A Phase II Study To Assess Safety and Efficacy Of Short-Course Regimens Of Amphotericin B Emulsion In Kala-Azar

Phase 2

Completed

• Conditions: Visceral Leishmaniasis
• Interventions: Drug: Amphotericin B fat emulsion in visceral leishmaniasis; Drug: Amphotericin B fat emulsion; Drug: Amphotericin B in fat emulsion

• Registration Number: NCT00497601
• Lead Sponsor: Banaras Hindu University

Brief Summary

The purpose of this study is:

1. To evaluate the Safety and Efficacy of four different short-course regimens of Amphotericin B emulsion in treatment of Kala-azar (visceral leishmaniasis) subjects who are either treatment naive or treatment resistant to other antileishmanial drugs except amphotericin B containing preparations.

2. To assess the safety and efficacy of single-bolus infusion of Amphotericin B emulsion in treatment of Kala-azar.

Detailed Description

1. To evaluate the Safety and Efficacy of four different short-course regimens of Amphotericin B emulsion in treatment of Kala-azar (visceral leishmaniasis) subjects who are either treatment naive or treatment resistant to other antileishmanial drugs except amphotericin B containing preparations.

2. To assess the safety and efficacy of single-bolus infusion of Amphotericin B emulsion in treatment of Kala-azar.

Subjects will be administered the study drug in either of the following four dose levels in an ascending manner, starting with the first dosage regimen:

* 7.5 mg/kg on day 1 and day3 (Regimen 1)

* 10 mg/kg on day 1, followed by 5 mg/kg on day 3 (Regimen 2)

* 12.5 mg/kg on day 1, followed by 2.5 mg/kg on day 3 (Regimen 3)

* Single-bolus infusion of 15 mg/kg over 2-4 hours on day 1 (Regimen 4)

Study Timeline

• Study Start: 2007-02
• Study First Submitted: 2007-07-05
• Study First Submitted QC: 2007-07-05
• Study First Posted: 2007-07-06
• Primary Completion: 2008-07
• Study Completion: 2008-07
• Status Verified: 2008-09
• Last Update Submitted: 2008-09-11
• Last Update Posted: 2008-09-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

1. Male or female subjects between 18 years and 65 years of age (both inclusive).
2. Subject/subject's legally acceptable representative is willing and able to give written informed consent to participate in the study.
3. Treatment naive subjects having symptoms and/or signs of visceral leishmaniasis with parasitological confirmation of Kala-azar (by splenic or bone marrow aspirate smear examination).

If subjects are previously treated with other antileishmanial drugs except amphotericin B containing preparations, they will be enrolled in the study only after clinical and parasitological evidence that the disease is unresponsive to adequate treatment with other drugs, and after an appropriate wash out period

Exclusion Criteria

1. Subjects with past history of treatment with Amphotericin B for Kala-azar.
2. Subjects positive for HIV infection.
3. Concomitant life threatening or serious disease.
4. Concurrent malaria (malarial parasite test to be negative prior to study treatment administration), tuberculosis or bacterial pneumonia.
5. Haemoglobin < 6 gm/dl, total leukocyte count < 1,500/cmm, platelet count < 50,000/cmm
6. Abnormal liver and renal functions (BUN and serum creatinine > 1.5 times upper limit of normal (ULN), AST/ALT > 2.5 times ULN, and bilirubin > 1.5 times ULN).
7. Pregnant or nursing women.
8. Known hypersensitivity to Amphotericin B or inactive ingredients of study drug formulation.
9. Subjects receiving any of the medications prohibited by the study protocol.
10. Evidence of significant haematological, cardiac, hepatic, renal, respiratory, neurological or metabolic disease or any condition which, in the opinion of the investigator, might interfere with the evaluation of the study objectives.
11. Simultaneous participation in another trial or received any investigational product < 30 days prior to enrolment.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
A	Amphotericin B fat emulsion in visceral leishmaniasis	Amphotericin B in fat emulsion (Amphomul) 7.5 mg/kg on day 1 and 3
A	Amphotericin B fat emulsion	Amphotericin B in fat emulsion (Amphomul) 7.5 mg/kg on day 1 and 3
A	Amphotericin B in fat emulsion	Amphotericin B in fat emulsion (Amphomul) 7.5 mg/kg on day 1 and 3
B	Amphotericin B fat emulsion in visceral leishmaniasis	Amphotericin B in fat emulsion (Amphomul) 10 mg/kg on day 1 and 5 mg/kg on day 3
B	Amphotericin B fat emulsion	Amphotericin B in fat emulsion (Amphomul) 10 mg/kg on day 1 and 5 mg/kg on day 3
B	Amphotericin B in fat emulsion	Amphotericin B in fat emulsion (Amphomul) 10 mg/kg on day 1 and 5 mg/kg on day 3
C	Amphotericin B fat emulsion in visceral leishmaniasis	Amphotericin B in fat emulsion (Amphomul) 12.5 mg/kg on day 1 and 2.5 mg/kg on day 3
C	Amphotericin B fat emulsion	Amphotericin B in fat emulsion (Amphomul) 12.5 mg/kg on day 1 and 2.5 mg/kg on day 3
C	Amphotericin B in fat emulsion	Amphotericin B in fat emulsion (Amphomul) 12.5 mg/kg on day 1 and 2.5 mg/kg on day 3
D	Amphotericin B fat emulsion in visceral leishmaniasis	Amphotericin B in fat emulsion (Amphomul) 15 mg/kg in a single dose administration on day 1
D	Amphotericin B fat emulsion	Amphotericin B in fat emulsion (Amphomul) 15 mg/kg in a single dose administration on day 1
D	Amphotericin B in fat emulsion	Amphotericin B in fat emulsion (Amphomul) 15 mg/kg in a single dose administration on day 1

Primary Outcome Measures

Name	Time	Method
Clinical and parasitological cure at end of treatment and final cure (no relapse) at six months, no hematological, hepatic or renal toxicity	one year

Trial Locations

Locations (1)

Kala-azar Medical Research Center; 🇮🇳 Muzaffarpur, Bihar, India