Onchocerciasis
Conditions
Keywords
onchocerciasis, onchocerca volvulus, river blindness, ivermectin, moxidectin
Brief summary
The primary purpose of this study was to determine the safety and tolerability of moxidectin in subjects infected with Onchocerca volvulus (a parasitic worm).
Detailed description
This was a phase 2, randomized, ivermectin-controlled, double-blind, single-ascending-dose, parallel design, inpatient/outpatient study of moxidectin administered to subjects of both sexes with different degrees of severity of O. volvulus infection. The study was conducted at a single site in Ghana. Secondary objects are to determine the pharmacokinetics of moxidectin, to obtain initial indication of the efficacy in terms of long term effect on skin microfilaria levels and an indication of the effect on the macrofilaria that may underlie the effect on skin microfilaria levels. Subjects were enrolled in consecutive cohorts to receive a single oral dose of 2 mg, 4 mg or 8 mg or moxidectin or ivermectin 150 µg/kg by severity of infection, based on the mean of the skin microfilariae densities at each of 4 body locations, both iliac crests and calves.
Interventions
DRUG2 mg moxidectin
Single-dose, tablet encapsulated for blinding
DRUGivermectin 150 mcg/kg
Single-dose, tablets encapsulated for blinding
DRUG4 mg moxidectin
Single dose, tablets encapsulated for blinding
DRUG8 mg moxidectin
single dose, tablets encapsulated for blinding
Sponsors
World Health Organization
Medicines Development for Global Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Written, signed (or thumb-printed), and dated informed consent 2. Aged 18 to 60 years, inclusive 3. Body weight ≥ 40 kg for women and ≥ 45 kg for men 4. Nonpregnant, nonbreastfeeding women. Women of child bearing potential must agree to use birth control during the first 150 days after treatment. 5. Healthy, as determined by a physician on the basis of a physical examination, ECG, and a thorough review of the medical history and clinical laboratory results 6. Adequate hematologic, renal, and hepatic function 7. Skin microfilarial density within the required range for the cohort
Exclusion criteria
1. Participation in any studies other than purely observational ones, within 4 weeks before test article administration. 2. Any vaccination within 4 weeks before test article administration 3. Acute infection requiring therapy within the last 10 days before test article administration 4. Administration of any medication (with the exception of medication required to treat any reactions during the screening fluorescein angiography (chlorpheniramine) or paracetamol) or herbal preparation within 10 days prior to test article administration or any condition currently requiring regular medication 5. Clinically significant ECG abnormalities or history of cardiac abnormality 6. Past or current history of neurological or neuropsychiatric disease or epilepsy 7. Subjects with orthostatic hypotension at the screening evaluation 8. History of drug or alcohol abuse or regular use of ≥ 3 cigarettes per day 9. Use of alcohol or other drugs of abuse within 72 hours before test article administration 10. Any condition, in the investigator's opinion, that places the subject at undue risk 11. Subjects who have donated blood within 8 weeks before study entry 12. Subjects with ocular onchocerciasis in cohorts intended to enroll subjects with mild infection. Ocular onchocerciasis is defined by the presence of live or dead microfilariae, onchocercal punctate opacities, onchocercal lesions of the posterior segment or lesions that mimic those seen in onchocerciasis. 13. Subjects with hyperreactive onchodermatitis 14. Antifilarial therapy within the previous 5 years 15. Coincidental infection with Loa Loa 16. Female subjects of childbearing potential with a contraindication to DMPA if not on Norplant 17. Any other condition which the investigator feels would exclude the subject from the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of clinical adverse events and clinically significant laboratory test results | Duration of follow up (18 months) |
Secondary
| Measure | Time frame |
|---|---|
| Skin mf counts at day 8 and months 1, 2, 3, 6, 12 and 18 | day 8 and months 1, 2, 3, 6, 12, 18 |
| Nodulectomy at 18 months | 18 months |
| Pharmacokinetics (PKs) at days 1, 2, 4, 13, and 18 and months 1, 2, 3, 6 and 12 | days 1, 2, 4, 13, and 18 and months 1, 2, 3, 6 and 12 |
Countries
Ghana
Outcome results
None listed