Evaluate Parasitological Clearance Rates And Pharmacokinetics Of The Combination Of Azithromycin And Chloroquine In Asymptomatic Pregnant Women With Falciparum Parasitemia In Africa
Primary Purpose
Asymptomatic Parasitemia In Pregnancy
Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Azithromycin plus chloroquine
Sponsored by
About this trial
This is an interventional treatment trial for Asymptomatic Parasitemia In Pregnancy focused on measuring P. falciparum malaria, asymptomatic parasitemia, parasitological clearance, Intermittent Preventive Treatment of Falciparum Malaria in Pregnant Women (IPTp)
Eligibility Criteria
Inclusion Criteria:
- Primigravidae and secundigravidae pregnant women at >=14 and <=30 weeks of gestational age (confirmed by ultrasound examination).
- Evidence of asymptomatic parasitemia with Plasmodium falciparum monoinfection (confirmed by microscopy) with parasite counts in the range of 80 100,000/uL on thick blood smears.
- Evidence of a personally signed and dated informed consent document indicating that the subject (or a legally acceptable representative if a subject is <18 years of age) has been informed of all pertinent aspects of the study and that all questions by the subject have been sufficiently answered. Assent will be obtained from subjects <18 years of age.
- Subjects who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
Exclusion Criteria:
- Age <16 years old or >35 years old.
- Multiple gestations (more than one fetus) as per the ultrasound results at screening.
- Clinical symptoms of malaria.
- Hemoglobin <8 g/dL (measured at baseline).
- Any condition requiring hospitalization or evidence of severe concomitant infection at time of presentation.
- Use of antimalarial drugs in previous 4 weeks.
- History of convulsions, hypertension, diabetes or any other chronic illness that may adversely affect fetal growth and viability.
- Known allergy to the study drugs (AZ, CQ, and SP) or to any macrolides or sulphonamides.
- Requirement to use medication during the study that might interfere with the evaluation of the study drug of AZ or CQ or is contra indicated during pregnancy per package inserts.
- Severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study.
- Evidence of current obstetric complications that may adversely impact the pregnancy and/or fetal outcomes, including presence of congenital anomalies, placenta previa or abruption.
- Known severe sickle cell (SS) disease or sickle hemoglobin C (SC) anemia.
- Known family history of prolonged QT syndrome, serious ventricular arrhythmia, or sudden cardiac death.
Sites / Locations
- Centre de Sante d'AHOUANSORI -AGUE
- Hôpital Bethesda
- Siaya District Hospital
- Zomba Central Hospital
- Teule Hospital
- National Institute for Medical Research (Mwanza Centre)/ Nyamagana District Hospital
- Mulanda Health Centre IV
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
AZCQ
Arm Description
Azithromycin/Chloroquine
Outcomes
Primary Outcome Measures
Percentage of Participants With Parasitologic Response (Polymerase Chain Reaction (PCR) Corrected) at Day 28 Post First Dose of Study Medication
The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.
Percentage of Participants With Parasitologic Response (PCR Corrected) at Day 28 Post First Dose of Study Medication
The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.
Secondary Outcome Measures
Percentage of Participants With Parasitologic Response (PCR Corrected) at Days 7, 14, 21, 35, and 42 Post First Dose of Study Medication
The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.
Percentage of Participants With Parasitologic Response (PCR Corrected) at Days 7, 14, 21, 35, and 42 , Post First Dose of Study Medication
The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.
Percentage of Participants With Parasitologic Response (PCR Corrected) at Days 7, 14, 21, 28, 35, and 42 Post First Dose of Study Medication
The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.
Percentage of Participants With Parasitologic Response (PCR Uncorrected) at Days 7, 14, 21, 28, 35, and 42 Post First Dose of Study Medication
The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR uncorrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR uncorrected) through the day of consideration, otherwise she is a parasitological failure.
Number of Asexual P. Falciparum Per Microliter of Blood at Days 7, 14, 21, 28, 35, and 42 Post First Dose of Study Medication
Parasite counts (actual counts per microliter of blood) was measured at various time points.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01103713
Brief Title
Evaluate Parasitological Clearance Rates And Pharmacokinetics Of The Combination Of Azithromycin And Chloroquine In Asymptomatic Pregnant Women With Falciparum Parasitemia In Africa
Official Title
An Open Label, Non-comparative Study To Evaluate Parasitological Clearance Rates And Pharmacokinetics Of Azithromycin And Chloroquine Following Administration Of A Fixed Dose Combination Of Azithromycin And Chloroquine (Azcq) In Asymptomatic Pregnant Women With Plasmodium Falciparum Parasitemia In Sub-saharan Africa
Study Type
Interventional
2. Study Status
Record Verification Date
January 2015
Overall Recruitment Status
Terminated
Why Stopped
See termination reason in detailed description.
