Malaria, Vivax
Conditions
Brief summary
The purpose of this two part study is to test the safety and efficacy of Tafenoquine (with Cholorquine) as a radical cure for Plasmodium vivax (P.vivax) malaria relative to the control Chloroquine.Part 1 aims to select an efficacious and well tolerated dose that can be co-administered with Chloroquine. Part 2 will investigate the safety and efficacy of the selected dose (300 mg tafenoquine) in the treatment and radical cure of Plasmodium Vivax Malaria.
Detailed description
Plasmodium vivax represents 50-80% of all malarial cases in Latin America and South East Asia. It is able to establish a dormant liver stage called the hypnozoite. Hypnozoite activation after initial infection can cause a relapse. Currently the only widely available drug is primaquine which requires administration over 14 days, resulting in poor compliance and treatment failure. Tafenoquine (an 8-aminoquinoline anti-malarial drug) has been shown to possess activity against all stages of the plasmodium life cycle, including the dormant stage in the liver. This is a multi-centre, double dummy, double blind, parallel group, randomized, active control study which is conducted in two parts. For both parts, subjects are treated with Chloroquine on days 1 to 3 (600mg, 600mg, and 300mg) to treat the blood stage vivax malaria. Part 1 will include at least 324 subjects and part 2 at least 600 subjects. Part 1 has 6 treatment arms, arms 1 to 4 contain different doses of Tafenoquine (50mg, 100mg, 300mg, and 600mg) dosed on day 1 or 2, arm 5 contains primaquine (15mg) dosing over 14 days (days 2-15 (15mg)) and arm 6 contains chloroquine only. The aim of this is to find a dose of Tafenoquine which meets the defined dose criteria. Based on Part 1 efficacy and safety, a single Tafenoquine dose (300 mg) will be studied in the pivotal Part 2. Part 2 contains 3 treatment arms one with the selected Tafenoquine dose (300 mg), the second arm will be 15mg Primaquine which will again be dosed over 14 days and the final arm contains chloroquine only dosed days 1-3 (600mg, 600mg, 300mg). Therefore as with Part 1, in Part 2 all subjects will receive Chloroquine. The aim of Part 2 is to investigate the safety and efficacy of the selected Tafenoquine/Chloroquine dose in the treatment and radical cure of Plasmodium vivax malaria. In addition to the Primary and Secondary endpoints stated below we will also be collecting; other efficacy endpoints (gametocyte clearance time, Recrudescence defined as any Plasmodium vivax parasitemia occurring on or before Day 29 (blood stage treatment failure), Incidence of Plasmodium falciparum malaria and Incidence of recrudescence and new Plasmodium vivax infection, determined by Polymerase Chain Reaction (PCR), safety endpoints (clinically relevant haemolysis leading to drops in haemoglobin / haematocrit or complications thereof (required transfusions, acute renal failure), changes in methaemoglobin, gastrointestinal (GI) tolerability - incidence of abdominal pain, heartburn, diarrhoea, constipation, nausea and vomiting and ophthalmic safety - incidence of corneal deposits, retinal and visual field abnormalities. Data collected at up to four centres . Additionally, the incidence and severity of adverse events and abnormal laboratory observations will be presented).Pharmacokinetic endpoints (Population pharmacokinetic parameters for tafenoquine including but not limited to oral clearance (CL/F) and volume of distribution (V/F)and Pharmacokinetic/Pharmacodynamic endpoints (e.g. tafenoquine plasma concentrations) and selected Pharmacodynamic endpoints (e.g. relapse efficacy, change in methaemoglobin) if appropriate, will be explored.
Interventions
DRUGTafenoquine 50mg
single dose 50mg Tafenoquine given to subject on treatment arm 1 on Days 1 or 2
DRUGChloroquine 600mg
600mg Chloroquine given to each subject on Day 1 and Day2 of the trial
DRUGChloroquine 300mg
300mg Chloroquine given to each subject on Day 3 of the trial
single dose 100mg Tafenoquine given to subject on treatment arm 2 on Days 1 or 2
single dose 300mg Tafenoquine given to subject on treatment arm 3 on Days 1 or 2
single dose 600mg Tafenoquine given to subject on treatment arm 4 on Days 1 or 2
DRUGPrimaquine 15mg
15mg Primaquine given once daily to subject on treatment arm 5 on Days 2 to 15.
