Malaria Clinical Trial
Official title:
Safety and Efficacy of L9LS, a Human Monoclonal Antibody Against Plasmodium Falciparum, in an Age De-Escalation, Dose-Escalation Trial and a Randomized, Placebo-Controlled, Double-Blind Trial of Children in Western Kenya
The purpose of this study is to evaluate the safety and tolerability of one-time subcutaneous (SC) administration of monoclonal antibody (MAb) L9LS in healthy Kenyan children aged 5 months to 10 years, as well as the protective efficacy of one or two doses of L9LS against naturally occurring Plasmodium falciparum (Pf) infection among Kenyan children aged 5 to 59 months at enrollment, in a setting of perennial high transmission.
Status | Recruiting |
Enrollment | 720 |
Est. completion date | June 30, 2024 |
Est. primary completion date | June 30, 2024 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 5 Months to 10 Years |
Eligibility | Inclusion Criteria: 1. Healthy children aged 5 months to 10 years (Part 1) or 5-59 months (Part 2). 2. Weight =5 kg and weight =30 kg (Part 1) or weight =5 kg and =22.5 kg (Part 2). 3. Hemoglobin level =8 g/dL. 4. Height and weight Z-scores >-2. 5. Living within Alego-Usonga sub-county. 6. Able to participate for the duration of the trial. 7. Parent and/or guardian of participant able to provide informed consent. Exclusion Criteria: 1. Taking long-term cotrimoxazole. 2. Participation or planned participation in an interventional trial with an investigational product until the last required protocol visit or receipt of an investigational product within the past 30 days. (Note: Past, current, or planned participation in observational studies is NOT exclusionary.) 3. Received any doses of any malaria vaccine. 4. Participation in part 1 of this study (for individuals being screened for enrollment into part 2) 5. Age < 12 months at the time the RTS,S/AS01 vaccine is anticipated to become available in the whole of Siaya County 6. Current significant medical condition (neurologic, cardiac, pulmonary, hepatic, endocrine, rheumatologic, authoimmune, renal, oncologic, or hematological) or evidence of any other serious underlying medical condition identified by medical history, physical examination, or laboratory examination. 1. Known sickle cell disease. (Note: Known sickle cell trait is NOT exclusionary.) 2. Hemoglobin, white blood cell, absolute neutrophil, or platelet count outside the local laboratory-defined limits of normal. (Subjects may be included at the investigator's discretion for "not clinically significant" values.) 3. Alanine transaminase (ALT) or creatinine (Cr) level above the local laboratory-defined upper limit of normal. (Subjects may be included at the investigator's discretion for "not clinically significant" values.) 4. Infected with HIV. 5. History of a severe allergic reaction or anaphylaxis. 6. Severe asthma (defined as asthma that is unstable or required emergency care, urgent care, hospitalization, or intubation during the past 2 years, or that has required the use of oral or parenteral corticosteroids at any time during the past 2 years). 7. Pre-existing autoimmune or antibody-mediated diseases including but not limited to: systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, or autoimmune thrombocytopenia. 8. Known immunodeficiency syndrome. 9. Use of chronic (=14 days) oral or IV corticosteroids (excluding topical or nasal) at immunosuppressive doses (i.e., prednisone >10 mg/day) or immunosuppressive drugs within 30 days of day 0. 10. Known asplenia or functional asplenia. 11. Clinical signs of malnutrition. 12. Receipt of immunoglobulins and/or blood products within the past 6 months. 7. Any history of menses. 8. Behavioral, cognitive, or psychiatric disease that in the opinion of the investigator affects the ability of the subject to understand and comply with the study protocol. 9. Parental/guardian study comprehension examination score of <80% correct or per investigator discretion. 10. Receipt of a live vaccine within the past 4 weeks or a killed vaccine within the past 2 weeks prior to study agent administration. 11. Known allergies or contraindication to dihydroartemisinin-piperaquine. 