Pan African Clinical Trials Registry

South African Medical Research Council, South African Cochrane Centre
PO Box 19070, Tygerberg, 7505, South Africa
Telephone: +27 21 938 0506 / +27 21 938 0834 Fax: +27 21 938 0836
Email: pactradmin@mrc.ac.za Website: pactr.samrc.ac.za
Trial no.: PACTR202401595629450 Date of Approval: 15/01/2024
Trial Status: Registered in accordance with WHO and ICMJE standards
TRIAL DESCRIPTION
Public title A Phase 4 Study of a 3-Day vs. 7-Day Regimen of Doxycycline for the Treatment of Chlamydial Infection
Official scientific title A Phase 4 Study of a 3-Day vs. 7-Day Regimen of Doxycycline for the Treatment of Chlamydial Infection
Brief summary describing the background and objectives of the trial This is a Phase 4 blinded, randomized, active-controlled, non-inferiority trial. Persons of any gender identity will be eligible. Final evaluable population will include a minimum 596 individuals: 298 persons assigned female sex at birth (AFAB) with confirmed urogenital chlamydia (CT) and 298 persons assigned male at birth (AMAB) with confirmed rectal chlamydia (CT). Approximately 664 participants will be enrolled to achieve a minimum 596 participants who contribute primary outcome data. Randomization will be stratified by study site and sex at birth: 332 persons assigned female sex at birth (AFAB) and 332 persons assigned male sex at birth (AMAB). Participants will be randomized 1:1 to a 3-day regimen of doxycycline or a 7-day regimen of doxycycline. The study blind will be maintained by providing 7 days of identical pre-filled blister packs, one with 3 days of active treatment and 4 days of placebo, and the other with 7 days of active treatment. Participants will be asked to return 28 days after randomization (at day 29), at which time they will be re-tested for chlamydia (CT) using a laboratory-based chlamydia (CT) nucleic acid amplification test (NAAT). The primary objective is to compare the efficacy of a 3-day vs. 7-day regimen of doxycycline for treatment of urogenital chlamydia (CT) infection in persons assigned female sex at birth (AFAB) based on proportion of participants with microbiologic cure (negative nucleic acid amplification test [NAAT] of vaginal swab and no positive nucleic acid amplification test (NAAT) of vaginal swab between study treatment and Day 29) at Day 29. Also, to compare the efficacy of a 3-day vs. 7-day regimen of doxycycline for treatment of rectal chlamydia (CT) infection in persons assigned male sex at birth (AMAB) based on proportion of participants with microbiologic cure (negative nucleic acid amplification test (NAAT) of rectal swab and no positive nucleic acid amplification test (NAAT) of rectal swab between study treatment and Day 29) at Day 29. The secondary objectives are to compare the efficacy of a 3-day vs. 7-day regimen of doxycycline for treatment of rectal CT infection in persons AFAB based on microbiologic cure. Also, to compare the efficacy of a 3-day vs. 7-day regimen of doxycycline for treatment of urethral CT infection in persons AMAB based on microbiologic cure. In addition, compare the efficacy of a 3-day vs. 7-day regimen of doxycycline for treatment of total CT infection (any anatomic site) in persons AFAB and AMAB based on microbiologic cure. Lastly, to compare the efficacy of a 3-day vs. 7-day regimen of doxycycline for treatment of rectal CT infection in persons AMAB based on microbiologic cure, stratified by lymphogranuloma venereum (LGV) status.