DRUGChloroquine 600mg (Part 2 )
600mg Chloroquine given to each subject on Day 1 and Day2 of the trial.
DRUGChloroquine 300mg (Part 2 )
300mg Chloroquine given to each subject on Day 3 of the trial.
DRUGTafenoquine 300mg (Part 2)
single dose 300mg Tafenoquine given to subject on treatment arm 3 on Days 1 or 2.
DRUGPrimaquine 15mg (Part2 )
15mg Primaquine given once daily to subject on treatment arm 3 on Days 2 to 15.
Sponsors
Medicines for Malaria Venture
GlaxoSmithKline
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- Positive Giemsa smear for P. vivax * Parasite density \>100 and \<200,000/μL * ≥16 years * A female is eligible if she is non-pregnant, nonlactating and if she is of: - non-child bearing potential defined as: post-menopausal (12 months of spontaneous amenorrhea or 6 months of spontaneous amenorrhea with serum follicle stimulating hormone \>40 mIU/mL), pre-menopausal and has had a hysterectomy or a bilateral oophorectomy (removal of the ovaries) or a bilateral tubal ligation with medical report verification, negative pregnancy test or, * child-bearing potential, has a negative serum pregnancy test at screening, and agrees to comply with one of the following during the treatment stage of the study and for a period of 90 days after stopping study drug: * Use of oral contraceptive, either combined or progestogen alone used in conjunction with double barrier method as defined below * Use of an intrauterine device with a documented failure rate of \<1% per year * Use of depo provera injection (part 2) * Double barrier method consisting of spermicide with either condom or diaphragm * Male partner who is sterile prior to the female subject's entry into the study and is the sole sexual partner for that female. * Complete abstinence from intercourse for 2 weeks prior to administration of study drug, throughout the study and for a period of 90 days after stopping study drug. * A signed and dated informed consent is obtained from the subject or the subject's legal representative prior to screening. NB Assent is obtained from subjects \<18 years, where applicable and written or oral witnessed consent has been obtained from parent or guardian. * The subject is able to understand and comply with protocol requirements, instructions and protocol-stated restrictions and is likely to complete the study as planned. * Willing to be hospitalized for 3 days and return to clinic for all follow-up visits including Day 180 * QTc \<450 msec at screening, based on a single QTcF value at screening (part 1 only) or as an average of triplicate Electrocardiogram obtained over a brief recording period by machine or manual over-read if first is \>450 msec.-
Exclusion criteria
- Mixed malaria infections (e.g. identified by Giemsa-stained smear or rapid diagnostic test) * Severe vivax malaria as defined by World Health Organisation criteria. * Severe vomiting (no food or inability to take food during previous 8 hours) * Screening haemoglobin concentration \<7 g/dL. * Glucose 6-phosphate dehydrogenase deficiency, assessed by a quantitative spectrophotometric phenotype assay: Part 1 - Males: Any subject with an enzyme level \<70% of the site median value for Glucose 6-phosphate dehydrogenase normals will be excluded. Females: Those females with a screening Hb ≥ 10 g/dL will only be excluded if their enzyme level is \<70% of the site median value for Glucose 6-Phosphate dehydrogenase normals. hose females with Hb ≥7 but \< 10 g/dL will be excluded if an enzyme level is not \> 90% of the site median value for Glucose 6-Phosphate dehydrogenase normals. Part 2 - Any subject with enzyme level \<70% of the site median value for Glucose 6-phosphate dehydrogenase normals will be excluded * Liver function test alanine transaminase \>2x Upper Limit of Normal * Any clinically significant concurrent illness (e.g. pneumonia, septicaemia), pre-existing conditions (e.g. renal disease, malignancy), conditions that may affect absorption of study medication (e.g. vomiting or severe diarrhea) or clinical signs and symptoms of severe cardiovascular disease (e.g. uncontrolled congestive heart failure or severe coronary artery disease). These abnormalities may be identified on the screening history and physical or laboratory examination. * Subject has taken antimalarials (e.g. ACT, mefloquine, primaquine, chloroquine) or drugs with anti-malarial activity within the past 30 days by history. * History of allergy to chloroquine, mefloquine, tafenoquine, primaquine or to any other 4- or 8-aminoquinolines. * Any contraindications to chloroquine or primaquine administration including a history of porphyria, psoriasis or epilepsy (please refer to chloroquine and primaquine locally approved prescribing information). * Subject who has previously received study medication for this protocol (all parts) or has received treatment with any other investigational drug within 30 days or 5 half-lives (whichever is longer) preceding the first dose of study medication. * History of illicit drug abuse or heavy alcohol intake within 6 months of the study. * Subjects who have taken or will likely require the use of medications from the prohibited medication list which include the following classes: Histamine-2 blockers and antacids. * Drugs with haemolytic potential. * Drugs known to prolong the QTc interval
