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Evaluate Parasitological Clearance Rates And Pharmacokinetics Of The Combination Of Azithromycin And Chloroquine In Asymptomatic Pregnant Women With Falciparum Parasitemia In Africa

Phase 3
Terminated
Conditions
Asymptomatic Parasitemia In Pregnancy
Interventions
Registration Number
NCT01103713
Lead Sponsor
Pfizer
Brief Summary

The study will be conducted in asymptomatic pregnant women with P. falciparum parasitemia. The subjects will be given 3 day dosing regiment of the fixed-dose combination of Azithromycin and Chloroquine. Parasitological clearance rate with polymerase chain reaction data will be evaluated on Day 28 as primary endpoint.

Detailed Description

After interim analysis of efficacy data by an External Data Monitoring Committee, this study was terminated. Investigators were notified on 22 Aug 2013. There were no safety concerns that led to this termination.

Recruitment & Eligibility

Status
TERMINATED
Sex
Female
Target Recruitment
168
Inclusion Criteria
  • Primigravidae and secundigravidae pregnant women at >=14 and <=30 weeks of gestational age (confirmed by ultrasound examination).
  • Evidence of asymptomatic parasitemia with Plasmodium falciparum monoinfection (confirmed by microscopy) with parasite counts in the range of 80 100,000/uL on thick blood smears.
  • Evidence of a personally signed and dated informed consent document indicating that the subject (or a legally acceptable representative if a subject is <18 years of age) has been informed of all pertinent aspects of the study and that all questions by the subject have been sufficiently answered. Assent will be obtained from subjects <18 years of age.
  • Subjects who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.
Exclusion Criteria
  • Age <16 years old or >35 years old.
  • Multiple gestations (more than one fetus) as per the ultrasound results at screening.
  • Clinical symptoms of malaria.
  • Hemoglobin <8 g/dL (measured at baseline).
  • Any condition requiring hospitalization or evidence of severe concomitant infection at time of presentation.
  • Use of antimalarial drugs in previous 4 weeks.
  • History of convulsions, hypertension, diabetes or any other chronic illness that may adversely affect fetal growth and viability.
  • Known allergy to the study drugs (AZ, CQ, and SP) or to any macrolides or sulphonamides.
  • Requirement to use medication during the study that might interfere with the evaluation of the study drug of AZ or CQ or is contra indicated during pregnancy per package inserts.
  • Severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study.
  • Evidence of current obstetric complications that may adversely impact the pregnancy and/or fetal outcomes, including presence of congenital anomalies, placenta previa or abruption.
  • Known severe sickle cell (SS) disease or sickle hemoglobin C (SC) anemia.
  • Known family history of prolonged QT syndrome, serious ventricular arrhythmia, or sudden cardiac death.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
AZCQAzithromycin plus chloroquineAzithromycin/Chloroquine
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With Parasitologic Response (PCR Corrected) at Day 28 Post First Dose of Study MedicationDay 28

The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.

Percentage of Participants With Parasitologic Response (Polymerase Chain Reaction (PCR) Corrected) at Day 28 Post First Dose of Study MedicationDay 28

The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Parasitologic Response (PCR Corrected) at Days 7, 14, 21, 28, 35, and 42 Post First Dose of Study MedicationDays 7, 14, 21, 28, 35, and 42

The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.

Percentage of Participants With Parasitologic Response (PCR Uncorrected) at Days 7, 14, 21, 28, 35, and 42 Post First Dose of Study MedicationDays 7, 14, 21, 28, 35, and 42

The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR uncorrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR uncorrected) through the day of consideration, otherwise she is a parasitological failure.

Percentage of Participants With Parasitologic Response (PCR Corrected) at Days 7, 14, 21, 35, and 42 Post First Dose of Study MedicationDays 7, 14, 21, 35, and 42

The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.

Percentage of Participants With Parasitologic Response (PCR Corrected) at Days 7, 14, 21, 35, and 42 , Post First Dose of Study MedicationDays 7, 14, 21, 35, and 42

The proportion of participants with parasitological response was estimated from the Kaplan Meier curve based on the time to the first occurrence of parasitological failure (PCR corrected). A participant will be a parasitological responder if she has a zero parasite count on the Day 7 visit without subsequent recurrence (PCR corrected) through the day of consideration, otherwise she is a parasitological failure.

Number of Asexual P. Falciparum Per Microliter of Blood at Days 7, 14, 21, 28, 35, and 42 Post First Dose of Study MedicationDays 7, 14, 21, 28, 35, and 42

Parasite counts (actual counts per microliter of blood) was measured at various time points.

Trial Locations

Locations (7)

Siaya District Hospital

🇰🇪

Siaya, Kenya

Teule Hospital

🇹🇿

Muheza, Tanga, Tanzania

Centre de Sante d'AHOUANSORI -AGUE

🇧🇯

Cotonou, Benin

Hôpital Bethesda

🇧🇯

Cotonou, Benin

National Institute for Medical Research (Mwanza Centre)/ Nyamagana District Hospital

🇹🇿

Mwanza, Tanzania

Mulanda Health Centre IV

🇺🇬

Kampala, Uganda

Zomba Central Hospital

🇲🇼

Zomba, Malawi

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