 will sign consent as adults in view of the laws governing emancipation of women in Mali. Subjects who do not participate in this study will receive PZQ as part of the national schistosomiasis control program.

Participation of Women:

-Pregnancy: The effects of praziquantel on the developing human fetus are unknown (pregnancy category B). For this reason, females of

childbearing-age must have a negative pregnancy test result prior to receiving praziquantel. Since the half-life of praziquantel is short (3-4 hours), contraceptive measures will not be required post-treatment.

-Breast feeding: Praziquantel is known to be present in breast milk for up to 3 days following a single dose and is not approved for use in children under the age of 4 years. Consequently, women will be asked to suspend breastfeeding after treatment with PZQ for 3 days. Formula will be provided for breastfed children affected by their mother s participation during this time to ensure adequate nutrition. Depending on the age of the child, formula may be given. A pediatric nurse will be present during this time to provide assistance and counsel to the mothers.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Sh

    ShMp

    Arm Description

    Mono infected with Schistosoma haematobium

    Coinfected with Schistosoma haematobium andMansonella perstans

    Outcomes

    Primary Outcome Measures

    Peak percentage change from baseline eosinophil count

    Secondary Outcome Measures

    Peak absolute change from the baseline eosinophil count and peakpercentage change in eosinophil granule protein levels
    Frequency and severity of adverse events
    Number of subjects with detectable Sh eggs in urine

    Full Information

    First Posted
    April 6, 2016
    Last Updated
    December 14, 2019
    Sponsor
    National Institute of Allergy and Infectious Diseases (NIAID)
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT02734186
    Brief Title
    Effect of Concomitant Mansonella Perstans Microfilaremia on Immune Responses Following Single Dose Praziquantel in People With Schistosomiasis
    Official Title
    Effect of Concomitant Mansonella Perstans Microfilaremia on Immune Responses Following Single Dose Praziquantel in Subjects With Schistosomiasis: A Pilot Study
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    December 14, 2018
    Overall Recruitment Status
    Withdrawn
    Study Start Date
    April 6, 2016 (undefined)
    Primary Completion Date
    December 14, 2018 (Actual)
    Study Completion Date
    December 14, 2018 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    National Institute of Allergy and Infectious Diseases (NIAID)

    4. Oversight

    5. Study Description

    Brief Summary
    Background: Schistosomiasis is a chronic infection. It is caused by parasitic worms called Schistosoma haematobium (Sh) that are spread by snails that live in rivers. It can lead to liver problems or bladder cancer. Praziquantel (PZQ) is a drug used to treat this infection. After taking it, some people develop increased resistance to reinfection with Sh. Some people with Sh infection can be infected with another worm called Mansonella perstans (Mp). Mp is spread through a biting insect called a midge. It rarely causes symptoms. However, researchers think that Mp infection could affect the body s response to PZQ treatment for or risk of reinfection with Sh. Objective: To find out the effects of Mp infection on the response to PZQ treatment for Sh infection. Eligibility: Men and women ages 14-80 who: Live in Tieneguebougou, Bougoudiana, or surrounding villages in Mali Are not pregnant Have Sh infection Have no other chronic medical conditions Design: Participants will be screened with: Medical history Physical exam Blood and urine tests Stool samples Participants will be treated with a single dose of PZQ by mouth. After receiving PZQ, participants will return to the clinic for blood and urine tests at the following times: 4, 8, 24, 48, and 72 hours later 5, 7, 9, and 14 days later 1, 3, and 6 months later Participants who are infected with Sh at the 6-month visit will get another treatment with PZQ. ...
    Detailed Description
    Chronic filarial infection is associated with downregulation of immune responses to both helminth and non-helminth antigens. Praziquantel (PZQ) treatment of schistosomiasis is associated with a dramatic interleukin-5 (IL-5)-dependent increase in eosinophilia that is correlated with resistance to reinfection. We hypothesize that chronic filarial infection with Mansonella perstans (Mp) may attenuate post-treatment eosinophilia and thus impact resistance to reinfection. To address the first part of this question, we plan to compare post-PZQ reactions and reinfection rates in 20 subjects with schistosomiasis and Mp infection to those in 20 subjects with schistosomiasis and no evidence of filarial infection in an area coendemic for both infections in Mali. Signs and symptoms, complete blood counts, intracellular and serum cytokine levels, and markers of eosinophil activation will be assessed at baseline, 4 and 8 hours, and 1, 2, 3, 5, 7, 9, and 14 days post-treatment and compared between the two treatment groups. Schistosoma haematobium reinfection rates will also be compared at 1, 3, and 6 months post-treatment.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Schistosomiasis
    Keywords
    Filariasis, Schistosoma Mansoni, Coinfection

    7. Study Design

    Primary Purpose
    Basic Science
    Study Phase
    Phase 4
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Sh
    Arm Type
    Experimental
    Arm Description
    Mono infected with Schistosoma haematobium
    Arm Title
    ShMp
    Arm Type
    Experimental
    Arm Description
    Coinfected with Schistosoma haematobium andMansonella perstans
    Intervention Type
    Drug
    Intervention Name(s)
    Praziquantel
    Intervention Description
    Anthelminthic
    Primary Outcome Measure Information:
    Title
    Peak percentage change from baseline eosinophil count
    Time Frame
    During the first 7 days post-treatment
    Secondary Outcome Measure Information:
    Title
    Peak absolute change from the baseline eosinophil count and peakpercentage change in eosinophil granule protein levels
    Time Frame
    During the first 7 days post-treatment
    Title
    Frequency and severity of adverse events
    Time Frame
    During the first 3 days post-treatment
    Title
    Number of subjects with detectable Sh eggs in urine
    Time Frame
    At 1, 3 and 6 months post-treatment

