Pharmacokinetics of Miltefosine in Children and Adults (PK)
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Purpose
The purpose of this study is to determine the pharmacokinetics of miltefosine in children and adults with cutaneous leishmaniasis in plasma and intracellularly, and its relation with the parasitologic response. The results will provide pharmacologic bases to optimize the use of miltefosine for the treatment of cutaneous leishmaniasis, and will provide the knowledge base to assess the impact of pharmacokinetic behavior in children and adults on the emergence of drug resistance.
| Condition | Intervention | Phase |
|---|---|---|
|
Cutaneous Leishmaniasis |
Drug: Miltefosine |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Pharmacokinetics Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Pharmacokinetics of Miltefosine in Children and Adults: Implications for the Treatment of Cutaneous Leishmaniasis in Colombia. |
- Intracellular and plasma concentration of miltefosine [ Time Frame: Participants will be followed for 7 months, completing 9 visits. ] [ Designated as safety issue: No ]
- Parasite burden in lesions and extralesional tissues. [ Time Frame: Participants will be followed for 7 months, completing 9 visits ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 60 |
| Study Start Date: | October 2011 |
| Estimated Study Completion Date: | April 2014 |
| Estimated Primary Completion Date: | January 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Miltefosine |
Drug: Miltefosine
Children (2-12 years of age) and adults (18-60 years of age) will receive Miltefosine PO at a dose of 1.8-2.5 mg/kg/day for 28 days.
|
Detailed Description:
An open-label phase IV clinical trial of miltefosine, designed to evaluate intracellular and plasma drug pharmacokinetics in children and adults using a population pharmacokinetics design. Two study groups have been defined: 1) children 2-12 years of age (n=30) and 2) adults 18-60 years of age (n=30) with confirmed parasitological diagnosis of cutaneous leishmaniasis. The participants will receive supervised standard treatment with miltefosine: 1.8 - 2.5 mg/Kg of weight for 28 days.
Miltefosine concentration will be determined in plasma and PBMCs, from 3 or 10ml peripheral blood samples in children and adults respectively. Sampling will be conducted pre-dosing at days 0,1,15 and 29 during treatment, and at months 1, 2, 3 and 6 post-treatment.
A population pharmacokinetics analysis will be performed using a non-linear model of mixed effects with the software NONMEM, R and Piranha. Parasite burden will be determined by 7SLRNA qPCR of Leishmania from swab samples of lesions and extralesional tissues before and at the end of treatment. The relationship between pharmacokinetics and parasite persistence/burden will be determined by correlation analysis and pharmacodynamic modeling.
Eligibility| Ages Eligible for Study: | 2 Years to 60 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age: 2-12 years of age, or 18-60 years of age
- Weight greater than 10 kg
- Parasitologic confirmation of cutaneous leishmaniasis
- Normal hepatic and kidney function
Exclusion Criteria:
- Pregnant or lactating women, and women who are planning to conceive during the study or that reject the use of birth control methods.
- Use of drugs with antileishmanial potential during the previous 6 months, including pentavalent antimonials, amphotericin B, miltefosine, and pentamidine
- Mucocutaneous or visceral leishmaniasis
- For female children, menses or other evidence of reproductive maturity
Contacts and Locations| Contact: Maria A Gomez, PhD | 572-5552164 ext 213 | mgomez@cideim.org.co |
| Contact: Alexandra Cossio, RN, MSc | 572-5552164 ext 114 | acossio@cideim.org.co |
| Colombia | |
| Corporación Centro Internacional de entrenamiento e Investigaciónes Médicas | |
| Cali, Valle, Colombia, 5930 | |
| Principal Investigator: | Nancy C Saravia, PhD | Centro Internacional de Entrenamiento e Investigaciones Médicas, CIDEIM |
More Information
Publications:
| Responsible Party: | Centro Internacional de Entrenamiento e Investigaciones Médicas |
| ClinicalTrials.gov Identifier: | NCT01462500 History of Changes |
| Other Study ID Numbers: | 2229-519-28930 |
| Study First Received: | October 25, 2011 |
| Last Updated: | October 27, 2011 |
| Health Authority: | Colombia: INVIMA Instituto Nacional de Vigilancia de Medicamentos y Alimentos |
Keywords provided by Centro Internacional de Entrenamiento e Investigaciones Médicas:
|
Miltefosine pharmacokinetics cutaneous leishmaniasis |
Additional relevant MeSH terms:
|
Leishmaniasis Leishmaniasis, Cutaneous Euglenozoa Infections Protozoan Infections Parasitic Diseases Skin Diseases, Parasitic Skin Diseases, Infectious Skin Diseases |
Miltefosine Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Antiprotozoal Agents Antiparasitic Agents Anti-Infective Agents Antifungal Agents |
ClinicalTrials.gov processed this record on May 19, 2013