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Dose-finding Study of Moxidectin for Treatment of Scabies

Primary Purpose

Scabies

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Moxidectin Oral Product
Sponsored by
Medicines Development for Global Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Scabies focused on measuring moxidectin, acaricide, oral

Eligibility Criteria

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

Inclusion Criteria:

  1. Aged ≥ 18 years.
  2. Provision of written informed consent.
  3. Parasitologically confirmed active Sarcoptes scabiei infestation, defined as the presence of at least two lesions (which may include burrows), each containing at least one live (internal and/or external structures discernable) adult Sarcoptes scabiei mite observed by reflectance confocal microscopy.
  4. Agree to the use of reliable contraceptive measures if female or male partner of a female of child-bearing potential from Screening and until 6 months after treatment with study product.

Exclusion Criteria:

  1. History of chronic or recurring dermatologic disease (other than scabies) that could interfere with the diagnosis and/or subsequent clinical assessment of scabies.
  2. Diagnosis of crusted/Norwegian scabies or scabies that, in the opinion of the Investigator, would require treatment with more than one standard of care (e.g. scabies requiring concurrent topical and oral treatment).
  3. Received any treatment for scabies within 7 days of Screening, including but not limited to permethrin, ivermectin, benzyl benzoate, lindane, crotamiton, malathion, and/or tea tree oil.
  4. Presence of any other clinically relevant condition, including infection, immunological disorder, malignant disease, and/or other underlying condition or circumstance at Screening or Baseline that would put the subject at increased risk from participating in the study or confound study evaluations.
  5. Poor venous access.
  6. Received an investigational agent within 28 days of Screening (or 5 half-lives of the investigational agent, whichever is longer).
  7. Body Mass Index over 35 kg/m2.
  8. Clinically relevant abnormal findings in vital signs, 12-lead electrocardiogram (ECG), or physical examination at Screening and/or Baseline in the opinion of the Investigator.
  9. Clinically relevant laboratory abnormalities at Screening, including:

    1. alanine aminotransferase or aspartate aminotransferase > 2.5 x upper limit of reference range;
    2. creatinine > 2.0 milligrams per deciliter (mg/dL);
    3. hemoglobin < 9.5 g/dL (female) or <10.5 g/dL (male);
    4. amylase > 2.0 x upper limit of reference range.
  10. Known or suspected hypersensitivity to macrocyclic lactones or excipients used in the formulation of moxidectin.
  11. Use of systemic steroids within 14 days of Screening, or history of prolonged use of systemic and/or high-dose inhaled corticosteroids, or use of topical steroids for 7 out of the 14 days prior to Screening.
  12. Subjects with known or suspected Loa loa coinfection.
  13. Difficulty swallowing tablets.
  14. Pregnant or breastfeeding, or planning to become pregnant.
  15. Known or suspected alcohol or illicit substance abuse.
  16. Unwilling, unlikely or unable to comply with all protocol specified assessments.
  17. Previous enrolment and treatment with moxidectin in this study.

Sites / Locations

  • Royal Darwin Hospital
  • Medizinischen Universität Wien
  • Hopital Henri Mondor AP-HP
  • CHU Nice Hopital Archet 2
  • CHU Saint-Etienne Hopital Nord

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Moxidectin 2 mg

Moxidectin 8 mg

Moxidectin 20 mg

Moxidectin 36 mg

Arm Description

Moxidectin 2 mg will be administered as a single dose. Each subject will receive the same number of tablets made up of moxidectin 2 mg tablets and placebo tablets to maintain the blind.

Moxidectin 8 mg will be administered as a single dose. Each subject will receive the same number of tablets made up of moxidectin 2 mg tablets and placebo tablets to maintain the blind.

Moxidectin 20 mg will be administered as a single dose. Each subject will receive the same number of tablets made up of moxidectin 2 mg tablets and placebo tablets to maintain the blind.

