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L-PZQ ODT in Schistosoma Infected Children

Primary Purpose

Schistosomiasis

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
L-PZQ ODT
Biltricide®
L-PZQ ODT
Sponsored by
Merck KGaA, Darmstadt, Germany
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schistosomiasis focused on measuring Schistosomiasis, Children, L-praziquantel, Biltricide®

Eligibility Criteria

3 Months - 6 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age of the participant is 4 to 6 years of age (Cohorts 1 and 4), 2 to 3 years of age (Cohorts 2 and 4) 3 to less than 24 months of age (Cohorts 3 and 4)
  • Participants are; Schistosoma (S.) mansoni positive (Cohorts 1, 2, and 3); diagnosis defined as positive egg counts in stool greater than or equal to ( >=) 1 egg per 1 occasion) according to World Health Organization (WHO) classification [1]: light (1 to 99 eggs per gram of feces), moderate (100 to 399 eggs per gram of feces) and heavy (>= 400 eggs per gram of feces) infections; S. haematobium positive (Cohort 4); diagnosis defined as positive egg counts in urine (>= 1 egg per 10 milliliter(mL) urine) according to WHO classification (Prevention and Control of Schistosomiasis and Soil Transmitted Helminthiasis. WHO Technical Report Series No. 912. WHO, Geneva, Switzerland, 2002).light (less than (<) 50 eggs per 10 mL of urine) and heavy (>=50 eggs per 10 mL of urine) infections
  • Participants have a minimum body weight of 8.0 Kilograms (Kg) in 2 to 6 years of age children and 5.0 Kg in 3 months to < 24 months of age infants and toddlers
  • Parent's or guardian/legally authorized representative's ability to communicate well with the Investigator and his/her delegate, to understand the protocol requirements and restrictions, and to be willing to have their children comply with the requirements of the entire study, that is:

    • To be examined by a study physician at screening and 17 to 21 days after treatment
    • To provide stool samples at screening and 17 to 21 days after treatment
    • To provide urine samples at screening and 17 to 21 days after treatment
    • To provide venous blood samples for laboratory assessments
    • To be housed in the clinic for 12 to 24 hours
    • To provide venous blood samples for pharmacokinetics (PK) assessments (for participants in the PK subset)
  • Participants have a minimum hemoglobin level of 10 gram per deciliter

Exclusion Criteria:

  • Participants with following medical conditions are excluded from the study; Findings in the clinical examination and/or laboratory safety examination on the treatment day, that in the opinion of the Investigator constitute a risk or a contraindication for the child's participation in the study or that could interfere with the study objectives, conduct or evaluation. This includes but is not restricted to bacterial or viral infections, such as dysentery, gastroenteritis, ascites, jaundice, etc.; Participants with seizures and/or medical history of seizures and/or other signs of potential central nervous system involvement; Participants with known cysticercosis, or with signs or symptoms (for example: subcutaneous nodules) suggestive of cysticercosis; Participants with an acute infection or other acute illness within the 7 days prior to study screening; Debilitating illness such as tuberculosis, malnutrition, etc.
  • Treatment with PZQ within the 4 weeks prior to the study screening
  • Concomitant treatment (within 2 weeks prior to enrollment) with medication that might affect the metabolism of PZQ, such as certain anti epileptics (for example: carbamazepine or phenytoin), glucocorticosteroids (for example: dexamethasone), chloroquine, rifampicin or cimetidine (see Biltricide® Summary of Product Characteristics [SmPC])
  • Treatment within the 2 weeks prior to the study screening with anti malarial medications
  • For infants and toddlers being breast fed, treatment of the mothers/wet nurses with PZQ in the 3 days prior to PZQ ODT administration
  • Participation in any clinical study within 4 weeks prior to administration of PZQ ODT, or anticipated at any time until completion of the End of study visit
  • Participants with marked increases of the liver enzymes: alanine aminotransferase and/or aspartate aminotransferase above 3 times the upper limit of normal (ULN); total bilirubin level above 1.5 times the ULN
  • Participants with hepatosplenic schistosomiasis
  • Fever, defined as temperature above 37.5 degree Celsius axillary or oral mixed S. haematobium and S. mansoni infections

Sites / Locations

  • Universitè de Cocody
  • Kemri Kisumu

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Active Comparator

Experimental

Experimental

Experimental

Arm Label

Cohort 1, Treatment 1a: L-PZQ ODT

Cohort 1, Treatment 1b: Biltricide®

Cohort 2: L-PZQ ODT

Cohort 3: L-PZQ ODT

Cohort 4: L-PZQ ODT

Arm Description

Participants aged 4 to 6 years infected with Schistosoma (S.) mansoni will receive single oral dose of L-PZQ ODT 50 milligram/Kilogram (mg/Kg) after food-intake.

