Malaria Clinical Trial
Official title:
A Phase Ib Study to Characterise the Antimalarial and Transmission Blocking Activity of a Single Dose of DSM265 or OZ439 in Healthy Subjects With Induced Blood Stage Plasmodium Falciparum or Plasmodium Vivax Infection
Part A
-Cohort 1 DSM265 will be administered as a single dose (400 mg). For cohort 1 only, an
additional single dose (400 mg) of DSM265 may be given if gametocytemia develops. Treatment
with DSM265 will be given after an overnight fasting period of ≥ 8 hours. If dosing is to
occur in the evening, subjects will be required to fast for ≥4 hours prior to receiving
treatment. Subjects will be required to fast for a further four hours anytime after dosing
with DSM265.
Part B
- Cohort 2 OZ439 will be administered as a single 200 mg dose. If recrudescence is
observed, a single 400 mg dose of OZ439 will be given. Treatment with OZ439 will be
administered after an overnight fasting period of ≥ 6 hours. If dosing is to occur in
the evening, subjects will be required to fast for ≥4 hours prior to receiving
treatment. Participants will drink 200 mL of milk prior to drug administration, and then
swallow the appropriate volume of OZ439 suspension. Subjects will be required to fast
for a further six hours anytime after dosing with OZ439.
- Cohort 3 DSM265 will be administered as a single dose (400 mg) as described for cohort
1. No additional dose will be administered.
This is a single-centre, open label study using induced blood stage malaria (IBSM) infection
to assess the effectiveness of the investigational drugs DSM265 or OZ439 in reducing
parasitemia. Transmission blocking activity of DSM265 (in P. falciparum infection; cohort 1
only) and infectivity to vector mosquitoes prior to drug treatment (in P. vivax infection;
cohort 2 and 3) will also be assessed. This study will be conducted in up to three cohorts (n
= 8 per cohort), and will be divided into 2 parts. In Part A (cohort 1) the efficacy of a
single administration of 400 mg DSM265 for the clearance of asexual blood stages of P.
falciparum will be determined. Activity of a second single dose of 400 mg DSM265 against
gametocytes will be assessed in this cohort only if sexual stages are identified by PCR
following the initial drug treatment. In Part B, subjects will be infected with P. vivax by
IBSM, then treated with a single 200 mg dose OZ439 (cohort 2) or 400 mg dose of DSM265
(cohort 3). For cohort 2, if recrudescence occurs following initial drug treatment with 200
mg OZ439, then affected participants who reach the treatment threshold will receive a single
400 mg dose of OZ439. The PK/PD relationship following drug treatment will be determined in
order to further characterize the antimalarial activity of the investigational drug in the
IBSM system using P. falciparum (for cohort 1; 400 mg DSM265) or P. vivax (for cohort 2, 200
mg OZ439; cohort 3, 400 mg DSM265).
The treatment effects on gametocytemia (if sexual blood stages are detected by PCR) and
transmission blocking activity of DSM265 will be investigated as a secondary objective for
cohort 1 (P. falciparum infection). Prior to drug treatment, the infectivity of P. vivax IBSM
infection to vector mosquitoes will also be investigated as a secondary objective for Part B,
cohorts 2 and 3. The exposures achieved with the doses proposed for DSM265 used in Part A and
DSM265 or OZ439 in Part B are associated with a safety profile which is well described from
previous studies and significantly below the maximum tolerated exposures reported for either
drug.
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