- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03893097
Evaluation of Artesunate-mefloquine as a Novel Alternative Treatment for Schistosomiasis in African Children (SchistoSAM)
A Proof-of-concept Trial to Evaluate Artesunate-mefloquine as a Novel Alternative Treatment for Schistosomiasis in African Children
The SchistoSAM study is an open label, two-arm, individually-randomized controlled trial with a non-inferiority design, conducted in northern Senegal.
The study aims at determining if the efficacy of one and of repeated courses of artesunate-mefloquine (AM) is respectively similar to or higher than that of a standard praziquantel (PZQ) treatment. Secondly, the study will assess if novel DNA- and antigen-based diagnostics are more accurate than microscopy in assessing antischistosomal treatment response.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The SchistoSAM study is an open label, two-arm, individually-randomized controlled trial with a non-inferiority design, conducted in northern Senegal.
The study aims at determining if the efficacy of one and of repeated courses of artesunate-mefloquine (AM) is respectively similar to or higher than that of a standard praziquantel (PZQ) treatment. Secondly, the study will assess if novel DNA- and antigen-based diagnostics are more accurate than microscopy in assessing antischistosomal treatment response.
For this purpose, 726 school children, aged 6-14 years old and infected with Schistosoma (as demonstrated by presence of eggs in stool and/or urine) will be randomized in one of the following arms:
- AM, available in fixed dose tablets of 25/50 mg and 100/200 mg will be administered once daily for three days in a dose closest to 4 mg/kg artesunate and 8 mg/kg mefloquine. This treatment course will be repeated 2 times at 6-week intervals.
- PZQ, available in tablets of 600 mg, will be administered as a single dose of 40 mg/kg.
Trial participants will be regularly followed-up:
- At each dose administration
- At day 7 after each dose for follow-up of safety
- At week 4, 10 and 16 for parasitological assessment and follow-up of safety
- At week 6 and 12 for clinical assessment before the second and third drug administration (only in the AM arm)
- At week 24 and 48 for assessment of Schistosoma spp. and malaria infection and associated morbidity (compared to baseline)
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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-
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Dakar, Senegal
- Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation (IRESSEF)
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Children ≥6 and ≤14 years of age
- Enrolled in one of the selected primary schools in the region
- Infected with schistosomiasis (i.e. Schistosoma spp. eggs in urine and/or stool)
- Informed consent from parents/guardians signed
Exclusion Criteria:
- History of, or ongoing, epilepsy or psychiatric illness (I.e. recent history of depression, generalized anxiety disorder; history of psychosis, schizophrenia or other major psychiatric disorders) or known hypersensitivity to one of the three study drugs
- Chronic medication for any reason
- Any severe underlying illness, including severe malnutrition or severe chronic schistosomiasis, based on clinical judgement
- Any febrile illness
- Exposure to PZQ or ACT within the three previous months.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Praziquantel
Participants in this arm will receive one dose of PZQ at baseline at 40 mg/kg.
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40 mg/kg at baseline
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EXPERIMENTAL: Artesunate-Mefloquine
Participants in this arm will receive the Artesunate-Mefloquine (fixed-drug)combination at 4 mg/kg artesunate and 8 mg/kg mefloquine at 3 consecutive days.
This will be repeated twice; at week 6 and week 12.
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4mg/kg artesunate and 8 mg/kg mefloquine at baseline (3 consecutive days) and repeated at Week 6 and Week 12
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluate the efficacy of a single course of artesunate-mefloquine for the treatment of schistosomiasis, compared to the standard PZQ regimen: Parasitological cure rate
Time Frame: Week 4
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Parasitological cure rate, as assessed by microscopy, after administration of PZQ and after one AM course
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Week 4
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Number of safety events of a single course of artesunate-mefloquine for the treatment of schistosomiasis, compared to the standard PZQ regimen
Time Frame: Week 4
|
Frequency of drug-related adverse events and serious adverse events
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Week 4
|
Number of safety events of a single course of artesunate-mefloquine for the treatment of schistosomiasis, compared to the standard PZQ regimen
Time Frame: Week 4
|
Pattern of drug-related adverse events and serious adverse events
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Week 4
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluate the cumulative efficacy of two additional courses of AM (at 6-week intervals each) for the treatment of schistosomiasis, compared to a single course of AM, and compared to the standard regimen: Cure rate
Time Frame: Week 48
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Cure rate, as assessed by microscopy, after the second and after the third AM administration
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Week 48
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Number of safety events of two additional courses of AM (at 6-week intervals each) for the treatment of schistosomiasis, compared to a single course of AM, and compared to the standard regimen.
