search
Back to results

Fexinidazole in Human African Trypanosomiasis Due to T.b. Gambiense at Any Stage

Primary Purpose

Trypanosomiasis, African, Sleeping Sickness, Trypanosomiasis; Gambian

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Fexinidazole
Sponsored by
Drugs for Neglected Diseases
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Trypanosomiasis, African focused on measuring T.b gambiense, HAT, outpatients

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female patient, including breastfeeding or pregnant women in the second or third trimester.
  • ≥ 6 years of age.
  • ≥ 20 kg body weight.
  • Signed Informed Consent Form and Assent Form for patients less than 18 years of age
  • Trypanosomes detected in any body fluid.
  • Physically able to ingest at least one solid meal per day.
  • Able to take oral medication.
  • Karnofsky Performance Status > 40%.
  • Able to comply with the schedule of follow-up visits and with the study constraints.
  • Easily reachable during the out-patient follow-up period.
  • Willing to undergo lumbar punctures.

Exclusion Criteria:

  • Active clinically relevant medical conditions other than HAT that, in the Investigator's opinion, could jeopardise patient safety or interfere with participation in the study, including but not limited to significant liver or cardiovascular diseases, HIV infection, CNS trauma or seizure disorders, coma or altered consciousness not related to HAT.
  • Severe renal or hepatic impairment defined as:

elevated creatinine at > 3 times the upper limit of normal (ULN) elevated ALT, AST or bilirubin at > 3 ULN

  • Severely deteriorated general condition, such as cardiovascular shock, respiratory distress or terminal illness.
  • Any condition (except symptoms of HAT) that compromises ability to communicate with the Investigator as required for completion of the study.
  • Any contraindication to imidazole products (known hypersensitivity to imidazoles).
  • Treatment for HAT within 2 years prior to inclusion.
  • Prior enrolment in the study or prior intake of fexinidazole.
  • Foreseeable difficulty in complying with the schedule of follow-up visits (migrants, refugees, itinerant traders, etc.).

Temporary Non-inclusion Criteria:

  • Recovery period after antimalarial treatment and/or treatment of helminthiasis (at least 3 days).
  • Uncontrolled diabetes or hypertension or any patients requiring clinical stabilisation; wait until appropriate treatment to control the disease has been initiated.
  • First trimester of pregnancy.
  • Traumatic lumbar puncture at Screening i.e. red blood cells visible in CSF; wait for 48 hours before repeating lumbar puncture.

Eligibility Criteria for Out-patient Treatment

  • Accepting to be treated on an out-patient basis;
  • Karnofsky Performance Status > 50%;
  • Good understanding of the method of administration of fexinidazole by the patient and/or caregiver* (checked using a questionnaire at the time of dispensing fexinidazole);
  • Residing close to the investigational centre, i.e. approximately one hour by road and/or boat, during the treatment period**;
  • Easily reachable during the treatment period;
  • No medical or psychiatric contraindications for treatment as out-patient;
  • No pregnancy or breastfeeding;
  • No neurological symptoms.

Sites / Locations

  • Dipumba Hospital
  • Bagata Hospital
  • Bandundu Hospital
  • Masi Manimba Hospital
  • Nkara Secondary Hospital
  • Mushie Hospital
  • Roi Baudouin Hospital
  • Dubreka Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Inpatients

Outpatients

Arm Description

Participants received fexinidazole orally for 10 days as inpatients (at the hospital)

Participants received fexinidazole orally for 10 days as outpatients (at home)

Outcomes

Primary Outcome Measures

Percentage of participants whose treatment outcome at Month 18 is a success
Treatment outcome at Month 18 is categorised as success or failure. Success is defined as a cure, according to the criteria adapted from the World Health Organization (WHO) update of the methodological framework for clinical trials in Sept 2014 (WHO/HTM/NTD/IDM/2015.5). Failure is defined as a relapse, probable relapse, death, use of rescue medication, loss to follow-up, refusal of all post-treatment lumbar puncture, and, in the absence of lumbar puncture at the Month 18 visit, an unfavorable outcome earlier than Month 18, or signs and symptoms evoking a relapse at Month 18. Success rate at Month 18 is defined as the percentage of participants (regardless of g-HAT stage) whose treatment outcome is a success at Month 18. An estimate of the success rate at Month 18 and the 95% exact Clopper-Pearson confidence interval (CI) of the estimate are provided.

