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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

Phase 2
Completed
Conditions
Primary Visceral Leishmaniasis
Interventions
Drug: Liposomal amphotericin B + miltefosine
Drug: 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
Inclusion Criteria
  • 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
Exclusion Criteria
  • 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
GroupInterventionDescription
Amb+MiltLiposomal amphotericin B + miltefosineAmBisome® 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+SSGLiposomal amphotericin B (AmBisome®) and sodium stibogluconateAmBisome® 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
MiltMiltefosineMonotherapy course of Miltefosine at 2.5mg/kg body weight (oral) from days 1-28
Primary Outcome Measures
NameTimeMethod
Initial cure: proportion cured at Day 28Day 28
Secondary Outcome Measures
NameTimeMethod
Adverse events and serious adverse events occurring in the three study armsup to day 60
Final cure: proportion cured at day 2106 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

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