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Recurrence-free Efficacy at 6 Months Post Dose | 6 months post dose | A participant was considered to have demonstrated recurrence-free efficacy at 6 months if: a) Participant had non-zero P vivax asexual parasite count at Baseline. b) Participant showed initial clearance of P vivax parasitemia defined as two negative asexual P vivax parasite counts, with at least 6 hours between the counts, and no positive counts in the interval. c) Participant had no positive asexual P vivax parasite count at any assessment prior to or on Study Day 201 following initial parasite clearance. d) Participant did not take a concomitant medication with anti-malarial activity at any point between Study Day 1 and their last parasite assessment. e) Participant is parasite-free at 6 months. Participants were censored if they did not have P.vivax at Baseline, or took a drug with anti-malarial action despite not having malaria parasites, or did not have a 6 month assessment. The number of participants with recurrence-free efficacy at 6 months has been summarized. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to Recurrence of P Vivax Malaria | Up to Day 180 | Recurrence was defined as the first confirmed presence of P vivax asexual stage parasites after clearance of initial parasitemia following CQ treatment. Time to recurrence was defined as the time (in days) from initial parasite clearance to recurrence. The time to recurrence was analyzed by the Kaplan-Meier method. NA indicates data was not available due to insufficient number of participants with events during the follow up period in the study. The median number of days to recurrence along with 95% confidence interval has been presented for each treatment group. |
| Time to Parasite Clearance | Up to Day 180 | Parasite clearance time was defined as time needed to clear asexual parasite from the blood that is, parasite numbers falling below the limit of detection in the thick blood smear and remaining undetectable after 6 to 12 hours. The time taken to achieve parasite clearance was analyzed using Kaplan Meier Methodology. The median parasite clearance time along with 95% confidence interval has been presented for each treatment group. |
| Time to Fever Clearance | Up to Day 180 | Fever clearance time was defined as time from first dose of treatment to the time when body temperature falls to normal within Study Days 1-4 and remains normal for at least 48 hours up to the Day 8 visit. Fever clearance was considered to have been achieved once an initial temperature of more than 37.40 degree Celsius is reduced to a value less than or equal to 37.40 degree Celsius and in the absence of value more than 37.40 degree Celsius in the following 48 hours up to the Day 8 visit. The time taken to achieve fever clearance was analyzed using Kaplan Meier Methodology. The median fever clearance time along with 95% confidence interval has been presented for each treatment group. |
| Number of Participants With Hemoglobin Decline From Baseline Over First 29 Days | Baseline and up to Day 29 | Glucose-6-phosphate dehydrogenase deficiency (G6PD) deficiency is known to be a risk factor for hemolysis in participants treated with 8-aminoquinolines. Blood samples were collected for the evaluation of hemoglobin levels. Hemoglobin decreases of \>=30% or \>3 grams/deciliter (g/dL) from Baseline; or, an overall drop in hemoglobin below 6.0 g/dL in the first 15 days of the study were considered as protocol defined serious adverse events (SAEs). Number of participants with maximum hemoglobin decline from Baseline over first 29 days of study has been summarized. Safety Population consisted of all randomized participants who received at least one dose of study medication. |
| Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Up to Day 180 | TEAEs are defined as adverse events (AEs) with an onset date and time on or after that of the start of first dose of study medication (including CQ). The number of participants with TEAEs potentially related to hemoglobin decrease has been presented. |
| Number of Participants Who Received Blood Transfusion | Up to Day 180 | The number of participants who received blood transfusion as a result of hemoglobin decline has been summarized. |
| Number of Participants With Acute Renal Failure | Up to Day 180 | There were no participants with acute renal failure in the study. |
