Trial Outcomes & Findings for TES of Artemether-lumefantrine for Pf and Chloroquine for Pv in the Philippines From 2013-2014 (NCT NCT04222088)

NCT ID: NCT04222088

Last Updated: 2023-07-21

Results Overview

The classification of treatment outcomes will be based on an assessment of the parasitological and clinical outcomes of antimalarial treatment according to the latest guidelines of WHO. Accordingly, all patients will be classified as having an Early Treatment Failure by microscopy results P without PCR correction * Development of danger signs or severe malaria on day 1, day 2, or day 3 in the presence of parasitemia; * Parasitaemia on day 2 higher than day 0 count irrespective of axillary temperature; * Parasitaemia on day 3 with axillary temperature ≥37.5 ºC; * Parasitaemia on day 3 ≥25% of count on day 0.

Recruitment status

COMPLETED

Target enrollment

159 participants

Primary outcome timeframe

Day 1-3

Results posted on

2023-07-21

Participant Flow

Study Sites: 1. Rural Health Unit, Bataraza, Palawan 2. Rural Health Unit, Rizal, Palawan 3. Rural Health Unit, Brooke's Point Palawan Study Period: May 2013 - December 2014

The number of total patients enrolled/started (159) is different from the total number of patients who completed the study (149) due to lost to follow-up and withdrawal of the patients in the middle of the study. Thus, all 159 patients have baseline characteristics and adverse effects, but only 149 patients who completed the study have outcome measurements.

Participant milestones

Participant milestones
Measure
Artemether-lumefantrine (Coartem™) + Primaquine
Administered to patients with mono-infection of Plasmodium falciparum with 1000-100 000 asexual forms per µl. Coartem™: 20/120 mg per tablet was administered 3 days (Days 0, 1 and 2) according to body weight. For patients with weight of 5 to \<15kg, 15 to \<25kg, 25 to \<35kg, or ≥35kg, tablets of 1, 2, 3, or 4 will be given respectively. At day 3, primaquine at 0.75 mg base/kg body weight single dose will be given .
Chloroquine + Primaquine
Administered to patients with mono-infection of Plasmodium vivax with parasite count of ≥ 250 per µl, Chloroquine 150 mg base tablet was administered according to body weight at a total dose of 25 mg/kg over 3 days (10 mg/kg on Day 0; 10 mg/kg on Day 1 and 5 mg/kg on Day 2). After 28 days of follow-up, primaquine will be given for 14 days.
Overall Study
STARTED
84
75
Overall Study
COMPLETED
75
74
Overall Study
NOT COMPLETED
9
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Artemether-lumefantrine (Coartem™) + Primaquine
Administered to patients with mono-infection of Plasmodium falciparum with 1000-100 000 asexual forms per µl. Coartem™: 20/120 mg per tablet was administered 3 days (Days 0, 1 and 2) according to body weight. For patients with weight of 5 to \<15kg, 15 to \<25kg, 25 to \<35kg, or ≥35kg, tablets of 1, 2, 3, or 4 will be given respectively. At day 3, primaquine at 0.75 mg base/kg body weight single dose will be given .
Chloroquine + Primaquine
Administered to patients with mono-infection of Plasmodium vivax with parasite count of ≥ 250 per µl, Chloroquine 150 mg base tablet was administered according to body weight at a total dose of 25 mg/kg over 3 days (10 mg/kg on Day 0; 10 mg/kg on Day 1 and 5 mg/kg on Day 2). After 28 days of follow-up, primaquine will be given for 14 days.
Overall Study
Lost to Follow-up
5
1
Overall Study
Withdrawal by Subject
4
0

Baseline Characteristics

Analysis of population was categorically subdivided depending on the period of enrollment