Secondary Outcome Measures

Percentage of participants whose treatment outcome at Month 12 is a success
Treatment outcome at Month 12 is categorised as success or failure. Success is defined as a cure, according to the criteria adapted from the World Health Organization (WHO) update of the methodological framework for clinical trials in Sept 2014 (WHO/HTM/NTD/IDM/2015.5). Failure is defined as a relapse, probable relapse, death, use of rescue medication, loss to follow-up, refusal of all post-treatment lumbar puncture, and, in the absence of lumbar puncture at the Month 12 visit, an unfavorable outcome earlier than Month 12, or signs and symptoms evoking a relapse at Month 12 (data collected at Month 18 are considered, if available). Success rate at Month 12 is defined as the percentage of participants (regardless of g-HAT stage) whose treatment outcome is a success at Month 12. An estimate of the success rate at Month 12 and the 95% exact Clopper-Pearson confidence interval (CI) of the estimate are provided.
Occurrence of grade ≥ 3 adverse events (AEs) including laboratory and haematological abnormalities (if considered clinically significant)
Occurrence is presented as the number of participants with any AE of grade ≥ 3. AE severity is graded according to the National Cancer Institute (NCI) Common Toxicity Criteria for AEs (CTCAE), Version 4.03 and, for certain laboratory parameters, modified CTCAE is used. The observation period extends from the first intake of fexinidazole (Day 1) until the end-of-hospitalization visit (between Day 13 and Day 18) for inpatients and until the end-of-treatment visit (on Day 11) for outpatients.
Occurrence of any serious adverse event (SAE)
Occurrence is presented as the number of participants with any SAE.
Occurrence of temporary or permanent treatment discontinuation (inpatient or outpatient) for reasons related to safety
Number of patients who prematurely discontinued treatment (temporarily or permanently) for reasons related to safety (including overdose).
Occurrence of hospitalization (outpatient only) for reasons related to safety
Number of outpatients who are hospitalized for reasons related to safety (including overdose). An outpatient is considered as "hospitalized for reasons related to safety" if he/she is initially planned to be treated as an outpatient but experiences an AE during the treatment period (Day 1 to Day 10) and is hospitalized during the treatment period.
Occurrence of permanent treatment discontinuation (inpatient or outpatient) for reasons related to safety
Number of patients who prematurely discontinued treatment permanently for reasons related to safety (including overdose).
Pharmacokinetic measure to assess patient compliance
Number of outpatients with a concentration of fexinidazole sulfone (M2, one of the metabolite of fexinidazole) in dried blood spot higher than 10 µg/mL at Day 11 (24 hours after last fexinidazole administration on Day 10). Concentrations of M2 are determined using a validated analytical method.
Outpatients compliance to the full course of the 10-day treatment
Number of outpatients who completed the full course of the 10-day treatment. Full completion can be either completing the 10-day treatment in the outpatient setting, or starting treatment as an outpatient but finishing treatment at the hospital, for those who have to be hospitalized (for any reason). At Day 11, the participant and caregiver have to present the treatment packaging they received at study inclusion, and the investigator has to record if the treatment calendar was fully completed or not.
Outpatients compliance to the 10-day treatment posology, including taking the correct number of tablets during the 2 phases of treatment and taking tablets all at once every day, with food and without any interruption of treatment
Number of patients whose response to the question "How did you take your treatment?" is correct, as determined by the study personnel leading the compliance interview at Day 11 (end-of-treatment visit). The expected answer for participants weighing 35 kg or more is: 2 phases. Day 1 to 4 = 3 tablets. Day 5 to 10 = 2 tablets. Tablets to be taken all at once during a meal. The expected answer for participants weighing less than 35 kg is: 2 phases. Day 1 to 4 = 2 tablets. Day 5 to 10 = 1 tablet. Tablets to be taken all at once during a meal. The answer is considered correct if the 4 key messages have been understood (treatment period composed of 2 phases, each with a different number of tablets to be taken; treatment to be taken for 10 days without interruption; tablets to be taken all at once every day; treatment to be taken during a meal)
