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AzTrials

MalariaPhase 2NCT04020653

A Study to Assess the Safety and Efficacy of 5-aminolevulinic Acid Hydrochloride (5-ALA HCl) and Sodium Ferrous Citrate (SFC) Added on Artemisinin-based Combination Therapy (ACT) in Adult Patients With Uncomplicated Malaria

A Phase 2 study testing 5-aminolevulinic acid hydrochloride (5-ALA HCl) 600 mg QD, Sodium ferrous citrate (SFC) 472 mg QD and Artemisinin-based combination (ACT) in people with Malaria, run by Neopharma Japan Co., Ltd..

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

This is a pilot, double-blind, randomized, parallel-group, placebo-control, exploratory study to evaluate the efficacy and safety of 5-aminolevulinic acid hydrochloride (5-ALA HCl) and sodium ferrous citrate (SFC) added on artemisinin-based combination therapy (ACT) compared with ACT alone in the treatment of malaria. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Malaria
What is being tested?
5-aminolevulinic acid hydrochloride (5-ALA HCl) 600 mg QD, Sodium ferrous citrate (SFC) 472 mg QD and Artemisinin-based combination (ACT)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
0 participants
Where
No sites listed yet
Study dates
6 Sep 2019to 30 Sep 2020
Phase
Phase 2
Are there results?
None posted in the registry

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 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Male or female patients of 18 to 60 years inclusive.
  • Weighing 35 to 90 kg.
  • Women with child bearing potential willing to give consent for pregnancy test.
  • Presence of symptomatic uncomplicated malaria of all species inclusive with a diagnosis confirmed by:
  • Microscopically confirmed parasite infection, between 500 and 100,000 asexual parasite count/μL of blood.
  • Fever, as defined by axillary/tympanic of ≥37.5°C within 24 hours before randomization (must be documented).
  • Patients must be willing and able to give written informed consent and comply with all study visits and procedures. If a patient cannot read informed consent and/or write a signature, an impartial witness who speaks the language of the patient must be present during the entire informed consent process and discussion with the patient.

Who cannot join

  • Patients with signs and symptoms of severe/complicated malaria requiring parenteral treatment according to the World Health Organization (WHO) Criteria 2010.
  • Severe vomiting, defined as more than three times in the 24 hours prior to inclusion in the study or inability to tolerate oral treatment.
  • Known history of photo-hypersensitivity, porphyria, or hemochromatosis.
  • Have taken any medication with antimalarial or antibiotic with antimalarial effect within 14 days before randomization.
  • Received an investigational drug within the past 28 days.
  • Patients whose Hemoglobin (Hb) level is lower than 8 g/dL.
Show all 14Show fewer
  • Liver function tests (aspartate aminotransferase/alanine aminotransferase [AST/ALT] levels) more than 2.5 times upper limit of normal values.
  • Known human immunodeficiency virus (HIV) or Hepatitis C virus (HCV) or hepatitis B surface antigen (HBsAg) positive, testing is not required.
  • Known significant renal impairment as indicated by serum creatinine of ≥1.4 mg/dL or estimated glomerular filtration rate (eGFR) of <45 mL/min.
  • Known history of hypersensitivity, allergic or adverse reactions to 5-aminolevulinic acid and sodium ferrous citrate.
  • Presence or history of uncontrolled systemic disease.
  • Female patients who are pregnant or breast-feeding.
  • Any other condition in the opinion of the investigator makes the patient unsuitable for study
  • Received any medication specified as contraindication for ACT or affecting blood concentration of ACT within 5 times the half-life of each medication before the first dose of study medication.

About this study

Official title: A Pilot, Double-blind, Randomized, Parallel-group, Placebo-controlled, Exploratory Study to Assess the Safety and Efficacy of 5-aminolevulinic Acid Hydrochloride (5-ALA HCl) and Sodium Ferrous Citrate (SFC) Added on Artemisinin-based Combination Therapy (ACT) in Adult Patients With Uncomplicated Malaria

This is a pilot, double-blind, randomized, parallel-group, placebo-control, exploratory study to evaluate the efficacy and safety of 5-aminolevulinic acid hydrochloride (5-ALA HCl) and sodium ferrous citrate (SFC) added on artemisinin-based combination therapy (ACT) compared with ACT alone in the treatment of malaria. Patients who are suffering from uncomplicated malaria, are eligible for randomization.The study will be conducted in a total of 75 patients with uncomplicated malaria.

