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MalariaPhase 2NCT03334747

Safety of KAE609 in Adults With Uncomplicated Plasmodium Falciparum Malaria.

A Phase 2 study testing KAE609 and Coartem in people with Malaria, run by Novartis Pharmaceuticals at 9 sites in 5 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

KAE609 will be evaluated primarily for hepatic safety of single and multiple doses in sequential cohorts with increasing doses.This study aims to determine the maximum safe dose of the investigational drug KAE609 in malaria patients. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Malaria
What is being tested?
KAE609 and Coartem
Could I receive a placebo?
No, everyone receives an active treatment
How many people
188 participants
Where
9 sitesin 5 countries
Study dates
16 Nov 2017to 23 Nov 2019
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male and female patients ≥ 18 years with a body weight ≥ 45 kg.
  • Microscopic confirmation of acute uncomplicated P. falciparum using by Giemsa-stained thick film.
  • P. falciparum parasitaemia of 500 to 50 000 parasites/µL.
  • Axillary temperature ≥ 37.5ºC or oral/tympanic/rectal temperature ≥ 38.0ºC; or history of fever during the previous 24 hours.
  • Written informed consent must be obtained before any study assessment is performed. If the patient is unable to write, then a witnessed consent according to local ethical standards is permitted.

Who cannot join

  • Mixed Plasmodium infections.
  • Signs and symptoms of severe malaria according to World Health Organization (WHO) 2016 criteria (WHO 2016).
  • Known liver abnormalities, liver cirrhosis (compensated or decompensated), known active or history of hepatitis B or C (testing not required), known gallbladder or bile duct disease, acute or chronic pancreatitis.
  • Clinical or laboratory evidence of any of the following:
  • AST/ALT > 1.5 x the upper limit of normal range (ULN), regardless of the level of total bilirubin
  • AST/ALT > 1.0 and ≤ 1.5 x ULN and total bilirubin is > ULN
Show all 12Show fewer
  • Total bilirubin > 2 x ULN, regardless of the level of AST/ALT
  • History of photodermatitis/increased sensitivity to sun.
  • Pregnant or nursing (lactating) women.
  • Known disturbances of electrolyte balance, e.g. hypokalemia, hypocalcemia or hypomagnesemia.
  • Moderate to severe anemia (Hemoglobin level <8 g/dL).
  • Other protocol-defined inclusion/exclusion criteria may apply

Trial locations and contacts

9 sites in 5 countries.

9 sites in 5 countries

Uganda3 sites
  • Novartis Investigative Site

    Bushenyi

  • Novartis Investigative Site

    Kampala

  • Novartis Investigative Site

    Tororo

Other trials in Uganda

Ghana2 sites
  • Novartis Investigative Site

    Kintampo

  • Novartis Investigative Site

    Navrango

Other trials in Ghana

Mali2 sites
  • Novartis Investigative Site

    Bamako

  • Novartis Investigative Site

    Sotouba

Other trials in Mali

Gabon1 site
  • Novartis Investigative Site

    Lambaréné

Other trials in Gabon

Rwanda1 site
  • Novartis Investigative Site

    Kigali

Other trials in Rwanda

About this study

Official title: A Phase 2, Multi-center, Randomized, Open-label, Dose-escalation Study to Determine Safety of Single (QD) and Multiple (3 QD) Doses of KAE609, Given to Adults With Uncomplicated Plasmodium Falciparum Malaria.

KAE609 will be evaluated primarily for hepatic safety of single and multiple doses in sequential cohorts with increasing doses.This study aims to determine the maximum safe dose of the investigational drug KAE609 in malaria patients.

Conditions
Malaria
Being tested
KAE609, Coartem
Keywords
uncomplicated Plasmodium falciparum Malaria.
Medical subject headings
Malaria

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • KAE609Drug

    Also called Cipargamin

    Exploration of different doses of KAE609 to establish safety profile.

  • CoartemDrug

    Also called Artemether Lumefantrine

    Control Arm

Study groups in NCT03334747
Study groupRoleWhat they receive
Treatment arm 1: KAE609 10 mg Single Dose (SD)ExperimentalKAE609 10 mg once daily (QD) for 1 day
Receives: Drug: KAE609
Treatment arm 2:KAE609 25 mg SDExperimentalKAE609 25 mg once daily (QD) for 1 day
Receives: Drug: KAE609
Treatment arm 3:KAE609 10 mg 3 DaysExperimentalKAE609 10 mg (QD) for 3 days
Receives: Drug: KAE609
Treatment arm 4:KAE609 50 mg SDExperimentalKAE609 50 mg once daily (QD) for 1 day
Receives: Drug: KAE609
Treatment arm 5:KAE609 25 mg 3 DaysExperimentalKAE609 25 mg once daily (QD) for 3 days
Receives: Drug: KAE609
Treatment arm 6:KAE609 75 mg SDExperimentalKAE609 75 mg once daily (QD) for 1 day
Receives: Drug: KAE609
Treatment arm 7:KAE609 50 mg 3 DaysExperimentalKAE609 50 mg once daily (QD) for 3 days
Receives: Drug: KAE609
Treatment arm 8: KAE609 150 mg SDExperimentalKAE609 150 mg once daily (QD) for 1 day
Receives: Drug: KAE609
Treatment arm 9: Coartem ControlActive comparatorCoartem® control
Receives: Drug: Coartem