12. Use or known need at the time of enrolment (DP administration) for concomitant prohibited medication. Patients taking any of the following drugs: a. Antimicrobial agents of the following classes (systemic use only): i. Macrolides (e.g. erythromycin, clarithromycin, azithromycin, roxithromycin) ii. Fluoroquinolones (e.g., levofloxacin, moxifloxacin, sparfloxacin) iii. Pentamidine b. Antiarrhythmic agents (e.g. amiodarone, sotalol) c. Antihistamines (e.g. promethazine) d. Antifungals (systemic): ketoconazole, fluconazole, itraconazole e. Antiretrovirals: Saquinavir f. Diuretics (e.g. hydrochlorothiazide, furosemide) g. Antipsychotics (neuroleptics): haloperidol, thioridazine h. Antidepressants: imipramin, citalopram, escitalopram i. Antiemetics: domperidone, chlorpromazine, ondansetron 13. Increased risk of salivary gland hypofunction (dryness of the mouth, swelling under the tongue and/or below the ear, halitosis) 14. History of any other illness or condition which, in the investigator's judgment, may substantially increase the risk associated with the subject's participation in the protocol or compromise the scientific objectives, or other condition(s) that, in the opinion of the investigator, would jeopardize the safety or rights of a subject participating in the trial, interfere with the evaluation of the study objectives, or render the subject unable to comply with the protocol. |
Country | Name | City | State |
---|---|---|---|
Kenya | Kenya Medical Research Institute (KEMRI) Center for Global Health Research (CGHR) | Kisumu |
Lead Sponsor | Collaborator |
---|---|
National Institute of Allergy and Infectious Diseases (NIAID) | Centers for Disease Control and Prevention, Kenya Medical Research Institute, Liverpool School of Tropical Medicine (LSTM), National Institutes of Health (NIH), Vaccine Research Center (VRC) |
Kenya,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Incidence and severity of local and systemic adverse events (AEs) occurring within 7 days after the administration of L9LS. | Age de-escalation and dose-escalation study | Measured through Day 7 | |
Primary | Incidence and severity of local and systemic adverse events (AEs) occurring within 7 days after the administration of L9LS. | Efficacy study | Measured through Day 7 | |
Primary | Rate of Pf blood-stage infection in participants as detected by microscopic examination of thick blood smear for 52 weeks after administration of two doses of L9LS or placebo. | Efficacy study | Measured through week 52 | |
Secondary | Rate of Pf blood-stage infection in participants as detected by microscopic examination of thick blood smear after administration of one dose of L9LS or placebo. | Efficacy study | Measured through 12 and 24 weeks after drug or placebo administration | |
Secondary | Pf blood-stage infection as detected by microscopic examination of thick blood smear diagnosed by blood smear microscopy after administration of one dose of L9LS or placebo. | Efficacy study | Measured for 52 weeks after drug or placebo administration | |
Secondary | Rate of Pf blood-stage infection in participants as detected by RT-PCR of L9LS or placebo. | Efficacy study | Measured at 24 and 52 weeks after drug or placebo administration | |
Secondary | Incidence of clinical malaria: an illness accompanied by measured fever =37.5°C in the previous 24 hours and Pf asexual parasitemia >5,000 parasites/µL as detected from microscopic examination of thick blood smear. | Age de-escalation, dose-escalation and efficacy study | Measured at 24 and 52 weeks after drug or placebo administration | |
Secondary | Incidence of clinical malaria: fever =37.5°C, history of fever in the previous 24 hours accompanied by any level of Pf asexual parasitemia, detected from microscopic examination of thick blood smear, requires administration of anti-malarial treatment. | Age de-escalation, dose-escalation and efficacy study | Measured at 24 and 52 weeks after drug or placebo administration | |
Secondary | L9LS sera concentration | Age de-escalation, dose-escalation and efficacy study | Through Day 336 |
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