Malaria, Falciparum Clinical Trial
Official title:
Phase I, Randomized, Parallel Group Study to Evaluate the Effect of Multiple Oral Doses of Eurartesim on the QT/QTc Interval Compared to Riamet, Placebo and Moxifloxacin in Healthy Male and Female Volunteers
The aim of such a study is to evaluate the impact of a therapeutic dose of Eurartesim™ compared to Riamet®, after multiple dose administration for 3 days in healthy male and female subjects on electrocardiographic parameters.
The fight against malaria, which the WHO reactivated in 1999 with its Roll Back Malaria
programme, emphasizes early curative treatment of malaria, particularly in children, in
order to decrease mortality and morbidity. Recent estimates confirm a disturbing persistence
of endemic malaria with around 515 million cases and 1.0 million deaths per year.The
available range of standard antimalarial drugs is narrow. There are only four classes of
compounds, probably with different mechanisms of action: 4-aminoquinolines, amino-alcohols,
artemisinin derivatives (isolated from a plant, Artemisia annua), and antifolates and drugs
related to them.
From a public health perspective, drug resistance is a critical factor that undermines
malaria control.Plasmodium falciparum and resistance to chloroquine and
sulfadoxine/pyrimethamine is widespread. At present, natural quinine is still effective
against P. falciparum everywhere in the world except partially in South-east Asia and South
America, where decreased susceptibility is reported. Only the artemisinin derivatives, used
for 15 years in Asia and, more recently in Africa, have not generated clinical resistance.
Overcoming or reducing resistance requires the adoption of several strategies; central to
these is the use of effective chemotherapy for those who need it. In addition, to new
molecules, we need to develop and implement strategies to protect drugs against resistance.
Resistance to single-drug therapies will inevitably occur. Drug combinations, which have
been standard practice for viral and bacterial diseases, are now being adopted for malaria
as well. The artemisinin derivatives in combination with standard antimalarials are now
being promoted as the best therapeutic option for treating drug-resistant malaria and
retarding the development of resistance.
The aim of the present study is to investigate the effect of this new Artemisinin
Combination Therapy (ACT) formulation on electrocardiographic parameters. In the literature
no relevant QT prolongation associated with Piperaquine treatment has been reported in
not-company sponsored trials but no specific TQT trials have been published. On the contrary
it has been reported that quinine, quinidine and halofantrine induced a QT prolongation
(from slight to severe).
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Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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