- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT04289558
Nitrite Infusion in Children With Malaria
Safety, Feasibility, and Endothelial Effects of Sodium Nitrite Infusion in Children With Falciparum Malaria
연구 개요
상세 설명
This is a Phase I, open-label, dose-escalation study that will enroll up to 24 patients total, using a 3+3 dose escalation design, with 3 to 6 patients per dose level at up to 4 sequential dose levels (0.16, 0.32, 0.64 and 1.28 mcg/kg/minute). At each dose level patients with moderately severe malaria will receive a single 60-minute intravenous infusion of sodium nitrite in 0.9% sodium chloride. Blood pressure and methemoglobin levels will be closely monitored during the infusion and for 24 hours post infusion.
This study will allow a preliminary analysis of the safety of intravenous sodium nitrite in children with moderately severe malaria and is expected to provide preliminary data on its effects on endothelial function. The hypothesis is that sodium nitrite infusion will be safe at low dosage levels. Additionally, since deficiency of nitric oxide is linked to endothelial dysfunction in malaria, there is the hypothesis that sodium nitrite will result in improved markers of endothelial function.
Children are the largest group affected by falciparum malaria. The study population will be male children residing in Tanzania, ages 4-10 years old diagnosed with moderately severe malaria, who have been hospitalized for treatment of their malaria at Hubert Kairuki Medical University in Dar es Salaam, Tanzania. Patients will receive standard anti-malaria and supportive care treatment. The study will enroll up to 24 subjects.
Participants will receive a single intravenous infusion of sodium nitrite diluted in 0.9% sodium chloride. The infusion will be administered over 60 minutes with an infusion pump. Escala-ting doses of sodium nitrite will be administered to patients in 4 dose level cohorts. Patients will be sequentially enrolled starting at the lowest dose level. Individual patients at the same dose level will also be enrolled sequentially, such that the next patient will not receive treatment until completion of a 24- hour safety monitoring period for the prior patient. Dose assign-ment will be based on the order of study enrollment. The maximum tolerated dose (MTD) is the highest dose level wherein ≤ 1 of 6 evaluable patients experiences dose limiting toxicity (DLT). If the MTD is exceeded at the first dose level, then dosing will cease.
연구 유형
단계
- 1단계
연락처 및 위치
연구 장소
-
-
-
Dar es Salaam, 탄자니아
- Hubert Kairuki Memorial University
-
-
참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- Provision of signed and dated informed consent from parent or legal guardian
- Males, >4 to 10 years of age
- Body weight > 12 kg
Parasitemia with Plasmodium falciparum including:
- Positive rapid diagnostic test result: AND
- >2,500 parasites/microliter by microscopy
Diagnosis of MSM, as follows:
- Clinical syndrome consistent with malaria associated with documented fever (axillary temperature >38C) or reported history of fever in the past 48 hours with no other cause present; AND
- Exhibiting no WHO warning signs or criteria for SM [27]
- A negative G6PD deficiency test (careSTART G6PD quantitative biosensor)
- Requires inpatient parenteral treatment because of inability to tolerate oral therapy
- Hemoglobin > 8 g/dL (subjects with prior blood transfusion will be eligible).
- Systolic blood pressure > 85 mmHg
- Baseline quantitative methemoglobin measurement less than 2%
- Creatinine less than the upper limit of normal
Exclusion Criteria:
- Female gender
- Diagnosis of severe malaria
- Presence of infection, or mixed infection, with non-falciparum strains of malaria
Signs of severe malaria[27], including 1 or more of the following:
- impaired consciousness (Blantyre coma score <3 in children)
- prostration
- multiple convulsions (>2 within 24 hours)
- acidosis (base deficit >8 mEq/L or bicarbonate <15 mmol/L or lactate > 5 mmol/L)
- hypoglycemia (blood glucose < 40 mg/dL or <2.2 mmol/L)
- severe anemia (Hb < 5g/dL )
- renal impairment (serum creatinine >265 uMol/L or 3 mg/dL; or blood urea >20 mmol/L)
- jaundice (bilirubin >50 umol or 3 mg/dL with parasite count >100000/ µL)
- pulmonary edema (including O2sat <92% with RR >30/min)
- circulatory collapse or shock
- significant bleeding
- hyperparasitemia (>10%)
- Presence of concomitant non-malarial infection
- Known G6PD deficiency
- Known chronic illness including renal, cardiac, pulmonary, epilepsy
- History of a reaction to a substance or medication consisting of dyspnea and cyanosis
- History of trauma or bleeding in the 2 weeks prior to presentation
- Clinical impression of disseminated intravascular coagulation
- Subjects treated with parenteral anti-malarial drugs for more than 12 hours
- Current use of drugs with oxidative potential (e.g., nitrates, dapsone, primaquine); or drugs that cause hypotension.
