Clinical trial NCT01659281: Efficacy of Artesunate-Mefloquine Combination Therapy in Trat Province, Thailand
Official title: Efficacy of Artesunate-Mefloquine Combination Therapy for the Treatment of Uncomplicated Falciparum Malaria in Trat Province, Thailand
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Plasmodium Falciparum Malaria
Keywords: Artesunate
Mefloquine
Plasmodium Falciparum
Thailand
Uncomplicated Plasmodium Falciparum malaria
Lead sponsor: Armed Forces Research Institute of Medical Sciences, Thailand
Sponsor class: OTHER_GOV
First posted: 2012-08-07
Enrollment: 13
Sex: ALL
Minimum age (years): 5
Maximum age (years): 70
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The main purpose of this study is to compare artesunate-mefloquine combination therapy given for 2 and 3 days at the same total dose for the treatment of uncomplicated falciparum malaria.

Detailed description: This will be a randomized, open-label comparison of two versus three days artesunate-mefloquine treatment in patients with uncomplicated falciparum malaria. Primary endpoints will be 63-day parasitological cure rates in the 2 treatment groups. Secondary endpoints will be parasitological failure rates at each of the weekly follow-up visits to Day 56, occurence of treatment-emergent adverse events on days 0, 1 and 2, mefloquine blood concentrations on days 7, 14 and 28, and in vitro drug sensitivity profiles for parasite isolates as measured by inhibitory concentrations. Genotyping of parasites for known markers of drug resistence will be performed.

Eligibility criteria: Inclusion Criteria:

1. Age 5 to 70 years inclusive. If aged \< 18 years the subject must have a parent or guardian in attendance.
2. Asexual stages of P. falciparum parasites in a thick or thin blood film with no other visible plasmodial species.
3. Willing to give informed consent. Parents or guardians of children and adolescents must agree to give informed consent. Assent is necessary in addition to parental informed consent.
4. Able to tolerate oral therapy.
5. Willing to attend follow-up appointments and undergo study procedures.

Exclusion Criteria:

1. History of anti-malarial drug use within the past two weeks or mefloquine (MQ) use within 4 weeks.
2. Bleeding tendency (by history or based on medical records).
3. Severe/complicated malaria as determined by the investigator (coma or seizures, pulmonary edema, shock, renal failure, jaundice, severe anemia, spontaneous bleeding, hyperparasitemia (\>5% RBCs infected), or prostration).
4. History of allergy to or intolerance of study medications.
5. Mixed malaria infection by Giemsa stain.
6. Any other condition that in the opinion of the study investigator warrants parenteral antimalarial treatment.
7. Pregnant woman or nursing mother

Primary outcomes:
measure: Determination of parasitological cure rate of directly observed antimalarial therapy
timeFrame: 63 days from initiation of treatment
Secondary outcomes:
measure: Parasitological cure rates
timeFrame: Weekly to Day 56
measure: Occurence of treatment-emergent adverse events
timeFrame: 3 days
measure: In vitro drug sensitivity profile for individual parasite isolates
timeFrame: Baseline
measure: Mefloquine whole blood concentrations
timeFrame: 28 days
Other outcomes:
Locations:
city: Borai, Khaosaming and Muang districts
country: Thailand
facility: Vector Borne Diseases Control Units (VBDC, malaria clinics)
state: Trat
Study officials:
affiliation: Bureau of Vector-Borne Disease, Department of Disease Control, Ministry of Public Health
name: Wichai - Satimai, M.D., D.T.M. & H.
role: PRINCIPAL_INVESTIGATOR
affiliation: Dept. of Immunology and Medicine, AFRIMS
name: Mark M. Fukuda, M.D.
role: PRINCIPAL_INVESTIGATOR
References: