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Primaquine Enantiomers in G6PD Deficient Human Volunteers

Phase 1
Completed
Conditions
G6PD Deficiency
Interventions
Drug: SPQ
Drug: Placebo
Drug: RPQ
Registration Number
NCT04073953
Lead Sponsor
University of Mississippi, Oxford
Brief Summary

This study is a single center, prospective, cross-over phase 1 trial. Eighteen subjects will be enrolled in the study evaluating the metabolism, pharmacokinetic behavior and tolerability of primaquine enantiomers and placebo over the course of 5 days.

Detailed Description

Each subject will receive a 15 mg dose of one enantiomer (SPQ or RPQ or Placebo) daily for up to 5 days, with careful monitoring of hematological parameters before and after each dose. In addition to the general CMP14 safety criteria, any subject who displays a fractional hemoglobin drop of 15% below his/her baseline value, then drug administration will stop (e.g. for baseline Hgb of 14 g/dL, if there is at any point a decrease of 2.1 g/dL). Hematocrit will be similarly monitored, with proportional stop criteria. Elevation in total bilirubin to 2.0 mg/dL or greater will also be used as a stopping criterion. After stopping drug administration (5 days or whenever stop criteria are met), subjects will have a 3-week washout period, and the study repeated with the other enantiomer, and similarly with Placebo.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
18
Inclusion Criteria
  • G6PD deficient, otherwise normal healthy adults aged 18 to 65
Exclusion Criteria
  • Known history of liver, kidney or hematological disease (other than G6PD deficiency)
  • Known history of cardiac disease, non-sinus rhythm arrhythmia or QT prolongation
  • Autoimmune disorders
  • Report of an active infection
  • Subject is pregnant or breast-feeding, or is expecting to conceive during the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
SPQ (+) enantiomerSPQCohort 1 will receive 15mg of SPQ every day for 5 days. Cohort 2 will receive 22.5 mg of SPQ every day for five days.
PlaceboPlaceboCohort 1 will receive placebo capsules every day for 5 days. Cohort 2 will receive placebo capsules every day for five days.
RPQ (-) enantiomerRPQCohort 1 will receive 15mg of RPQ every day for 5 days. Cohort 2 will receive 22.5 mg of RPQ every day for five days.
Primary Outcome Measures
NameTimeMethod
Change in Methemoglobin concentration in blood from baselineDays 0, 3, 5

Change in Methemoglobin concentration in blood from baseline (% hemoglobin)

Secondary Outcome Measures
NameTimeMethod
Change in Hematocrit (%) compared to baselineDays 0, 3, 5

Change in Hematocrit (%) compared to baseline

Primaquine Orthoquinone Plasma concentration, ng/mLDays 0, 3, 5

Plasma concentrations of Primaquine Orthoquinone metabolite

Change in Hemoglobin (g/dL) compared to baselineDays 0, 3, 5

Change in Hemoglobin (g/dL) compared to baseline

Primaquine Plasma Concentration, ng/mLDays 0, 3, 5

Plasma concentrations of parent drug

Carboxy-Primaquine Plasma Contration, ng/mLDays 0, 3, 5

Plasma concentrations of carboxy-primaquine metabolite

Primaquine N-carbamoyl-glucuronide Plasma contration, ng/mLDays 0, 3, 5

Plasma concentrations of Primaquine N-carbamoyl-glucuronide metabolite

Change is AST (U/L) compared to baselineDays 0, 3, 5

Change is AST (U/L) compared to baseline; used to monitor liver function

Change in ALT (U/L) compared to baselineDays 0, 3, 5

Change in ALT (U/L) compared to baseline; used to monitor liver function

Change in total Bilirubin (mg/dL) compared to baselineDays 0, 3, 5

Change in total Bilirubin (mg/dL) compared to baseline; used to monitor liver function and red cell integrity

Trial Locations

Locations (1)

University of Mississippi

🇺🇸

University, Mississippi, United States

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