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Combination Therapy in Indian Visceral Leishmaniasis

This study is currently recruiting participants.
Verified by Banaras Hindu University, August 2007

Sponsors and Collaborators: Banaras Hindu University
Drugs for Neglected Diseases
Rajendra Memorial Research Institute of Medical Sciences
Information provided by: Banaras Hindu University
ClinicalTrials.gov Identifier: NCT00523965
  Purpose

Rationale

The overall objective of this trial is to identify a safe and effective combination, (co-administration) short course treatment for the treatment of VL which could be easily deployed in a control programme. The hypothesis is that the combination treatment is as effective or better than the 5 mg/kg single dose of AmBisome and will reduce the risk of parasite resistance occurring. Safety and tolerability should be such that the combination can be easily deployed.

Objective

The specific primary and secondary objectives are as follows:

Primary objective:

To identify a short course combination treatment regimen which is at least as effective as a single dose of AmBisome 5mg/kg

Secondary objective:

To compare safety and tolerability of the various treatments measured by vital signs, blood biochemistry, (renal and liver function tests) haematology, spontaneous and elicited adverse event reporting

Primary Endpoint:

The primary efficacy endpoint variable is parasitological clearance 2 weeks after start of treatment with no relapse during follow up and no clinical signs or symptoms of VL at 6 months post treatment.

Parasitology is only carried out at any time during follow-up or at six months post treatment if there are signs or symptoms of VL infection.


Condition Intervention Phase
Leishmaniasis, Visceral
Drug: amphotericin B deoxycholate
Drug: Liposomal Amphotericin B with Miltefosine
Drug: Liposomal Amphotericin B and Paromomycin Sulfate
Drug: miltefosine + Paromomycin sulfate
Phase III

MedlinePlus related topics:   Leishmaniasis   

ChemIDplus related topics:   Amphotericin B    Miltefosine    Paromomycin    Paromomycin sulfate   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study
Official Title:   A Randomised, Open-Label, Parallel-Group, Safety and Efficacy Study to Evaluate Different Combination Treatment Regimens (co-Administration), of AmBisome, Paromomycinand Miltefosine in Visceral Leishmaniasis (VL)

Further study details as provided by Banaras Hindu University:

Primary Outcome Measures:
  • Final cure at six month follow up [ Time Frame: 18 months ] [ Designated as safety issue: Yes ]
  • Cure at six month follow up [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Initial cure at the end of treatment [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]

Estimated Enrollment:   624
Study Start Date:   September 2007
Estimated Study Completion Date:   October 2009
Estimated Primary Completion Date:   September 2009 (Final data collection date for primary outcome measure)

Arms Assigned Interventions
A: Experimental
AmBisome 5 mg/kg iv infusion over 2 h x 1 day (single dose) + oral miltefosine 50mg once daily (< 25 kg body weight) or twice daily ( > 25 kg body weight) or 2.5 mg/kg for children under 12 years, for 10 days on day 2-11
Drug: Liposomal Amphotericin B with Miltefosine
Liposomal Amphotericin B 5 mg Miltefosine 50 mg twice daily if patient weighs equal to or > 25 kg Miltefosine 50 mg once daily if patient weighs <25 mg
B: Experimental
AmBisome 5mg/kg iv infusion over 2 h x 1 day (single dose) + paromomycin sulfate 15 mg/kg/day i.m for 10 days, on day 2-11
Drug: Liposomal Amphotericin B and Paromomycin Sulfate
AmBisome 5mg/kg iv infusion over 2 h x 1 day (single dose) + paromomycin sulfate 15 mg/kg/day i.m for 10 days, on day 2-11
C: Experimental
oral miltefosine 50mg once daily (< 25 kg body weight) or twice daily ( > 25 kg body weight) or 2.5 mg/kg for children under 12 years, for 10 days + Paromomycin sulfate 15 mg/kg/day im. for 10 days
Drug: miltefosine + Paromomycin sulfate
oral miltefosine 50mg once daily (< 25 kg body weight) or twice daily ( > 25 kg body weight) or 2.5 mg/kg for children under 12 years, for 10 days + Paromomycin sulfate 15 mg/kg/day im. for 10 days
D: Active Comparator
amphotericin B deoxycholate at 1 mg/kg every other day for 15 infusions
Drug: amphotericin B deoxycholate
Amphotericin B deoxycholate 1 mg/kg on alternate days for 15 infusions

  Eligibility
Ages Eligible for Study:   12 Years to 60 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria

Inclusion Criteria:

  • Patients > 12 years old with symptoms and signs of kala-azar (fever, weight loss, splenomegaly) and parasites demonstrated by microscopy in splenic aspirate smear

Exclusion Criteria:

  • Pregnant or breast-feeding women, individuals seropositive to HIV or individuals with a serious concurrent infection such as tuberculosis or bacterial pneumonia. Women of child-bearing age will be counseled about adequate birth control during and for three months after miltefosine treatment and provided with a satisfactory method of contra-ception.
  • Granulocyte count < 1,000/mm3, hemoglobin < 5 g/dL or platelet count < 40,000/mm3; hepatic transaminases or total bilirubin greater than three times normal; serum creatinine > 2.0 mg/dL; and prothrombin time > 5 seconds above control.
  • Inability of subject or guardian to provide written informed consent.
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00523965

Contacts
Contact: Shyam Sundar, MD     91-621-2287570     drshyamsundar@hotmail.com    

Locations
India, Bihar
Kala-azar Medical Research Center     Recruiting
      Muzaffarpur, Bihar, India, 842001
      Contact: Kumar Dheeraj     91-621-2287570     kamrcmfp@hotmail.com    

Sponsors and Collaborators
Banaras Hindu University
Drugs for Neglected Diseases
Rajendra Memorial Research Institute of Medical Sciences

Investigators
Principal Investigator:     Shyam Sundar, MD     Institute of Medical Sciences, Banaras HIndu University    
  More Information

Responsible Party:   Drugs for Neglected Diseases Initiative ( Shyam Sundar )
Study ID Numbers:   VLCombo 07
First Received:   August 31, 2007
Last Updated:   July 11, 2008
ClinicalTrials.gov Identifier:   NCT00523965
Health Authority:   India: Ministry of Health

Keywords provided by Banaras Hindu University:
Kala-azar  
miltefosine  
liposomal amphotericin B  

Study placed in the following topic categories:
Leishmaniasis
Abelcet
Protozoan Infections
Amphotericin B
Skin Diseases
Clotrimazole
Miconazole
Miltefosine
Tioconazole
Paromomycin
Skin Diseases, Infectious
AmBisome
Deoxycholic Acid
Leishmaniasis, Visceral
Parasitic Diseases
Amphotericin B-deoxycholate

Additional relevant MeSH terms:
Anti-Infective Agents
Antiprotozoal Agents
Skin Diseases, Parasitic
Antineoplastic Agents
Gastrointestinal Agents
Mastigophora Infections
Pharmacologic Actions
Anti-Bacterial Agents
Antiparasitic Agents
Therapeutic Uses
Antifungal Agents
Cholagogues and Choleretics
Antibiotics, Antifungal
Sarcomastigophora Infections
Amebicides

ClinicalTrials.gov processed this record on September 05, 2008




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