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.
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
Ghana2 sites
Novartis Investigative Site
Kintampo
Novartis Investigative Site
Navrango
Mali2 sites
Novartis Investigative Site
Bamako
Novartis Investigative Site
Sotouba
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 group | Role | What they receive |
|---|---|---|
| Treatment arm 1: KAE609 10 mg Single Dose (SD) | Experimental | KAE609 10 mg once daily (QD) for 1 day Receives: Drug: KAE609 |
| Treatment arm 2:KAE609 25 mg SD | Experimental | KAE609 25 mg once daily (QD) for 1 day Receives: Drug: KAE609 |
| Treatment arm 3:KAE609 10 mg 3 Days | Experimental | KAE609 10 mg (QD) for 3 days Receives: Drug: KAE609 |
| Treatment arm 4:KAE609 50 mg SD | Experimental | KAE609 50 mg once daily (QD) for 1 day Receives: Drug: KAE609 |
| Treatment arm 5:KAE609 25 mg 3 Days | Experimental | KAE609 25 mg once daily (QD) for 3 days Receives: Drug: KAE609 |
| Treatment arm 6:KAE609 75 mg SD | Experimental | KAE609 75 mg once daily (QD) for 1 day Receives: Drug: KAE609 |
| Treatment arm 7:KAE609 50 mg 3 Days | Experimental | KAE609 50 mg once daily (QD) for 3 days Receives: Drug: KAE609 |
| Treatment arm 8: KAE609 150 mg SD | Experimental | KAE609 150 mg once daily (QD) for 1 day Receives: Drug: KAE609 |
| Treatment arm 9: Coartem Control | Active comparator | Coartem® control Receives: Drug: Coartem |
What is being measured
The primary outcome is the main question the study is designed to answer.
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)
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
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
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
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
Maximum Peak Observed Concentration (Cmax)
Maximum Peak Observed Concentration (Cmax)
Measured: Day 1, Day 3
Tmax
Tmax
Measured: Day 1, Day 3
AUC0-24
AUC0-24
Measured: Day 1, Day 3
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.
- First posted7 Nov 2017
- Study start16 Nov 2017
- Primary completion23 Nov 2019
- Study completion23 Nov 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for MalariaStudies of the same condition, open and under way.
- More trials run by Novartis PharmaceuticalsThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Wellcome Trust
- Responsible party
- Sponsor
- Investigators
- Novartis Pharmaceuticals, Study director, Novartis Pharmaceuticals
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
- Results posted
- Yes, on ClinicalTrials.gov
- 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 34930267Schmitt 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
Study at a glance
From the registry record, last updated by the sponsor on 11 Oct 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- 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.
- ClinicalTrials.gov ID
- NCT03334747
- Acronym / sponsor ID
- CKAE609A2202
- Conditions
- Malaria
- Keywords
- uncomplicated Plasmodium falciparum Malaria.
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 188 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Collaborators
- Wellcome Trust
- Study start
- 16 Nov 2017 (actual)
- Primary completion
- 23 Nov 2019 (actual)
- Study completion
- 23 Nov 2019 (actual)
- First posted
- 7 Nov 2017 (actual)
- Results
- Posted 25 Sep 2020
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 9
- 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
| Arm | Type | Receives |
|---|---|---|
| Treatment arm 1: KAE609 10 mg Single Dose (SD) | Experimental | Drug: KAE609KAE609 10 mg once daily (QD) for 1 day |
| Treatment arm 2:KAE609 25 mg SD | Experimental | Drug: KAE609KAE609 25 mg once daily (QD) for 1 day |
| Treatment arm 3:KAE609 10 mg 3 Days | Experimental | Drug: KAE609KAE609 10 mg (QD) for 3 days |
| Treatment arm 4:KAE609 50 mg SD | Experimental | Drug: KAE609KAE609 50 mg once daily (QD) for 1 day |
| Treatment arm 5:KAE609 25 mg 3 Days | Experimental | Drug: KAE609KAE609 25 mg once daily (QD) for 3 days |
| Treatment arm 6:KAE609 75 mg SD | Experimental | Drug: KAE609KAE609 75 mg once daily (QD) for 1 day |
| Treatment arm 7:KAE609 50 mg 3 Days | Experimental | Drug: KAE609KAE609 50 mg once daily (QD) for 3 days |
| Treatment arm 8: KAE609 150 mg SD | Experimental | Drug: KAE609KAE609 150 mg once daily (QD) for 1 day |
| Treatment arm 9: Coartem Control | Active comparator | Drug: CoartemCoartem® control |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- 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.
Key exclusion criteria (12 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| KAE609Also: CipargaminExploration of different doses of KAE609 to establish safety profile. | Drug | Treatment arm 1: KAE609 10 mg Single Dose (SD), Treatment arm 2:KAE609 25 mg SD, Treatment arm 3:KAE609 10 mg 3 Days, Treatment arm 4:KAE609 50 mg SD, Treatment arm 5:KAE609 25 mg 3 Days, Treatment arm 6:KAE609 75 mg SD, Treatment arm 7:KAE609 50 mg 3 Days, Treatment arm 8: KAE609 150 mg SD |
| CoartemAlso: Artemether LumefantrineControl Arm | Drug | Treatment arm 9: Coartem Control |
Primary outcome
Number of Participants With at Least 2 CTCAE Grades Increase From Baseline in Alanine Aminotransferase (ALT) or Aspartate Aminotransferase (AST)
Time frame: Day 29
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.
8 secondary outcomes
Percentage of Participants With Polymerase Chain Reaction (PCR)-Corrected and Uncorrected Adequate Clinical and Parasitological Response (ACPR) at Day 15 and Day 29
Time frame: Day 15, Day 29
Parasite Clearance Time (PCT)
Time frame: Day 29
Fever Clearance Time (FCT)
Time frame: Day 29
Time to Recrudescence and Reinfection at Study Day 29
Time frame: Day 29
Maximum Peak Observed Concentration (Cmax)
Time frame: Day 1, Day 3
Tmax
Time frame: Day 1, Day 3
AUC0-24
Time frame: Day 1, Day 3
Half-life (T^1/2)
Time frame: Upto day 15 post dose
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Oct 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 34930267Ndayisaba 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.
- Derived from this study: PubMed 34410358Schmitt 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.
- A Plain Language Trial Summary is available on novartisclinicaltrials.comLink provided by the sponsor.
- Individual participant dataSharing planned: 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
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Novartis Pharmaceuticals study director
Novartis Pharmaceuticals
9 sites in 5 countries: see every site and its status.
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.