Efficacy and Safety of High-dose Ivermectin for Reducing Malaria Transmission: A Dose Finding Study

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

141 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-31

Study Completion Date

2016-07-31

Brief Summary

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In western Kenya the prevalence of malaria in \<5 year olds has fallen from 70% in 1997 to 40% in 2008, where it has now stagnated. Innovative approaches are needed to continue towards elimination. Ivermectin is a broad spectrum antiparasitic endectocide widely used for the control of onchocerciasis and lymphatic filariasis at a dose of 150-200 mcg/kg. Ivermectin at this dose has a potent, but short-lived effect for 6-11 days on mosquito survival, egg-laying, and parasite sporogony. Higher doses are needed to prolong its mosquitocidal effects. Previous studies have shown ivermectin is very well tolerated and safe even up to 2,000 mcg/kg. This dose finding study will evaluate the transmission blocking effect of high-dose ivermectin to define the optimal dose for future use of ivermectin in combination with artemisinin-based combination therapy (ACT) for mass drug administration (MDA). It explores a research question of global relevance. A prolonged transmission blocking effect of ivermectin could have substantial consequences for malaria control in the next decades. The results are expected to inform national malaria control programs in malaria endemic countries, to inform WHO guidelines, and to contribute to the regulatory process.

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Detailed Description

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Conditions

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Malaria

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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placebo

Standard 3-day course of dihydroartemisinin-piperaquine, plus once a day for 3 days: placebo 600 mcg/kg/day.

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

Placebo for ivermectin.

dihydroartemisinin-piperaquine

Intervention Type DRUG

ivermectin 300 mcg/kg

Standard 3-day course of dihydroartemisinin-piperaquine, plus once a day for 3 days: ivermectin 300 mcg/kg/day and placebo 300 mcg/kg/day.

Group Type EXPERIMENTAL

ivermectin

Intervention Type DRUG

placebo

Intervention Type DRUG

Placebo for ivermectin.

dihydroartemisinin-piperaquine

Intervention Type DRUG

ivermectin 600 mcg/kg

Standard 3-day course of dihydroartemisinin-piperaquine, plus once a day for 3 days: ivermectin 600 mcg/kg/day.

Group Type EXPERIMENTAL

ivermectin

Intervention Type DRUG

dihydroartemisinin-piperaquine

Intervention Type DRUG

Interventions

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ivermectin

Intervention Type DRUG

placebo

Placebo for ivermectin.

Intervention Type DRUG

dihydroartemisinin-piperaquine

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Symptomatic, uncomplicated Plasmodium falciparum infection
* Positive malaria microscopy or malaria RDT (pLDH)
* Age: 18-50 years
* Provide written informed consent
* Agree to be able to travel to clinic on days: 1, 2, 7, 10, 14, 21, and 28

Exclusion Criteria

* Signs or symptoms of severe malaria
* Unable to provide written informed consent
* For women: pregnancy or lactation
* Hypersensitivity to ivermectin or DP
* QTc \>460 ms on ECG
* Body Mass Index (BMI) below 16 or above 32 kg/m2
* Haemoglobin concentration below 9 g/dL
* Taken ivermectin in the last month
* Taken dihydroartemisinin-piperaquine in the last 12 weeks
* Loa loa as assessed by travel history to Angola, Cameroon, Chad, Central African Republic, Congo, DR Congo, Equatorial Guinea, Ethiopia, Gabon, Nigeria and Sudan
* History and/or symptoms indicating chronic illness
* Current use of tuberculosis or anti-retroviral medication
* Previously enrolled in the same study

Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No