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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
Medicines for Malaria Venture
About
Eligibility
Locations
Arms
Outcomes
Full info

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

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female patients between the age of 18 and 60 years, inclusive
  2. Body weight between 40 kg and 90 kg inclusive
  3. 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
  4. 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
  5. Ability to swallow oral medication
  6. Ability and willingness to participate and access the health facility
  7. Agree to minimum of 4 days hospitalisation for drug administration and pharmacokinetic sampling

Exclusion Criteria:

  1. Patients with signs and symptoms of severe/complicated malaria requiring parenteral treatment according to the World Health Organisation Criteria 2010 (Attachment 2)
  2. Mixed Plasmodium infection
  3. 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
  4. Presence of other serious or chronic clinical condition requiring hospitalisation.
  5. 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).
  6. 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).
  7. Known history of hypersensitivity, allergic or adverse reactions to artemisinin containing compounds or mefloquine or drug in the national guidelines for P. vivax.
  8. Known active Hepatitis A IgM (HAV-IgM), Hepatitis B surface antigen (HBsAg) or Hepatitis C antibody (HCV Ab).
  9. Have received any antimalarial treatment in the preceding 14 days, as determined by history and screening test.
  10. Have received antibacterial with known antimalarial activity in the preceding 14 days.
  11. Have received an investigational drug within the past 4 weeks.
  12. Liver function tests (ASAT/ALAT levels) more than 2 x ULN
  13. Hb level below 10 g/dL.
  14. Bilirubin levels greater than 40 µmol/L.
  15. 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.
  16. 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

    First Posted
    October 1, 2010
    Last Updated
    November 17, 2014
    Sponsor
    Medicines for Malaria Venture
    Collaborators
    Mahidol University
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    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

    Learn more about this trial

    Efficacy, Tolerability, PK of OZ439 in Adults With Acute, Uncomplicated P.Falciparum or Vivax Malaria Mono-infection

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