- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT07559370
Safety and Efficacy of Imatinib in Combination With Artemether-Lumefantrine for Uncomplicated Malaria
Evaluating the Safety and Efficacy of Imatinib in Combination With Artemether and Lumefantrine for Treatment of Uncomplicated Malaria
연구 개요
상태
상세 설명
Most antimalarial drugs work by directly attacking the Plasmodium falciparum parasite, but this approach carries a fundamental weakness: the parasite can slowly rewrite its own biology to shrug off these chemical assaults. Imatinib, a drug already proven safe in cancer treatment for over two decades, takes a radically different tack. Instead of targeting the invader, it targets the human red blood cell that the parasite infects. Specifically, Imatinib inhibits a human enzyme called Syk kinase a key that the parasite turns to pry open the cell and burst forth into the bloodstream. By jamming this lock, the drug traps the parasite inside the cell, where toxic byproducts accumulate and ultimately kill it. Because the parasite cannot alter human biology the way it alters its own, researchers believe resistance to Imatinib will be extraordinarily difficult if not impossible for malaria to evolve.
To test this promising strategy, a clinical trial is now underway at the Alupe sub county hospital in Busia County, Kenya, a region bearing some of the nation's highest malaria burdens. The study unfolds in three cautious phases. First, between ninety and two hundred ten adults will receive varying doses of Imatinib starting at 400 milligrams twice daily to determine the safest regimen. If side effects prove too severe, the dose will be lowered to 600 or 400 milligrams once per day. Once the optimal dose is identified, the second phase will enroll 516 adults to confirm that adding Imatinib to the standard artemether lumefantrine (AL) regimen is as safe as AL alone, and to test whether a two day course works as well as the conventional three days. Finally, because children under five account for nearly eighty percent of malaria deaths, the third phase will extend the trial to younger participants from twelve months to seventeen years using weight based dosing.
Participants who enroll must remain in the hospital for forty eight to seventy two hours of close observation. Medical staff will draw frequent blood samples, often via finger prick, to count parasites and monitor liver and kidney health. After discharge, patients return for follow up visits on days seven, twenty one, and thirty five to ensure the infection has not recurred. To compensate for time and lost wages, each participant receives 1,500 Kenyan shillings per day, and the study covers all travel and medical expenses.
Safety is reinforced by clear boundaries. Although Imatinib is already FDA approved and widely used for cancer, its combination with AL is novel. To avoid dangerous drug interactions, anyone taking medications for high cholesterol, high blood pressure, or HIV cannot enroll. Pregnant or breastfeeding women are also excluded, as Imatinib can harm a developing fetus, and female participants must use birth control throughout the trial.
The study operates under rigorous ethical oversight. It has been reviewed by the Jaramogi Oginga Odinga Teaching and Referral Hospital and the Pharmacy and Poisons Board, while an independent Data Safety Monitoring Board composed of doctors and scientists will continuously review the data to determine whether the trial remains safe to proceed. All participant information is protected under the Kenyan Data Protection Act, ensuring personal privacy is never compromised. Overall, the trial expects to enroll between 906 and 1,116 participants by the end of 2027, with the ultimate goal of delivering a more powerful, resistance proof tool for malaria elimination.
연구 유형
등록 (추정된)
단계
- 2 단계
연락처 및 위치
연구 연락처
- 이름: Dr. Quentin Awori, MBChB
- 전화번호: +254722913616
- 이메일: qawori@vibriafrica.org
연구 연락처 백업
- 이름: David Owino Ogolla, Msc
- 전화번호: +254714421248
- 이메일: dogolla@vibriafrica.org
연구 장소
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Kisumu, 케냐, 40100
- 모병
- Victoria Biomedical Research Institute
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연락하다:
- Dr. Diana Odhiambo Irene, MBChB
- 전화번호: +254722243110
- 이메일: dodhiambo@vibriafrica.org
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연락하다:
- David Owino Ogolla, Msc
- 전화번호: +254714421248
- 이메일: dogolla@vibriafrica.org
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수석 연구원:
- Dr. Quentin Awori MBChB
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부수사관:
- Dr. Lucas Otieno Tina, MBChB
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부수사관:
- Dr. Diana Irene Odhiambo, MBChB
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수석 연구원:
- Dr. Karson Putt Phd
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부수사관:
- Dr. Simon Kariuki Phd
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부수사관:
- Dr Antony Oindo MBChB
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참여기준
자격 기준
공부할 수 있는 나이
- 어린이
- 성인
건강한 자원 봉사자를 받아들입니다
설명
Inclusion Criteria:
For Part 1 and 2 of the study design, all individuals must meet all the inclusion criteria below:
- Patients diagnosed with symptomatic mild to moderate P. falciparum malaria with a parasite density of >= 5000 parasites/μl
- Adult male, age 18-55 years old or adult female, age 18-55 years that are post-menopausal, or test negative on a pregnancy test and will be on active birth control through to the end of the follow up period.
