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Phase 3 N=361 Randomized Treatment

Azithromycin Plus Chloroquine Versus Artemether-Lumefantrine For The Treatment Of Uncomplicated P. Falciparum Malaria In Children In Africa

Malaria, Falciparum

Enrolled (actual)
361
Serious AEs
1.1%
Results posted
Jun 2014
Primary outcome: Primary: Percentage of Participants With Polymerase Chain Reaction (PCR)-Corrected Adequate Clinical and Parasitologic Response (ACPR) at Day 28 in the Modified Intent-to-treat (mITT) Population — 89.27; 98.37 Percentage of participants

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Azithromycin plus Chloroquine (Drug); Artemether-lumefantrine (Drug)
Age
Pediatric · 0+ yrs
Sex
All
Sponsor
Pfizer
Primary completion
Sep 2010

Outcome Measures

OutcomeResultp-value
PRIMARY
Percentage of Participants With Polymerase Chain Reaction (PCR)-Corrected Adequate Clinical and Parasitologic Response (ACPR) at Day 28 in the Modified Intent-to-treat (mITT) Population
89.27; 98.37
PRIMARY
Percentage of Participants With PCR-corrected ACPR at Day 28 in Per-Protocol (PP) Population
93.08; 99.16
SECONDARY
Percentage of Participants With PCR-corrected ACPR in the mITT Population
94.17; 99.21; 92.47; 99.21; 91.59; 98.37
SECONDARY
Percentage of Participants With PCR-corrected ACPR in PP Population
98.25; 100.00; 96.46; 100.00; 95.53; 99.16
SECONDARY
Percentage of Participants With PCR-uncorrected ACPR in the mITT Population
94.17; 99.21; 89.08; 96.79; 67.87; 82.96
SECONDARY
Percentage of Participants With PCR-uncorrected ACPR in PP Population
98.25; 100.00; 92.89; 97.56; 70.56; 83.62
SECONDARY
Percentage of Participants With Early Treatment Failure (ETF) in the mITT Population (PCR-corrected)
5.83; 0.79
SECONDARY
Percentage of Participants With ETF in PP Population (PCR-corrected)
1.75; 0
SECONDARY
Percentage of Participants With Late Clinical Failure (LCF) in the mITT Population (PCR-corrected)
0; 0; 0; 0; 0; 0
SECONDARY
Percentage of Participants With LCF in PP Population (PCR-corrected)
0; 0; 0; 0; 0; 0
SECONDARY
Percentage of Participants With Late Parasitologic Failure (LPF) in the mITT Population (PCR-corrected)
0; 0; 1.67; 0; 2.50; 0.79
SECONDARY
Percentage of Participants With LPF in PP Population (PCR-corrected)
0; 0; 1.75; 0; 2.63; 0.81
SECONDARY
Percentage of Participants With Asexual Parasitologic Response (PCR-corrected)
93.33; 99.22; 91.67; 99.21; 90.83; 98.44
SECONDARY
Percentage of Participants With Gametocytologic Response
81.97; 91.47; 81.15; 91.54; 80.33; 93.08
SECONDARY
Fever Clearance Time
24.000; 24.000 0.2564
SECONDARY
Asexual Plasmodium Falciparum Parasite Clearance Time
48.000; 24.000 <0.0001 sig
SECONDARY
Nadir Hemoglobin Level
9.63; 9.82
SECONDARY
Change From Nadir Hemoglobin Level at Days 14, 28, and 42
0.52; 0.44; 1.15; 0.96; 1.29; 1.14
SECONDARY
Time to Recurrence of Parasitemia
34; NA 0.0006 sig
SECONDARY
Number of Participants With Recurrent Parasitemia Versus Baseline Plasmodium Falciparum Chloroquine Resistance Transporter (PfCRT) Status
SECONDARY
Percentage of Participants With PfCRT in True Failures

Summary

The primary objective is to confirm the hypothesis that azithromycin used in combination with chloroquine is non-inferior to artemether- Lumefantrine for the treatment of symptomatic, uncomplicated malaria due to P. falciparum in children in African countries.

Eligibility Criteria

Inclusion Criteria

  • Girls and boys ≥5 years to ≤12 years (Cohort 1); and ≥6 to ≤59 months of age (Cohort 2) with uncomplicated, symptomatic malaria as indicated by the presence of the following:
  • Blood smears positive for monoinfection with P. falciparum and asexual parasitemia between 1000 -100,000 parasites/µL;
  • Documented fever (38.0°C/100.4°F rectal or tympanic; 37.2°C/99.0°F axillary or 37.5°C/99.5°F oral) or history of fever (as reported by the legally acceptable representative) within the prior 24 hours;
  • Appropriate for outpatient treatment;
  • Blood glucose ≥60 mg/dL;
  • Hemoglobin ≥6 g/dl or hematocrit ≥18% without signs of anemia-induced Congestive Heart Failure (CHF);
  • Negative urine pregnancy test for females ≥10 years of age (and of child bearing potential)

Exclusion Criteria

  • Peripheral blood smear positive for mixed infection with multiple Plasmodium spp.
  • Severe or complicated malaria including subjects with any of the following:
  • Impaired consciousness (eg, obtundation, unarousable coma), seizures or abnormal neurologic exam suggestive of severe or complicated malaria;
  • Known hemoglobinuria;
  • Jaundice;
  • Respiratory distress;
  • Persistent vomiting;
  • Gross hematuria, as reported by the subject's legally acceptable representative;
  • Recent history of convulsions;
  • Inability to drink or breastfeed;
  • Unable to sit or stand as appropriate for age;
  • Known pregnancy or breast-feeding or positive urine pregnancy test (females ≥10 years of age and of child bearing potential);
  • History of allergy to or hypersensitivity to azithromycin, any macrolide, chloroquine, artemether, any artemisinin derivative, lumefantrine;
  • Any contraindication to any study drug including AZ, CQ and AL;
  • History of treatment with any antimalarial drug (such as halofantrine, chloroquine, quinine, mefloquine, Malarone, SP, artemisinin compounds) or antibacterial with known antimalarial activity (macrolides, doxycycline, clindamycin) within 2 weeks prior to enrollment of a subject (and/or of the mother of a subject who is being breastfed) into the study;
  • Known or suspected cardiovascular, hepatic or renal abnormality that in the opinion of the investigator would place the subject at increased risk to participate in the study.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00677833). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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