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WR 279,396 for the Treatment of Cutaneous Leishmaniasis (PAGELEC)

Primary Purpose

Cutaneous Leishmaniasis

Status
Completed
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
WR 279,396
Sponsored by
Assistance Publique - Hôpitaux de Paris
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cutaneous Leishmaniasis focused on measuring Cutaneous leishmaniasis, Paromomycin + Gentamicin Topical Cream, Safety, Efficacy

Eligibility Criteria

2 Years - 80 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

To be eligible for the study, patients must:

  1. Be male or females ages 2 to 80 years of age, inclusive.
  2. Have non-complicated, non-severe CL.
  3. Be able to give written informed consent or by their legal representative.
  4. Have a diagnosis of CL in at least one lesion by at least one of the following methods: 1) positive culture for promastigotes; 2) microscopic identification of amastigotes in stained lesion tissue and/or 3) by positive polymerase chain reaction (PCR). Patients who have a prior diagnosis of CL within 30 days of the start of treatment are eligible without a confirmatory test during screening.
  5. Have at least one ulcerative lesion ≥ 1 cm and < 5 cm, that meets the criteria for an index lesion.
  6. Be willing to forego other forms of treatments for CL including other investigational treatment during the study.
  7. In the opinion of the investigator, be capable of understanding (or their legal representative) and complying with the protocol.
  8. Expect to be located in the area of the clinical site for at least the duration of the screening, 20-day treatment period, and for the followup visits at Days 28 +/- 2 days, 42 +/- 7 days and 100 +/- 14 days.
  9. If female and of child-bearing potential, have a negative serum or urine pregnancy test during screening and agree to use an acceptable method of birth control during the treatment phase and for 1 month after treatment is completed.

Exclusion Criteria:

Also, to be eligible for the study, patients must not:

  1. Have a prior diagnosis of leishmaniasis where all lesions had healed.
  2. Have only a single lesion whose characteristics include any of the following: verrucous or nodular lesion (non-ulcerative), lesion <1 cm in its greatest diameter, lesion in a location that in the opinion of the Investigator is difficult to maintain application of study drug topically.
  3. Have a lesion due to leishmania that involves the mucosa or palate.
  4. Have signs and symptoms of disseminated disease.
  5. Be a female who is breast-feeding.
  6. Have an active malignancy or history of solid, metastatic or hematologic malignancy with the exception of basal or squamous cell carcinoma of the skin that has been removed.
  7. Have significant organ abnormality, chronic disease such as diabetes, severe hearing loss, evidence of renal or hepatic dysfunction, myasthenia gravis, parkinsonism, impairment of the eighth cranial nerve or clinically significant levels of creatinine, AST, or ALT in the judgment of the investigator.
  8. Have received treatment for leishmaniasis (except mercurochrome or local antiseptics) including any medication with pentavalent antimony including sodium stibogluconate (Pentostam), meglumine antimoniate (Glucantime); amphotericin B (including liposomal amphotericin B and amphotericin B deoxycholate); WR 279,396; or other medications containing paromomycin (administered parenterally or topically) within 56 days of starting study treatments, or methylbenzethonium chloride (MBCL); or local or systemic antibiotics of the following families (penicillin, betalactamics, cyclines, synergistin, macrolides, lincosamides, fusidic acid, mupirocin) within 8 days of starting study treatments.
  9. Have history of known or suspected hypersensitivity or idiosyncratic reactions to aminoglycosides.
  10. Have any other topical disease/condition which would interfere with the objectives of this study.

Sites / Locations

  • Groupe Hospitalier Pitié-Salpêtrière
  • Centre d'investigations cliniques- Hopital Robert Debré

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

WR 279,396

Arm Description

All patients with the same Study drug: WR 279,396 (Topical Paromomycin and Gentamicin Cream)

Outcomes

Primary Outcome Measures

final clinical cure rate for the index lesion: initial clinical cure
Initial clinical cure: 100% reepithelialization (ie, a 0 x 0 length x width measurement) of the lesion at the nominal Day 42 evaluation, or initial clinical improvement followed >50% reepithelialization by Day 100

Secondary Outcome Measures

final clinical cure rate for the index lesion: Relapse
Relapse is defined as a 10 percent or greater increase in the area of ulceration of the index lesion or a shift from 100% to < 100% re-epithelialization of the index lesion at nominal Day 100 for those patients that had 100% re-epithelialization of the index lesion at nominal Day 42 or before

Full Information

First Posted
November 14, 2013
Last Updated
January 24, 2017
Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
U.S. Army Medical Research and Development Command
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1. Study Identification

Unique Protocol Identification Number
NCT01988909
Brief Title
WR 279,396 for the Treatment of Cutaneous Leishmaniasis
Acronym
PAGELEC
Official Title
An Open-Label Study to Examine the Safety and Efficacy, of WR 279,396 (Paromomycin + Gentamicin Topical Cream) for the Treatment of Cutaneous Leishmaniasis in France
Study Type
Interventional

2. Study Status

Record Verification Date
January 2017
Overall Recruitment Status
Completed
Study Start Date
September 2013 (Actual)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
December 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
U.S. Army Medical Research and Development Command