- Provision of informed consent and agrees to hospital admission for 48-72hrs
- Good health condition other than malaria
- The patient has not taken anti-malarial drugs in the past 4 weeks
For Part 3 of the trial, all individuals must meet all the inclusion criteria below:
- Patients diagnosed with symptomatic mild to moderate P. falciparum malaria and a parasite density of >= 5000 parasites/μl
- Age 12 months to below 18 years
- Presented by parent or legally accepted representative (LAR) who has consented to the participation of the child in the trial and agrees to hospital admission for 48-72hrs.
- Hb levels > 5mg/dL
- Child has not taken anti-malarial drugs in the past 6 weeks.
Exclusion Criteria:
- Prospective study participant, LAR and/or impartial witness (where applicable) declines to provide informed consent.
Symptoms and signs of severe or complicated malaria including:
- significant confusion or impaired consciousness (including unarousable coma)
- multiple convulsions (more than two episodes within 24 hours),
- respiratory distress
- circulatory collapse (systolic blood pressure <80mm Hg with evidence of impaired perfusion)
- clinical jaundice plus evidence of other vital organ dysfunction
- simultaneous infection of unrelated origin
- Parasite density > 200,000 parasites /μl
- In the case of female participants: currently pregnant or lactating
- Other neurological or psychiatric symptoms or disorders
- Abnormal bleeding
- Resting heart rate lower than 55 or higher than 100 bpm
- History of cardiac disease
- Signs, symptoms and laboratory results of impairment of vital organs such as liver, lungs, kidney and cardiovascular system
Abnormal blood chemistry:
- hemoglobin < 9.0 g/dL in adults or < 5.0 g/dL in children 12 months-18 years
- WBC not in the range of 4800-10,000/mm3
- RBC if < 4.0x106/ mm3
- Platelet < 1.3x105/ mm3
- ALAT not in the normal range (4 to 36 U / l)
- ASAT not in the normal range (8 to 33 U / l)
- Total bilirubin 0.1 to 1.2 mg / 100 ml
- Serum protein if < 5.5 g/dL
- Symptoms and signs of infection such as pneumonia, dengue fever, and other viral or bacterial infection.
- Patients with symptoms of gastrointestinal infections or any sign of malabsorption that may interfere with drug absorption.
- Concomitant infection by plasmodium species other than P. falciparum
- Inability to attend/meet study staff on follow up visits
Concomitant use of medicines, including:
- medicines used to treat high cholesterol (such as atorvastatin, lovastatin, simvastatin);
- medicines used to treat hypertension and heart problems (such as diltiazem, nifedipine, nitrendipine, verapamil, felodipine, amlodipine);
- medicine used to treat HIV (antiretroviral medicines) including protease inhibitors (such as amprenavir, atazanavir, indinavir, nelfinavir, ritonavir), non-nucleoside reverse transcriptase inhibitors (such as efavirenz, nevirapine);
- medicines used to treat microbial infections (such as telithromycin, rifampicin, dapsone);
- medicines used to help you fall asleep: benzodiazepines (such as midazolam, triazolam, diazepam, alprazolam), zaleplon, zolpidem;
- medicines used to prevent/treat epileptic seizures including barbiturates (such as phenobarbital), carbamazepine or phenytoin;
- medicines used after organ transplantation and in autoimmune diseases (such as cyclosporin, tacrolimus);
- nefazodone (used to treat depression);
- aprepitant (used to treat nausea);
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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활성 비교기: Artemether Lumefantrine Alone
Standard 3-day course.
Used as control in all parts.
