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Efficacy, Safety and Tolerability of KLU156 in Adults and Children ≥ 5 kg Body Weight With Uncomplicated P. Falciparum Malaria (KALUMA)

Primary Purpose

Uncomplicated Plasmodium Falciparum Malaria

Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
KLU156
Coartem
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Uncomplicated Plasmodium Falciparum Malaria focused on measuring malaria, Plasmodium falciparum, KLU156, Coartem, artemether, lumefantrine, ganaplacide

Eligibility Criteria

2 Months - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Key Inclusion criteria (Core phase) Male or female patients ≥ 5 kg of body weight and ≥ 2 months of age Microscopically confirmed diagnosis of uncomplicated P. falciparum malaria with an asexual P. falciparum parasitemia ≥ 1,000 and ≤ 200,000 parasites/µL at the time of pre-screening with or without other Plasmodium spp. co-infection. Axillary temperature ≥ 37.5 ºC or oral temperature ≥ 38.0 ºC or tympanic/rectal temperature ≥ 38.5 ºC; or history of fever during the previous 24 hours (at least documented verbally) Negative pregnancy test for patients of childbearing potential Signed informed consent must be obtained before any assessment is performed; for minors, signed informed consent must be obtained from parent/legal guardian. If the parent/legal guardian is unable to read and write, then a witnessed consent according to local ethical standards is permitted. Patients who are capable of providing assent, must provide it along with parent/legal guardian consent or as per local ethical standards The patient and/or their parent/legal guardian is able to understand and comply with protocol requirements, instructions and protocol-stated restrictions and is likely to complete the study as planned. Key Exclusion criteria (Core phase) Signs and symptoms of severe malaria according to WHO 2015 (World Health Organization) Concurrent febrile illnesses (e.g., typhoid fever, known or suspected dengue fever, known COVID19) Severe malnutrition. For patients ≥ 12 years: body mass index (BMI) < 16.0. For children < 12 years: less than 70% of median normalized WHO reference weight or very low mid-upper arm circumference (MUAC < 115 mm) Repeated vomiting (defined as > 3 times in the 24 hours prior to start of screening) or severe diarrhea (defined as > 3 watery stools in the 24 hours prior to start of screening) Clinically relevant abnormalities of electrolyte balance which require correction, e.g., hypokalemia, hypocalcemia or hypomagnesemia Anemia (hemoglobin level <7 g/dL) Any surgical or medical condition which might significantly alter the absorption, distribution, metabolism, or excretion of drugs (e.g., Human immunodeficiency virus (HIV) patients on antiretroviral therapy (ART) or tuberculosis (TB) patients on treatment), or which may jeopardize the patient in case of participation in the study. Any of the following: Aspartate Aminotransferase/ Alanine Aminotransferase (AST/ALT) > 3 x the upper limit of normal (ULN), regardless of the level of total bilirubin Total bilirubin > 3 x ULN Resting QT interval corrected by Fridericia's formula (QTcF) > 450 ms at screening Prior antimalarial therapy or antibiotics with antimalarial activity within minimum of their five plasma half-lives (or within 4 weeks of screening if half-life is unknown) History or family history of long QT syndrome or sudden cardiac death, or any other clinical condition known to prolong the QTc interval, such as history of symptomatic cardiac arrhythmias, clinically relevant bradycardia or severe heart disease Pregnant or nursing (lactating) patients. Other protocol-defined inclusion/exclusion criteria may apply.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    KLU156

    Coartem

    Arm Description

    KLU156 once daily (QD) for 3 days under fed conditions (light meal).

    Coartem twice a day (BID) for 3 days under fed conditions.

    Outcomes

    Primary Outcome Measures

    PCR-corrected adequate clinical and parasitological response (ACPR)
    To confirm the efficacy of KLU156 in adults and children ≥ 5 kg body weight and ≥ 2 months of age suffering from uncomplicated malaria caused by P. falciparum (with or without other Plasmodium spp. co-infection) by demonstrating that KLU156 is non-inferior to Coartem (non-inferiority margin = 5%) based on the PCR-corrected ACPR at Day 29.

