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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/show/NCT02431650




Registration number
NCT02431650
Ethics application status
Date submitted
17/04/2015
Date registered
1/05/2015
Date last updated
26/05/2020

Titles & IDs
Public title
Effectiveness of OZ439 as a Gametocytocidal and Transmission Blocking Agent
Scientific title
A Proof-Of-Concept Study to Assess the Effectiveness of OZ439 as a Gametocytocidal and Transmission Blocking Agent in Experimental P. Falciparum Infection
Secondary ID [1] 0 0
QP15C05
Universal Trial Number (UTN)
Trial acronym
OZGAM
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Malaria 0 0
Condition category
Condition code
Infection 0 0 0 0
Other infectious diseases
Infection 0 0 0 0
Studies of infection and infectious agents

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - OZ439
Treatment: Drugs - Primaquine

Experimental: OZ439 - Each participant in the cohort will be inoculated on Day 0 with ~2,800 viable parasites of Plasmodium falciparum-infected human erythrocytes (BSPC) administered intravenously. when PCR quantification of all participants is = 5,000 parasites/mL, they will receive a single dose of 480 mg of piperaquine phosphate to clear blood stage parasitemia. When gametocytemia is at the peak (approximately 15 days after administration of piperaquine), participants will be randomised to receive either OZ439 or a control group (primaquine treatment).
In the first cohort 500 mg OZ439 will be administered as a single dose. Doses used in subsequent cohort(s) will be determined following a review of observed safety and pharmacodynamic drug effects.

Active Comparator: Primaquine - Each participant in the cohort will be inoculated on Day 0 with ~2,800 viable parasites of Plasmodium falciparum-infected human erythrocytes (BSPC) administered intravenously. when PCR quantification of all participants is = 5,000 parasites/mL, they will receive a single dose of 480 mg of piperaquine phosphate to clear blood stage parasitemia. When gametocytemia is at the peak (approximately 15 days after administration of piperaquine), participants will be randomised to receive either OZ439 or a control group (primaquine treatment).
Primaquine is a positive control for OZ439, to be administered 15 mg as a single dose.


Treatment: Drugs: OZ439


Treatment: Drugs: Primaquine


Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Infection Success of Vector Mosquitoes - Assessing the transmissibility by oocyst detection in mosquito midgut preparations following direct and membrane (indirect) feeding.
Timepoint [1] 0 0
From day 10 to 21 post Piperaquine dosing
Secondary outcome [1] 0 0
Safety: Number of AEs - Adverse events incidence
Timepoint [1] 0 0
From Challenge inoculum on day 0 until end of study on day 31

Eligibility
Key inclusion criteria
Demography:

- Adult (male and females) participants between 18 and 55 years of age, inclusive who do
not live alone (from Day 0 until at least the end of the anti-malarial drug treatment)
and be contactable and available for the duration of the trial (maximum of 6 weeks).

- Body weight, minimum 50.0 kg, body mass index between 18.0 and 32.0 kg/m

Health status:

- Certified as healthy by a comprehensive clinical assessment (detailed medical history
and complete physical examination).

- Normal vital signs after 10 minutes resting in supine position:

- 90mmHg < systolic blood pressure (SBP) <140 mmHg,

- 50 mmHg < diastolic blood pressure (DBP) <90 mmHg,

- 40 bpm< heart rate (HR) <100 bpm.

- Normal standard 12-lead electrocardiogram (ECG) after 5 minutes resting in supine
position, QTcF=450 ms average with absence of second or third degree atrioventricular
block or abnormal T wave morphology.

- Laboratory parameters within the normal range, unless the Investigator considers an
abnormality to be clinically irrelevant for healthy participants enrolled in this
clinical investigation. More specifically for serum creatinine, hepatic transaminase
enzymes (aspartate aminotransferase, alanine aminotransferase), and total bilirubin
(unless the Participant has documented Gilbert syndrome) should not exceed the upper
laboratory norm and haemoglobin must be equal or higher than the lower limit of the
normal range, - - As there is the risk of adverse effects of OZ439, Riamet and
primaquine in early pregnancy, it is important that any participants involved in this
study do not get pregnant or get their female partners pregnant.

Regulations:

- Having given written informed consent prior to undertaking any study-related procedure.
Minimum age
18 Years
Maximum age
55 Years
Gender
Both males and females
Can healthy volunteers participate?
Yes
Key exclusion criteria
Medical history and clinical status:

- Any history of malaria or participation to a previous malaria challenge study

- Must not have travelled to or lived (>2 weeks) in a malaria-endemic country during the
past 12 months or planned travel to a malaria-endemic country during the course of the
study.

