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| Name | Class |
|---|---|
| Medicines for Malaria Venture | OTHER |
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The aim of such a study is to evaluate the impact of a therapeutic dose of Eurartesim™ compared to Riamet®, after multiple dose administration for 3 days in healthy male and female subjects on electrocardiographic parameters.
The fight against malaria, which the WHO reactivated in 1999 with its Roll Back Malaria programme, emphasizes early curative treatment of malaria, particularly in children, in order to decrease mortality and morbidity. Recent estimates confirm a disturbing persistence of endemic malaria with around 515 million cases and 1.0 million deaths per year.The available range of standard antimalarial drugs is narrow. There are only four classes of compounds, probably with different mechanisms of action: 4-aminoquinolines, amino-alcohols, artemisinin derivatives (isolated from a plant, Artemisia annua), and antifolates and drugs related to them.
From a public health perspective, drug resistance is a critical factor that undermines malaria control.Plasmodium falciparum and resistance to chloroquine and sulfadoxine/pyrimethamine is widespread. At present, natural quinine is still effective against P. falciparum everywhere in the world except partially in South-east Asia and South America, where decreased susceptibility is reported. Only the artemisinin derivatives, used for 15 years in Asia and, more recently in Africa, have not generated clinical resistance. Overcoming or reducing resistance requires the adoption of several strategies; central to these is the use of effective chemotherapy for those who need it. In addition, to new molecules, we need to develop and implement strategies to protect drugs against resistance. Resistance to single-drug therapies will inevitably occur. Drug combinations, which have been standard practice for viral and bacterial diseases, are now being adopted for malaria as well. The artemisinin derivatives in combination with standard antimalarials are now being promoted as the best therapeutic option for treating drug-resistant malaria and retarding the development of resistance.
The aim of the present study is to investigate the effect of this new Artemisinin Combination Therapy (ACT) formulation on electrocardiographic parameters. In the literature no relevant QT prolongation associated with Piperaquine treatment has been reported in not-company sponsored trials but no specific TQT trials have been published. On the contrary it has been reported that quinine, quinidine and halofantrine induced a QT prolongation (from slight to severe).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 | Experimental | 3 or 4 tablets of Eurartesim™, depending of body weight, (3 tablets for subjects weighting less than 75 kg, 4 tablets for subjects weighting 75 kg or more), once daily from Day 1 to Day 3. Administration of Eurartesim will be in fed condition following a high-fat/low-Kcal meal. |
|
| Group 2 | Active Comparator | 4 tablets of Riamet® on Day -1 evening, 4 tablets of Riamet® bid (with an interval of 12 ± 0.5 h), in the morning and in the evening of Day 1 and Day 2, 4 tablets of Riamet® in the morning of Day 3. Administration of Riamet® will be in fed condition following a high-fat/low-Kcal meal. |
|
| Group 3 | Other | 3 or 4 tablets of Eurartesim™ placebo, depending of body weight, (3 tablets for subjects weighting less than 75 kg, 4 tablets for subjects weighting 75 kg or more), once daily from Day1 to Day 3. Administration will be in the morning, in fed condition, following a high-fat/low-Kcal meal 1 tablet of Izilox® (400 mg moxifloxacin) in fed condition following a high-fat/low-Kcal meal, on Day 4 morning. |
|
| Group 4 | Experimental | 3 or 4 tablets of Eurartesim™, depending of body weight, (3 tablets for subjects weighting less than 75 kg, 4 tablets for subjects weighting 75 kg or more), once daily from Day 1 to Day 3. Administration of Eurartesim will be in fed condition following a high-fat/high-Kcal meal. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Eurartesim™ | Drug | 3 or 4 tablets of Eurartesim™ (40mg Dihydroartemisinin and 320 mg Piperaquine phosphate), depending of body weight (3 tablets for subjects weighting less than 75 kg, 4 tablets for subjects weighting 75 kg or more), once daily from Day 1 to Day 3 |
| Measure | Description | Time Frame |
|---|---|---|