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Artemether-lumefantrine (Coartem™) + Primaquine
n=84 Participants
Administered to patients with mono-infection of Plasmodium falciparum with 1000-100 000 asexual forms per µl. Coartem™: 20/120 mg per tablet was administered 3 days (Days 0, 1 and 2) according to body weight. For patients with weight of 5 to \<15kg, 15 to \<25kg, 25 to \<35kg, or ≥35kg, tablets of 1, 2, 3, or 4 will be given respectively. At day 3, primaquine at 0.75 mg base/kg body weight single dose will be given.
Chloroquine + Primaquine
n=75 Participants
Administered to patients with mono-infection of Plasmodium vivax with parasite count of ≥ 250 per µl, Chloroquine 150 mg base tablet was administered according to body weight at a total dose of 25 mg/kg over 3 days (10 mg/kg on Day 0; 10 mg/kg on Day 1 and 5 mg/kg on Day 2). After 28 days of follow-up, primaquine will be given for 14 days.
Total
n=159 Participants
Total of all reporting groups
Age, Continuous
13.52 years
n=84 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
10.26 years
n=75 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
11.98 years
n=159 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
Age, Customized
>15 years old
20 Participants
n=84 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
22 Participants
n=75 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
42 Participants
n=159 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
Age, Customized
5 - 15 years old
48 Participants
n=84 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
24 Participants
n=75 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
72 Participants
n=159 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
Age, Customized
<5 years old
16 Participants
n=84 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
29 Participants
n=75 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
45 Participants
n=159 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
Sex: Female, Male
Female
37 Participants
n=84 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
21 Participants
n=75 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
58 Participants
n=159 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
Sex: Female, Male
Male
47 Participants
n=84 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
54 Participants
n=75 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
101 Participants
n=159 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Weight (mean, sd)
27.23 kg
STANDARD_DEVIATION 15.62 • n=84 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
25.58 kg
STANDARD_DEVIATION 17.72 • n=75 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
26.45 kg
STANDARD_DEVIATION 16.61 • n=159 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
Weight (mean, full range)
27.23 kg
n=84 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
25.58 kg
n=75 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
26.45 kg
n=159 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
Temperature Day 0(mean, SD)
38.1 degrees celcius
STANDARD_DEVIATION 1.3 • n=84 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
38.0 degrees celcius
STANDARD_DEVIATION 1.1 • n=75 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
38.0 degrees celcius
STANDARD_DEVIATION 1.2 • n=159 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
Temperature Day 0 (mean, full range)
38.1 degrees Celcius
n=84 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
38.0 degrees Celcius
n=75 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
38.0 degrees Celcius
n=159 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
Parasitemia Day 0
16860 uL
n=84 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
5514 uL
n=75 Participants • Analysis of population was categorically subdivided depending on the period of enrollment
9952 uL
n=159 Participants • Analysis of population was categorically subdivided depending on the period of enrollment

PRIMARY outcome

Timeframe: Day 1-3

Population: Analysis of population is categorically subdivided depending on the period of enrollment of participants to the study

The classification of treatment outcomes will be based on an assessment of the parasitological and clinical outcomes of antimalarial treatment according to the latest guidelines of WHO. Accordingly, all patients will be classified as having an Early Treatment Failure by microscopy results P without PCR correction * Development of danger signs or severe malaria on day 1, day 2, or day 3 in the presence of parasitemia; * Parasitaemia on day 2 higher than day 0 count irrespective of axillary temperature; * Parasitaemia on day 3 with axillary temperature ≥37.5 ºC; * Parasitaemia on day 3 ≥25% of count on day 0.

Outcome measures

Outcome measures
Measure
Artemether-lumefantrine (Coartem™) + Primaquine
n=75 Participants
Administered to patients with mono-infection of Plasmodium falciparum with 1000-100 000 asexual forms per µl. Coartem™: 20/120 mg per tablet was administered 3 days (Days 0, 1 and 2) according to body weight. For patients with weight of 5 to \<15kg, 15 to \<25kg, 25 to \<35kg, or ≥35kg, tablets of 1, 2, 3, or 4 will be given respectively. At day 3, primaquine at 0.75 mg base/kg body weight single dose will be given.
Chloroquine + Primaquine
n=74 Participants
Administered to patients with mono-infection of Plasmodium vivax with parasite count of ≥ 250 per µl, Chloroquine 150 mg base tablet was administered according to body weight at a total dose of 25 mg/kg over 3 days (10 mg/kg on Day 0; 10 mg/kg on Day 1 and 5 mg/kg on Day 2). After 28 days of follow-up, primaquine will be given for 14 days.
Early Treatment Failure (ETF)
0 participants
Interval 0.0 to 4.8
0 participants
Interval 0.0 to 4.9

PRIMARY outcome

Timeframe: Day 4-28

Population: Analysis of population is categorically subdivided depending on the period of enrollment of participants in the study

Patients with late clinical failure without PCR correction: * Development of danger signs or severe malaria on any day from day 4 to day 28 in the presence of parasitaemia, without previously meeting any of the criteria of Early Treatment Failure; * Presence of parasitemia and axillary temperature ≥37.5 ºC (or history of fever in low/moderate transmission areas) on any day from day 4 to day 28, without previously meeting any of the criteria of Early Treatment Failure.