Type of trial RCT
Acronym (If the trial has an acronym then please provide)
Disease(s) or condition(s) being studied Infections and Infestations
Sub-Disease(s) or condition(s) being studied Chlamydial Infection
Purpose of the trial Treatment: Drugs
Anticipated trial start date 15/12/2023
Actual trial start date
Anticipated date of last follow up 15/12/2025
Actual Last follow-up date
Anticipated target sample size (number of participants) 664
Actual target sample size (number of participants)
Recruitment status Not yet recruiting
Publication URL https://clinicaltrials.gov/study/NCT05840159
Secondary Ids Issuing authority/Trial register
220019 Division of Microbiology and Infectious Diseases
NCT05840159 ClinicalTrials.gov
4841 KEMRI SERU
STUDY DESIGN
Intervention assignment Allocation to intervention If randomised, describe how the allocation sequence was generated Describe how the allocation sequence/code was concealed from the person allocating the participants to the intervention arms Masking If masking / blinding was used
Parallel: different groups receive different interventions at same time during study Randomised Permuted block randomization Allocation was determined by the holder of the sequence who is situated off site Masking/blinding used Care giver/Provider,Outcome Assessors,Participants
INTERVENTIONS
Intervention type Intervention name Dose Duration Intervention description Group size Nature of control
Experimental Group Doxycycline and Placebo 100 mg twice daily 3 days 100 mg of doxycycline orally administered twice daily for 3 days and 4 days of placebo (mannitol powder) to assigned female at birth (AFAB) participants >/= 16 years old with confirmed urogenital Chlamydia trachomatis (CT). N=166. 166
Control Group Doxycycline 100 mg twice daily 7 days 100 mg of doxycycline orally administered twice daily for 7 days to assigned female at birth (AFAB) participants >/= 16 years old with confirmed urogenital Chlamydia trachomatis (CT). 166 Active-Treatment of Control Group
Experimental Group Doxycycline and Placebo 100 mg twice daily 3 days 100 mg of doxycycline orally administered twice daily for 3 and 4 days of placebo days to assigned male at birth (AMAB) participants >/= 16 years old with confirmed rectal Chlamydia trachomatis (CT). 166
Control Group Doxycycline 100 mg twice daily 7 days 100 mg of doxycycline orally administered twice daily for 7 days to assigned male at birth (AMAB) participants >/= 16 years old with confirmed rectal Chlamydia trachomatis (CT). 166 Active-Treatment of Control Group
ELIGIBILITY CRITERIA
List inclusion criteria List exclusion criteria Age Category Minimum age Maximum age Gender
1. Has untreated urogenital chlamydia (CT) (in persons assigned female sex at birth (AFAB)) or rectal CT (in persons assigned male sex at birth (AMAB)), diagnosed with a positive nucleic acid amplification test (NAAT) result or point-of care test * result within 14 days *Point-of-care test may or may not be FDA-cleared for CLIA waiver for diagnosis depending upon anatomic site of infection 2. Must be age ≥16 years (where the IRB permits individuals aged 16-17 years old to consent to research); otherwise age > 18 years 3. Willing and able to understand and provide written informed consent before initiation of any study procedures 4. Willing to complete a 7-day study drug regimen 5. Willing to abstain from condomless anal or vaginal sex during the trial 6. Willing and able to adhere to planned study procedures for all study visits 7. Has valid contact information 1. For persons AFAB: lower abdominal or pelvic pain or other signs or symptoms consistent with a clinical diagnosis of pelvic inflammatory disease (PID). 2. Signs and symptoms that, in the judgement of a qualified clinician, warrant a prolonged course of treatment with doxycycline. 3. Received antimicrobial therapy active against C. trachomatis within 21 days prior to positive CT test result, or between the positive CT test result and study enrollment. 4. Planning to take antimicrobial therapy active against CT during the study period (e.g. doxycycline post-exposure prophylaxis, treatment for mycoplasma genitalium infection, acne, or any other non-STI medical condition). 