Randomized Clinical Trial of Three Drug Combinations for Late-Stage Gambiense Human African Trypanosomiasis

Clinical Trial Comparing the Therapeutic Combinations Melarsoprol-Nifurtimox, Melarsoprol-Eflornithine and Eflornithine-Nifurtimox in the Treatment of Gambiense Human African Trypanosomiasis in the Meningo-Encephalitic Phase

Status

Terminated

Phases

Phase 3

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT00330148

Enrollment

435

Registered

2006-05-26

Start date

2001-03-31

Completion date

2004-06-30

Last updated

2006-05-26

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Trypanosomiasis, African

Keywords

trypanosomiasis, gambiense, combination drug therapy, sleeping sickness, Uganda

Brief summary

The treatment human African trypanosomiasis (HAT) in the meningoencephalitic phase relies on two molecules officially registered: melarsoprol, the most commonly used, has a poor safety profile and is becoming ineffective due to parasite resistance; and eflornithine, with better tolerance but more complicated and expensive to implement in endemic countries. nifurtimox, registered only for Chagas' disease but used off-label since the 1970's in series of cases of HAT, is at present the only other available alternative. The very limited number of compounds available, the lack of prospects for the development of new products and the emergence of resistance are arguments for the use of therapeutic combinations. This study evaluates the efficacy and safety of three drug combination therapies: melarsoprol-nifurtimox, melarsoprol-eflornithine and eflornithine-nifurtimox.

Detailed description

Dosages per drug are the same in either arm of the study: IV melarsoprol 1.8 mg/kg/day, daily for 10 days; IV eflornithine 400 mg/kg/day, 6-hourly for 7 days; oral nifurtimox 15 or 20 (children \<15 years) mg/kg/day, 8-hourly for 10 days. For efficacy assessment, patients are followed-up for 24 months after treatment, with planned clinical and laboratory controls. The safety assessment includes clinical and hematological adverse events.

Interventions

DRUGmelarsoprol 1.8 mg/kg/d, 10d + nifurtimox 15/20 mg/kg/d, 10d

DRUGmelarsoprol 1.8 mg/kg/d, 10d + eflornithine 400 mg/kg/d, 7d

DRUGnifurtimox 15/20 mg/kg/d 10d + eflornithine 400 mg/kg/d 7d

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

0 Years to No maximum

Healthy volunteers

Inclusion criteria

* confirmed second-stage T.b. gambiense infection : * Infection diagnosed parasitologically (blood or lymph node fluid) and white blood cells \> 5/mm3 in cerebrospinal fluid (CSF) * or Trypanosomes detected in the CSF with any CSF cell count * and resident in the district * and written consent of the patient or of one of the parents/guardians for children under 15 years of age.

Exclusion criteria

* Trypanosome absent from blood (or lymph node fluid) and from CSF * Or women pregnant on inclusion * Or previous history of HAT confirmed treated during the last 24 months * Or impossibility of regular access to the treatment centre during the 2 years following the end of the treatment * Or less than 10 kg of body weight * Or refugee patient

Design outcomes

Primary

Measure	Time frame
Cure rate	—

Secondary

Measure	Time frame
Adverse events temporally associated with the treatment	—
Major adverse events temporally associated with the treatment	—

Countries

Uganda

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026