Trypanosomiasis, African Clinical Trial
— OXA005Official title:
Pharmacokinetic, Efficacy, Safety, and Tolerability Study of a Single Dose of Acoziborole Under Fasting Conditions in Paediatric Patients From 1 to 14 Years of Age and With g-HAT: a Multicentre, Open-label Study
Acoziborole has been studied in an open-label pivotal Phase II/III trial (DNDi-OXA-02-HAT) in the DRC and Guinea. As the numbers of reported cases diminish, resources for surveillance and specialised screening will also taper. This decrease, coupled with the loss of diagnostic skills and disease management expertise, will lead to a weak and less specialised HAT technical environment. The history of g-HAT has shown that outbreaks or re-emergence of the disease have already happened under different circumstances when surveillance was relaxed or simply because the populations at risk live in areas of political instability, limiting access to specialised care. Even with a steady decrease of reported incidence, no model can currently predict that HAT could not re-emerge. Although g-HAT is predominantly a disease of adults, children are also affected at diverse rates depending on the geographical and behavioural characteristics in the different areas of disease transmission. Hence efforts are needed to develop a paediatric formulation from a new generation of oral HAT treatments.
Status | Recruiting |
Enrollment | 35 |
Est. completion date | June 30, 2024 |
Est. primary completion date | June 30, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 1 Year to 14 Years |
Eligibility | Inclusion Criteria: - Signed informed consent from one parent or from the legal representative - Assent from the paediatric patient (for paediatric patients >6 years of age) to participate in the study, collected in the presence of an impartial witness - Between 1 and 14 years of age and between 10 and =40 kg (as per the requirements of step 1 and step 2) - Male or female - Evidence of trypanosomes in any body fluid (blood or lymph or CSF) - Having a permanent address and able to comply with the schedule of follow-up visits - Agreement to not take part in any other clinical trials during the participation in this study - For pubescent girls of childbearing potential must agree to have protected sexual relations to avoid becoming pregnant from enrolment up to 3 months after dosing (contraceptive protection will be advised and offered at no cost) Exclusion Criteria: - Previous treatment for g-HAT - Refusal to participate in the study, expressed by the paediatric patient and/or parent or legal representative - Complicated severe acute malnutrition as defined by weight for height (-3 SDs Z score) - Unable to take medication by the oral route - Clinically significant medical condition (other than HAT) that could, in the opinion of the Investigator, jeopardise the patient's safety or interfere with participation in the study - Any condition (excluding HAT-specific symptoms) that affects the patient's and/or parent's ability to communicate with the Investigator as required to complete the study - Prior enrolment in the study or prior intake of acoziborole - Foreseeable difficulty complying with follow-up, including family of migrant workers, refugee status, itinerant trader, etc. - Clinically significant laboratory test abnormality, with: - Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) more than twice the upper limit of normal (ULN) - Total bilirubin more than 1.5 x ULN - Severe leukopenia at <2000/mm3 - Potassium <3.5 mmol/L - Any other clinically significant laboratory test abnormality - Pregnancy confirmed by a positive urine pregnancy test (during the screening period and/or within 24 hours prior to the start of treatment) for pubescent girls of childbearing potential - Not tested for malaria and/or not having received appropriate treatment for malaria - Not having received appropriate treatment for soil-transmitted helminthiasis |
Country | Name | City | State |
---|---|---|---|
Congo, The Democratic Republic of the | HGR Bagata | Bagata | Kwilu |
Congo, The Democratic Republic of the | General Hospital of Bandundu | Bandundu | |
Congo, The Democratic Republic of the | CDTC Katanda | Katanda | Kasaï-Oriental |
Congo, The Democratic Republic of the | Hospital of Masi-Manimba | Masi-Manimba | Kwilu |
Congo, The Democratic Republic of the | Hôpital Général de Dipumba | Mbuji-Mayi | Kasai-Oriental |
Lead Sponsor | Collaborator |
---|---|
Drugs for Neglected Diseases |
Congo, The Democratic Republic of the,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Maximum concentration (Cmax) | Primary PK parameters in blood | From time 0 to 96 hours | |
Primary | Area under the curve (AUC0-96h) | Primary PK parameters in blood | From time 0 to 96 hours | |
Primary | Time to maximum concentration (Tmax) | Primary PK parameters in blood | From time 0 to 96 hours | |
Primary | Area under curve (AUC0-8) | Secondary PK parameters in blood | Day 1 Hour 0, Day 1 Hour 4, Day 1 Hour 9, Day 2 Hour 24, Day 3 Hour 48, Day 4 Hour 72, Day 5 Hour 96, Day 11 Hour 264, month 3 any time | |
Primary | Clearance | Secondary PK parameters in blood | Day 1 Hour 0, Day 1 Hour 4, Day 1 Hour 9, Day 2 Hour 24, Day 3 Hour 48, Day 4 Hour 72, Day 5 Hour 96, Day 11 Hour 264, month 3 any time | |
Primary | Volume of distribution (Vd) | Secondary PK parameters in blood | Day 1 Hour 0, Day 1 Hour 4, Day 1 Hour 9, Day 2 Hour 24, Day 3 Hour 48, Day 4 Hour 72, Day 5 Hour 96, Day 11 Hour 264, month 3 any time | |
Primary | Half-life (t1/2) | Secondary PK parameters in blood | Day 1 Hour 0, Day 1 Hour 4, Day 1 Hour 9, Day 2 Hour 24, Day 3 Hour 48, Day 4 Hour 72, Day 5 Hour 96, Day 11 Hour 264, month 3 any time | |
Primary | CSF concentration | Acoziborole concentration in CSF | Day 11 | |
Secondary | Success or failure | Assess efficacy of acoziborole. Failure defined as death, if rescue medication is required, if evidence of trypanosome in any body fluid, if WBC in CSF >20 cells, clinical signs or symptoms evoking a failure, lost to follow-up, if post treatment LPs refused | 6 and 12 months post-treatment | |
Secondary | Cumulative risk of proven failure over time (Kaplan-Meyer estimate) | Assess efficacy of acoziborole. Failure defined as death, if rescue medication is required, if evidence of trypanosome in any body fluid, if WBC in CSF >20 cells, clinical signs or symptoms evoking a failure, lost to follow-up, if post treatment LPs refused | 6 and 12 months post-treatment | |
Secondary | Occurrence of any treatment-emergent adverse events (TEAEs) (any grade) during the observation period | Assess the safety profile of acoziborole | Day 1 to month 3 | |
Secondary | Occurrence of any TEAEs (grade =3 or severe) and relatedness to medication during the observation period | Assess the safety profile of acoziborole | Day 1 to month 3 | |
Secondary | Occurrence of any serious adverse events (SAEs) during the study | Assess the safety profile of acoziborole | Day 1 to month 12 | |
Secondary | Corrected QT interval (QTc) | Assess the potential relationship between concentration of acoziborole and corrected QT interval (QTc) | Day 1 Hour 0, Day 1 Hour 4, Day 1 Hour 9, Day 2 Hour 24, Day 3 Hour 48, Day 4 Hour 72, Day 5 Hour 96, Day 11 Hour 264, month 3 any time | |
Secondary | Palatability questionnaire | Assess the palatability of the paediatric formulation in paediatric patients (only in step 2), questionnaire to be completed by the patient. Scores of the 5-point hedonic scale | Day 1 | |
Secondary | Acceptability questionnaire | Assess the acceptability of the paediatric formulation in paediatric patients (only in step 2), questionnaire to be completed by the caregiver. Scores of the 5-point hedonic scale | Day 1 |
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