Read the detailed description

Approximately 75 patients will be randomized in a 1:2:2 ratio to 3 arms:

Arm 1: placebo+ACT group (15 patients)

Arm 2: 5 ALA/SFC+Placebo+ACT twice daily (BID) (30 patients)

Arm 3: 5-ALA/SFC+Placebo+ACT once daily (QD) (30 patients)

The study duration will be a maximum of 98 days with treatment period of 7 days and follow-up period of 91 days.

Conditions
Malaria
Being tested
5-aminolevulinic acid hydrochloride (5-ALA HCl) 600 mg QD, Sodium ferrous citrate (SFC) 472 mg QD, Artemisinin-based combination (ACT), Placebo, 5-aminolevulinic acid hydrochloride (5-ALA HCl) 300 mg BID
Keywords
Uncomplicated malaria, sodium ferrous citrate (SFC), 5-aminolevulinic acid hydrochloride (5-ALA HCl), artemisinin-based combination therapy
Medical subject headings
Malaria

What participants receive

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

  • 5-aminolevulinic acid hydrochloride (5-ALA HCl) 600 mg QDDrug

    5-ALA HCl 150 mg capsules will be given to the patients as 600 mg QD

  • Sodium ferrous citrate (SFC) 472 mg QDDrug

    SFC 118 mg capsules will be given to the patients as 472 mg QD

  • Artemisinin-based combination (ACT)Drug

    Also called Artemether 20 mg and lumefantrine 120 mg

    Tablets of ACT will be administered following Dosage and Administration in the package insert of ACT. ACT will be supplied as a combination tablet.

  • PlaceboDrug

    Matching placebo capsules to 5-ALA HCl and SFC will be administered to the patients

  • 5-aminolevulinic acid hydrochloride (5-ALA HCl) 300 mg BIDDrug

    5-ALA HCl 150 mg capsules will be given to the patients as 300 mg BID

  • Sodium ferrous citrate (SFC) 236 mg BIDDrug

    SFC 118 mg capsules will be given to the patients as 236 mg BID

Study groups in NCT04020653
Study groupRoleWhat they receive
Placebo + ACTPlacebo comparatorPatients will receive placebo for Day 1 to Day 7 and ACT (as per package instruction) for Day 1 to Day 3.
Receives: Drug: Artemisinin-based combination (ACT); Drug: Placebo
5 ALA/SFC+placebo+ACT BIDExperimental5-ALA HCl 300 mg and SFC 236 mg will be administered BID for Day 1 to Day 7 and ACT (as per package instruction) for Day 1 to Day 3. Patients will receive 5-ALA HCl+Placebo and SFC+Placebo at odd number of study medication dosing (Dose 1, 3, 5, 7, 9, 11, 13) and only 5-ALA HCl and SFC at even numbers of study medication dosing (Dose 2, 4, 6, 8, 10,12, 14).
Receives: Drug: Artemisinin-based combination (ACT); Drug: Placebo; Drug: 5-aminolevulinic acid hydrochloride (5-ALA HCl) 300 mg BID; Drug: Sodium ferrous citrate (SFC) 236 mg BID
5-ALA/SFC+placebo+ACT QDExperimental5-ALA HCl 600 mg and SFC 472 mg will be administered QD in the morning or evening for Day 1 to Day 7 and ACT (as per package instruction) for Day 1 to Day 3. Patients will receive 5-ALA HCl and SFC at odd number of study medication dosing (Dose 1, 3, 5, 7) and placebo at even numbers of study medication dosing (Dose 2, 4, 6).
Receives: Drug: 5-aminolevulinic acid hydrochloride (5-ALA HCl) 600 mg QD; Drug: Sodium ferrous citrate (SFC) 472 mg QD; Drug: Artemisinin-based combination (ACT); Drug: Placebo

What is being measured

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

  1. Number of patients with adverse events

    Number of patients with any adverse events or clinically significant abnormal laboratory parameters to investigate safety and tolerability of 5-ALA HCl and SFC in simultaneous administration with ACT.

