Evaluation of Fosmidomycin and Piperaquine in the Treatment of Acute Falciparum Malaria (FOSPIP)
A Phase IIa Proof of Concept Study to Explore the Efficacy, Tolerability and Safety of Fosmidomycin Sodium When Administered With Piperaquine Tetraphosphate to Adults and Older Children With Acute Uncomplicated Plasmodium Falciparum Malaria
The objective of this study is to explore the role of fosmidomycin and piperaquine as non-artemisinin-based combination therapy for acute uncomplicated Plasmodium falciparum when administered over three days.
Together, fosmidomycin and piperaquine fulfil the WHO criteria for combination therapy by meeting the three key parameters of having different modes of action and different biochemical targets while exhibiting independent blood schizonticidal activity. Like the artemisinins, fosmidomycin is fast-acting, has an excellent safety record and is active against existing drug-resistant parasites. Piperaquine has a long half life protecting fosmidomycin as a much shorter lived molecule against selection of resistant parasites and will provide post-treatment prophylaxis.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Male and female subjects aged 1 to 60 years inclusive
- Body weight between 5kg and 90kg inclusive
- Acute manifestations of a mono-infection with Plasmodium falciparum as determined by either a rapid diagnostic test for adults or microscopically confirmed by an asexual parasitaemia of 1,000 to 150,000/uL and fever with an axillary temperature of > 37.5 degress C or oral/rectal/tympanic temperature of > 38.0 degrees C or history of fever during the previous 72 hours
- Compliance with contraceptive measures throughout the study period of 63 days in females of child bearing potential
Exclusion Criteria:
To be eligible for inclusion in the study, subjects must NOT meet any of the following criteria:
- Signs of severe/complicated malaria according to WHO criteria
- Pregnancy as excluded by negative serum human chorionic gonadotrophin (hCG) test
- Lactation
- Mixed Plasmodium infection
- Severe vomiting on three or more occasions in the previous 24 hours
- Severe diarrhoea on four or more occasions in the previous 24 hours
Concomitant disease masking assessment of response including
- abnormal liver function tests with bilirubin > 40 µmol/L, aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) levels > x 2 upper limit of normal
- impaired renal function with creatinine level > x 2 upper limit of normal
- haemoglobin level < 7.5g/dl
- white cell count > 12000/µL
- History of cardiovascular disease including arrhythmia with QTc interval ≥ 450msec, respiratory disease including active tuberculosis, hepatic disease including jaundice, renal failure, malignancy, neurological disorders including convulsions and psychiatric disturbances
- History of immunological disease including Hepatitis A, B and C and HIV-AIDS
- Severe malnutrition
- History of hypersensitivity or adverse reactions to fosmidomycin, piperaquine, artesunate and mefloquine
- Treatment with antimalarial and antibacterial agents within the previous 28 days
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Fosmidomycin-Piperaquine
Fosmidomycin sodium capsules 450 mg, dosage: 30mg/kg twice daily for 3 days Piperaquine phosphate tablets 320 mg, dosage: 16 mg/kg once a day for 3 days
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Per protocol, PCR-corrected cure rate on Day 28
Time Frame: 28 days
|
Six-hourly asexual counts until negative on three successive occasions. Weekly smears on days 7, 14, 21 and 28 |
28 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Per protocol, PCR-corrected cure rates on Day 7 and Day 63
Time Frame: 63 days
|
Weekly smears on days 35 +/- 3 days, 42 +/- 3 days and 63 +/- 3 days
|
63 days
|
|
Derived parasite reduction ratio at 48 hours
Time Frame: 2 days
|
Six-hourly asexual counts until negative on three successive occasions
|
2 days
|
|
Parasite clearance time
Time Frame: 96 hours
|
Six-hourly asexual counts until negative on three successive occasions
|
96 hours
|
|
Fever clearance time
Time Frame: 96 hours
|
Six hourly temperature recordings until normal on three successisve occasions
|
96 hours
|
|
Proportion of subjects with gametocytes on Day 7
Time Frame: 7 days
|
Smear on Day 7
|
7 days
|
|
Adverse event recording
Time Frame: 28 days
|
Recording of vital signs and ECG monitoring Recording of incidence, severity, drug-relatedness and seriousness of AEs and laboratory abnormalites |
28 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- JP017
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