Time Frame: Week 16
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Frequency of adverse events and serious adverse events up to 4 weeks after the second and third AM administration.
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Week 16
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Determine the egg reduction rate obtained after single and repeated courses of AM compared to the standard PZQ regimen.
Time Frame: Week 48
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Egg reduction rate after administration of PZQ and after each AM course
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Week 48
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Determine the parasitological efficacy of single and repeated courses of AM by Schistosoma species and by infection intensity.
Time Frame: Week 16
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Cure rate and egg reduction rate by Schistosoma species (S. haematobium and S. mansoni) and by initial Schistosoma infection intensity after PZQ administration and single and repeated courses of AM
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Week 16
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Assess the impact of repeated AM courses on schistosomiasis-related morbidity
Time Frame: Week 48
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Prevalence and severity of general and organ-specific schistosomiasis morbidity (as assessed by clinical evaluation, ultrasound, point-of-care morbidity markers and hemoglobin level) compared to baseline and compared to the control arm.
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Week 48
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Determine the diagnostic accuracy of novel schistosomiasis antigen- and DNA-based diagnostic assays to monitor antischistosomal treatment response
Time Frame: Week 48
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Diagnostic accuracy of the different conventional and novel diagnostic tests (antigen- and DNA-based) at baseline and at defined time points after treatment compared to conventional stool/urine microscopy, and to composite reference standards (any positive test would be considered as infection).
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Week 48
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Determine the effect of repeated AM courses on prevalence of P. falciparum infection as well as on incidence and morbidity of clinical malaria in school-age children with schistosomiasis
Time Frame: Week 48
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Week 48
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Monitor the prevalence of Pf molecular markers associated with mefloquine resistance and the potential emergence of reduced artesunate susceptibility
Time Frame: Week 48
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Prevalence and patterns of mutations in the K13 gene (for artemisinin susceptibility) and increased copy number of the Pfmdr1 gene or other relevant mutations (for mefloquine resistance) observed in the molecular surveys Presence and patterns of mutations observed in incident malaria cases.
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Week 48
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Number of safety events of two additional courses of AM (at 6-week intervals each) for the treatment of schistosomiasis, compared to a single course of AM, and compared to the standard regimen.
Time Frame: Week 16
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Pattern of adverse events and serious adverse events up to 4 weeks after the second and third AM administration.
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Week 16
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Moustapha Mbow, MD, IRESSEF
Publications and helpful links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Infections
- Vector Borne Diseases
- Parasitic Diseases
- Helminthiasis
- Trematode Infections
- Schistosomiasis
- Anti-Infective Agents
- Antiviral Agents
- Antineoplastic Agents
- Antiprotozoal Agents
- Antiparasitic Agents
- Antimalarials
- Anthelmintics
- Schistosomicides
- Antiplatyhelmintic Agents
- Artesunate
- Praziquantel
- Mefloquine
Other Study ID Numbers
- 1269/18
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
For the first five years from submission of the data, decisions regarding data access for third parties will be taken by the authors in collaboration with the ITM Data Access Committee (DAC). After five years, all requests for access to the Data from third parties shall automatically be delegated to DAC of IDDO. The IDDO DAC will provide controlled access to third party researchers whose applications for Data held within the IDDO repository are approved by the DAC in accordance with specific Data Access Guidelines.
All requests are reviewed for qualifications of the researchers, the design and objectives of the secondary research, analysis plan and publication plan, consistency with ITM data sharing policies, applicable laws and regulations, and required ethics approvals.
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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