| QTcF interval (Fridericia's correction QT interval) | Group 1,4 and 5 (Day -1: pre-dose, each hour till 13h post-dose. Day 1: pre-dose, 1, 2, 3, 4, 5, and 6 h post-dose. Day 3: pre-dose, each hour till 13h post-dose and then 24h). Group 2 (Day -2: pre-dose, each hour till 13h post-dose and then 24h. Day 3: pre-dose, each hour till 13h post-dose and then 24h). Group 3 and 6 (Day -1: pre-dose, each hour till 13h post-dose. Day 1: pre-dose, 1, 2, 3, 4, 6, 8, 12 and 24h post-dose. Day 3: pre-dose, pre-dose, each hour till 13h post-dose. Day 4: pre-dose, 1, 2, 3, 4, 6, 8, 12 and 24h post-dose). | before study drugs administration, during the 24 hrs post first and third dose and during follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Effect of Eurartesim™ administered in different food conditions, on ECG parameters | To evaluate the impact of a therapeutic dose of Eurartesim™ under different food intake conditions on the cardiac activity, as expressed by ECG parameters. | before study drugs administration, during the 24 hrs post first and last dose and during follow-up |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lionel Hovsepian, MD | SGS Aster S.A.S. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| SGS aster s.a.s | Paris | 75015 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30692558 | Derived | Funck-Brentano C, Bacchieri A, Valentini G, Pace S, Tommasini S, Voiriot P, Ubben D, Duparc S, Evene E, Felices M, Corsi M. Effects of Dihydroartemisinin-Piperaquine Phosphate and Artemether-Lumefantrine on QTc Interval Prolongation. Sci Rep. 2019 Jan 28;9(1):777. doi: 10.1038/s41598-018-37112-6. |
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| Group 5 | Experimental | 3 or 4 tablets of Eurartesim™, depending of body weight, (3 tablets for subjects weighting less than 75 kg, 4 tablets for subjects weighting 75 kg or more), once daily from Day 1 to Day 3. Administration of Eurartesim will be in fasting condition. |
|
| Group 6 | Other | 3 or 4 tablets of Eurartesim™ placebo, depending of body weight, (3 tablets for subjects weighting less than 75 kg, 4 tablets for subjects weighting 75 kg or more), once daily from Day1 to Day 3. Administration will be in the morning, in fasting condition. 1 tablet of Izilox® (400 mg moxifloxacin) in fed condition following a high-fat/low-Kcal meal, on Day 4 morning. |
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| Riamet® | Drug | 4 tablets of Riamet® (20mg artemether/120mg lumefantrine) on Day -1 evening, 4 tablets of Riamet® bid (with an interval of 12 ± 0.5 h), in the morning and in the evening of Day 1 and Day 2, 4 tablets of Riamet® in the morning of Day 3. |
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|
| Placebo and finally Moxifloxacin | Other | 3 or 4 tablets of Eurartesim™ placebo, depending of body weight, (3 tablets for subjects weighting less than 75 kg, 4 tablets for subjects weighting 75 kg or more), once daily from Day1 to Day 3. 1 tablet of Izilox® (400 mg moxifloxacin) on Day 4 morning. |
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|
| Eurartesim™ | Drug | 3 or 4 tablets of Eurartesim™ (40mg Dihydroartemisinin and 320 mg Piperaquine phosphate), depending of body weight (3 tablets for subjects weighting less than 75 kg, 4 tablets for subjects weighting 75 kg or more), once daily from Day 1 to Day 3. |
|
|
| Eurartesim™ | Drug | 3 or 4 tablets of Eurartesim™ (40mg Dihydroartemisinin and 320 mg Piperaquine phosphate), depending of body weight (3 tablets for subjects weighting less than 75 kg, 4 tablets for subjects weighting 75 kg or more), once daily from Day 1 to Day 3. |
|
|
| Placebo and finally Moxifloxacin | Other | 3 or 4 tablets of Eurartesim™ placebo, depending of body weight, (3 tablets for subjects weighting less than 75 kg, 4 tablets for subjects weighting 75 kg or more), once daily from Day1 to Day 3. 1 tablet of Izilox® (400 mg moxifloxacin)on Day 4 morning. |
|
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| Effect of food on bioavailability of Eurartesim™ |
To evaluate the impact of high-fat/high-Kcal or high-fat/low-Kcal meals on the overall relative bioavailability of Eurartesim™ in respect to no food. |
| during the 24 hrs post first and last dose |
| To evaluate differences in PK and ECG profiles according to posology scheme | To compare, within the Eurartesim™ groups, the PK profiles and the QT intervals of subjects with a body weight below or equal and above 75kg | during the 24 hrs post first and last dose |
| relationship within the Pk parameters of active substances and ECG parameters | To evaluate the relationship between the PK parameters of Dihydroartemisinin and Piperaquine and the ECG parameters | during the 24 hrs post first and last dose |
| to asses general safety and tolerability of Eurartesim™ | To assess the safety and tolerability of Eurartesim™ under different food intake conditions in healthy subjects | during the treatment and follow-up period |
| ID | Term |
|---|---|
| D016778 | Malaria, Falciparum |
| ID | Term |
|---|---|
| D008288 | Malaria |
| D011528 | Protozoan Infections |
| D010272 | Parasitic Diseases |
| D007239 | Infections |
| D000096724 | Mosquito-Borne Diseases |
| D000079426 | Vector Borne Diseases |
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| ID | Term |
|---|---|
| C039060 | artenimol |
| D000077549 | Artemether |
| D000077266 | Moxifloxacin |
| ID | Term |
|---|---|
| D037621 | Artemisinins |
| D017382 | Reactive Oxygen Species |
| D005609 | Free Radicals |
| D007287 | Inorganic Chemicals |
| D009930 | Organic Chemicals |
| D012717 | Sesquiterpenes |
| D013729 | Terpenes |
| D006838 | Hydrocarbons |
| D024841 | Fluoroquinolones |
| D042462 | 4-Quinolones |
| D015363 | Quinolones |
| D011804 | Quinolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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