| Change From Baseline in Percent Methemoglobin | Baseline and up to Day 120 | Methemoglobin assessment was made with the aid of a non-invasive signal extraction pulse CO-Oximeter handheld machine (Masimo). The change from Baseline in percent methemoglobin by treatment, time and sex has been summarized. The last assessment performed prior to the first dose of study medication (CQ or randomized treatment) was considered as Baseline. Change from Baseline was calculated as the post baseline assessment minus the Baseline assessment for percent methemoglobin. Only those participants with data available at the specified data points were analyzed. |
| Number of Participants With Gastrointestinal Disorders | Up to Day 180 | Gastrointestinal tolerability was analyzed by the number of par experiencing gastrointestinal disorders such as abdominal pain, heartburn, diarrhea, constipation, nausea, and vomiting. The number of participants with gastrointestinal disorders for each treatment group has been summarized. |
| Number of Participants With Keratopathy | Up to Day 180 | Ophthalmic assessments were carried out at pre-qualified sites (Manaus) prior to randomization and at Days 29 and 90 and at withdrawal. Assessments were carried out at Day 180 if the Day 90 assessments showed abnormalities. The last assessment performed on the day of randomization or earlier was considered Baseline. The number of participants displaying keratopathy in each eye was summarized for each visit. The number of participants with new keratopathy at any time post Baseline was also reported. Ophthalmic Safety Population comprised of all participants in the Safety Population who have results from any eye assessments. Only those participants with data available at the specified data points were analyzed. |
| Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Up to Day 180 | Ophthalmic assessments were carried out at pre-qualified sites (Manaus) prior to randomization and at Days 29 and 90 and at withdrawal. Assessments were carried out at Day 180 if the Day 90 assessments showed abnormalities. The last assessment performed on the day of randomization or earlier was considered Baseline. Best corrected visual acuity was assessed individually for each eye. Scores were recorded as a ratio. The values were used to derive a logMAR score for statistical analysis where logMAR=-1x log10 (ratio score). The mean and standard deviation of logMAR score for each treatment group has been summarized. High scores were associated with worse vision, and low scores with better vision. Only those participants with data available at the specified data points were analyzed. |
| Number of Participants With Recurrence-free Efficacy at 4 Months Post Dose | 4 months post dose | A participant (par) was considered to have demonstrated recurrence-free efficacy at 4 months if: a) Par had non-zero P vivax asexual parasite count at Baseline. b) Par showed initial clearance of P vivax parasitemia. c) Par had no positive asexual P vivax parasite count at any assessment prior to or on Study Day 130 following initial parasite clearance. d) Par did not take a concomitant medication with anti-malarial activity at any point between Study Day 1 and their last parasite assessment after Study Day 109 (up to and including Study Day 130). e) Par is parasite-free at 4 months defined as a negative asexual P vivax parasite count at the first parasite assessment performed after Study Day 109 (up to and including Study Day 130). Par were censored if they did not have P.vivax at Baseline, or took a drug with anti-malarial action despite not having malaria parasites or did not have a 4 month assessment. The number of par with recurrence-free efficacy at 4 months has been summarized. |
| Number of Participants With TEAEs and Serious TEAEs | Up to Day 180 | An AE is defined as any untoward medical occurrence in a participant under clinical investigation, temporarily associated with the use of a medicinal product, whether or not considered related to the medicinal product. SAE is defined as any untoward medical occurrence that, at any dose results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/ birth defect, other situations and is associated with possible drug induced liver injury with hyperbilirubinemia. TEAEs is defined as AEs with an onset date and time on or after that of the start of first dose of study medication (including CQ). Number of participants with TEAEs and serious TEAEs have been presented. |
| Number of Participants With TEAEs by Maximum Intensity | Up to Day 180 | An AE is defined as any untoward medical occurrence in a participant under clinical investigation, temporarily associated with the use of a medicinal product, whether or not considered related to the medicinal product. TEAE is defined as AEs with an onset date and time on or after that of the start of first dose of study medication (including CQ). Number of participants with AEs based on severity has been presented. |