    Measured: From screening visit (Day -1) untill the Follow-up Visit (Day 98)

  2. Cure rate on Day 28

    Cure rate is defined as the proportion of patients with polymerase chain reaction (PCR)-corrected Adequate Clinical and Parasitological Response (ACPR). PCR-corrected ACPR is defined as patients with clearance of asexual parasites within 28 days of initiation of study medication and without recrudescence within 28 days. Cure rate to investigate the preliminary efficacy of 5-ALA HCl and SFC in simultaneous administration with ACT.

    Measured: Day 28

  3. Parasite Clearance Time

    Time from first dosing to time of first of 4 consecutive readings with zero parasite count in blood. Calculated based on parasite count in blood every 4 hours after the start of study medication for 72 hours until there are 4 consecutive negative readings.

    Measured: Every 4 hours for 72 hours from Day 1 to Day 7 until 4 consecutive negative readings

  4. Fever Reduction Time

    Time to Fever Reduction is defined as the time from first dosing to first normal reading of temperature (<37.5 °C) for two consecutive normal temperature reading plus confirmed normal temperature every 4 hours after the start of study medication for 72 hours

    Measured: Every 4 hours for 72 hours from Day 1 to Day 7

  5. Gametocyte Clearance Time

    Time from the first dose until first total and continued disappearance of gametocytes which remains at least a further 24 hours

    Measured: Day 1 to Day 7 + 24 hours

  6. Change in inflammatory parameter: C-reactive protein

    Change from baseline in C-reactive protein to investigate change in inflammatory parameters

    Measured: Days 1, 3, 7, and 28

  7. Change in inflammatory parameter: interleukin-6

    Change from baseline in interleukin-6 to investigate change in inflammatory parameters

    Measured: Days 1, 3, 7, and 28

  8. Change in inflammatory parameter: tumor necrosis factor (TNF)-alpha

    Change from baseline in tumor necrosis factor (TNF)-alpha to investigate change in inflammatory parameters

    Measured: Days 1, 3, 7, and 28

  9. Change in iron metabolism: Serum iron

    Change from baseline in serum iron to investigate change in iron metabolism parameters

    Measured: Days 1, 3, 7, 28, and 98

  10. Change in iron metabolism: Hepcidin

    Change from baseline in hepcidin to investigate change in iron metabolism parameters

    Measured: Days 1, 3, 7, 28, and 98

  11. Change in iron metabolism: total iron binding capacity (TIBC)

    Change from baseline in total iron binding capacity (TIBC) to investigate change in iron metabolism parameters

    Measured: Days 1, 3, 7, 28, and 98

  12. Change in iron metabolism: unsaturated iron binding capacity (UIBC)

    Change from baseline in unsaturated iron binding capacity (UIBC) to investigate change in iron metabolism parameters

    Measured: Days 1, 3, 7, 28, and 98

Timeline

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

  1. First posted16 Jul 2019
  2. Study start6 Sep 2019 (estimated)
  3. Primary completion31 May 2020 (estimated)
  4. Study completion30 Sep 2020 (estimated)

Why it stopped: Considering the Thai FDA requirement, changes of Malaria cases in Thailand and EC recommendation, the decision to withdrawal the study was made.

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
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04020653
Sponsor's protocol ID
NPJ005-MAL-0122
Status last verified
Feb 2020
First submitted
12 Jul 2019
Last updated
3 Mar 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing 5-aminolevulinic acid hydrochloride (5-ALA HCl) 600 mg QD, Sodium ferrous citrate (SFC) 472 mg QD and Artemisinin-based combination (ACT) in people with Malaria, run by Neopharma Japan Co., Ltd..

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 7 inclusion and 14 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: withdrawn, as of the sponsor's last update on 3 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. 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?

The study was withdrawn before enrolling participants, so there are no results.

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 patients with adverse events (time frame: From screening visit (Day -1) untill the Follow-up Visit (Day 98)). The study lists 12 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 3 Mar 2020.

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