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There is no difference
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실험적: Artemether Lumefantrine and Imatinib 400mg Twice Daily (3 days)
3-day course with imatinib 400mg twice daily.
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There is no difference
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실험적: Artemether Lumefantrine and Imatinib (Optimal Dose, 3 days)
3-day course with optimal dose determined from Part 1.
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There is no difference
|
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실험적: Artemether Lumefantrine and Imatinib (Optimal Dose, 2 days)
2-day imatinib course (optimal dose) with 3-day AL.
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There is no difference
|
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실험적: Pediatric: Artemether Lumefantrine and Imatinib (Weight-based)
Weight-based imatinib (340 or 260 mg/m²/day, max 600mg) plus weight-based AL for 3 days.
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There is no difference
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Dose of Imatinib (in mg) Required to Eliminate Viable Parasites
기간: 48 hours post-first dose
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Identification of imatinib dose that eliminates all viable parasites after 2 days of dosing, determined by absence of viable parasites on blood culture from samples taken immediately after 48 hours of study drug administration.
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48 hours post-first dose
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Number of Participants with Treatment-Emergent Adverse Events (TEAEs) by Severity Grade
기간: Up to Day 35
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Safety and tolerability of imatinib mesylate combined with artemether-lumefantrine (AL+IM) compared to artemether-lumefantrine alone (AL).
Non-inferior safety defined as insignificant increase (p > 0.05) in number and severity of adverse events in AL+IM cohorts versus AL alone.
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Up to Day 35
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Number of Participants with PCR-Corrected Recrudescence
기간: Day 35
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Non-inferiority of 2-day AL+IM dosing compared to 3-day AL dosing as determined by PCR-corrected recrudescence using strain genotyping.
Non-inferiority defined as insignificant increase (p > 0.05) in recrudescence in 2-day AL+IM cohorts versus 3-day AL alone.
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Day 35
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Change from Baseline in Parasite Density (parasites/μL)
기간: Days 1, 2, and 3
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Accelerated parasite clearance of AL+IM compared to AL alone.
Superior efficacy defined as significant decrease (p < 0.05) in average parasite density in AL+IM cohorts versus AL cohort.
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Days 1, 2, and 3
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Change from Baseline in Body Temperature (°C)
기간: Days 1, 2, and 3
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Accelerated decrease in body temperature in AL+IM compared to AL alone.
Superior efficacy defined as significant decrease (p < 0.05) in elevated average body temperature in AL+IM cohorts versus AL cohort.
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Days 1, 2, and 3
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Percentage Reduction in Parasite Density from Baseline
기간: Days 1, 2, and 3
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Faster parasite clearance in participants with starting parasite density >10,000 parasites/μL compared to those with <10,001 parasites/μL in AL+IM cohorts.
Defined as significant decrease (p < 0.05) in percentage of parasites after first drug administration between high and low baseline density groups.
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Days 1, 2, and 3
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공동 작업자 및 조사자
수사관
- 수석 연구원: Dr. Quentin Awori MBChB, Victoria Biomedical Research Institute
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (추정된)
연구 완료 (추정된)
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
키워드
추가 관련 MeSH 약관
- 벡터 매개 질병
- 모기 매개 질병
- 감염
- 원충 감염
- 기생충 질병
- 말라리아
- 말라리아, 팔시파룸
- 유기 화학 물질
- 이종 사이 클릭 화합물, 1- 링
- 이종 사이 클릭 화합물
- 제약 준비
- 탄화수소
- 탄화수소, 순환
- 테르펜
- 카르 복실 산
- 다 환식 방향족 탄화수소
- 탄화수소, 방향족
- 다 환식 화합물
- 아미드
- 무기 화학 물질
- 피리 미딘
- 벤젠 유도체
- 약물 조합
- 산, 카르 보 사이 클릭
- 벤조테스
- 반응성 산소 종
- 자유 라디칼
- Artemether
- 아르테 미시 닌
- Lumefantrine
- 플루오 레네스
- Sesquiterpenes
- 벤자 아미드
- 파이퍼 라진
- 이마티닙 메실레이트
- Artemether, Lumefantrine 약물 조합
기타 연구 ID 번호
- VIBRI-ALIM01
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
미국에서 제조되어 미국에서 수출되는 제품
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