    Secondary Outcome Measures

    PCR-corrected and uncorrected ACPR
    To confirm the efficacy of KLU156 by assessing uncorrected and PCR-corrected ACPR at additional time points
    Uncorrected ACPR
    To further confirm the efficacy of KLU156 by demonstrating non-inferiority of KLU156 to Coartem (NI margin 7.5%) based on the uncorrected ACPR at Day 29
    Incidence and severity of Adverse Events (AEs) and Serious Adverse Events (SAEs)
    Incidence and severity of AEs and SAEs by treatment group, including changes in vital signs, electrocardiograms (ECGs), and laboratory results qualifying and reported as AEs.
    Fever Clearance Time
    To confirm the efficacy of KLU156 by assessing fever clearance between the two treatment arms
    Parasite Clearance Time
    To assess parasite clearance time between the two treatment arms
    Incidence rate of recrudescence and new infection
    Proportion of patients with recrudescence and new infections between the two treatment arms
    Proportion of patients with parasitemia
    For the parasitemia assessment, blood sampling can be done by means of a finger prick except when the timing for parasitology assessments coincides with time for clinical laboratory tests, in which case, blood sample can be taken from the venous blood collected for clinical laboratory analyses.
    Gametocytemia
    Disappearance or development of gametocytemia in patients with or without gametocytemia at baseline (pre-first dose administration), respectively
    Extension phase: PCR-corrected and uncorrected ACPR
    To evaluate efficacy over repeated treatment with KLU156 in adults and children ≥ 5 kg body weight and ≥ 2 months of age suffering from uncomplicated malaria caused by P. falciparum (with or without other Plasmodium spp. co-infection) for a maximum of 2 years
    Extension phase: KLU156-related AE/SAE incidence and severity by malaria episode
    To assess the safety and tolerability over repeated treatment with KLU156 in adults and children ≥ 5 kg body weight and ≥ 2 months of age suffering from uncomplicated malaria caused by P. falciparum (with or without other Plasmodium spp. co-infection) for a maximum of 2 years
    Extension phase: Gametocyte carriage over time
    To assess gametocyte carriage over time by malaria episode in the extension phase

    Full Information

    First Posted
    April 24, 2023
    Last Updated
    September 8, 2023
    Sponsor
    Novartis Pharmaceuticals
    Collaborators
    MMV, EDCTP, WANECAM
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05842954
    Brief Title
    Efficacy, Safety and Tolerability of KLU156 in Adults and Children ≥ 5 kg Body Weight With Uncomplicated P. Falciparum Malaria
    Acronym
    KALUMA
    Official Title
    A Randomized, Open-label, Multicenter Study to Compare Efficacy, Safety and Tolerability of KLU156 With Coartem® in the Treatment of Uncomplicated Plasmodium Falciparum Malaria in Adults and Children ≥ 5 kg Body Weight Followed by an Extension Phase With Repeated KLU156 Treatment
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 11, 2023 (Anticipated)
    Primary Completion Date
    November 29, 2024 (Anticipated)
    Study Completion Date
    November 6, 2026 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Novartis Pharmaceuticals
    Collaborators
    MMV, EDCTP, WANECAM

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This study aims to confirm the efficacy, safety and tolerability of KLU156, a fixed dose combination of ganaplacide (KAF156) and a solid dispersion formulation of lumefantrine (lumefantrine-SDF), when administered once daily for three days in adults and children ≥ 5 kg body weight and ≥ 2 months of age suffering from uncomplicated P. falciparum malaria (with or without other Plasmodium spp. co-infection). In the Extension phase, the safety, tolerability and efficacy of repeated treatment with KLU156 will be assessed for a maximum of two years in patients who did not experience early treatment failure (ETF), who did not experience any study treatment-related SAE (Serious Adverse Event) previously and who gave informed consent to participate in the Extension phase.
    Detailed Description
    The purpose of this study is to confirm the efficacy, safety and tolerability of KLU156 in patients with uncomplicated P. falciparum malaria (with or without other Plasmodium spp. co-infection) by demonstrating that KLU156 is non-inferior to Coartem. The study duration will be 43 days (Core phase) plus 24 months (Extension phase). The treatment duration will be 3 days for each malaria episode. The visit frequency will be Days 1-3 (hospitalized) and 5 follow-up visits (Days 4, 8, 22, 29 and 43) in the Core phase and Days 1-3 (hospitalized) and 3 follow-up visits (Days 4, 8 and 29) in the Extension phase.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Uncomplicated Plasmodium Falciparum Malaria
    Keywords
    malaria, Plasmodium falciparum, KLU156, Coartem, artemether, lumefantrine, ganaplacide