Study Start Date
March 2011 (undefined)
Primary Completion Date
June 2013 (Actual)
Study Completion Date
October 2013 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pfizer
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The study will be conducted in asymptomatic pregnant women with P. falciparum parasitemia. The subjects will be given 3 day dosing regiment of the fixed-dose combination of Azithromycin and Chloroquine. Parasitological clearance rate with polymerase chain reaction data will be evaluated on Day 28 as primary endpoint.
Detailed Description
After interim analysis of efficacy data by an External Data Monitoring Committee, this study was terminated. Investigators were notified on 22 Aug 2013. There were no safety concerns that led to this termination.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Asymptomatic Parasitemia In Pregnancy
Keywords
P. falciparum malaria, asymptomatic parasitemia, parasitological clearance, Intermittent Preventive Treatment of Falciparum Malaria in Pregnant Women (IPTp)
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
168 (Actual)
8. Arms, Groups, and Interventions
Arm Title
AZCQ
Arm Type
Experimental
Arm Description
Azithromycin/Chloroquine
Intervention Type
Drug
Intervention Name(s)
Azithromycin plus chloroquine
Other Intervention Name(s)
Zithromax; Aralen
Intervention Description
Study drug is a fixed dose tablet of AZCQ containing 250 mg AZ and 155 mg CQ base. All subjects will be administered a 3 day course of AZCQ IPTp regimen: a single dose of 1000 mg AZ/620 mg CQ base (4 fixed dose combination tablets of AZCQ: 250mg/155mg) administered per os (PO, orally) once daily for 3 days (Days 0, 1, 2).
Primary Outcome Measure Information:
Title
Percentage of Participants With Parasitologic Response (Polymerase Chain Reaction (PCR) Corrected) at Day 28 Post First Dose of Study Medication
Description
The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.
Time Frame
Day 28
Title
Percentage of Participants With Parasitologic Response (PCR Corrected) at Day 28 Post First Dose of Study Medication
Description
The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.
Time Frame
Day 28
Secondary Outcome Measure Information:
Title
Percentage of Participants With Parasitologic Response (PCR Corrected) at Days 7, 14, 21, 35, and 42 Post First Dose of Study Medication
Description
The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.
Time Frame
Days 7, 14, 21, 35, and 42
Title
Percentage of Participants With Parasitologic Response (PCR Corrected) at Days 7, 14, 21, 35, and 42 , Post First Dose of Study Medication
Description
The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.
Time Frame
Days 7, 14, 21, 35, and 42
Title
Percentage of Participants With Parasitologic Response (PCR Corrected) at Days 7, 14, 21, 28, 35, and 42 Post First Dose of Study Medication
Description
The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.
Time Frame
Days 7, 14, 21, 28, 35, and 42
Title
Percentage of Participants With Parasitologic Response (PCR Uncorrected) at Days 7, 14, 21, 28, 35, and 42 Post First Dose of Study Medication
Description
The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR uncorrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR uncorrected) through the day of consideration, otherwise she is a parasitological failure.
Time Frame
Days 7, 14, 21, 28, 35, and 42
Title
Number of Asexual P. Falciparum Per Microliter of Blood at Days 7, 14, 21, 28, 35, and 42 Post First Dose of Study Medication
Description
Parasite counts (actual counts per microliter of blood) was measured at various time points.
Time Frame
Days 7, 14, 21, 28, 35, and 42
Other Pre-specified Outcome Measures:
Title
Summary of Pregnancy Outcome: Location of Delivery
Description
All participants were followed up for exposure-in-utero (EIU) safety assessments following delivery or termination of pregnancy.
Time Frame
Following delivery or pregnancy termination
Title
Summary of Pregnancy Outcome: Mode of Delivery
Description
All participants were followed up for EIU safety assessments following delivery or termination of pregnancy.
Time Frame
Following delivery or pregnancy termination
Title
Summary of Pregnancy Outcome: Delivery Assisted by Trained Obstetric Personnel?
Description
All participants were followed up for EIU safety assessments following delivery or termination of pregnancy.
Time Frame
Following delivery or pregnancy termination
Title
Summary of Pregnancy Outcome: Labor Induced?
Description
All participants were followed up for EIU safety assessments following delivery or termination of pregnancy.
Time Frame
Following delivery or pregnancy termination
Title
Summary of Pregnancy Outcome: Complications During Delivery?
Description
All participants were followed up for EIU safety assessments following delivery or termination of pregnancy.
Time Frame
Following delivery or pregnancy termination
Title
Summary of Pregnancy Outcome: Outcome of Birth
Description
All participants were followed up for EIU safety assessments following delivery or termination of pregnancy.
Time Frame
Following delivery or pregnancy termination
Title
Incidence of Fever Based on Oral Temperature
Description
Oral temp was taken by the fieldworker through Day 42.
