Phase 3
N=251
Study to Assess the Incidence of Hemolysis, Safety, and Efficacy of Tafenoquine (SB-252263, WR238605) Versus Primaquine in Subjects With Plasmodium Vivax Malaria
Malaria, Vivax
Bottom Line
View on ClinicalTrials.gov: NCT02216123 ↗Enrolled (actual)
251
Serious AEs
2.8%
Results posted
May 2018
Primary outcome: Primary: Percentage of Participants With Clinically Relevant Hemolysis. — 2.41; 1.18 Percentage of participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Tafenoquine (Drug); Tafenoquine Placebo (Drug); Chloroquine (Drug); Primaquine (Drug); Primaquine Placebo (Drug)
- Age
- Pediatric, Adult, Older Adult · 16+ yrs
- Sex
- All
- Sponsor
- GlaxoSmithKline
- Primary completion
- Nov 2016
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants With Clinically Relevant Hemolysis. |
2.41; 1.18 | — |
| PRIMARY Percentage of Female Participants With Moderate Glucose-6 Phosphate Dehydrogenase (G6PD) Deficiency Experiencing Clinically Relevant Hemolysis. |
— | — |
| SECONDARY Rate of Relapse-free Efficacy at Six Months Post Dose |
72.7; 75.1 | — |
| SECONDARY Rate of Relapse-free Efficacy at Four Months Post Dose |
82.3; 79.7 | — |
| SECONDARY Time to Relapse of P. Vivax Malaria |
NA; NA | — |
| SECONDARY Time to Parasite Clearance |
41; 44 | — |
| SECONDARY Time to Fever Clearance |
10; 13 | — |
| SECONDARY Time to Gametocyte Clearance |
38; 41 | — |
| SECONDARY Number of Participants With Recrudescence |
0; 0 | — |
| SECONDARY Number of Participants With Genetically Homologous and Genetically Heterologous P. Vivax Infections |
8; 9; 29; 10; 5; 1 | — |
| SECONDARY Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range |
8; 0; 0; 1; 6; 3 | — |
| SECONDARY Number of Participants With Hematology Laboratory Data Outside the Reference Range |
32; 15; 0; 0; 8; 1 | — |
| SECONDARY Number of Participants With Abnormal Urinalysis Dipstick Results |
1; 1; 9; 2; 3; 0 | — |
| SECONDARY Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious TEAEs |
119; 64; 6; 1 | — |
| SECONDARY Number of Participants With Electrocardiogram (ECG) Findings |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Change From Baseline in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Mean Arterial Pressure (MAP) |
1.2; -0.9; 0.4; -2.3; -0.8; -2.7 | — |
| SECONDARY Change From Baseline in Pulse Rate |
-10.8; -9.3; -9.9; -9.9; -11.9; -11.8 | — |
| SECONDARY Change From Baseline in Temperature |
-0.6; -0.5; -0.6; -0.6; -0.6; -0.6 | — |
| SECONDARY Number of Participants With P. Falciparum |
4; 3 | — |
| SECONDARY Number of Participants With Keratopathy |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants With Change in Best Corrected Visual Acuity Test Scores |
1; 0; 0; 0; 2; 0 | — |
| SECONDARY Number of Participants With Retinal Changes From Baseline |
0; 0; 2; 0; 0; 0 | — |
| SECONDARY Change From Baseline in Percent Methemoglobin |
0.02; 0.02; -0.16; -0.06; 0.18; 0.03 | — |
| SECONDARY Cost Associated With Relapse Episode of P Vivax Malaria |
8.208; 8.032; 42.776; 4.194; 16.775; 16.775 | — |
| SECONDARY Cost Associated With a Hemolysis Event |
9.174 | — |
| SECONDARY Cost Incurred With Purchase of Medications Associated With Relapse Episode of P. Vivax Malaria |
2.516; 4.194; 0.491; 0.327; 0.468; 2.341 | — |
| SECONDARY Cost Incurred With Purchase of Medications Associated With Hemolysis Event |
— | — |
| SECONDARY Number of Participants or Care Givers Who Had Taken Time Off From Normal Occupation Due to Relapse Episode of Malaria |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants or Care Givers Who Had Taken Time Off From Normal Occupation Due to a Hemolysis Event |
— | — |
| SECONDARY Number of Participants With Action Taken to Treat Relapse Episode of P. Vivax Malaria |
19; 17; 5; 0; 2; 2 | — |
| SECONDARY Number of Participants With Action Taken to Treat a Hemolysis Event |
1 | — |
| SECONDARY Oral Clearance (CL/F) of TQ |
2.96 | — |
| SECONDARY Volume of Distribution (Vc/F) of TQ |
915 | — |
Summary
This is a prospective, double-blind, double-dummy, multicenter, comparative study. A total of 300 subjects will be randomized to treatment on Day 1, of which a minimum of 50 female subjects must be enrolled that display moderate glucose-6-phosphate dehydrogenase (G6PD) deficiency (>=40% - <70% of the site median G6PD value). Subjects must have a blood smear that is positive for P. vivax at entry. Subjects will be randomized 2:1 to receive tafenoquine (TQ)/chloroquine(CQ) or the active comparator primaquine (PQ)/CQ. All subjects will receive CQ on Days 1 to 3, followed by TQ or PQ and matching placebo beginning on Day 1 or 2. Tafenoquine, or matching placebo, will be given as a single, 300mg dose. Subjects will receive PQ (15mg once daily) or matching placebo for 14 days. The duration of the study is 180 days, including screening and randomization to treatment (Day 1), three in-hospital days (Days 1-3), four out-patient visits while on treatment with study medication (Days 5, 8, 11 and 15) and seven follow-up visits (Days 22, 29, 60, 90, 120, 150 and 180).