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    Outcomes Assessor
    Masking Description
    The Novartis clinical trial team (CTT) will be blinded to the identity of the treatment from the time of randomization until the database lock for the analysis of the Core phase. Prior to unblinding the data of the Core phase (for the Novartis CTT), at least two DMC reviews are planned to minimize risks in this vulnerable patient population: Once the first 200 patients (across both treatment arms) in the Core phase have been dosed and followed up to at least Day 22. Once the first 750 patients (across both treatment arms) in the Core phase have been dosed and followed up to at least Day 22. Additional DMC reviews may be conducted ad-hoc during the study, as deemed necessary. All safety data from the Core phase as well as from the Extension phase that are available at these 2 scheduled timepoints will be included in the DMC reviews. After the database lock of the Core phase, the CTT will be unblinded.
    Allocation
    Randomized
    Enrollment
    1500 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    KLU156
    Arm Type
    Experimental
    Arm Description
    KLU156 once daily (QD) for 3 days under fed conditions (light meal).
    Arm Title
    Coartem
    Arm Type
    Active Comparator
    Arm Description
    Coartem twice a day (BID) for 3 days under fed conditions.
    Intervention Type
    Drug
    Intervention Name(s)
    KLU156
    Intervention Description
    Oral use. KLU156 (400/480 mg) is the dose for patients with a bodyweight ≥ 35kg. Patients < 35kg will take a fraction of the dose according to weight group as defined in the protocol.
    Intervention Type
    Drug
    Intervention Name(s)
    Coartem
    Intervention Description
    Oral use. Dosing will be selected based on patient's body weight as per product's label.
    Primary Outcome Measure Information:
    Title
    PCR-corrected adequate clinical and parasitological response (ACPR)
    Description
    To confirm the efficacy of KLU156 in adults and children ≥ 5 kg body weight and ≥ 2 months of age suffering from uncomplicated malaria caused by P. falciparum (with or without other Plasmodium spp. co-infection) by demonstrating that KLU156 is non-inferior to Coartem (non-inferiority margin = 5%) based on the PCR-corrected ACPR at Day 29.
    Time Frame
    Day 29 (i.e., 28 days post-first dose administration)
    Secondary Outcome Measure Information:
    Title
    PCR-corrected and uncorrected ACPR
    Description
    To confirm the efficacy of KLU156 by assessing uncorrected and PCR-corrected ACPR at additional time points
    Time Frame
    Days 22 and 43 (i.e., 21 and 42 days post-first dose administration)
    Title
    Uncorrected ACPR
    Description
    To further confirm the efficacy of KLU156 by demonstrating non-inferiority of KLU156 to Coartem (NI margin 7.5%) based on the uncorrected ACPR at Day 29
    Time Frame
    Day 29
    Title
    Incidence and severity of Adverse Events (AEs) and Serious Adverse Events (SAEs)
    Description
    Incidence and severity of AEs and SAEs by treatment group, including changes in vital signs, electrocardiograms (ECGs), and laboratory results qualifying and reported as AEs.
    Time Frame
    Day 43
    Title
    Fever Clearance Time
    Description
    To confirm the efficacy of KLU156 by assessing fever clearance between the two treatment arms
    Time Frame
    Up to Day 3
    Title
    Parasite Clearance Time
    Description
    To assess parasite clearance time between the two treatment arms
    Time Frame
    Up to Day 3
    Title
    Incidence rate of recrudescence and new infection
    Description
    Proportion of patients with recrudescence and new infections between the two treatment arms
    Time Frame
    Days 22, 29 and 43
    Title
    Proportion of patients with parasitemia
    Description
    For the parasitemia assessment, blood sampling can be done by means of a finger prick except when the timing for parasitology assessments coincides with time for clinical laboratory tests, in which case, blood sample can be taken from the venous blood collected for clinical laboratory analyses.
    Time Frame
    12, 24, 48 and 72 hours after treatment
    Title
    Gametocytemia
    Description
    Disappearance or development of gametocytemia in patients with or without gametocytemia at baseline (pre-first dose administration), respectively
    Time Frame
    From baseline up to Day 43
    Title
    Extension phase: PCR-corrected and uncorrected ACPR
    Description
    To evaluate efficacy over repeated treatment with KLU156 in adults and children ≥ 5 kg body weight and ≥ 2 months of age suffering from uncomplicated malaria caused by P. falciparum (with or without other Plasmodium spp. co-infection) for a maximum of 2 years
    Time Frame
    Day 29 of malaria episode
    Title
    Extension phase: KLU156-related AE/SAE incidence and severity by malaria episode
    Description
    To assess the safety and tolerability over repeated treatment with KLU156 in adults and children ≥ 5 kg body weight and ≥ 2 months of age suffering from uncomplicated malaria caused by P. falciparum (with or without other Plasmodium spp. co-infection) for a maximum of 2 years
    Time Frame
    Up to 2 years
    Title
    Extension phase: Gametocyte carriage over time
    Description
    To assess gametocyte carriage over time by malaria episode in the extension phase
    Time Frame
    Up to 2 years