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    14 Years
    Maximum Age & Unit of Time
    80 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    INCLUSION CRITERIA (SCREENING): Male or non-pregnant female subjects Age 14-80 years (per participant self-report) Resident of Tienegubougou, Bougoudiana or surrounding villages 5. Consent to a blood draw to screen for filarial infection and a urine exam to screen for schistosomiasis 6. Must be willing to have blood samples stored. EXCLUSION CRITERIA (SCREENING): Known to be pregnant (by history) Chronic medical conditions, including but not limited to diabetes, renal or hepatic insufficiency, immunodeficiency, psychiatric disorder, seizure, that in the investigators judgments are deemed to be clinically significant History of hypersensitivity reaction to PZQ. Weight less than 20 kg INCLUSION CRITERIA (INTERVENTIONAL STUDY): S. haematobium infection documented at screening and within 14 days prior to the baseline visit The subject agrees to storage of samples for study. EXCLUSION CRITERIA (INTERVENTIONAL STUDY): Pregnancy (by urine beta-HCG) Chronic kidney or liver disease Hgb <10 mg/dL PZQ treatment since the screening visit Concomitant Schistosoma mansoni, Wuchereria bancrofti (Wb) or Onchocerca volvulus infection Use of immunosuppressive therapies, including steroids, within the past month Any condition that in the investigator s opinion places the subject at undue risk by participating in the study. EXCLUSION OF CHILDREN AND PREGNANT WOMEN: Pregnant women will be excluded from this study since it involves administration of medications contraindicated in pregnancy. Children less than 14 years old will be excluded because of the amount of blood required for the immunologic studies. The age of consent in Mali is 18 years of age, so children aged 14 to 17 years will sign an assent form in addition to the consent form to be signed by a parent or tutor. However, married women between the ages of 14 and 17 will sign consent as adults in view of the laws governing emancipation of women in Mali. Subjects who do not participate in this study will receive PZQ as part of the national schistosomiasis control program. Participation of Women: -Pregnancy: The effects of praziquantel on the developing human fetus are unknown (pregnancy category B). For this reason, females of childbearing-age must have a negative pregnancy test result prior to receiving praziquantel. Since the half-life of praziquantel is short (3-4 hours), contraceptive measures will not be required post-treatment. -Breast feeding: Praziquantel is known to be present in breast milk for up to 3 days following a single dose and is not approved for use in children under the age of 4 years. Consequently, women will be asked to suspend breastfeeding after treatment with PZQ for 3 days. Formula will be provided for breastfed children affected by their mother s participation during this time to ensure adequate nutrition. Depending on the age of the child, formula may be given. A pediatric nurse will be present during this time to provide assistance and counsel to the mothers.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Amy D Klion, M.D.
    Organizational Affiliation
    National Institute of Allergy and Infectious Diseases (NIAID)
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    23133692
    Citation
    Dolo H, Coulibaly YI, Dembele B, Konate S, Coulibaly SY, Doumbia SS, Diallo AA, Soumaoro L, Coulibaly ME, Diakite SA, Guindo A, Fay MP, Metenou S, Nutman TB, Klion AD. Filariasis attenuates anemia and proinflammatory responses associated with clinical malaria: a matched prospective study in children and young adults. PLoS Negl Trop Dis. 2012;6(11):e1890. doi: 10.1371/journal.pntd.0001890. Epub 2012 Nov 1.
    Results Reference
    background
    PubMed Identifier
    15213147
    Citation
    Fitzsimmons CM, Joseph S, Jones FM, Reimert CM, Hoffmann KF, Kazibwe F, Kimani G, Mwatha JK, Ouma JH, Tukahebwa EM, Kariuki HC, Vennervald BJ, Kabatereine NB, Dunne DW. Chemotherapy for schistosomiasis in Ugandan fishermen: treatment can cause a rapid increase in interleukin-5 levels in plasma but decreased levels of eosinophilia and worm-specific immunoglobulin E. Infect Immun. 2004 Jul;72(7):4023-30. doi: 10.1128/IAI.72.7.4023-4030.2004.
    Results Reference
    background
    PubMed Identifier
    14628953
    Citation
    Keiser PB, Coulibaly YI, Keita F, Traore D, Diallo A, Diallo DA, Semnani RT, Doumbo OK, Traore SF, Klion AD, Nutman TB. Clinical characteristics of post-treatment reactions to ivermectin/albendazole for Wuchereria bancrofti in a region co-endemic for Mansonella perstans. Am J Trop Med Hyg. 2003 Sep;69(3):331-5.
    Results Reference
    background

    Learn more about this trial

    Effect of Concomitant Mansonella Perstans Microfilaremia on Immune Responses Following Single Dose Praziquantel in People With Schistosomiasis

    We'll reach out to this number within 24 hrs