Moxidectin 36 mg will be administered as a single dose. Each subject will receive the same number of tablets made up of moxidectin 2 mg tablets and placebo tablets to maintain the blind.

Outcomes

Primary Outcome Measures

Mortality Rate for Adult Scabies Mites
Adult scabies mite death was based on the reflectance confocal microscopy (RCM) morphology assessment of 2 live adult scabies mites nominated pre-treatment (Baseline), hence overall number of units analyzed are different from the overall number of participants. For the outcome measure, the number of adult mites assessed at each timepoint is the sum of the number of adult mites from all participants in the analysis population for each dose. Therefore, mortality was assessed in 2 mites in the 2 mg group, 6 in the 8 mg group, 8 in the 20 mg group and 14 in the 32 mg group. Adult mite death was defined as the degradation (homogenization of internal structures and/or external anatomic structures, and increased reflectance) of the adult mite observed by RCM. The number of dead mites was assessed at Hours 4, 8, 24, 48 and 72, and Days 7, 14 and 28 compared to the baseline adult mites.
Summary of Participants With Most Commonly Occurring Adverse Events by Preferred Term (Safety Analysis Set)
No formal statistical analysis of AEs was undertaken. Adverse events reported in this Section refer to treatment emergent adverse events (TEAE), defined as AEs that started, or worsened, on or after the start of the administration of Investigational Product (Moxidectin). Moxidectin was generally well tolerated, with no treatment-related SAEs reported and no treatment emergent adverse event (TEAEs) leading to study withdrawal or resulting in death. Treatment-Emergent Adverse Events by MedDRA System Organ Class and Preferred Term. Data up to and including the Day 28 assessment for each subject.
Number of Participants and Severity of Adverse Events
Number of participants with Adverse events reported in this Section refer to treatment emergent adverse events (TEAE), defined as AEs that started, or worsened, on or after the start of the administration of IP. Data up to and including the Day 28 assessment for each subject. The severity of adverse events were assessed using the Toxicity Grading Scale for Healthy Adult and Adolescent volunteers Enrolled in Preventive Vaccine Clinical Trials.

Secondary Outcome Measures

Analysis of Moxidectin Plasma Concentrations
The final PK analysis dataset included a total of 240 evaluable PK samples from 22 subjects. All pre-dose samples were below the limit of quantitation (BQL).
Analysis of Moxidectin Maximum Plasma Concentrations (Cmax)
The final PK analysis dataset included a total of 240 evaluable PK samples from 22 subjects. All pre-dose samples were below the limit of quantitation (BQL).

Full Information

First Posted
March 18, 2019
Last Updated
September 21, 2023
Sponsor
Medicines Development for Global Health
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1. Study Identification

Unique Protocol Identification Number
NCT03905265
Brief Title
Dose-finding Study of Moxidectin for Treatment of Scabies
Official Title
A Phase II, Randomized, Double-blind, Parallel Group Dose Finding Study of Single Oral Doses of Moxidectin in Adults With Scabies
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Completed
Study Start Date
January 13, 2020 (Actual)
Primary Completion Date
February 28, 2022 (Actual)
Study Completion Date
February 28, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medicines Development for Global Health

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
The effective dose of moxidectin to treat human scabies is not known. This study aims to provide proof of concept that a single dose of moxidectin is effective in eliminating the scabies parasite in humans and to enable the determination of an optimal dose of moxidectin for treatment of scabies for further clinical studies.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Scabies
Keywords
moxidectin, acaricide, oral