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    2 Months
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Key Inclusion criteria (Core phase) Male or female patients ≥ 5 kg of body weight and ≥ 2 months of age Microscopically confirmed diagnosis of uncomplicated P. falciparum malaria with an asexual P. falciparum parasitemia ≥ 1,000 and ≤ 200,000 parasites/µL at the time of pre-screening with or without other Plasmodium spp. co-infection. Axillary temperature ≥ 37.5 ºC or oral temperature ≥ 38.0 ºC or tympanic/rectal temperature ≥ 38.5 ºC; or history of fever during the previous 24 hours (at least documented verbally) Negative pregnancy test for patients of childbearing potential Signed informed consent must be obtained before any assessment is performed; for minors, signed informed consent must be obtained from parent/legal guardian. If the parent/legal guardian is unable to read and write, then a witnessed consent according to local ethical standards is permitted. Patients who are capable of providing assent, must provide it along with parent/legal guardian consent or as per local ethical standards The patient and/or their parent/legal guardian is able to understand and comply with protocol requirements, instructions and protocol-stated restrictions and is likely to complete the study as planned. Key Exclusion criteria (Core phase) Signs and symptoms of severe malaria according to WHO 2015 (World Health Organization) Concurrent febrile illnesses (e.g., typhoid fever, known or suspected dengue fever, known COVID19) Severe malnutrition. For patients ≥ 12 years: body mass index (BMI) < 16.0. For children < 12 years: less than 70% of median normalized WHO reference weight or very low mid-upper arm circumference (MUAC < 115 mm) Repeated vomiting (defined as > 3 times in the 24 hours prior to start of screening) or severe diarrhea (defined as > 3 watery stools in the 24 hours prior to start of screening) Clinically relevant abnormalities of electrolyte balance which require correction, e.g., hypokalemia, hypocalcemia or hypomagnesemia Anemia (hemoglobin level <7 g/dL) Any surgical or medical condition which might significantly alter the absorption, distribution, metabolism, or excretion of drugs (e.g., Human immunodeficiency virus (HIV) patients on antiretroviral therapy (ART) or tuberculosis (TB) patients on treatment), or which may jeopardize the patient in case of participation in the study. Any of the following: Aspartate Aminotransferase/ Alanine Aminotransferase (AST/ALT) > 3 x the upper limit of normal (ULN), regardless of the level of total bilirubin Total bilirubin > 3 x ULN Resting QT interval corrected by Fridericia's formula (QTcF) > 450 ms at screening Prior antimalarial therapy or antibiotics with antimalarial activity within minimum of their five plasma half-lives (or within 4 weeks of screening if half-life is unknown) History or family history of long QT syndrome or sudden cardiac death, or any other clinical condition known to prolong the QTc interval, such as history of symptomatic cardiac arrhythmias, clinically relevant bradycardia or severe heart disease Pregnant or nursing (lactating) patients. Other protocol-defined inclusion/exclusion criteria may apply.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Novartis Pharmaceuticals
    Phone
    +41613241111
    Email
    Novartis.email@novartis.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Novartis Pharmaceuticals

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com.

    Learn more about this trial

    Efficacy, Safety and Tolerability of KLU156 in Adults and Children ≥ 5 kg Body Weight With Uncomplicated P. Falciparum Malaria

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