Participants aged 4 to 6 years infected with S. mansoni will receive single oral dose of Biltricide® 40 mg/Kg crushed tablet after food intake.

Participants aged 2 to 3 years infected with S. mansoni will receive single oral dose of L-PZQ ODT 50 mg/Kg after the food intake.

Participants aged 3 to less than 24 months infected with S. mansoni will receive single oral dose of L-PZQ ODT 50 mg/Kg after the food intake.

Participants aged 3 months to 6 years infected with S. haematobium will receive single oral dose of L-PZQ ODT 50 mg/Kg after the food intake. Additional participants will receive 60 mg/Kg of L-PZQ ODT as decided by the Independent data monitoring committee (IDMC).

Outcomes

Primary Outcome Measures

Numbers of Participants With Clinical Cure
Clinical cure is defined as no parasite eggs in the stool or urine 17 to 21 days post-treatment.

Secondary Outcome Measures

Egg Reduction Rate
Egg reduction rate will be calculated using parasite egg counts as determined by the Kato Katz method for Cohorts 1, 2 and 3 and the urine filtration method for Cohort 4.
Cure Rate
Cure defined as no evidence of parasite antigens in urine as measured with Point-of-Care Circulating Cathodic Antigen (POC-CCA) test.
Acceptability of the Study Intervention
Acceptability of the study intervention will be recorded as the reaction of participants to study intervention. The acceptability will be assessed by the nurse/site staff for all children enrolled in the study.
Maximum Observed Plasma Concentration (Cmax) of L-PZQ ODT
Time to Reach Maximum Plasma Concentration (Tmax) of L-PZQ ODT
Area Under the Plasma Concentration-Time Curve From Time Zero to the Last Sampling Time (AUC 0-t) of L-PZQ ODT
Occurrence and Severity of Treatment-emergent Adverse Events (TEAEs) and Serious AEs (SAEs)
Occurrence of Treatment Related Adverse Events
Number of Participants With Clinically Significant Changes in Vital Signs, Laboratory Parameters and 12-lead Electrocardiogram (ECG) Findings
Number of participants with clinically significant changes will be reported.

Full Information

First Posted
February 15, 2019
Last Updated
October 13, 2021
Sponsor
Merck KGaA, Darmstadt, Germany
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1. Study Identification

Unique Protocol Identification Number
NCT03845140
Brief Title
L-PZQ ODT in Schistosoma Infected Children
Official Title
An Open Label, Phase III Efficacy and Safety Study of L-PZQ ODT in Schistosoma Infected Children 3 Months to 6 Years of Age, Including a 2:1 Randomized, Controlled Cohort of Schistosoma Mansoni Infected Children 4 to 6 Years of Age Treated With L PZQ ODT or Commercial PZQ (Biltricide®)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
September 2, 2019 (Actual)
Primary Completion Date
October 11, 2021 (Actual)
Study Completion Date
October 11, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Merck KGaA, Darmstadt, Germany

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
The study will evaluate the safety and efficacy of L-praziquantel orodispersible (L-PZQ ODT) tablets in Schistosoma infected children aged 3 months to 6 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schistosomiasis
Keywords
Schistosomiasis, Children, L-praziquantel, Biltricide®