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Parallel, double blind, multicenter, randomized, pharmacokinetic/pharmacodynamic study. Three cohorts of six subjects per cohort are planned. Subjects will be randomized 1:1:1 to receive 2, 8 or 20 mg moxidectin as a single oral dose. An additional cohort of 36 mg may be initiated with a target sample size of 6 subjects.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
To maintain blinding to treatment allocation, all subjects will receive treatment with the same number of tablets, comprised of moxidectin 2 mg tablets and matched placebo (as required).
Allocation
Randomized
Enrollment
22 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Moxidectin 2 mg
Arm Type
Experimental
Arm Description
Moxidectin 2 mg will be administered as a single dose. Each subject will receive the same number of tablets made up of moxidectin 2 mg tablets and placebo tablets to maintain the blind.
Arm Title
Moxidectin 8 mg
Arm Type
Experimental
Arm Description
Moxidectin 8 mg will be administered as a single dose. Each subject will receive the same number of tablets made up of moxidectin 2 mg tablets and placebo tablets to maintain the blind.
Arm Title
Moxidectin 20 mg
Arm Type
Experimental
Arm Description
Moxidectin 20 mg will be administered as a single dose. Each subject will receive the same number of tablets made up of moxidectin 2 mg tablets and placebo tablets to maintain the blind.
Arm Title
Moxidectin 36 mg
Arm Type
Experimental
Arm Description
Moxidectin 36 mg will be administered as a single dose. Each subject will receive the same number of tablets made up of moxidectin 2 mg tablets and placebo tablets to maintain the blind.
Intervention Type
Drug
Intervention Name(s)
Moxidectin Oral Product
Intervention Description
The required number of moxidectin 2 mg oral tablets will be administered as a single dose with placebo to match as required
Primary Outcome Measure Information:
Title
Mortality Rate for Adult Scabies Mites
Description
Adult scabies mite death was based on the reflectance confocal microscopy (RCM) morphology assessment of 2 live adult scabies mites nominated pre-treatment (Baseline), hence overall number of units analyzed are different from the overall number of participants. For the outcome measure, the number of adult mites assessed at each timepoint is the sum of the number of adult mites from all participants in the analysis population for each dose. Therefore, mortality was assessed in 2 mites in the 2 mg group, 6 in the 8 mg group, 8 in the 20 mg group and 14 in the 32 mg group. Adult mite death was defined as the degradation (homogenization of internal structures and/or external anatomic structures, and increased reflectance) of the adult mite observed by RCM. The number of dead mites was assessed at Hours 4, 8, 24, 48 and 72, and Days 7, 14 and 28 compared to the baseline adult mites.
Time Frame
28 days
Title
Summary of Participants With Most Commonly Occurring Adverse Events by Preferred Term (Safety Analysis Set)
Description
No formal statistical analysis of AEs was undertaken. Adverse events reported in this Section refer to treatment emergent adverse events (TEAE), defined as AEs that started, or worsened, on or after the start of the administration of Investigational Product (Moxidectin). Moxidectin was generally well tolerated, with no treatment-related SAEs reported and no treatment emergent adverse event (TEAEs) leading to study withdrawal or resulting in death. Treatment-Emergent Adverse Events by MedDRA System Organ Class and Preferred Term. Data up to and including the Day 28 assessment for each subject.
Time Frame
Day 0 to Day 28 inclusive
Title
Number of Participants and Severity of Adverse Events
Description
Number of participants with Adverse events reported in this Section refer to treatment emergent adverse events (TEAE), defined as AEs that started, or worsened, on or after the start of the administration of IP. Data up to and including the Day 28 assessment for each subject. The severity of adverse events were assessed using the Toxicity Grading Scale for Healthy Adult and Adolescent volunteers Enrolled in Preventive Vaccine Clinical Trials.
Time Frame
Day 0 to Day 28 inclusive
Secondary Outcome Measure Information:
Title
Analysis of Moxidectin Plasma Concentrations
Description
The final PK analysis dataset included a total of 240 evaluable PK samples from 22 subjects. All pre-dose samples were below the limit of quantitation (BQL).