Outcome measures

Outcome measures
Measure
Artemether-lumefantrine (Coartem™) + Primaquine
n=75 Participants
Administered to patients with mono-infection of Plasmodium falciparum with 1000-100 000 asexual forms per µl. Coartem™: 20/120 mg per tablet was administered 3 days (Days 0, 1 and 2) according to body weight. For patients with weight of 5 to \<15kg, 15 to \<25kg, 25 to \<35kg, or ≥35kg, tablets of 1, 2, 3, or 4 will be given respectively. At day 3, primaquine at 0.75 mg base/kg body weight single dose will be given.
Chloroquine + Primaquine
n=74 Participants
Administered to patients with mono-infection of Plasmodium vivax with parasite count of ≥ 250 per µl, Chloroquine 150 mg base tablet was administered according to body weight at a total dose of 25 mg/kg over 3 days (10 mg/kg on Day 0; 10 mg/kg on Day 1 and 5 mg/kg on Day 2). After 28 days of follow-up, primaquine will be given for 14 days.
Late Clinical Failure (LCF)
1 participants
Interval 0.0 to 7.2
0 participants
Interval 0.0 to 4.9

PRIMARY outcome

Timeframe: day 7 to day 28

Population: Analysis of population is categorically subdivided depending on the period of enrollment of participants in the study

Patients with late parasitological failure without PCR correction: • Presence of parasitemia on any day from day 7 to day 28 and axillary temperature \<37.5 ºC, without previously meeting any of the criteria of Early Treatment Failure or Late Clinical Failure.

Outcome measures

Outcome measures
Measure
Artemether-lumefantrine (Coartem™) + Primaquine
n=75 Participants
Administered to patients with mono-infection of Plasmodium falciparum with 1000-100 000 asexual forms per µl. Coartem™: 20/120 mg per tablet was administered 3 days (Days 0, 1 and 2) according to body weight. For patients with weight of 5 to \<15kg, 15 to \<25kg, 25 to \<35kg, or ≥35kg, tablets of 1, 2, 3, or 4 will be given respectively. At day 3, primaquine at 0.75 mg base/kg body weight single dose will be given.
Chloroquine + Primaquine
n=74 Participants
Administered to patients with mono-infection of Plasmodium vivax with parasite count of ≥ 250 per µl, Chloroquine 150 mg base tablet was administered according to body weight at a total dose of 25 mg/kg over 3 days (10 mg/kg on Day 0; 10 mg/kg on Day 1 and 5 mg/kg on Day 2). After 28 days of follow-up, primaquine will be given for 14 days.
Late Parasitological Failure (LPF)
0 participants
Interval 0.0 to 4.8
2 participants
Interval 0.3 to 9.4

PRIMARY outcome

Timeframe: Day 0-28

Population: Analysis of population is categorically subdivided depending on the period pf enrollment of the participant in the study

Adequate Clinical and Parasitological Response (ACPR): Absence of parasitemia on day 28 irrespective of axillary temperature without previously meeting any of the criteria of Early Treatment Failure or Late Clinical Failure or Late Parasitological Failure.

Outcome measures

Outcome measures
Measure
Artemether-lumefantrine (Coartem™) + Primaquine
n=75 Participants
Administered to patients with mono-infection of Plasmodium falciparum with 1000-100 000 asexual forms per µl. Coartem™: 20/120 mg per tablet was administered 3 days (Days 0, 1 and 2) according to body weight. For patients with weight of 5 to \<15kg, 15 to \<25kg, 25 to \<35kg, or ≥35kg, tablets of 1, 2, 3, or 4 will be given respectively. At day 3, primaquine at 0.75 mg base/kg body weight single dose will be given.
Chloroquine + Primaquine
n=74 Participants
Administered to patients with mono-infection of Plasmodium vivax with parasite count of ≥ 250 per µl, Chloroquine 150 mg base tablet was administered according to body weight at a total dose of 25 mg/kg over 3 days (10 mg/kg on Day 0; 10 mg/kg on Day 1 and 5 mg/kg on Day 2). After 28 days of follow-up, primaquine will be given for 14 days.
Adequate Clinical and Parasitological Response (ACPR)
74 Participants
72 Participants

Adverse Events

Artemether-lumefantrine (Coartem™) + Primaquine

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Chloroquine + Primaquine

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Fe Esperanza Caridad J. Espino

Research Institute for Tropical Medicine

Phone: 63288072628

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place