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Cohort 1, Treatment 1a: L-PZQ ODT
Arm Type
Experimental
Arm Description
Participants aged 4 to 6 years infected with Schistosoma (S.) mansoni will receive single oral dose of L-PZQ ODT 50 milligram/Kilogram (mg/Kg) after food-intake.
Arm Title
Cohort 1, Treatment 1b: Biltricide®
Arm Type
Active Comparator
Arm Description
Participants aged 4 to 6 years infected with S. mansoni will receive single oral dose of Biltricide® 40 mg/Kg crushed tablet after food intake.
Arm Title
Cohort 2: L-PZQ ODT
Arm Type
Experimental
Arm Description
Participants aged 2 to 3 years infected with S. mansoni will receive single oral dose of L-PZQ ODT 50 mg/Kg after the food intake.
Arm Title
Cohort 3: L-PZQ ODT
Arm Type
Experimental
Arm Description
Participants aged 3 to less than 24 months infected with S. mansoni will receive single oral dose of L-PZQ ODT 50 mg/Kg after the food intake.
Arm Title
Cohort 4: L-PZQ ODT
Arm Type
Experimental
Arm Description
Participants aged 3 months to 6 years infected with S. haematobium will receive single oral dose of L-PZQ ODT 50 mg/Kg after the food intake. Additional participants will receive 60 mg/Kg of L-PZQ ODT as decided by the Independent data monitoring committee (IDMC).
Intervention Type
Drug
Intervention Name(s)
L-PZQ ODT
Intervention Description
Participants will receive single oral dose of L-PZQ ODT 50 mg/Kg on Day 1.
Intervention Type
Drug
Intervention Name(s)
Biltricide®
Intervention Description
Participants will receive single oral dose of Biltricide® 40 mg/kg crushed tablet on Day 1.
Intervention Type
Drug
Intervention Name(s)
L-PZQ ODT
Intervention Description
Participant will receive single oral dose of L-PZQ ODT 60 mg/kg as decided by the IDMC.
Primary Outcome Measure Information:
Title
Numbers of Participants With Clinical Cure
Description
Clinical cure is defined as no parasite eggs in the stool or urine 17 to 21 days post-treatment.
Time Frame
17 to 21 days post-treatment
Secondary Outcome Measure Information:
Title
Egg Reduction Rate
Description
Egg reduction rate will be calculated using parasite egg counts as determined by the Kato Katz method for Cohorts 1, 2 and 3 and the urine filtration method for Cohort 4.
Time Frame
Pre-treatment, 17 to 21 days post-treatment
Title
Cure Rate
Description
Cure defined as no evidence of parasite antigens in urine as measured with Point-of-Care Circulating Cathodic Antigen (POC-CCA) test.
Time Frame
17 to 21 days post-treatment
Title
Acceptability of the Study Intervention
Description
Acceptability of the study intervention will be recorded as the reaction of participants to study intervention. The acceptability will be assessed by the nurse/site staff for all children enrolled in the study.
Time Frame
Day 1
Title
Maximum Observed Plasma Concentration (Cmax) of L-PZQ ODT
Time Frame
Pre-dose, 0.5, 1, 2, 3, 4, 6, 8, 12 hours post-dose
Title
Time to Reach Maximum Plasma Concentration (Tmax) of L-PZQ ODT
Time Frame
Pre-dose, 0.5, 1, 2, 3, 4, 6, 8, 12 hours post-dose
Title
Area Under the Plasma Concentration-Time Curve From Time Zero to the Last Sampling Time (AUC 0-t) of L-PZQ ODT
Time Frame
Pre-dose, 0.5, 1, 2, 3, 4, 6, 8, 12 hours post-dose
Title
Occurrence and Severity of Treatment-emergent Adverse Events (TEAEs) and Serious AEs (SAEs)
Time Frame
Day 1 up to Day 21
Title
Occurrence of Treatment Related Adverse Events
Time Frame
Day 1 up to Day 21
Title
Number of Participants With Clinically Significant Changes in Vital Signs, Laboratory Parameters and 12-lead Electrocardiogram (ECG) Findings
Description
Number of participants with clinically significant changes will be reported.
Time Frame
Day 1 up to Day 21