Time Frame
Nominal time of PK sample collection was Pre-dose, 2hours (h), 3h, 4h, 8h, Day 1 (24h), Day 2 (48h), Day 3 (72h), Day 7 (168h), Day 14 (336h) and Day 28 (672h)
Title
Analysis of Moxidectin Maximum Plasma Concentrations (Cmax)
Description
The final PK analysis dataset included a total of 240 evaluable PK samples from 22 subjects. All pre-dose samples were below the limit of quantitation (BQL).
Time Frame
Nominal time of PK sample collection was Pre-dose, 2hours (h), 3h, 4h, 8h, Day 1 (24h), Day 2 (48h), Day 3 (72h), Day 7 (168h), Day 14 (336h) and Day 28 (672h)
Other Pre-specified Outcome Measures:
Title
Incidence and Severity of Scabies Signs and Symptoms
Description
The incidence and severity of signs and symptoms of scabies infection will be explored using a clinician-reported scabies severity assessment.
Time Frame
28 days
Title
Severity of Pruritus
Description
The severity of pruritus will be determined using the Numerical Rating Scale where 0="no itch" and 10="worst itch imaginable"
Time Frame
28 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged ≥ 18 years. Provision of written informed consent. Parasitologically confirmed active Sarcoptes scabiei infestation, defined as the presence of at least two lesions (which may include burrows), each containing at least one live (internal and/or external structures discernable) adult Sarcoptes scabiei mite observed by reflectance confocal microscopy. Agree to the use of reliable contraceptive measures if female or male partner of a female of child-bearing potential from Screening and until 6 months after treatment with study product. Exclusion Criteria: History of chronic or recurring dermatologic disease (other than scabies) that could interfere with the diagnosis and/or subsequent clinical assessment of scabies. Diagnosis of crusted/Norwegian scabies or scabies that, in the opinion of the Investigator, would require treatment with more than one standard of care (e.g. scabies requiring concurrent topical and oral treatment). Received any treatment for scabies within 7 days of Screening, including but not limited to permethrin, ivermectin, benzyl benzoate, lindane, crotamiton, malathion, and/or tea tree oil. Presence of any other clinically relevant condition, including infection, immunological disorder, malignant disease, and/or other underlying condition or circumstance at Screening or Baseline that would put the subject at increased risk from participating in the study or confound study evaluations. Poor venous access. Received an investigational agent within 28 days of Screening (or 5 half-lives of the investigational agent, whichever is longer). Body Mass Index over 35 kg/m2. Clinically relevant abnormal findings in vital signs, 12-lead electrocardiogram (ECG), or physical examination at Screening and/or Baseline in the opinion of the Investigator. Clinically relevant laboratory abnormalities at Screening, including: alanine aminotransferase or aspartate aminotransferase > 2.5 x upper limit of reference range; creatinine > 2.0 milligrams per deciliter (mg/dL); hemoglobin < 9.5 g/dL (female) or <10.5 g/dL (male); amylase > 2.0 x upper limit of reference range. Known or suspected hypersensitivity to macrocyclic lactones or excipients used in the formulation of moxidectin. Use of systemic steroids within 14 days of Screening, or history of prolonged use of systemic and/or high-dose inhaled corticosteroids, or use of topical steroids for 7 out of the 14 days prior to Screening. Subjects with known or suspected Loa loa coinfection. Difficulty swallowing tablets. Pregnant or breastfeeding, or planning to become pregnant. Known or suspected alcohol or illicit substance abuse. Unwilling, unlikely or unable to comply with all protocol specified assessments. Previous enrolment and treatment with moxidectin in this study.
Facility Information:
Facility Name
Royal Darwin Hospital
City
Darwin
Country
Australia
Facility Name
Medizinischen Universität Wien
City
Vienna
Country
Austria
Facility Name
Hopital Henri Mondor AP-HP
City
Créteil
Country
France
Facility Name
CHU Nice Hopital Archet 2
City
Nice
Country
France
Facility Name
CHU Saint-Etienne Hopital Nord
City
Saint-Priest-en-Jarez
Country
France

12. IPD Sharing Statement

Plan to Share IPD
No

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Dose-finding Study of Moxidectin for Treatment of Scabies

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