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With at Least 2 CTCAE Grades Increase From Baseline in Alanine Aminotransferase (ALT) or Aspartate Aminotransferase (AST)

    The occurrence of at least 2 CTCAE grades increase from baseline in ALT or AST during the 4 weeks study period was evaluated to characterize hepatic safety aspects of single and multiple ascending doses of KAE609 in adult malaria subjects for treatment of uncomplicated malaria caused by plasmodium falciparum. If 2 patients in a 10 patient cohort (Cohorts 1 and 2) or 3 patients in a 20 patient cohort (Cohorts 3, 4 and 5) had at least 2 CTCAE grades increase from Baseline in ALT or AST, recruitment was suspended and a review of liver safety (and any other relevant data) by safety review committee was initiated. Any further progression of the study was based on the decision by the safety review committee.

    Measured: Day 29

Secondary outcomes (8)
  1. Percentage of Participants With Polymerase Chain Reaction (PCR)-Corrected and Uncorrected Adequate Clinical and Parasitological Response (ACPR) at Day 15 and Day 29

    PCR-corrected and PCR-uncorrected were evaluated at Days 15 and 29 (i.e., 14 and 28 days post-dose). The presence of parasitaemia after 7 days due to reinfection was considered as PCR-corrected ACPR. Missing blood smear data at Day 15 visit and thereafter were not considered as responder for the visit unless there was a later blood smear test indicating no parasitaemia.

    Measured: Day 15, Day 29

  2. Parasite Clearance Time (PCT)

    Parasite Clearance Time (PCT) is defined as the time from the first dose until the first total and continued disappearance of asexual parasite forms which remained at least a further 48 hours. In case a patient received rescue medication before (parasite) clearance, the time to event was censored at the first use of rescue medication.

    Measured: Day 29

  3. Fever Clearance Time (FCT)

    Fever Clearance Time (FCT) is defined as the time from the first dose until the first time the axillary body temperature decreased below and remained below 37.5°C axillary or 38.0°C oral/tympanic/rectal for at least a further 24 hours. In case a patient received rescue medication before (fever) clearance, the time to event was censored at the first use of rescue medication.

    Measured: Day 29

  4. Time to Recrudescence and Reinfection at Study Day 29

    Time to recrudescence is calculated from the date of first study medication to the date of first event. Participants without recrudescence/reinfection after Day 7 are censored at the time of treatment failure or at the time of last parasite assessment if no treatment failure occured.

    Measured: Day 29

  5. Maximum Peak Observed Concentration (Cmax)

    Maximum Peak Observed Concentration (Cmax)

    Measured: Day 1, Day 3

  6. Tmax

    Tmax

    Measured: Day 1, Day 3

  7. AUC0-24

    AUC0-24

    Measured: Day 1, Day 3

  8. Half-life (T^1/2)

    Half-life (T^1/2)

    Measured: Upto day 15 post dose

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Nov 2017
  2. Study start16 Nov 2017
  3. Primary completion23 Nov 2019
  4. Study completion23 Nov 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Patients were randomized to KAE609 and Coartem in parallel treatment arms. Increasing doses of KAE609 (single dose and multiple dose) were evaluated in dose escalated manner in sequential cohorts
Masking
None (open label)
Enrolment
188 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03334747
Sponsor's protocol ID
CKAE609A2202
Other IDs
207813/Z/17/Z
Status last verified
Oct 2021
First submitted
27 Oct 2017
Last updated
11 Oct 2021
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Publications

  • Ndayisaba G, Yeka A, Asante KP, Grobusch MP, Karita E, Mugerwa H, Asiimwe S, Oduro A, Fofana B, Doumbia S, Jain JP, Barsainya S, Kullak-Ublick GA, Su G, Schmitt EK, Csermak K, Gandhi P, Hughes D. Hepatic safety and tolerability of cipargamin (KAE609), in adult patients with Plasmodium falciparum malaria: a randomized, phase II, controlled, dose-escalation trial in sub-Saharan Africa. Malar J. 2021 Dec 20;20(1):478. doi: 10.1186/s12936-021-04009-1.

    PubMed 34930267
  • Schmitt EK, Ndayisaba G, Yeka A, Asante KP, Grobusch MP, Karita E, Mugerwa H, Asiimwe S, Oduro A, Fofana B, Doumbia S, Su G, Csermak Renner K, Venishetty VK, Sayyed S, Straimer J, Demin I, Barsainya S, Boulton C, Gandhi P. Efficacy of Cipargamin (KAE609) in a Randomized, Phase II Dose-Escalation Study in Adults in Sub-Saharan Africa With Uncomplicated Plasmodium falciparum Malaria. Clin Infect Dis. 2022 May 30;74(10):1831-1839. doi: 10.1093/cid/ciab716.

    PubMed 34410358

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing KAE609 and Coartem in people with Malaria, run by Novartis Pharmaceuticals at 9 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in Uganda, Ghana, Mali, Gabon, Rwanda. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 25 Sep 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With at Least 2 CTCAE Grades Increase From Baseline in Alanine Aminotransferase (ALT) or Aspartate Aminotransferase (AST) (time frame: Day 29). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03334747, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Oct 2021.

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