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.: PACTR202408719575384 Date of Approval: 01/08/2024
Trial Status: Registered in accordance with WHO and ICMJE standards
TRIAL DESCRIPTION
Public title MALANOSE: First-in-human dose-escalation phase 1 study of intranasal spraying of artesunate.
Official scientific title First-in-human, single center, open-label, dose-escalation phase 1 study in healthy non-malaria adults to evaluate the safety and pharmacokinetic parameters of unidose UDSp intranasal spraying of artesunate.
Brief summary describing the background and objectives of the trial A rapid and optimal antimalarial treatment is critical to improve the outcome of severe cases. The first-line treatment recommended for severe malaria is intravenous artesunate, a semisynthetic derivative of artemisinin. In rural areas where intravenous treatments are not available, the World Health Organization (WHO) recommends the use of a pre-referral artesunate treatment before addressing the patient to the nearest hospital for appropriate care. The nasal route was described as an alternative to parenteral and oral routes [15]. It is better accepted than the rectal route and it avoids the first-pass hepatic metabolism. This phase 1 study aims to determine the safety and the pharmacokinetic (PK) parameters of intranasal administration of artesunate powder in healthy non-malaria adult volunteers.
Type of trial Non-Randomised
Acronym (If the trial has an acronym then please provide) MALANOSE 1
Disease(s) or condition(s) being studied Infections and Infestations
Sub-Disease(s) or condition(s) being studied Malaria
Purpose of the trial Treatment: Other
Anticipated trial start date 05/08/2024
Actual trial start date 12/08/2024
Anticipated date of last follow up 30/11/2024
Actual Last follow-up date 31/12/2024
Anticipated target sample size (number of participants) 12
Actual target sample size (number of participants)
Recruitment status Not yet recruiting
Publication URL
Secondary Ids Issuing authority/Trial register
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 Non-randomised Allocation was determined by the holder of the sequence who is situated off site Open-label(Masking Not Used)
INTERVENTIONS
Intervention type Intervention name Dose Duration Intervention description Group size Nature of control
Experimental Group Moderate dose Artesunate intranasal doses 1 mg/kg Artesunate powder per dose, once. 24 hours. Dose will be administrate once and participants will be followed for 24 hours to evaluate the pharmacokinetics of the drug 1 m g/kg of Artesunate powder will be administrated once by intranasal route and followed for 24 hours post administration. Whole blood will be collected immediately after administration of artesunate, and at 5, 20, 40 minutes, and 1, 2, 4, 6, 8 hours using the PVC. These samples will be sused to assess Artesunate and dihydroartemisinin Cmax, Tmax and AUC0-24h. Systemic and local adverses events will be assessed 4
Control Group Low dose intranasal artesunate 0.5 mg/kg artesunate powder per dose 24 hours 0.5 mg/kg of Artesunate powder will be administrated once by intranasal route and participants will be followed for 24 hours post administration. Whole blood will be collected immediately after administration of artesunate, and at 5, 20, 40 minutes, and 1, 2, 4, 6, 8 hours using the PVC. These samples will be sused to assess Artesunate and dihydroartemisinin Cmax, Tmax and AUC0-24h. Systemic and local adverses events will be assessed 4 Dose Comparison
Experimental Group High dose intranasal artesunate 2.4 mg /kg of Artesunate powder once 24 hours 2.4 mg/kg of Artesunate powder will be administrated once by intranasal route and followed for 24 hours post administration. Whole blood will be collected immediately after administration of artesunate, and at 5, 20, 40 minutes, and 1, 2, 4, 6, 8 hours using the PVC. These samples will be sused to assess Artesunate and dihydroartemisinin Cmax, Tmax and AUC0-24h. 4
ELIGIBILITY CRITERIA
List inclusion criteria List exclusion criteria Age Category Minimum age Maximum age Gender
Potential subjects are required to meet all of the following criteria for enrollment into the study: Healthy adults between the ages 18-25 (inclusive); Able and willing to provide written, informed consent; Able and willing to comply with all research requirements, in the opinion of the Investigator; Axillary temperature < 37.5°C Laboratory Criteria within 10 days before enrollment: Hemoglobin ≥ 11.7 g/dL for women; ≥ 12.0 g/dL for men; White Blood Cell count = 3,800-10,800 cells/mm3; Platelets = >140,000/mm Subjects meeting any of the following criteria are not eligible for inclusion in this study. 