The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers
Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/show/NCT02867059




Registration number
NCT02867059
Ethics application status
Date submitted
5/08/2016
Date registered
15/08/2016
Date last updated
5/05/2020

Titles & IDs
Public title
SJ733 Induced Blood Stage Malaria Challenge Study
Scientific title
A Proof-of-concept Study to Assess the Effect of (+)-SJ000557733 (SJ733) Against Early Plasmodium Falciparum Blood Stage Infection in Healthy Participants
Secondary ID [1] 0 0
QP15C20
Universal Trial Number (UTN)
Trial acronym
SJ733IBSMCS
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Plasmodium Falciparum 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 - (+)-SJ000557733

Experimental: first dose - The dose used in the first cohort was determined on the basis of the safety and PK data generated in the FIM study (NCT02661373) currently ongoing in United States (US) and will be 150 mg.

Experimental: second dose - Depending on the pharmacodynamics data (effect of SJ733 on parasitaemia) obtained from this first cohort, the dose in Cohort 2 may be adjusted but will not exceed 600 mg.


Treatment: Drugs: (+)-SJ000557733
(+)-SJ000557733 (SJ733), in short SJ733, will be the second PfATP4 inhibitor to enter clinical development after KAE609 (Novartis) which is currently in Phase 2 stage. KAE609 (cipargamin; previously known as NITD609) is a spirotetrahydro-ß-carbolines (spiroindolone). KAE609 inhibits QP15C20_SJ733_Challenge Protocol_v2.0_26July2016 Page 28 of 110 PfATP4, which results in a disruption of parasite sodium homeostasis. Compared to KAE609, SJ733 has the potential to be a very fast acting, antimalarial drug for human therapeutic application and may have a different safety profile in human participants. Finally, SJ733 blocks parasite transmission in vivo at potencies close to those where it is efficacious in blood stages, indicating its potential for transmission blockade in humans.

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

Outcomes
Primary outcome [1] 0 0
Activity of SJ733 Administered Orally on Clearance of P. Falciparum Blood Stage Parasites From the Blood in Healthy Subjects (Men and WNCBP) - The parasite reduction ratio (PRR) provides an estimate of the efficacy of an antimalarial treatment and is the ratio of the parasite density between admission and 48 h post antimalarial treatment. The primary efficacy variable is parasite reduction ratio (PRR) of parasites based on qPCR after administration of SJ733. The PRR was estimated using the slope of the optimal fit of the log-linear relationship of the parasitaemia decay.
PRR was calculated for each subject using the retrospective 18S rRNA qPCR data. If the model fit was adequate for the subject (defined as overall model p-value <0.001), the slope and corresponding standard error from the log-linear regression was used to calculate the overall cohort specific PRR.
Timepoint [1] 0 0
Until End of Study (Day 28±3)
Primary outcome [2] 0 0
Number of Participants With Adverse Events - The safety and tolerability of SJ733 in healthy subjects (men and WNCBP) following infection with blood stage P. falciparum during the IBSM challenge study will be evaluated by observation of occurrence of adverse events.
Timepoint [2] 0 0
for up to 25th day post SJ733 treatment or longer as determind by the principal investigator

Eligibility
Key inclusion criteria
- Adult, male and women of non-child bearing potential (WNCBP as defined in Section
6.17), participants between 18 and 55 years of age inclusive, who do not live alone
(from Day 0 until at least the end of the antimalarial drug treatment) and will 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/m2, inclusive.

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

- Normal vital signs after 5 minutes resting in supine position:

90 mmHg = 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 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 in accordance with Sponsor-approved clinically acceptable
laboratory ranges documented prior to study start. 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 acceptable ranges approved by the Sponsor and
haemoglobin must be equal or higher than the lower limit of the normal range.

- Male participants must agree to use a double barrier method of contraception including
condom plus diaphragm or condom plus IUD or condom plus stable
oral/transdermal/injectable hormonal contraceptive by female partner for at least 7
days prior to the time of the first dose of study drug through 90 days after the 5th
half-life of the last dose of study drug (half-life of ~20 hours). Abstinent
participants have to agree starting a double barrier method if they start sexual
relationships during the study and up to 95 days after the last dose of study drug.

- 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
- 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 region during the
past 12 months or planned travel to a malaria-endemic region during the course of the
study (for endemic regions see http://www.map.ox.ac.uk/browse-resources/).

- Has evidence of increased cardiovascular disease risk (defined as >10%, 5 year risk
for those greater than 35 years of age), as determined by the Australian Absolute
Cardiovascular Disease Risk Calculator (http://www.cvdcheck.org.au/). Risk factors
include sex, age, systolic blood pressure (mm/Hg), smoking status, total and HDL
cholesterol (mmol/L) 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
non-insulin dependent diabetes (excluding glucose intolerance if E03 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.

- History of photosensitivity.

- History of G6PD deficiency.

- 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.

- 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 participant safety.

- Significant inter-current 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, diarrhea.

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

- 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 treatment drug dose in the study.

- Participant unwilling to defer blood donations to the ARCBS 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.