Feasibility of self-management of treatment intake in outpatients: occurrence of temporary treatment discontinuation
The occurrence of temporary treatment discontinuation is recorded at Day 11 (end-of-treatment visit) in the case report form by the study personnel (Section on feasibility, question "Was the treatment temporarily discontinued?). Occurrence is presented as the number of outpatients who temporarily discontinued their treatment.
Feasibility of self-management of treatment intake in outpatients: occurrence of permanent treatment discontinuation
The occurrence of permanent treatment discontinuation is recorded at Day 11 (end-of-treatment visit) in the case report form by the study personnel (Section on feasibility, question "Was the treatment stopped permanently?). Occurrence is presented as the number of outpatients who prematurely (prior to Day 10) discontinued their treatment permanently.
Feasibility of self-management of treatment intake in outpatients: delayed treatment start
The occurrence of delayed treatment start is recorded at Day 11 (end-of-treatment visit) in the case report form by the study personnel (Section on feasibility, date of first administration [Day 1] minus date of dispensing [Day 0] > 1 day). The occurrence of delayed treatment start is presented as the number of outpatients who had their planned treatment start delayed by at least 1 day.
Feasibility of self-management of treatment intake in outpatients: hospitalization during the treatment period due to non-compliance
The occurrence of hospitalization is recorded at Day 11 (end-of-treatment visit) in the case report form by the study personnel (Section on feasibility, question "Did the patient finish his/her treatment in hospital?"), with "non-compliance" as the reason for hospitalisation. Occurrence of hospitalization is presented as the number of outpatients who had to be hospitalized during the treatment period due to non-compliance.
Acceptability of packaging in outpatients: full understanding of instructions concerning dosing regimen
Full understanding of the instructions concerning the dosing regimen of fexinidazole is assessed at Day 0 (day of treatment dispensing) by the study personnel. During the interview, the study personnel asks the participant and caregiver 8 questions about posology. To each of these 8 questions, the study personnel ticks 'Yes' if the immediate answer is consistent with the expected answer. Full understanding of the instructions requires all 8 questions to be answered correctly. Full understanding is presented as the number of patients who correctly answered all 8 questions.
Acceptability of packaging in outpatients: help requested to follow the treatment
Acceptability of packaging is assessed at Day 11 (end-of-treatment visit) by a questionnaire filled out by the participant and caregiver. The occurrence of help needed is presented as the number of outpatients who indicate at the end of treatment that they had to request help to follow the treatment (Section on acceptability, question "Did you have to request help to follow the treatment?").
Acceptability of packaging in outpatients: instructions found helpful
Acceptability of packaging is assessed at Day 11 (end-of-treatment visit) by a questionnaire filled out by the participant and caregiver. The number of patients who found the instructions helpful is recorded (Section on acceptability, question "Did you find the instruction sheet provided with the medication helpful / Did it help you to remember the important information?").
Whole blood concentration of fexinidazole from dry blood spot, measured 24 hours after the last dose of fexinidazole
Concentrations of fexinidazole is determined using a validated analytical method, in all patients with available PK data.
Whole blood concentration of fexinidazole metabolite M1 from dry blood spot, measured 24 hours after the last dose of fexinidazole
Concentrations of fexinidazole metabolite M1 (fexinidazole sulfoxide) is determined using a validated analytical method, in all patients with available PK data.
Whole blood concentration of fexinidazole metabolite M2 from dry blood spot, measured 24 hours after the last dose of fexinidazole
Concentrations of fexinidazole metabolite M2 (fexinidazole sulfone) is determined using a validated analytical method, in all patients with available PK data.

