Moxidectin Versus Ivermectin as Mass Drug Administration for the Control of Onchocerciasis and Other Neglected Tropical Diseases: A Cluster-randomised Trial

Not Applicable

Recruiting

• Conditions: Onchocerciasis; Ascaris Lumbricoides Infection; Trichuris Trichiura; Infection; Hookworm Infections; Scabies
• Interventions: Drug: Moxidectin; Drug: Ivermectin

• Registration Number: NCT07145736
• Lead Sponsor: Kirby Institute

Brief Summary

This clinical trial compares two treatments - ivermectin and moxidectin - to learn which is better at reducing the proportion of people with onchocerciasis (river blindness) when given through mass drug administration (MDA) in Angola. Both drugs are approved by the United States Food and Drug Administration (FDA) to treat this disease. The study also explores how these treatments affect other infections common in the region, including intestinal worms (soil-transmitted helminths) and scabies.

The trial aims to answer the following key questions:

* How do moxidectin and ivermectin compare in reducing the prevalence (how common the disease is) and intensity (amount of parasites per person) of onchocerciasis in the community?

* Do the treatments differ in their effect on the prevalence and intensity of soil-transmitted helminths and the prevalence of scabies?

* Does moxidectin reduce transmission of onchocerciasis more effectively than ivermectin, based on genetic testing of parasites in people and lab testing of the blackflies that carry the infection?

* How many more years of treatment would be needed to reach elimination with each drug, based on mathematical disease modelling?

* How do communities feel about receiving moxidectin versus ivermectin, and what factors help or make it harder to carry out MDA programs with moxidectin versus ivermectin?

The study takes place in Bié Province, Angola, and involves 20 groups of villages randomly assigned to receive either moxidectin or ivermectin once a year for four years. Prior to every round of MDA, researchers will collect skin, stool and blood samples from a sample of the people living in the study area. We believe the results will help guide global policy on the use of moxidectin in efforts to eliminate onchocerciasis and control related diseases.

Detailed Description

Not available

Study Timeline

• Status Verified: 2025-08
• Study Start: 2025-08-04
• Study First Submitted: 2025-08-21
• Study First Submitted QC: 2025-08-21
• Last Update Submitted: 2025-08-21
• Study First Posted: 2025-08-28
• Last Update Posted: 2025-08-28
• Primary Completion: 2029-03-31
• Study Completion: 2029-06-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 52000

Inclusion Criteria

• Male or female children and adults
• Residents in the villages selected for MDA treatment

Exclusion Criteria

• Arm 1 (ivermectin): children under the age of 5 and/or under 90 cm of height
• Arm 2 (moxidectin): children under the age of 12 years (who will receive ivermectin if they are at least 90 cm in height/5 years of age and above).
• Arm 1 (ivermectin): Women breast-feeding babies under 45 days of age
• Arm 2 (moxidectin): All breastfeeding women (who will be offered ivermectin if their infants is at least 45 days old)
• Know allergy to ivermectin or moxidectin
• Attending other clinical trials during the study
• Pregnant
• Arm 2 (moxidectin): Women planning to become pregnant in the 3 months post-treatment
• Refusal to receive one or both study drugs, i.e. participants in villages allocated to receive moxidectin who refuse to receive moxidectin will be given the option to receive ivermectin; if they refuse to receive both drugs they will be excluded from the MDA altogether
• Has an illness that makes them too sick or weak to get out of bed
• Currently hospitalized

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Moxidectin	Moxidectin	Single oral dose of moxidectin treatment 8 mg (4 tablets of 2 mg of moxidectin), once per year
Ivermectin	Ivermectin	Single oral dose of ivermectin treatment with approximately 150 µg/kg determined based on height (between 1 and 4 tablets of 3 mg of ivermectin), once per year

Primary Outcome Measures

Name	Time	Method
Prevalence of Onchocerca volvulus microfilariae	36 months after the first intervention	Prevalence of O. volvulus microfilariae at 36 months in skin snips, the marker most likely to show change in the shorter term as demonstrated by the therapeutic trials

Secondary Outcome Measures

Name	Time	Method
Prevalence of O. volvulus microfilaria/mg skin	12, 24 and 36 months after the first intervention
Microfilariae density (mean, median)	12, 24 and 36 months after the first intervention
Prevalence of nodules	12, 24 and 36 months after the first intervention
Prevalence of onchocerciasis skin disease	12, 24 and 36 months after the first intervention
Proportion of black flies with infective O. volvulus larvae	12, 24 and 36 months after the first intervention	Infection assessed based on all 3 are markers recommended by WHO to define population-level elimination
Prevalence of anti-Ov-16	12, 24 and 36 months after the first intervention
Prevalence of Ascaris lumbricoides	12, 24 and 36 months after the first intervention
Intensity of Ascaris lumbricoides	12, 24 and 36 months after the first intervention
Prevalence of Trichuris trichiura	12, 24 and 36 months after the first intervention
Intensity of Trichuris trichiura	Baseline and 12, 24 and 36 months after the first intervention
Prevalence of hookworm	12, 24 and 36 months after the first intervention
Intensity of hookworm	12, 24 and 36 months after the first intervention
Prevalence of Strongyloides stercoralis	12, 24 and 36 months after the first intervention
Intensity of Strongyloides stercoralis	12, 24 and 36 months after the first intervention
Prevalence of scabies/impetigo	12, 24 and 36 months after the first intervention

Trial Locations

Locations (1)

Villages in Andulo and Nharea Municipalities; 🇦🇴 Andulo, Bíe Province, Angola