Time Frame
Baseline, Days 1, 2, 7, 14, 21, 28, 35, and 42
Title
Summary of Hemoglobin Concentration: Abnormal Hemoglobin Level
Description
Abnormal hemoglobin level on Day 42 was measured. The hemoglobin levels were measured with HemoCueTM, via finger stick or peripheral blood collection. The reference range was 10-16g/dL. Any value <0.8 times lower limit of normal was considered clinically significant.
Time Frame
Day 42
Title
Summary of Serum Azithromycin Concentration Versus Time
Description
AZ concentrations in the serum was determined at specified time points as PK endpoints
Time Frame
Planned time: 0 (Day 0), 48 (Day 2), 50 (Day 2), 56 (Day 2), 168 (Day 7), and 336 (Day 14) hours post the first dose. Note: Assuming "hour not specified" as 0 hours on Day 7 and Day 14 for planned time post first dose calculation.
Title
Summary of Plasma Chloroquine Concentration Versus Time
Description
CQ concentrations in the plasma were determined at specified time points as PK endpoints
Time Frame
Planned time: 0 (Day 0), 48 (Day 2), 50 (Day 2), 56 (Day 2), 168 (Day 7), 336 (Day 14), 504 (Day 21) and 672 (Day 28) post first dose. Note: Assuming "hour not specified" as 0 hours on Days 7, 14, 21 and 28 for planned time post first dose calculation.
Title
Summary of Plasma Desethylchloroquine Concentration Versus Time
Description
CQ concentrations in the plasma were determined at specified time points as PK endpoints
Time Frame
Planned time: 0 (Day 0), 48 (Day 2), 50 (Day 2), 56 (Day 2), 168 (Day 7), 336 (Day 14), 504 (Day 21) and 672 (Day 28) post first dose. Note: Assuming "hour not specified" as 0 hours on Days 7, 14, 21 and 28 for planned time post first dose calculation.
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
16 Years
Maximum Age & Unit of Time
35 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Primigravidae and secundigravidae pregnant women at >=14 and <=30 weeks of gestational age (confirmed by ultrasound examination).
Evidence of asymptomatic parasitemia with Plasmodium falciparum monoinfection (confirmed by microscopy) with parasite counts in the range of 80 100,000/uL on thick blood smears.
Evidence of a personally signed and dated informed consent document indicating that the subject (or a legally acceptable representative if a subject is <18 years of age) has been informed of all pertinent aspects of the study and that all questions by the subject have been sufficiently answered. Assent will be obtained from subjects <18 years of age.
Subjects who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
Exclusion Criteria:
Age <16 years old or >35 years old.
Multiple gestations (more than one fetus) as per the ultrasound results at screening.
Clinical symptoms of malaria.
Hemoglobin <8 g/dL (measured at baseline).
Any condition requiring hospitalization or evidence of severe concomitant infection at time of presentation.
Use of antimalarial drugs in previous 4 weeks.
History of convulsions, hypertension, diabetes or any other chronic illness that may adversely affect fetal growth and viability.
Known allergy to the study drugs (AZ, CQ, and SP) or to any macrolides or sulphonamides.
Requirement to use medication during the study that might interfere with the evaluation of the study drug of AZ or CQ or is contra indicated during pregnancy per package inserts.
Severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study.
Evidence of current obstetric complications that may adversely impact the pregnancy and/or fetal outcomes, including presence of congenital anomalies, placenta previa or abruption.
Known severe sickle cell (SS) disease or sickle hemoglobin C (SC) anemia.
Known family history of prolonged QT syndrome, serious ventricular arrhythmia, or sudden cardiac death.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pfizer CT.gov Call Center
Organizational Affiliation
Pfizer
Official's Role
Study Director
Facility Information:
Facility Name
Centre de Sante d'AHOUANSORI -AGUE
City
Cotonou
Country
Benin
Facility Name
Hôpital Bethesda
City
Cotonou
Country
Benin
Facility Name
Siaya District Hospital
City
Siaya
Country
Kenya
Facility Name
Zomba Central Hospital
City
Zomba
Country
Malawi
Facility Name
Teule Hospital
City
Muheza
State/Province
Tanga
Country
Tanzania
Facility Name
National Institute for Medical Research (Mwanza Centre)/ Nyamagana District Hospital
City
Mwanza
ZIP/Postal Code
1903
Country
Tanzania
Facility Name
Mulanda Health Centre IV
City
Kampala
Country
Uganda
12. IPD Sharing Statement
Links:
URL
https://trialinfoemail.pfizer.com/pages/landing.aspx?StudyID=A0661201&StudyName=Evaluate%20Parasitological%20Clearance%20Rates%20And%20Pharmacokinetics%20Of%20The%20Combination%20Of%20Azithromycin%20And%20Chloroquine%20In%20Asymptomatic%20Pregnant%20Wome
Description
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Learn more about this trial
Evaluate Parasitological Clearance Rates And Pharmacokinetics Of The Combination Of Azithromycin And Chloroquine In Asymptomatic Pregnant Women With Falciparum Parasitemia In Africa
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