Full Information

First Posted
November 11, 2016
Last Updated
July 7, 2023
Sponsor
Drugs for Neglected Diseases
Collaborators
Sanofi
search

1. Study Identification

Unique Protocol Identification Number
NCT03025789
Brief Title
Fexinidazole in Human African Trypanosomiasis Due to T.b. Gambiense at Any Stage
Official Title
An Open-label Study Assessing Effectiveness, Safety and Compliance With Fexinidazole in Patients With Human African Trypanosomiasis Due to T.b. Gambiense at Any Stage
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
November 10, 2016 (Actual)
Primary Completion Date
February 1, 2021 (Actual)
Study Completion Date
February 1, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Drugs for Neglected Diseases
Collaborators
Sanofi

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study evaluates the effectiveness of fexinidazole administered to patients with g-HAT at all stages of the disease. The aim of the present study is to provide additional information on the effectiveness and safety of fexinidazole and to assess its use under conditions as close as possible to those in real life, both in patients treated on an out-patient basis and in the hospital setting, depending on clinical status. Participants will receive fexinidazole oral treatment for 10 days. Regular blood draws and lumbar punctures will be performed over 18 months to confirm the cure of the disease. Other assessments will include the recording of adverse events, signs and symptoms of the disease, laboratory tests, vital signs, electrocardiograms. Participants receiving treatment at home will also complete questionnaires to check that instructions for fexinidazole administration are clear enough and followed correctly.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Trypanosomiasis, African, Sleeping Sickness, Trypanosomiasis; Gambian
Keywords
T.b gambiense, HAT, outpatients