- Tobacco use of more than 5 cigarettes or equivalent per day and unable to stop smoking
during 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).

- Excessive consumption of beverages containing xanthine bases, including red bull,
chocolate etc. more than 400 mg of caffeine per day (more than 4 cups or glasses per
day).

- 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 micrograms per day or fluticasone
750 micrograms).

- Any recent (less than 6 weeks) or current systemic therapy with an antibiotic or drug
with potential antimalarial activity (chloroquine, piperaquine, benzodiazepine,
flunarizine, fluoxetine, tetracycline, azithromycin, clindamycin, hydroxychloroquine,
etc.).

- 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 antimalarial
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 employee of the sponsor or research site personnel directly affiliated with this
study or their immediate family members defined as a spouse, parent, sibling, or child
whether biological or legally adopted.

- Any participant without a good peripheral venous access.Male participant with a female
partner who is pregnant or lactating from the time of administration of study
medication.

- Positive result on any of the following tests: hepatitis B surface (HBs Ag) antigen,
anti-hepatitis 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).

- A positive urine drug test at screening, pre-inoculation, or pre any SJ733 dose. Any
drug listed in Table 2 (Drug Screening) 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.

- A positive alcohol breath test at screening, pre-inoculation or pre any SJ733 dose.

- Cardiac/QT risk:

- Known pre-existing prolongation of the QTcB/QTcF interval considered clinically
significant.

- History of symptomatic cardiac arrhythmias or with clinically relevant bradycardia.
Electrolyte disturbances, particularly hypokalaemia, hypocalcaemia or hypomagnesaemia.

- Electrocardiogram (ECG) abnormalities in the standard 12-lead ECG (at screening) which
in the opinion of the Investigator is clinically relevant or will interfere with the
ECG analysis.

- A history of clinically significant ECG abnormalities.

- Known hypersensitivity to SJ733 or any of its excipients or artemether or other
artemisinin derivatives, lumefantrine, or other arylaminoalcohols.

- Unwillingness to abstain from consumption of citrus (grapefruit, Seville orange, etc.)
for at least 28 days prior to initiation of the study (inoculation, Day 0) and for the
study duration.

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

- Use of prescription or non-prescription drugs and herbal supplements (such as St
John's Wort) within 14 days or 5 half-lives (whichever is the longer) prior to the
inoculation administration. (As an exception, ibuprofen (preferred) may be used at
doses of up to 1.2 g/day, or paracetamol at doses of up to 2 g/day. Limited use of
other non-prescription medications or dietary supplements not believed to affect
subject safety or the overall results of the study, may be permitted on a case-by-case
basis following approval by the Sponsor in consultation with the Investigator.) (Note:
diazepam interferes with the analysis of blood levels of SJ733 and thus should not
have been used for at least 8 weeks prior to administration of the study drug).

- Known severe reaction to mosquito bites other than local itching and redness.
Participants are requested to refrain from taking non-approved concomitant medication
from recruitment until the conclusion of the study.

Participants who are excluded from participation on study days for any of the above reasons
may be eligible to participate on a postponed schedule if the Investigator considers this
appropriate.

Study design
Purpose of the study
Treatment
Allocation to intervention
Non-randomised 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
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, Royal Brisbane and Women's Hospital - Brisbane
Recruitment hospital [2] 0 0
Q-Pharm Clinics - Herston
Recruitment postcode(s) [1] 0 0
4006 - Brisbane
Recruitment postcode(s) [2] 0 0
4006 - Herston

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

Ethics approval
Ethics application status

Summary
Brief summary
This is a single-centre, open-label, study using induced blood stage malaria (IBSM) infection
to characterize the activity of (+)-SJ000557733 or SJ733 for short, against early Plasmodium
falciparum blood stage infection. The study will be conducted in two cohorts (n=8 per
cohort). The anticipated efficacious dose range is expected to be within a range of 125 to
600 mg. The dose used in the first cohort was determined on the basis of the safety and PK
data generated in the FIM study (NCT02661373) currently ongoing in United States (US) and
will be 150 mg. Depending on the pharmacodynamics data (effect of SJ733 on parasitaemia)
obtained from this first cohort, the dose in Cohort 2 may be adjusted but will not exceed 600
mg. Based on the PK from all three cohort from the FIM study, the median estimated dose to
obtain the target SJ733 AUC of 13,000 (ug hr/L) is 370 mg. The dose of cohort 2 (=600mg) is
intended to provide further concentration-response information in the human challenge model.

For Cohort 2 only, a second dose of SJ733 may be administered at peak gametocytaemia to
assess if SJ733 can reduce gametocytes and subsequent infectivity to mosquitoes (a washout of
~15 days post initial SJ733 treatment will be observed). Depending on the data obtained from
the first two cohorts, there may be a subsequent cohort, with the investigated dose of SJ733
to be determined by the Sponsor and Principal Investigator (PI) and endorsed by the Safety
Review Team. Should this third dose be investigated, a substantial amendment including
preliminary data from the first two cohorts will be submitted to the HREC for approval.
Trial website
https://clinicaltrials.gov/show/NCT02867059
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Address 0 0
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