1. Ages < 18 or > 25; 2. Pregnant or lactating female 3. Not able or not willing to provide written, informed consent; 4. Signs and symptoms of severe or non-severe malaria according to WHO 2015 criteria 5. Active infections including tuberculosis 6. Axillary temperature ≥ 37.5°C 7. Any confirmed or suspected immunosuppressive or immunodeficient condition, including human immunodeficiency virus (HIV) infection 8. Severe malnutrition (body mass index (BMI) less than 70% of median normalized WHO reference weight) 7. Severe vomiting (defined as more than 3 times in the 24 hours prior to inclusion in the study) or severe diarrhea (defined as more than 3 watery stools in the 24 hours prior to inclusion in the study) 8. Anemia (Hemoglobin level < 11.7 g/dL) 9. History of malignancy of any organ system (other than localized basal cell carcinoma of the skin or in situ cervical cancer), treated or untreated, within the past 5 years, regardless of whether there is evidence of local recurrence or metastases 10. Known chronic underlying disease such as sickle cell disease, and severe cardiac, renal, or hepatic impairment 11. Known active or uncontrolled ear, nose and throat (ENT) disease 12. Inability to tolerate oral medication (in tablet and/or liquid form) 13. Patients with prior antimalarial therapy within minimum of 4 weeks 14. Use of other investigational drugs within 5 half-lives of enrollment, or within 30 days or until the expected pharmacodynamic effect has returned to baseline, whichever is longer 15. History or family history of long QT syndrome or sudden cardiac death, or any other clinical condition known to prolong the QTc interval, such as history of symptomatic cardiac arrhythmias, clinically relevant bradycardia or severe heart disease 16. History of hypersensitivity to artesunate and dihydroartemisinin, or its excipients or to drugs of similar chemical classes Adolescent: 13 Year-18 Year,Adult: 19 Year-44 Year 18 Year(s) 25 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 24/04/2024 Ethics comittee of USTTB
Ethics Committee Address
Street address City Postal code Country
Faculty of medicine and odonto-stomatology, Point G Bamako 1805 Mali
OUTCOMES
Type of outcome Outcome Timepoint(s) at which outcome measured
Primary Outcome To assess the pharmacokinetic parameters of intranasal administration of artesunate powder. Endpoints: artesunate and dihydroartemisinin Cmax, Tmax and AUC0-24h 5, 20, 40 minutes, and 1, 2, 4, 6, 8, 24 hours post administration of the unique dose of artesunate
Secondary Outcome To evaluate safety and tolerability of intranasal administration of artesunate powder. Endpoints: AE/SAE incidence and severity, hematology tests, electrocardiogram abnormalities 5, 20, 40 minutes, and 1, 2, 4, 6, 8, 24 hours
RECRUITMENT CENTRES
Name of recruitment centre Street address City Postal code Country
Malaria Research and Training Center Clinical site at the National Hospital of Point G BP 1805 Point G Bamako BP 1805 Mali
FUNDING SOURCES
Name of source Street address City Postal code Country
University Claude Bernard Lyon 1 Campus Lyon Tech-la Doua, 69100 Villeurbanne Lyon 69100 France
SPONSORS
Sponsor level Name Street address City Postal code Country Nature of sponsor
Primary Sponsor University of sciences techniques and technologies of Bamako Hamdalaye ACI Rue 405 porte 359 Bamako E 423 Mali University
COLLABORATORS
Name Street address City Postal code Country
Malaria Research unit 2 Rue Victor Grignard Lyon 69100 France
CONTACT PEOPLE
Role Name Email Phone Street address
Principal Investigator Karim Traore karim@icermali.org +22376729939 FMOS-MRTC-Parasitology, Point G
City Postal code Country Position/Affiliation
Bamako 1805 Mali Senior researcher
Role Name Email Phone Street address
Scientific Enquiries Mahamadou Ali Thera mthera@icermali.org +22376105289 FMOS-MRTC-Parasitology
City Postal code Country Position/Affiliation
Bamako 1805 Mali Scientific Director
Role Name Email Phone Street address
Scientific Enquiries Stephane Picot stephane.picot@univ-lyon1.fr +33625540132 2 Rue Victor Grignard
City Postal code Country Position/Affiliation
Lyon 69100 France Co principal investigator
Role Name Email Phone Street address
Scientific Enquiries Drissa Coulibaly coulibalyd@icermali.org +22376328752 FMOS-MRCT-Parasitology
City Postal code Country Position/Affiliation
Bamako 1805 Mali Senior researcher
Role Name Email Phone Street address
Public Enquiries Anne Lise Bienvenu anne-lise.bienvenu@univ-lyon1.fr +33625540132 2 rue Victor Grignard
City Postal code Country Position/Affiliation
Lyon 69100 France Hospital practcian
REPORTING
Share IPD Description Additional Document Types Sharing Time Frame Key Access Criteria
Yes Individual patient data of this trial include the sociodemographic data, the heamtological and biochimistry data as well as the pharmacokinetics data. These data will be included in a data base under a deidentified format. After completion of the participants follow-up and the data analysis, the data base will be available on demand. Analytic Code,Clinical Study Report,Statistical Analysis Plan,Study Protocol Data base will be posted on this site within 12 months upon the study completion and analysis completed. Data base can be also shared on demand at any time once the data analysis is completed Preliminary data will be available on the site, addtional data can be provided on demand to the PI and the sponsor
URL Results Available Results Summary Result Posting Date First Journal Publication Date
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