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
174 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Inpatients
Arm Type
Experimental
Arm Description
Participants received fexinidazole orally for 10 days as inpatients (at the hospital)
Arm Title
Outpatients
Arm Type
Experimental
Arm Description
Participants received fexinidazole orally for 10 days as outpatients (at home)
Intervention Type
Drug
Intervention Name(s)
Fexinidazole
Intervention Description
Tablets of 600 mg; Participants with a weight between 20 and 34 kg received 1200 mg (2 tablets) for 4 days, then 600 mg (1 tablet) for 6 days (with food); Participants with a weight of 35 kg and above received 1800 mg (3 tablets) for 4 days, then 1200 mg (1 tablet) for 6 days (with food)
Primary Outcome Measure Information:
Title
Percentage of participants whose treatment outcome at Month 18 is a success
Description
Treatment outcome at Month 18 is categorised as success or failure. Success is defined as a cure, according to the criteria adapted from the World Health Organization (WHO) update of the methodological framework for clinical trials in Sept 2014 (WHO/HTM/NTD/IDM/2015.5). Failure is defined as a relapse, probable relapse, death, use of rescue medication, loss to follow-up, refusal of all post-treatment lumbar puncture, and, in the absence of lumbar puncture at the Month 18 visit, an unfavorable outcome earlier than Month 18, or signs and symptoms evoking a relapse at Month 18. Success rate at Month 18 is defined as the percentage of participants (regardless of g-HAT stage) whose treatment outcome is a success at Month 18. An estimate of the success rate at Month 18 and the 95% exact Clopper-Pearson confidence interval (CI) of the estimate are provided.
Time Frame
Between the first intake of fexinidazole (Day 1) and the end of the follow-up period (18 months)
Secondary Outcome Measure Information:
Title
Percentage of participants whose treatment outcome at Month 12 is a success
Description
Treatment outcome at Month 12 is categorised as success or failure. Success is defined as a cure, according to the criteria adapted from the World Health Organization (WHO) update of the methodological framework for clinical trials in Sept 2014 (WHO/HTM/NTD/IDM/2015.5). Failure is defined as a relapse, probable relapse, death, use of rescue medication, loss to follow-up, refusal of all post-treatment lumbar puncture, and, in the absence of lumbar puncture at the Month 12 visit, an unfavorable outcome earlier than Month 12, or signs and symptoms evoking a relapse at Month 12 (data collected at Month 18 are considered, if available). Success rate at Month 12 is defined as the percentage of participants (regardless of g-HAT stage) whose treatment outcome is a success at Month 12. An estimate of the success rate at Month 12 and the 95% exact Clopper-Pearson confidence interval (CI) of the estimate are provided.
Time Frame
Between the first intake of fexinidazole (Day 1) and the end of the follow-up period (18 months)
Title
Occurrence of grade ≥ 3 adverse events (AEs) including laboratory and haematological abnormalities (if considered clinically significant)
Description
Occurrence is presented as the number of participants with any AE of grade ≥ 3. AE severity is graded according to the National Cancer Institute (NCI) Common Toxicity Criteria for AEs (CTCAE), Version 4.03 and, for certain laboratory parameters, modified CTCAE is used. The observation period extends from the first intake of fexinidazole (Day 1) until the end-of-hospitalization visit (between Day 13 and Day 18) for inpatients and until the end-of-treatment visit (on Day 11) for outpatients.
Time Frame
Between the first intake of fexinidazole (Day 1) and the end of the observation period, or the end of the follow-up period (18 months) for non-serious AEs assessed as related to fexinidazole
Title
Occurrence of any serious adverse event (SAE)
Description
Occurrence is presented as the number of participants with any SAE.
Time Frame
Between the first intake of fexinidazole (Day 1) and the end of the follow-up period (18 months)
Title
Occurrence of temporary or permanent treatment discontinuation (inpatient or outpatient) for reasons related to safety
Description
Number of patients who prematurely discontinued treatment (temporarily or permanently) for reasons related to safety (including overdose).
Time Frame
Between the first intake (Day 1) and last intake of fexinidazole (Day 10, or Day 11 if re-administration occurred)
Title
Occurrence of hospitalization (outpatient only) for reasons related to safety
Description
Number of outpatients who are hospitalized for reasons related to safety (including overdose). An outpatient is considered as "hospitalized for reasons related to safety" if he/she is initially planned to be treated as an outpatient but experiences an AE during the treatment period (Day 1 to Day 10) and is hospitalized during the treatment period.
Time Frame
Between the first intake (Day 1) and last intake of fexinidazole (Day 10, or Day 11 if re-administration occurred)
Title
Occurrence of permanent treatment discontinuation (inpatient or outpatient) for reasons related to safety
Description
Number of patients who prematurely discontinued treatment permanently for reasons related to safety (including overdose).
Time Frame
Between the first intake (Day 1) and last intake of fexinidazole (Day 10, or Day 11 if re-administration occurred)
Title
Pharmacokinetic measure to assess patient compliance
Description
Number of outpatients with a concentration of fexinidazole sulfone (M2, one of the metabolite of fexinidazole) in dried blood spot higher than 10 µg/mL at Day 11 (24 hours after last fexinidazole administration on Day 10). Concentrations of M2 are determined using a validated analytical method.