- Known severe reaction to mosquito bites other than local itching and redness

- Has evidence of increased cardiovascular disease risk (defined as >10%, 5 year risk)
as determined by the method of Gaziano et al. (1). Risk factors include sex, age,
systolic blood pressure (mm/Hg), smoking status, body mass index (BMI, kg/m) and
reported diabetes status.

- History of splenectomy.

- Presence or history of drug hypersensitivity, or allergic disease diagnosed and
treated by a physician or history of a severe allergic reaction, anaphylaxis or
convulsions following any vaccination or infusion.

- Presence of current or suspected serious chronic diseases such as cardiac or
autoimmune disease (HIV or other immunodeficiencies), insulin-dependent and NIDDM
diabetes (excluding glucose intolerance if E04 is met ), progressive neurological
disease, severe malnutrition, acute or progressive hepatic disease, acute or
progressive renal disease, psoriasis, rheumatoid arthritis, asthma, epilepsy or
obsessive compulsive disorder, skin carcinoma excluding non-spreadable skin cancers
such as basal cell and squamous cell carcinoma

- Participants with history of schizophrenia, bi-polar disease, or other severe
(disabling) chronic psychiatric diagnosis including depression or receiving
psychiatric drugs or who has been hospitalized within the past 5 years prior to
enrollment for psychiatric illness, history of suicide attempt or confinement for
danger to self or others.

- Frequent headaches and/or migraine, recurrent nausea, and/or vomiting (more than twice
a month).

- Presence of acute infectious disease or fever (e.g., sub-lingual temperature = 38.5°C)
within the five days prior to inoculation with malaria parasites.

- Evidence of acute illness within the four weeks before trial prior to screening that
the Investigator deems may compromise subject safety.

- Significant intercurrent disease of any type, in particular liver, renal, cardiac,
pulmonary, neurologic, rheumatologic, or autoimmune disease by history, physical
examination, and/or laboratory studies including urinalysis.

- Participant has a clinically significant disease or any condition or disease that
might affect drug absorption, distribution or excretion, e.g. gastrectomy, diarrhoea.

- Participation in any investigational product study within the 12 weeks preceding the
study.

- Blood donation, any volume, within 1 month before inclusion or participation in any
research study involving blood sampling (more than 450 mL/ unit of blood), or blood
donation to Red Cross (or other) blood bank during the 8 weeks preceding the reference
drug dose in the study.

- Participant unwilling to defer blood donations for 6 months.

- Medical requirement for intravenous immunoglobulin or blood transfusions.

- Participant who has ever received a blood transfusion.

- Symptomatic postural hypotension at screening, irrespective of the decrease in blood
pressure, or asymptomatic postural hypotension defined as a decrease in systolic blood
pressure =20 mmHg within 2-3 minutes when changing from supine to standing position.

- History or presence of alcohol abuse (alcohol consumption more than 40 g per day) or
drug habituation, or any prior intravenous usage of an illicit substance.

- Smoking more than 5 cigarettes or equivalent per day and unable to stop smoking for
the duration of the study.

- Ingestion of any poppy seeds within the 24 hours prior to the screening blood test
(participants will be advised by phone not to consume any poppy seeds in this time
period).

Interfering substance:

- Any medication (including St John's Wort) within 14 days before inclusion or within 5
times the elimination half-life (whichever is longer) of the medication,

- Any vaccination within the last 28 days.

- Any corticosteroids, anti-inflammatory drugs, immunomodulators or anticoagulants. Any
participant currently receiving or having previously received immunosuppressive
therapy, including systemic steroids including adrenocorticotrophic hormone (ACTH) or
inhaled steroids in dosages which are associated with hypothalamic-pituitary-adrenal
axis suppression such as 1 mg/kg/day of prednisone or its equivalent or chronic use of
inhaled high potency corticosteroids (budesonide 800 µg per day or fluticasone 750
µg).

- Any recent or current systemic therapy with an antibiotic or drug with potential
anti-malarial activity (chloroquine, piperaquine, benzodiazepine, flunarizine,
fluoxetine, tetracycline, azithromycin, clindamycin, hydroxychloroquine, etc.).

General conditions:

- Any participant who, in the judgment of the Investigator, is likely to be noncompliant
during the study, or unable to cooperate because of a language problem or poor mental
development.

- Any participant in the exclusion period of a previous study according to applicable
regulations.

- Any participant who lives alone (from Day 0 until at least the end of the
anti-malarial drug treatment).

- Any participant who cannot be contacted in case of emergency for the duration of the
trial and up to 2 weeks following end of study visit.

- Any participant who is the Investigator or any sub-investigator, research assistant,
pharmacist, study coordinator, or other staff thereof, directly involved in conducting
the study.

- Any participant without a good peripheral venous access.