| Number of Participants With Hematology Laboratory Data Outside the Reference Range | Up to Day 120 | Blood samples were collected for the evaluation of hematology parameters including eosinophils, leukocytes, lymphocytes, neutrophils, platelets, reticulocytes and methemoglobin. The number of participants with hematology laboratory data outside the extended normal range (F3) was presented. The upper and lower limits for F3 range were defined by multiplying the normal range limits by different factors. High and low indicated that the participants had values flagged as high and low respectively for the particular parameter any time on-treatment. Only those participants with data available at the specified data points were analyzed. |
| Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Up to Day 120 | Blood samples were collected for the evaluation of clinical chemistry parameters including Alanine Aminotransferase (ALT), Alkaline Phosphatase (Alk. Phos), Aspartate Aminotransferase (AST), bilirubin, creatine kinase, creatinine, glomerular filtration rate (GFR), indirect bilirubin and urea. The number of participants with clinical chemistry laboratory data outside the extended normal range (F3) was presented. The upper and lower limits for F3 range were defined by multiplying the normal range limits by different factors. High and low indicated that the participants had values flagged as high and low respectively for the particular parameter any time on-treatment. Only those participants with data available at the specified data points were analyzed. |
| Cost Associated With Recurrence Episode of P Vivax Malaria | Up to Day 180 | Health outcomes were evaluated based on the total costs spent on treatment, transport, medication and tests. The cost was summarized according to the place at which the participant went to for care (drug shop, trial clinic, other clinic, hospital (inpatient/outpatient), traditional healer, other). The reported costs by type and by site has been summarized. Where costs have not been reported at a visit, the number of participants analyzed is given as 0. Only those participants with data available at the specified data points were analyzed. |
| Cost Incurred With Purchase of Medications Associated With Recurrence Episode of Malaria | Up to Day 180 | Health outcomes were evaluated based on the cost of medications purchased. The reported total medication cost for paracetamol associated with recurrence episode of P vivax malaria has been reported by site. Where costs have not been reported at a visit, the number of participants analyzed is given as 0. Medications recorded as Other and medications without costs are excluded from the analysis. Only those participants with data available at the specified data points were analyzed. |
| Time Lost by Participants or Care Givers From Normal Occupation | Up to Day 180 | Health outcomes were evaluated based on total time lost by participants or care givers due to an episode of malaria. The reported time lost due to recurrence episode of P vivax malaria has been summarized by category and by site. Where categories by site have not been reported at a visit, the number of participants analyzed is given as 0. Only those participants with data available at the specified data points were analyzed. |
| Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Up to Day 180 | Health outcomes were evaluated based on the actions taken by the participants to treat recurrence episode of P vivax malaria. The reported action taken by site is summarized. Where no action by site have been reported at a visit, the number of participants analyzed is given as 0. Only those participants with data available at the specified data points were analyzed. |
| Oral Clearance (CL/F) of TQ | Day 2, Day 8, Day 15, Day 29 and Day 60 | Apparent population oral clearance of TQ |
| Volume of Distribution (Vc/F) of TQ | Day 2, Day 8, Day 15, Day 29 and Day 60 | Apparent population central volume of distribution of TQ |
| Number of Participants With Retinal Changes From Baseline | Baseline and up to Day 180 | Ophthalmic assessments were carried out at pre-qualified sites (Manaus) prior to randomization and at Days 29 and 90 and at withdrawal. Assessments were carried out at Day 180 if the Day 90 assessments showed abnormalities. The last assessment performed on the day of randomization or earlier was considered Baseline. Change from Baseline was calculated as the post Baseline assessment minus the Baseline assessment. The number of participants with definite retinal change and questionable (ques) retinal change from Baseline was presented. Only those participants with data available at the specified data points were analyzed. |
Countries
Bangladesh, Brazil, Cambodia, Ethiopia, India, Peru, Philippines, Thailand
Participant flow
Recruitment details
This was a multi-centre, double-blind, randomized, parallel-group, active-controlled study to evaluate the efficacy, safety and tolerability of tafenoquine (TQ) in participants with Plasmodium vivax (P vivax) malaria. TAF112582 consisted of two parts-Part 1 (Phase 2 dose ranging) and Part 2 (Phase 3 pivotal). Results have been presented for Part 2.
