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Eval 3-Drug Therapy Diethylcarbamize, Albendazole and Ivermectin That Could Accelerate LF Elimination Outside of Africa

Phase 2
Completed
Conditions
Lymphatic Filariasis
Interventions
Registration Number
NCT01975441
Lead Sponsor
University Hospitals Cleveland Medical Center
Brief Summary

This study will determine if a combination of 3 drugs used to treat the infection that cause lymphatic filariasis (LF) due to Wuchereria bancrofti infection are more effective in killing or sterilizing the adult worms compared to just 2 of the 3 drugs that usually given to treat this infection. The three drugs used together are called albendazole (ALB), ivermectin (IVM) and diethylcarbamazine (DEC). The usual treatment in Papua New Guinea (PNG) for lymphatic filariasis are DEC and ALB. A combination of these 3 drugs has not been previously used to treat LF.

Detailed Description

This study will determine whether a single dose of the triple drug regimen of DEC/Iver/Alb is non-inferior to annual treatments with DEC/Alb in inducing sustained clearance of Mf in LF infected subjects (\>50 Mf/ml) at 36 months post-treatment. This study also tests the hypothesis that single dose of triple drug is super in sustained clearance of microfilariae compared to single dose of DEC/ALB.

There will be 3 treatment arms as follows:

1. The comparator (standard treatment) DEC 6 mg/kg + Alb 400 mg administered annually (at 0, 12, and 24 months).

2. DEC 6 mg/kg + Alb 400 mg given once

3. DEC 6 mg/kg + Alb 400 mg + Iver 200 µg/kg administered once only at the beginning of the RCT (0 month).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
182
Inclusion Criteria
  • Men and women 18-65 years
  • >50 mf/ml in finger stick blood samples
  • Willing to give informed consent
Exclusion Criteria
  • Prior treatment for LF within last 5 years
  • Pregnant (do pregnancy test)
  • Hemoglobin < 7 g/dl
  • permanent disability, serious medical illness that prevents or impedes study participation and/or comprehension
  • AST/ALT and creatinine > 1.5 upper limit of normal.
  • Urine dipstick with glucose ≥ 2+ and/or protein ≥ 2+

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
standard treatmentDiethylcarbamazineDiethylcarbamazine 6 mg/kg + Albendazole 400 mg administered annually (at 0, 12, and 24 months).
standard treatmentAlbendazoleDiethylcarbamazine 6 mg/kg + Albendazole 400 mg administered annually (at 0, 12, and 24 months).
DEC 6 mg/kg + Alb 400 mg x 1DiethylcarbamazineDiethylcarbamazine 6 mg/kg + Albendazole 400 mg given once
DEC 6 mg/kg + Alb 400 mg x 1AlbendazoleDiethylcarbamazine 6 mg/kg + Albendazole 400 mg given once
DEC + ALB + IVMIvermectinDiethylcarbamazine 6 mg/kg + Albendazole 400 mg + Ivermectin 200 µg/kg administered once only at the beginning of the RCT (0 month)
DEC + ALB + IVMDiethylcarbamazineDiethylcarbamazine 6 mg/kg + Albendazole 400 mg + Ivermectin 200 µg/kg administered once only at the beginning of the RCT (0 month)
DEC + ALB + IVMAlbendazoleDiethylcarbamazine 6 mg/kg + Albendazole 400 mg + Ivermectin 200 µg/kg administered once only at the beginning of the RCT (0 month)
Primary Outcome Measures
NameTimeMethod
Percentage of subjects with total clearance of in Wuchereria bancrofti (Wb) microfilaria (mf)at 36 months
Secondary Outcome Measures
NameTimeMethod
Percentage of subjects with total clearance of Mf at 24 months.24 months
Percent of subjects who become circulating antigen negative at 24 months and 36 months after the beginning of the study24 months and 36 months
Percent reduction in W. bancrofti antigen levels compared to baseline measured at 24 and 36 months24 months and 36 months

Trial Locations

Locations (1)

Papua New Guinean Institute for Medical Research

🇵🇬

Maprik, East Sepik, Papua New Guinea

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