Clinical Trial to Assess the Safety and Efficacy of Sodium Stibogluconate (SSG) and AmBisome® Combination, Miltefosine and AmBisome® and Miltefosine Alone for the Treatment Visceral Leishmaniasis in Eastern Africa
- Conditions
- Primary Visceral Leishmaniasis
- Interventions
- Drug: Liposomal amphotericin B + miltefosineDrug: Liposomal amphotericin B (AmBisome®) and sodium stibogluconate
- Registration Number
- NCT01067443
- Lead Sponsor
- Drugs for Neglected Diseases
- Brief Summary
This study is to assess if shorter combinations of SSG plus single dose AmBisome®, Miltefosine plus single dose AmBisome® and Miltefosine alone are effective in treating visceral leishmaniasis in Eastern Africa.
- Detailed Description
The current study intends to look at potential feasible short course combination therapies as well as evaluate (and possibly register) miltefosine in its conventional dose against VL in Sudan and Kenya.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 151
- Patients with clinical signs and symptoms of VL and diagnosis confirmed by visualization of parasites in tissue samples (lymph node, bone marrow or spleen where relevant) on microscopy.
- Patients aged between 7 (to allow for blood sampling) and 60 years (inclusive) who are able to comply with the protocol.
- Patients for whom written informed consent has been signed by the patients themselves (if aged 18 years and over) or by parents(s) or legal guardian for patients under 18 years of age.
- HIV negative status
- Patients who have received any anti-leishmanial drugs in the last 6 months/ relapse cases.
- Patients with a negative lymph node/bone marrow (or spleen) smears.
- Patients with severe protein and or caloric malnutrition (Kwashiorkor or marasmus ; Adults: BMI </= 15, Children W/H<70, presence of oedema)
- Patients with previous history of hypersensitivity reaction to SSG or Amphotericin B.
- Patients suffering from a concomitant severe infection such as TB or any other serious underlying disease (cardiac, renal, hepatic) which would preclude evaluation of the patient's response to study medication.
- Patients suffering from other conditions associated with splenomegaly such as schistosomiasis.
- Patients with previous history of cardiac arrhythmia or an abnormal ECG
- Patients who are female of child bearing age (all females who have achieved menarche) / pregnant or lactating.
- Patients with haemoglobin < 5gm/dl.
- Patients with WBC < 1 x 10³/mm³.
- Patients with platelets < 40,000/mm³.
- Patients with abnormal liver function (ALT and AST) tests of more than three times the normal range.
- Patients with serum creatinine outside the normal range for age and gender.
- Major surgical intervention within 2 weeks prior to enrolment.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Amb+Milt Liposomal amphotericin B + miltefosine AmBisome® one dose of 10mg/kg body weight (IV) on day 1 followed by 10 days Miltefosine at 2.5mg/kg body weight (oral) from days 2-11 Amb+SSG Liposomal amphotericin B (AmBisome®) and sodium stibogluconate AmBisome® one dose of 10mg/kg body weight (IV) on day 1 followed by 10 days of SSG at 20mg/kg body weight (IV/IM) from days 2-11 Milt Miltefosine Monotherapy course of Miltefosine at 2.5mg/kg body weight (oral) from days 1-28
- Primary Outcome Measures
Name Time Method Initial cure: proportion cured at Day 28 Day 28
- Secondary Outcome Measures
Name Time Method Adverse events and serious adverse events occurring in the three study arms up to day 60 Final cure: proportion cured at day 210 6 months post treatment
Trial Locations
- Locations (3)
Kimalel Health Centre
🇰🇪Kimalel, Kenya
Kassab Hospital
🇸🇩Kassab, Gedaref, Sudan
El Hassan Centre for Tropical Medicine
🇸🇩Doka, Gedarif, Sudan