Biological status:

- Positive result on any of the following tests: hepatitis B surface (HBs Ag) antigen,
antihepatitis B core antibodies (anti-HBc Ab), anti-hepatitis C virus (anti-HCV)
antibodies, anti-human immunodeficiency virus 1 and 2 antibodies (anti-HIV1 and anti
HIV2 Ab),

- Participant is found to be G6PD deficient.

- Any drug listed in Table 2 in the urine drug screen unless there is an explanation
acceptable to the medical investigator (e.g., the participant has stated in advance
that they consumed a prescription or OTC product which contained the detected drug)
and/or the Participant has a negative urine drug screen on retest by the pathology
laboratory.

- Positive alcohol - breath test.

Specific to the study:

- Cardiac/QT risk:

- Known pre-existing prolongation of the QTc interval considered clinically
significant

- Family history of sudden death or of congenital prolongation of the QTc interval
or known congenital prolongation of the QTc-interval or any clinical condition
known to prolong the QTc interval. History of symptomatic cardiac arrhythmias or
with clinically relevant bradycardia.

- Known hypersensitivity to OZ439, piperaquine or any of its excipients or
4-aminoquinolines, artemether or other artemisinin derivatives, lumefantrine, or other
arylaminoalcohols.

- Unwillingness to abstain from quinine containing foods/beverages such as tonic water,
lemon bitter, from inoculation (Day 0) to the end of the malaria treatment.

- Any history or presence of lactose intolerance.

On dosing day, and during the blood collection intervals:

- Ingestion of any other drug, in the two weeks prior to dosing or during the blood
sampling period that, in the opinion of the Medical Investigator, could compromise the
study, e.g., through pharmacokinetic or metabolic interactions, or analytical
interference. However the Medical Investigator may permit the use of paracetamol for
the treatment of headache or other pain. If drug therapy other than paracetamol or
drug specified in the protocol, is required during the study periods, a decision to
continue or discontinue the participant's participation will be made by the Medical
Investigator, based on the nature of the medication and the time the medication was
taken.

- Failure to conform to the requirements of the protocol.

- Detection of any drug listed in this protocol in the urine drug screen unless there is
an explanation acceptable to the medical investigator (e.g., the participant has
stated in advance that they consumed a prescription or OTC product which contained the
detected drug).

- Vital signs outside the reference range and considered as clinically significant by
the Investigator or his representative.

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Parallel
Other design features
Phase
Phase 1/Phase 2
Type of endpoint(s)
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
QLD
Recruitment hospital [1] 0 0
Q-Pharm Clinics - Herston
Recruitment postcode(s) [1] 0 0
4006 - Herston

Funding & Sponsors
Primary sponsor type
Other
Name
Medicines for Malaria Venture
Address
Country
Other collaborator category [1] 0 0
Commercial sector/Industry
Name [1] 0 0
Q-Pharm Pty Limited
Address [1] 0 0
Country [1] 0 0
Other collaborator category [2] 0 0
Commercial sector/Industry
Name [2] 0 0
Clinical Network Services (CNS) Pty Ltd
Address [2] 0 0
Country [2] 0 0
Other collaborator category [3] 0 0
Other
Name [3] 0 0
Sullivan Nicolaides Pathology
Address [3] 0 0
Country [3] 0 0
Other collaborator category [4] 0 0
Other
Name [4] 0 0
QIMR Berghofer Medical Research Institute
Address [4] 0 0
Country [4] 0 0
Other collaborator category [5] 0 0
Other
Name [5] 0 0
Army Malaria Institute, Australia
Address [5] 0 0
Country [5] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
This is a single-centre, controlled, open label study using P. falciparum-induced blood stage
malaria (IBSM) infection to assess the effectiveness of OZ439 as a gametocytocidal agent, as
well as its treatment effects on gametocyte infectivity and development in vector mosquitoes.
Previous clinical studies including one IBSM study have shown that in addition to effectively
clearing replicating, asexual (pathogenic) life cycle stages of malaria, a single dose of
piperaquine (480 mg) results in the production of gametocytes, as determined by
gametocyte-specific transcript (pfs25) qPCR. The propensity of piperaquine to induce
gametocytaemia will be employed in this study to assess the efficacy of OZ439 as a
gametocytocidal and transmission blocking agent. Experimental mosquito feeding via both
direct feeding on participants and artificial (indirect) membrane mosquito feeding will be
performed. The study will be conducted in up to 3 cohorts where participants will be
randomised into an experimental or a control group (n=2 per group) when peak gametocytemia
occurs (approximately 15 days after administration of piperaquine).
Trial website
https://clinicaltrials.gov/show/NCT02431650
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
James McCarthy, Prof
Address 0 0
QIMR Berghofer Medical Research Institute
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries

Summary results
Other publications