Time Frame
End-of-treatment visit (Day 11, 24 hours after last treatment administration)
Title
Outpatients compliance to the full course of the 10-day treatment
Description
Number of outpatients who completed the full course of the 10-day treatment. Full completion can be either completing the 10-day treatment in the outpatient setting, or starting treatment as an outpatient but finishing treatment at the hospital, for those who have to be hospitalized (for any reason). At Day 11, the participant and caregiver have to present the treatment packaging they received at study inclusion, and the investigator has to record if the treatment calendar was fully completed or not.
Time Frame
Between the first intake (Day 1) and last intake of fexinidazole (Day 10, or Day 11 if re-administration occurred)
Title
Outpatients compliance to the 10-day treatment posology, including taking the correct number of tablets during the 2 phases of treatment and taking tablets all at once every day, with food and without any interruption of treatment
Description
Number of patients whose response to the question "How did you take your treatment?" is correct, as determined by the study personnel leading the compliance interview at Day 11 (end-of-treatment visit). The expected answer for participants weighing 35 kg or more is: 2 phases. Day 1 to 4 = 3 tablets. Day 5 to 10 = 2 tablets. Tablets to be taken all at once during a meal. The expected answer for participants weighing less than 35 kg is: 2 phases. Day 1 to 4 = 2 tablets. Day 5 to 10 = 1 tablet. Tablets to be taken all at once during a meal. The answer is considered correct if the 4 key messages have been understood (treatment period composed of 2 phases, each with a different number of tablets to be taken; treatment to be taken for 10 days without interruption; tablets to be taken all at once every day; treatment to be taken during a meal)
Time Frame
End-of-treatment visit (Day 11)
Title
Feasibility of self-management of treatment intake in outpatients: occurrence of temporary treatment discontinuation
Description
The occurrence of temporary treatment discontinuation is recorded at Day 11 (end-of-treatment visit) in the case report form by the study personnel (Section on feasibility, question "Was the treatment temporarily discontinued?). Occurrence is presented as the number of outpatients who temporarily discontinued their treatment.
Time Frame
End-of-treatment visit (Day 11)
Title
Feasibility of self-management of treatment intake in outpatients: occurrence of permanent treatment discontinuation
Description
The occurrence of permanent treatment discontinuation is recorded at Day 11 (end-of-treatment visit) in the case report form by the study personnel (Section on feasibility, question "Was the treatment stopped permanently?). Occurrence is presented as the number of outpatients who prematurely (prior to Day 10) discontinued their treatment permanently.
Time Frame
End-of-treatment visit (Day 11)
Title
Feasibility of self-management of treatment intake in outpatients: delayed treatment start
Description
The occurrence of delayed treatment start is recorded at Day 11 (end-of-treatment visit) in the case report form by the study personnel (Section on feasibility, date of first administration [Day 1] minus date of dispensing [Day 0] > 1 day). The occurrence of delayed treatment start is presented as the number of outpatients who had their planned treatment start delayed by at least 1 day.
Time Frame
End-of-treatment visit (Day 11)
Title
Feasibility of self-management of treatment intake in outpatients: hospitalization during the treatment period due to non-compliance
Description
The occurrence of hospitalization is recorded at Day 11 (end-of-treatment visit) in the case report form by the study personnel (Section on feasibility, question "Did the patient finish his/her treatment in hospital?"), with "non-compliance" as the reason for hospitalisation. Occurrence of hospitalization is presented as the number of outpatients who had to be hospitalized during the treatment period due to non-compliance.
Time Frame
End-of-treatment visit (Day 11)
Title
Acceptability of packaging in outpatients: full understanding of instructions concerning dosing regimen
Description
Full understanding of the instructions concerning the dosing regimen of fexinidazole is assessed at Day 0 (day of treatment dispensing) by the study personnel. During the interview, the study personnel asks the participant and caregiver 8 questions about posology. To each of these 8 questions, the study personnel ticks 'Yes' if the immediate answer is consistent with the expected answer. Full understanding of the instructions requires all 8 questions to be answered correctly. Full understanding is presented as the number of patients who correctly answered all 8 questions.
Time Frame
Before treatment (Day 0)
Title
Acceptability of packaging in outpatients: help requested to follow the treatment
Description
Acceptability of packaging is assessed at Day 11 (end-of-treatment visit) by a questionnaire filled out by the participant and caregiver. The occurrence of help needed is presented as the number of outpatients who indicate at the end of treatment that they had to request help to follow the treatment (Section on acceptability, question "Did you have to request help to follow the treatment?").
Time Frame
End-of-treatment visit (Day 11)
Title
Acceptability of packaging in outpatients: instructions found helpful
Description