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objectives of the study are to evaluate the safety and efficacy of open label treatment with WR 279,396 (topical paromomycin & gentamicin) in patients with non-complicated, non-severe cutaneous leishmaniasis (CL).
Detailed Description
Patients with suspected CL will be screened up to a 14 day period for eligibility including parasitology for confirmation of ulcerative CL. Recruitment will primarily be from patients exposed to leishmaniasis. A target enrollment of 30 patients will receive WR 279,396 (15% paromomycin + 0.5% gentamicin topical cream) once daily for 20 days. The index lesion and all other ulcerated lesions will be assessed for clinical response by measurement of the length and width of area of ulceration. A lesion will be considered to be completely cured if 100% re-epithelialization is observed. Non-ulcerated lesions will also be measured to monitor the total area of exposure of lesions to study drug and will be evaluated for cure.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cutaneous Leishmaniasis
Keywords
Cutaneous leishmaniasis, Paromomycin + Gentamicin Topical Cream, Safety, Efficacy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
WR 279,396
Arm Type
Experimental
Arm Description
All patients with the same Study drug: WR 279,396 (Topical Paromomycin and Gentamicin Cream)
Intervention Type
Drug
Intervention Name(s)
WR 279,396
Intervention Description
Paromomycin + Gentamicin Topical Cream
Primary Outcome Measure Information:
Title
final clinical cure rate for the index lesion: initial clinical cure
Description
Initial clinical cure: 100% reepithelialization (ie, a 0 x 0 length x width measurement) of the lesion at the nominal Day 42 evaluation, or initial clinical improvement followed >50% reepithelialization by Day 100
Time Frame
Day 42 or day 100
Secondary Outcome Measure Information:
Title
final clinical cure rate for the index lesion: Relapse
Description
Relapse is defined as a 10 percent or greater increase in the area of ulceration of the index lesion or a shift from 100% to < 100% re-epithelialization of the index lesion at nominal Day 100 for those patients that had 100% re-epithelialization of the index lesion at nominal Day 42 or before
Time Frame
day 42 or day 100

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: To be eligible for the study, patients must: Be male or females ages 2 to 80 years of age, inclusive. Have non-complicated, non-severe CL. Be able to give written informed consent or by their legal representative. Have a diagnosis of CL in at least one lesion by at least one of the following methods: 1) positive culture for promastigotes; 2) microscopic identification of amastigotes in stained lesion tissue and/or 3) by positive polymerase chain reaction (PCR). Patients who have a prior diagnosis of CL within 30 days of the start of treatment are eligible without a confirmatory test during screening. Have at least one ulcerative lesion ≥ 1 cm and < 5 cm, that meets the criteria for an index lesion. Be willing to forego other forms of treatments for CL including other investigational treatment during the study. In the opinion of the investigator, be capable of understanding (or their legal representative) and complying with the protocol. Expect to be located in the area of the clinical site for at least the duration of the screening, 20-day treatment period, and for the followup visits at Days 28 +/- 2 days, 42 +/- 7 days and 100 +/- 14 days. If female and of child-bearing potential, have a negative serum or urine pregnancy test during screening and agree to use an acceptable method of birth control during the treatment phase and for 1 month after treatment is completed. Exclusion Criteria: Also, to be eligible for the study, patients must not: Have a prior diagnosis of leishmaniasis where all lesions had healed. Have only a single lesion whose characteristics include any of the following: verrucous or nodular lesion (non-ulcerative), lesion <1 cm in its greatest diameter, lesion in a location that in the opinion of the Investigator is difficult to maintain application of study drug topically. Have a lesion due to leishmania that involves the mucosa or palate. Have signs and symptoms of disseminated disease. Be a female who is breast-feeding. Have an active malignancy or history of solid, metastatic or hematologic malignancy with the exception of basal or squamous cell carcinoma of the skin that has been removed. Have significant organ abnormality, chronic disease such as diabetes, severe hearing loss, evidence of renal or hepatic dysfunction, myasthenia gravis, parkinsonism, impairment of the eighth cranial nerve or clinically significant levels of creatinine, AST, or ALT in the judgment of the investigator. Have received treatment for leishmaniasis (except mercurochrome or local antiseptics) including any medication with pentavalent antimony including sodium stibogluconate (Pentostam), meglumine antimoniate (Glucantime); amphotericin B (including liposomal amphotericin B and amphotericin B deoxycholate); WR 279,396; or other medications containing paromomycin (administered parenterally or topically) within 56 days of starting study treatments, or methylbenzethonium chloride (MBCL); or local or systemic antibiotics of the following families (penicillin, betalactamics, cyclines, synergistin, macrolides, lincosamides, fusidic acid, mupirocin) within 8 days of starting study treatments. Have history of known or suspected hypersensitivity or idiosyncratic reactions to aminoglycosides. Have any other topical disease/condition which would interfere with the objectives of this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pierre Buffet, MD, PhD
Organizational Affiliation
Assistance Publique - Hôpitaux de Paris
Official's Role
Principal Investigator
Facility Information:
Facility Name
Groupe Hospitalier Pitié-Salpêtrière
City
Paris
ZIP/Postal Code
75013
Country
France
Facility Name
Centre d'investigations cliniques- Hopital Robert Debré
City
Paris
ZIP/Postal Code
75019
Country
France

12. IPD Sharing Statement

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WR 279,396 for the Treatment of Cutaneous Leishmaniasis

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