5. Currently enrolled in or plan to enroll in another study using antimicrobial therapy active against C. trachomatis during the study period. 6. Pregnant or lactating, or plan to become pregnant within the study period. 7. Known moderate to severe allergy to tetracyclines, excluding tetracycline-induced photosensitivity. 8. Plan to move or travel to another location that would preclude study follow-up appointments in clinic in the next 30 days. 9. Use of a medication contraindicated to treatment with doxycycline within 7 days prior to enrollment or during the study period (systemic retinoids, barbiturates, carbamazepine, phenytoin, warfarin). 10. Previous enrollment in this trial. 11. Any condition that, in the judgment of the investigator, precludes participation because it could affect participant safety or determination of study endpoints. Of note, the following factors will NOT exclude participants from the study: Concomitant untreated gonorrhea (rectal, pharyngeal, or urethral) or known exposure to gonorrhea in the time between CT testing and study enrollment. Gonococcus (GC) infection identified during the course of pre-screening or screening will be treated with a single dose of ceftriaxone 500mg IM without concomitant azithromycin treatment. Clinical diagnosis of concomitant untreated untreated primary or secondary syphilis or known exposure to syphilis Urethritis among persons AMAB Contraception status Diagnosis of HIV 80 and over: 80+ Year,Adolescent: 13 Year-18 Year,Adult: 19 Year-44 Year,Aged: 65+ Year(s),Middle Aged: 45 Year(s)-64 Year(s) 18 Year(s) 100 Year(s) Both
ETHICS APPROVAL
Has the study received appropriate ethics committee approval Date the study will be submitted for approval Date of approval Name of the ethics committee
Yes 12/12/2023 KEMRI SERU
Ethics Committee Address
Street address City Postal code Country
P.O. BOX 54840 00200 OFF MBAGATHI ROAD Nairobi 00200 Kenya
Has the study received appropriate ethics committee approval Date the study will be submitted for approval Date of approval Name of the ethics committee
Yes 15/01/2024 KEMRI SERU
Ethics Committee Address
Street address City Postal code Country
P.O. BOX 54840 00200 OFF MBAGATHI ROAD Nairobi 00200 Kenya
OUTCOMES
Type of outcome Outcome Timepoint(s) at which outcome measured
Primary Outcome Proportion of assigned female at birth (AFAB) participants with microbiologic cure as detected via vaginal swab. A participant with microbiologic cure is defined as having a negative Chlamydia trachomatis (CT) Nucleic Acid Amplification Test (NAAT) at Day 29 and no positive CT NAATs between study treatment and Day 29. Day 1 through Day 29
Primary Outcome Proportion of assigned male at birth (AMAB) participants with microbiologic cure as detected via rectal swab. A participant with microbiologic cure is defined as having a negative Chlamydia trachomatis (CT) Nucleic Acid Amplification Test (NAAT) at Day 29 and no positive CT NAATs between study treatment and Day 29 Day 1 through Day 29
Secondary Outcome Proportion of assigned female at birth (AFAB) participants with microbiologic cure as detected via rectal swab. A participant with microbiologic cure is defined as having a negative Chlamydia trachomatis (CT) Nucleic Acid Amplification Test (NAAT) at Day 29 and no positive CT NAATs between study treatment and Day 29. Day 1 through Day 29
Secondary Outcome Proportion of assigned female at birth (AFAB) participants with microbiologic cure at all anatomic sites that were positive at baseline. A participant with microbiologic cure is defined as having a negative Chlamydia trachomatis (CT) Nucleic Acid Amplification Test (NAAT) at Day 29 and no positive CT NAATs between study treatment and Day 29. Day 1 through Day 29
Secondary Outcome Proportion of assigned male at birth (AMAB) participants with microbiologic cure as detected via urine. A participant with microbiologic cure is defined as having a negative Chlamydia trachomatis (CT) Nucleic Acid Amplification Test (NAAT) at Day 29 and no positive CT NAATs between study treatment and Day 29. Day 1 through Day 29