Acceptability of packaging is assessed at Day 11 (end-of-treatment visit) by a questionnaire filled out by the participant and caregiver. The number of patients who found the instructions helpful is recorded (Section on acceptability, question "Did you find the instruction sheet provided with the medication helpful / Did it help you to remember the important information?").
Time Frame
End-of-treatment visit (Day 11)
Title
Whole blood concentration of fexinidazole from dry blood spot, measured 24 hours after the last dose of fexinidazole
Description
Concentrations of fexinidazole is determined using a validated analytical method, in all patients with available PK data.
Time Frame
End-of-treatment visit (Day 11, 24 hours after last treatment administration)
Title
Whole blood concentration of fexinidazole metabolite M1 from dry blood spot, measured 24 hours after the last dose of fexinidazole
Description
Concentrations of fexinidazole metabolite M1 (fexinidazole sulfoxide) is determined using a validated analytical method, in all patients with available PK data.
Time Frame
End-of-treatment visit (Day 11, 24 hours after last treatment administration)
Title
Whole blood concentration of fexinidazole metabolite M2 from dry blood spot, measured 24 hours after the last dose of fexinidazole
Description
Concentrations of fexinidazole metabolite M2 (fexinidazole sulfone) is determined using a validated analytical method, in all patients with available PK data.
Time Frame
End-of-treatment visit (Day 11, 24 hours after last treatment administration)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patient, including breastfeeding or pregnant women in the second or third trimester. ≥ 6 years of age. ≥ 20 kg body weight. Signed Informed Consent Form and Assent Form for patients less than 18 years of age Trypanosomes detected in any body fluid. Physically able to ingest at least one solid meal per day. Able to take oral medication. Karnofsky Performance Status > 40%. Able to comply with the schedule of follow-up visits and with the study constraints. Easily reachable during the out-patient follow-up period. Willing to undergo lumbar punctures. Exclusion Criteria: Active clinically relevant medical conditions other than HAT that, in the Investigator's opinion, could jeopardise patient safety or interfere with participation in the study, including but not limited to significant liver or cardiovascular diseases, HIV infection, CNS trauma or seizure disorders, coma or altered consciousness not related to HAT. Severe renal or hepatic impairment defined as: elevated creatinine at > 3 times the upper limit of normal (ULN) elevated ALT, AST or bilirubin at > 3 ULN Severely deteriorated general condition, such as cardiovascular shock, respiratory distress or terminal illness. Any condition (except symptoms of HAT) that compromises ability to communicate with the Investigator as required for completion of the study. Any contraindication to imidazole products (known hypersensitivity to imidazoles). Treatment for HAT within 2 years prior to inclusion. Prior enrolment in the study or prior intake of fexinidazole. Foreseeable difficulty in complying with the schedule of follow-up visits (migrants, refugees, itinerant traders, etc.). Temporary Non-inclusion Criteria: Recovery period after antimalarial treatment and/or treatment of helminthiasis (at least 3 days). Uncontrolled diabetes or hypertension or any patients requiring clinical stabilisation; wait until appropriate treatment to control the disease has been initiated. First trimester of pregnancy. Traumatic lumbar puncture at Screening i.e. red blood cells visible in CSF; wait for 48 hours before repeating lumbar puncture. Eligibility Criteria for Out-patient Treatment Accepting to be treated on an out-patient basis; Karnofsky Performance Status > 50%; Good understanding of the method of administration of fexinidazole by the patient and/or caregiver* (checked using a questionnaire at the time of dispensing fexinidazole); Residing close to the investigational centre, i.e. approximately one hour by road and/or boat, during the treatment period**; Easily reachable during the treatment period; No medical or psychiatric contraindications for treatment as out-patient; No pregnancy or breastfeeding; No neurological symptoms.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Victor Kande Betu Kumeso, MD
Organizational Affiliation
Ministry of Health, Kinshasa, The Democratic Republic of the Congo
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dipumba Hospital
City
Mbuji-Mayi
State/Province
Kasaï Oriental Province
Country
Congo, The Democratic Republic of the
Facility Name
Bagata Hospital
City
Bagata
State/Province
Kwilu Province
Country
Congo, The Democratic Republic of the
Facility Name
Bandundu Hospital
City
Bandundu
State/Province
Kwilu Province
Country
Congo, The Democratic Republic of the
Facility Name
Masi Manimba Hospital
City
Masi Manimba
State/Province
Kwilu Province
Country
Congo, The Democratic Republic of the
Facility Name
Nkara Secondary Hospital
City
Nkara
State/Province
Kwilu Province
Country
Congo, The Democratic Republic of the
Facility Name
Mushie Hospital
City
Mushie
State/Province
Maï Ndombe Province
Country
Congo, The Democratic Republic of the
Facility Name
Roi Baudouin Hospital
City
Kinshasa
Country
Congo, The Democratic Republic of the
Facility Name
Dubreka Hospital
City
Dubreka
Country
Guinea

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
Citation
WHO. Human African trypanosomiasis: update of the methodological framework for clinical trials: report of the first meeting of the Development of New Tools subgroup, Geneva, 24 September 2014. World Health Organization 2015. WHO/HTM/NTD/IDM/2015.5
Results Reference
background

Learn more about this trial

Fexinidazole in Human African Trypanosomiasis Due to T.b. Gambiense at Any Stage

We'll reach out to this number within 24 hrs