Efficacy of Ivermectin and Albendazole Against Onchocerciasis in the Volta Region, Ghana

April 25, 2019 updated by: Christopher L. King, MD, PhD, University Hospitals Cleveland Medical Center

Comparison of Ivermectin Alone With Albendazole (ALB) Plus Ivermectin (IVM) in Their Efficacy Against Onchocerciasis in the Volta Region, Ghana.

We will examine whether a combination of Ivermectim (IVM) plus Albendazole (ALB) compared to IVM alone given annually, which is the current standard for mass drug administration (MDA), is more effective in sterilizing adult worms. We will also address whether IVM plus ALB given twice per year is superior to IVM given once per year or twice per year.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

We hypothesize that more effective combinations of dose schedules of existing antifilarial drugs for MDA against onchocerciasis could shorten the number of years needed to interrupt onchocerciasis transmission and eliminate this infectious disease in areas that previously had high disease rates. Improved treatments should also make it feasible to extend MDA into areas that are currently not being helped. These changes have the potential to completely change the game to make global elimination of onchocerciasis a feasible goal.

Participants will be randomized into 5 treatment arms with 75 subjects in each arm for a total of 375 and followed for 36 months after the initial treatment. The primary endpoint will be the percent fertile adult female worms in nodules removed 36 months after the initiation of treatment.

Study Type

Interventional

Enrollment (Anticipated)

375

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Hohoe, Ghana
        • Onchocerciasis Chemotherapy Research Centre, (OCRC) Municipal Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 60 years (ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Men and women 18-60 years residing along the Kpassa in the Nkwanta North District of the Volta Region in Ghana
  2. Two or more assessable onchocercal nodules
  3. Skin microfilaria density ≥5mf/mg.

Exclusion Criteria:

  1. Prior treatment with the antifilarial and/or anti-nematodal drugs diethylcarbamazine, suramin, ivermectin, albendazole, levamisole or >1week of treatment with doxycycline, within 12 months before planned test article administration.
  2. Pregnant or breastfeeding women.
  3. Low probability of residency in the area (based on subject's assessment) over the next 36 months.
  4. Permanent disability, serious medical illnesses such as a stroke, advanced heart disease, uncontrolled diabetes, emphysema, etc. that prevents or impedes study participation and/or comprehension
  5. Weight of <40kg suggesting malnourishment
  6. Hemoglobin levels <7 gm/dL
  7. aspartate aminotransferase, alanine aminotransferase, creatinine > 1.5 upper limit of normal.
  8. Significant glycosuria or proteinuria (2+ or 3+ protein or glucose).
  9. Known or suspected allergy to albendazole or ivermectin or other compounds related to these classes of medication.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: DIAGNOSTIC
  • Allocation: RANDOMIZED
  • Interventional Model: FACTORIAL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
ACTIVE_COMPARATOR: Annual Ivermectin
Ivermectin 200 µg/kg body weight given orally at 0, 12 and 24 months
EXPERIMENTAL: Biannual IVM 200 µg/kg plus ALB 800 mg
IVM 200 µg/kg plus ALB 800 mg (regardless of weight) given at 0, 6, 12, 18, and 24 months.
EXPERIMENTAL: Annual IVM 200 µg/kg plus ALB 800 mg
IVM 200 µg/kg plus ALB 800 mg given at 0, 12 and 24 months; vitamin pills at given at 6 and 18 months.
EXPERIMENTAL: Biannual IVM 200 µg/kg
IVM 200 µg/kg given 0, 6, 12, 18, and 24 months.
EXPERIMENTAL: IVM 200 µg/kg plus ALB 400 mg
IVM 200 µg/kg plus ALB 400 mg given at 0, 6, 12, 18, and 24 months.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
parasitologic efficacy
Time Frame: 36 months
To compare the parasitologic efficacy, as measured by percent fertile adult female worms in nodules at 36 months after administration of annual doses of oral ivermectin alone versus ivermectin plus albendazole given annually or biannually in the treatment of subjects infected with Onchocerca volvolus
36 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
additional measures of parasitologic efficacy
Time Frame: 0, 6, 12, 18, 24 and 36 months
To compare additional measures of parasitologic efficacy of annual doses of oral ivermectin alone versus ivermectin plus albendazole given annually or biannually in the treatment of subjects infected with Onchocerca volvulus as measured by skin microfilaria levels at additional time points.
0, 6, 12, 18, 24 and 36 months
compare the percentage living versus dead female worms
Time Frame: 36 months
To compare the percentage living versus dead female worms in nodules at 36 months following initiation of therapy of annual doses of oral ivermectin alone versus ivermectin plus albendazole given annually or biannually in the treatment of subjects infected with Onchocerca volvulus.
36 months
compare the number of nodules with intact microfilaria
Time Frame: 36 months
To compare the number of nodules with intact microfilaria (Mf) at 36 months after administration annual doses of oral ivermectin alone versus ivermectin plus albendazole given annually or biannually in the treatment of subjects infected with Onchocerca volvulus.
36 months
assess different treatment regimens on Soil Transmitted Helminth infections
Time Frame: 0, 6, 12, 18, 24 and 36 months
To assess different treatment regimens on Soil Transmitted Helminth (STH) infections based on presence and intensity of ova in stools.
0, 6, 12, 18, 24 and 36 months
determine if IVM plus ALB enhances immunological reactions
Time Frame: 0, 6, 12, 18, 24 and 36 months
To determine if IVM plus ALB enhances immunological reactions to adult worms antigens, or release of circulating parasite antigens as potential biomarkers of drug efficacy.
0, 6, 12, 18, 24 and 36 months
determine if the host immune response facilitates killing or sterilizing adult worms and microfilariae
Time Frame: 0, 6, 12, 18, 24 and 36 months
To determine if the host immune response facilitates killing or sterilizing adult worms and microfilariae. This can be accomplished by examining immune biomarkers prior to and following treatment using stored whole blood, and serum/plasma samples.
0, 6, 12, 18, 24 and 36 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Nicholas O Opoku, MBChB, MSc, Municipal Hospital, Hohoe, Ghana

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 2014

Primary Completion (ACTUAL)

June 1, 2018

Study Completion (ACTUAL)

June 25, 2018

Study Registration Dates

First Submitted

February 28, 2014

First Submitted That Met QC Criteria

February 28, 2014

First Posted (ESTIMATE)

March 4, 2014

Study Record Updates

Last Update Posted (ACTUAL)

April 26, 2019

Last Update Submitted That Met QC Criteria

April 25, 2019

Last Verified

April 1, 2019

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • WU-10-205
  • CWRU-OCR-1 (OTHER: CWRU)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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