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| Name | Class |
|---|---|
| Università degli Studi di Sassari | OTHER |
| Purdue University | OTHER |
| Vinmec Healthcare System | OTHER |
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The purpose of this study is to provide a new drug combination for a better treatment of P. falciparum for a faster parasite clearance and to counteract artemisinin resistance.
According to WHO, resistance to artemisinin derivatives (ART) is emerging in many areas of the Greater Mekong Region as a delayed parasite clearance following a standard treatment by artemisinin combined therapy (ACT). Artemisinin resistance is often accompanied by the resistance to the partner drugs such as piperaquine (PPQ), mefloquine (MEF), amodiaquine (AQ) and lumefantrine (LF).
The slow and incomplete clearance of parasites following ACT treatment is considered to permit the selection of resistant parasites.
The availability of new, more efficient treatments accelerating the clearance of parasites is therefore needed to counteract the selection of ART resistant strains.
Imatinib (IMA) has been demonstrated to increase the efficacy of ART in a synergic fashion. This positive effect is further potentiated by low concentrations of PPQ.
IMA is active both on the intra-erythrocyte asexual forms and on gametocytes. It is therefore expected that the combination DHA-PPQ-IMA should lead to faster and radical clearance of the parasites, therefore reducing the frequency of healthy carriers and transmission.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| imatinib-Dihydroartemisinin-piperaquine | Experimental | triple combination |
|
| Dihydroartemisinin-piperaquine | Active Comparator | standard of care |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Imatinib | Drug | triple combination for the treatment of malaria |
|
| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of Adverse Events | Occurrence of Adverse Events over 42 days observation period | From baseline to day 42 |
| Occurrence of Severe Adverse Events | Occurrence of Severe Adverse Events over 42 days observation period | From baseline to day 42 |
| Occurrence of Abnormal Physical Symptoms | Occurrence of Abnormal Physical Symptoms (Clinical Abnormalities) over 42 days observation period | From baseline to day 42 |
| Occurrence of Abnormal Laboratory Values | Occurrence of Abnormal Laboratory Values over 42 days observation period | From baseline to day 42 |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of residual parasitemia: % of patients with >1000 parasites/ ul at day 3 and 28 | Parasitemia is determined by assessing the parasite count in blood, using thin film, thick film and qPCR analysis. | day 3 and day 28 |
| Frequency of fever and malaria symptoms |
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Inclusion Criteria:
Exclusion Criteria:
unable to provide Informed Consent or Patient History Form
symptoms and signs of severe or complicated malaria including: continuous high fever over 39 °C, confusion, convulsions
parasitemia<150.000 parasites /microliter
other neurological or psychiatric symptoms or disorders
abnormal bleeding
resting hearth rate lower than 60 and higher than 100 bpm
abnormal ECG, history of cardiac diseases
male adults with corrected QT intervals > 450ms
signs, symptoms and laboratory results of impairment of vital organs such as liver, lungs, kidney and cardiovascular system
hemoglobin < 9.0 gm/100ml
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 meet daily with local doctor during period of clinical trial
concomitant medicines like:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Huynh D Chien, MD,PhD | Contact | +84903580518 | huynhdinhchien55@gmail.com | |
| Tran A Tuan, MD | Contact | +84982290426 | tuanhuonghoa@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Huynh D Chien, MD, PhD | UNIVERSITY OF HUE, VIETNAM AND VINMEC DANANG INTERNATIONAL HOSPITAL, Hai Chau, Danang. | Principal Investigator |
| Francesco M Turrini, MD, PhD | University of Turin, Italy | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| A Tuc | Recruiting | Hương Hóa | Quang Tri | 520000 | Vietnam |
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| ID | Term |
|---|---|
| D016778 | Malaria, Falciparum |
| ID | Term |
|---|---|
| D008288 | Malaria |
| D011528 | Protozoan Infections |
| D010272 | Parasitic Diseases |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D000068877 | Imatinib Mesylate |
| C064909 | benzene-1,4-diphosphonic acid |
| ID | Term |
|---|---|
| D001549 | Benzamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D001565 | Benzoates |
| D000146 |
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interventional
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The research method will be a Phase 2 trial, 2 arms, randomized, open label (only the microscopist will be blinded), adaptive, dose de-escalation, trial conducted in adult male subjects with uncomplicated P.falciparum malaria.
In all phases, patients will be treated by a triple combination IMA-DHA-PPQ (ARM 1) or by the standard DHA-PPQ treatment (ARM 2).
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| Dihydroartemisinin-piperaquine | Drug | standard malaria treatment |
|
|
Percentage of patients with fever or malaria symptoms observed at Phisical Visit at day 3 and 28. |
| day 3 and day 28 |
| Mean parasitemia in the control and investigational arms | Mean parasitemia by assessing the parasite count in blood, using thin film, thick film and qPCR analysis, expressed as parasites / ul at day 2, 3 and 5 measured in the control and investigational arms | day 2 and day 5 |
| Parasite half-life measured at 12 and 24 hours | Mean parasite clearance half-life calculated using parasitemia measured at baseline, 12 and 24 hours post-treatment | from baseline to 24 hours post-treatment |
| D000096724 |
| Mosquito-Borne Diseases |
| D000079426 | Vector Borne Diseases |
| Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D010879 | Piperazines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D011743 | Pyrimidines |