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Months
Maximum Age & Unit of Time
6 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age of the participant is 4 to 6 years of age (Cohorts 1 and 4), 2 to 3 years of age (Cohorts 2 and 4) 3 to less than 24 months of age (Cohorts 3 and 4) Participants are; Schistosoma (S.) mansoni positive (Cohorts 1, 2, and 3); diagnosis defined as positive egg counts in stool greater than or equal to ( >=) 1 egg per 1 occasion) according to World Health Organization (WHO) classification [1]: light (1 to 99 eggs per gram of feces), moderate (100 to 399 eggs per gram of feces) and heavy (>= 400 eggs per gram of feces) infections; S. haematobium positive (Cohort 4); diagnosis defined as positive egg counts in urine (>= 1 egg per 10 milliliter(mL) urine) according to WHO classification (Prevention and Control of Schistosomiasis and Soil Transmitted Helminthiasis. WHO Technical Report Series No. 912. WHO, Geneva, Switzerland, 2002).light (less than (<) 50 eggs per 10 mL of urine) and heavy (>=50 eggs per 10 mL of urine) infections Participants have a minimum body weight of 8.0 Kilograms (Kg) in 2 to 6 years of age children and 5.0 Kg in 3 months to < 24 months of age infants and toddlers Parent's or guardian/legally authorized representative's ability to communicate well with the Investigator and his/her delegate, to understand the protocol requirements and restrictions, and to be willing to have their children comply with the requirements of the entire study, that is: To be examined by a study physician at screening and 17 to 21 days after treatment To provide stool samples at screening and 17 to 21 days after treatment To provide urine samples at screening and 17 to 21 days after treatment To provide venous blood samples for laboratory assessments To be housed in the clinic for 12 to 24 hours To provide venous blood samples for pharmacokinetics (PK) assessments (for participants in the PK subset) Participants have a minimum hemoglobin level of 10 gram per deciliter Exclusion Criteria: Participants with following medical conditions are excluded from the study; Findings in the clinical examination and/or laboratory safety examination on the treatment day, that in the opinion of the Investigator constitute a risk or a contraindication for the child's participation in the study or that could interfere with the study objectives, conduct or evaluation. This includes but is not restricted to bacterial or viral infections, such as dysentery, gastroenteritis, ascites, jaundice, etc.; Participants with seizures and/or medical history of seizures and/or other signs of potential central nervous system involvement; Participants with known cysticercosis, or with signs or symptoms (for example: subcutaneous nodules) suggestive of cysticercosis; Participants with an acute infection or other acute illness within the 7 days prior to study screening; Debilitating illness such as tuberculosis, malnutrition, etc. Treatment with PZQ within the 4 weeks prior to the study screening Concomitant treatment (within 2 weeks prior to enrollment) with medication that might affect the metabolism of PZQ, such as certain anti epileptics (for example: carbamazepine or phenytoin), glucocorticosteroids (for example: dexamethasone), chloroquine, rifampicin or cimetidine (see Biltricide® Summary of Product Characteristics [SmPC]) Treatment within the 2 weeks prior to the study screening with anti malarial medications For infants and toddlers being breast fed, treatment of the mothers/wet nurses with PZQ in the 3 days prior to PZQ ODT administration Participation in any clinical study within 4 weeks prior to administration of PZQ ODT, or anticipated at any time until completion of the End of study visit Participants with marked increases of the liver enzymes: alanine aminotransferase and/or aspartate aminotransferase above 3 times the upper limit of normal (ULN); total bilirubin level above 1.5 times the ULN Participants with hepatosplenic schistosomiasis Fever, defined as temperature above 37.5 degree Celsius axillary or oral mixed S. haematobium and S. mansoni infections
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Responsible
Organizational Affiliation
Merck KGaA, Darmstadt, Germany
Official's Role
Study Director
Facility Information:
Facility Name
Universitè de Cocody
City
Abidjan
ZIP/Postal Code
22BP770
Country
Côte D'Ivoire
Facility Name
Kemri Kisumu
City
Kisumu
ZIP/Postal Code
40100
Country
Kenya

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
We are committed to enhancing public health through responsible sharing of clinical trial data. Following approval of a new product or a new indication for an approved product in both the US and European Union, the study sponsor and/or its affiliated companies will share study protocols, anonymized patient data and study level data, and redacted clinical study reports with qualified scientific and medical researchers, upon request, as necessary for conducting legitimate research. Further information on how to request data can be found on our website bit.ly/IPD21
IPD Sharing Time Frame
Within six months after the approval of a new product or a new indication for an approved product in both the United States and the European Union
IPD Sharing Access Criteria
Qualified scientific and medical researchers can request the data. Such requests must be submitted in writing to the company's portal and will be internally reviewed regarding criteria for researchers' qualification and legitimacy of the research proposal.
IPD Sharing URL
http://bit.ly/IPD21
Links:
URL
https://clinicaltrials.emdgroup.com/en/trial-details/?id=MS200661_0003
Description
Trial Awareness and Transparency website

Learn more about this trial

L-PZQ ODT in Schistosoma Infected Children

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