Secondary Outcome Proportion of assigned male at birth (AMAB) participants with microbiologic cure at all anatomic sites that were positive at baseline A participant with microbiologic cure is defined as having a negative Chlamydia trachomatis (CT) Nucleic Acid Amplification Test (NAAT) at Day 29 and no positive CT NAATs between study treatment and Day 29 Day 1 through Day 29
Secondary Outcome Proportion of lymphogranuloma venereum (LGV)-negative assigned male at birth (AMAB) participants with microbiologic cure as detected via rectal swab. A participant with microbiologic cure is defined as having a negative Chlamydia trachomatis (CT) Nucleic Acid Amplification Test (NAAT) at Day 29 and no positive CT NAATs between study treatment and Day 29. Day 1 through Day 29
Secondary Outcome Proportion of lymphogranuloma venereum (LGV)-positive assigned male at birth (AMAB) participants with microbiologic cure as detected via rectal swab. A participant with microbiologic cure is defined as having a negative Chlamydia trachomatis (CT) Nucleic Acid Amplification Test (NAAT) at Day 29 and no positive CT NAATs between study treatment and Day 29. Day 1 through Day 29
RECRUITMENT CENTRES
Name of recruitment centre Street address City Postal code Country
Pwani Research Centre PO Box 91276 80103 Mnazi Mmoja Road opposite Mombasa Sports Club Mombasa 80103 Kenya
Partners in Health and Research Development CCR KEMRI OAU Road, Thika Section 9 Thika Kenya
Emory University Hospital Midtown 550 Peachtree Street, NE Atlanta GA 30308 United States of America
Emory Ponce Clinical Research Site 341 Ponce De Leon Ave NE, Atlanta, GA 30308 Atlanta GA 30308 United States of America
Monroe County Sexual Health Clinic University of Rochester 819 W Main St, Rochester, NY 14611, United States Rochester NY 14611 United States of America
University of Washington Harborview 908 Jefferson St, Seattle, WA 98104, United States Seattle WA 98104 United States of America
FUNDING SOURCES
Name of source Street address City Postal code Country
National Institute of Allergy and Infectious Diseases 5601 Fishers Lane MSC 9806 Bethesda, MD 20892-9806 Bethesda MD United States of America
SPONSORS
Sponsor level Name Street address City Postal code Country Nature of sponsor
Primary Sponsor Division of Microbiology and Infectious Diseases 5601 Fishers Lane MSC 9806 Bethesda, MD 20892-9806 Bethesda MD United States of America Funding Agency
COLLABORATORS
Name Street address City Postal code Country
Partners in Health and Research Development CCR KEMRI OAU, Thika Section 9 Thika Kenya
CONTACT PEOPLE
Role Name Email Phone Street address
Principal Investigator R. Scott McClelland mcclell@uw.edu +12065434278 325 9th Avenue Seattle, WA 98104
City Postal code Country Position/Affiliation
Seattle WA 98104 United States of America VTEU Principal Investigator
Role Name Email Phone Street address
Scientific Enquiries Julia Dombrowski jdombrow@uw.edu +12067445640 359777 Seattle, WA
City Postal code Country Position/Affiliation
Seattle WA 359777 United States of America Protocol PI
Role Name Email Phone Street address
Public Enquiries Melinda Tibbals melinda.tibbals@nih.gov +12406273387 NA
City Postal code Country Position/Affiliation
NA United States of America Project Manager
REPORTING
Share IPD Description Additional Document Types Sharing Time Frame Key Access Criteria
Yes Individual participant data will not be made public. Summary results or a link to summary results will be provided. Informed Consent Form,Study Protocol Study updates are shared annually to IRB. Complete IPD will be shared by sponsor at end of study as this is a multisite trial. Open Access at https://clinicaltrials.gov/study/NCT05840159. Digital archive PubMed Central upon acceptance for publication. Additional requests will require sponsor approval
URL Results Available Results Summary Result Posting Date First Journal Publication Date
https://clinicaltrials.gov/study/NCT05840159 No
Result Upload 1: Result Upload 2: Result Upload 3: Result Upload 4: Result Upload 5:
Result URL Hyperlinks Link To Protocol
Result URL Hyperlinks
Changes to trial information