The primary safety data collected in this study will help to understand the hemolysis risk to both G6PD-normal and G6PD-deficient subjects. The efficacy data produced from this study will support the results for sister study TAF112582, the pivotal phase III efficacy and safety study of the TQ program.
Eligibility Criteria
Inclusion Criteria
- A female is eligible to enter and participate in the study if she is non-pregnant, nonlactating and if she is of: a. Non-childbearing potential defined as: post-menopausal (12 months of spontaneous amenorrhea or 40 milli-International units per milliliter [mIU/mL]), or pre-menopausal and has had a hysterectomy or a bilateral oophorectomy (removal of the ovaries) or a bilateral tubal ligation, negative pregnancy test or, b. Child-bearing potential, has a negative pregnancy test at screening, and agrees to comply with one of the following during the treatment stage of the study and for a period of 90 days after stopping study medication: Use of oral contraceptive, either combined or progestogen alone used in conjunction with double barrier method as defined below. Use of an intrauterine device with a documented failure rate of = 40 percent of the site median value for G6PD normal males. Male subjects must have an enzyme level >= 70 percent of the site median value for G6PD normal males.
- The subject has a screening hemoglobin (Hb) value as follows: Any subject with a G6PD value >=70 percent of the site median value must have a screening Hb value >=7 g/dL; Female subjects with a G6PD value is >=40 - =8 g/dL.
- The subject has a QT duration corrected for heart rate by Fridericia's Formula (QTcF) 100 and 2 x upper limit of normal (ULN).
- The subject has severe vomiting (no food or inability to take food during the previous 8 hours).
- The subject has a clinically significant concurrent illness (e.g., pneumonia, septicemia), pre-existing condition (e.g., renal disease, malignancy), condition that may affect absorption of study medication (e.g., vomiting, severe diarrhea), or clinical signs and symptoms of severe cardiovascular disease (e.g., uncontrolled congestive heart failure, severe coronary artery disease).
- The subject has a history of porphyria, psoriasis, or epilepsy.
- The subject has a history of significant ocular disease (e.g. surgery to the globe, glaucoma, diabetic retinopathy) or has evidence of corneal or retinal abnormalities identified in the clinical screening ophthalmologic examination.
- The subject has taken anti-malarials (e.g., artemisinin-based combination therapies, mefloquine, primaquine, or any other 4- or 8-aminoquinoline) within 30 days prior to study entry.
- The subject has taken or will likely require during the study the use of medications from the following classes: Histamine-2 blockers and antacids; Drugs with hemolytic potential; Drugs known to prolong the QTcF interval; The biguanides phenformin and buformin (but excluding metformin); Drugs that are substrates of the renal transporters OCT2, MATE1 AND MATE-2K and have a narrow therapeutic index (for example, the anti-arrhythmic agents dofetilide, procainamide and pilsicainide)
- The subject has received treatment with any investigational drug within 30 days of study entry, or within 5 half-lives, whichever is longer.
- The subject has a recent history of illicit drug abuse or heavy alcohol intake, such that full participation in the study could be compromised.
Data sourced from ClinicalTrials.gov (NCT02216123). 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.