- Known allergic reactions to sodium nitrite injection
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 해당 없음
- 중재 모델: 단일 그룹 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
---|---|
실험적: Sodium Nitrite
Single 60-minute intravenous infusion of sodium nitrite in 0.9% sodium chloride at up to 4 sequential dose levels (0.16, 0.32, 0.64 and 1.28 mcg/kg/minute)
|
Single 60 minute infusion at 1 of 4 sequential dose levels (0.16, 0.32, 0.64 and 1.28 mcg/kg/minute).
The dose amount will depend on when the participant enters the study
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
Safety as measured by number of subjects with at least one adverse event
기간: 48 hours post infusion
|
Adverse events will be assessed according to the NIH's Table for Grading the Severity of Adult and Pediatric Adverse Events.
Events will be numerically graded 1-5; 1 being a mild event and 5 being death
|
48 hours post infusion
|
Percent change in microvascular function/activation for each of the 4 dosing levels by linear regression
기간: 48 hours post infusion
|
We will assess possible covariate relationships.
A model will be developed that links the pharmacokinetics with the pharmacodynamic measures of endothelial function and activation
|
48 hours post infusion
|
공동 작업자 및 조사자
연구 기록 날짜
연구 주요 날짜
연구 시작 (예상)
기본 완료 (예상)
연구 완료 (예상)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
기타 연구 ID 번호
- Pro00100364
- R01HL130763 (미국 NIH 보조금/계약)
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
미국에서 제조되어 미국에서 수출되는 제품
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
열대열 말라리아에 대한 임상 시험
-
Novartis Pharmaceuticals모병복잡하지 않은 Plasmodium Falciparum 말라리아코트디부아르, 케냐, 가나, 우간다
-
Medicines for Malaria Venture완전한복잡하지 않은 Plasmodium Falciparum 말라리아우간다, 베냉, 부키 나 파소, 콩고 민주 공화국, 가봉, 모잠비크, 베트남
-
Karolinska University HospitalMuhimbili University of Health and Allied Sciences완전한
-
University of OxfordEuropean and Developing Countries Clinical Trials Partnership (EDCTP); Medical Research...모병
-
Jomaa Pharma GmbHCentre de Recherche Médicale de Lambaréné알려지지 않은단순 급성 Plasmodium Falciparum 말라리아의 경구 치료
-
Shanghai Wanxing Bio-Pharmaceutical Co. Ltd.PATH; World Health Organization; Xinhua Hospital, Shanghai Jiao Tong University School of... 그리고 다른 협력자들완전한
-
Muhimbili University of Health and Allied SciencesUppsala University; The Swedish Research Council아직 모집하지 않음
-
Novartis PharmaceuticalsEuropean and Developing Countries Clinical Trials Partnership (EDCTP)모병복잡하지 않은 Plasmodium Falciparum 말라리아부키 나 파소, 말리, 가봉
-
David SaundersNational Centre for Parasitology, Entomology and Malaria Control, Cambodia; Royal Cambodian... 그리고 다른 협력자들정지된
-
University of Oxford아직 모집하지 않음복잡하지 않은 Plasmodium Falciparum 말라리아
Sodium Nitrite에 대한 임상 시험
-
Paradigm Biopharmaceuticals USA (INC)모집하지 않고 적극적으로
-
Shandong New Time Pharmaceutical Co., LTD아직 모집하지 않음
-
SB Istanbul Education and Research HospitalBezmialem Vakif University모병
-
Cytonet GmbH & Co. KGCRS Clinical Research Services Mannheim GmbH완전한
-
National Taiwan University HospitalTCM Biotech International Corporation모병
-
Shanghai General Hospital, Shanghai Jiao Tong University...아직 모집하지 않음
-
IBSA Farmaceutici Italia Srl모집하지 않고 적극적으로
-
Eagle Pharmaceuticals, Inc.종료됨