Pre-assignment details
A total of 683 participants were screened of which 161 failed screening and 522 participants were randomized to receive chloroquine (CQ) + 300 milligrams (mg) TQ, CQ + 15 mg primaquine (PQ) and CQ alone regimen in a ratio of 2:1:1.
Participants by arm
| Arm | Count |
|---|---|
| CQ Only Participants were administered a single oral dose of CQ 600 mg on Days 1 and 2 and CQ 300 mg on Day 3. TQ placebo was administered on Day 1 or Day 2. PQ placebo capsule was administered once daily for 14 days starting from either Day 1 or Day 2. | 133 |
| TQ + CQ Participants were administered a single oral dose of CQ 600 mg on Days 1 and Day 2 and CQ 300 mg on Day 3. Participants were dosed with TQ 300 mg either on Day 1 or Day 2. PQ placebo capsule was administered once daily for 14 days starting from either Day 1 or Day 2. | 260 |
| PQ + CQ Participants were administered a single oral dose of CQ 600 mg on Days 1 and 2 and CQ 300 mg on Day 3. Participants were dosed with TQ placebo either on Day 1 or Day 2 and PQ 15 mg was administered once daily for 14 days starting from either Day 1 or Day 2. | 129 |
| Total | 522 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Lost to Follow-up | 2 | 4 | 2 |
| Overall Study | Physician Decision | 1 | 1 | 0 |
| Overall Study | Withdrawal by Subject | 1 | 5 | 4 |
Baseline characteristics
| Characteristic | CQ Only | TQ + CQ | PQ + CQ | Total |
|---|---|---|---|---|
| Age, Continuous | 35.3 Years STANDARD_DEVIATION 14.23 | 35.0 Years STANDARD_DEVIATION 14.39 | 34.7 Years STANDARD_DEVIATION 14.26 | 35.0 Years STANDARD_DEVIATION 14.29 |
| Race/Ethnicity, Customized American(Amer) Indian(Ind) or Alaska(Al) Native(N) | 43 Participants | 81 Participants | 41 Participants | 165 Participants |
| Race/Ethnicity, Customized Asian-South East Asian (A) Heritage (Her) | 26 Participants | 50 Participants | 26 Participants | 102 Participants |
| Race/Ethnicity, Customized Black or African (Afr) Amer | 14 Participants | 28 Participants | 13 Participants | 55 Participants |
| Race/Ethnicity, Customized Multiple-Afr Amer/Afr Her/Amer Ind or Al N | 47 Participants | 95 Participants | 47 Participants | 189 Participants |
| Race/Ethnicity, Customized Multiple-Afr Amer/Afr Her/White-White/Cau/Eur Her | 0 Participants | 1 Participants | 0 Participants | 1 Participants |
| Race/Ethnicity, Customized Multiple-Amer Ind or Al N/A-Central/South A Her | 0 Participants | 1 Participants | 0 Participants | 1 Participants |
| Race/Ethnicity, Customized White-White/Caucasian(Cau)/European(Eur) Her | 3 Participants | 4 Participants | 2 Participants | 9 Participants |
| Sex: Female, Male Female | 36 Participants | 64 Participants | 30 Participants | 130 Participants |
| Sex: Female, Male Male | 97 Participants | 196 Participants | 99 Participants | 392 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 133 | 0 / 260 | 0 / 129 |
| other Total, other adverse events | 72 / 133 | 119 / 260 | 56 / 129 |
| serious Total, serious adverse events | 6 / 133 | 21 / 260 | 4 / 129 |
Outcome results
Primary
Number of Participants With Recurrence-free Efficacy at 6 Months Post Dose
A participant was considered to have demonstrated recurrence-free efficacy at 6 months if: a) Participant had non-zero P vivax asexual parasite count at Baseline. b) Participant showed initial clearance of P vivax parasitemia defined as two negative asexual P vivax parasite counts, with at least 6 hours between the counts, and no positive counts in the interval. c) Participant had no positive asexual P vivax parasite count at any assessment prior to or on Study Day 201 following initial parasite clearance. d) Participant did not take a concomitant medication with anti-malarial activity at any point between Study Day 1 and their last parasite assessment. e) Participant is parasite-free at 6 months. Participants were censored if they did not have P.vivax at Baseline, or took a drug with anti-malarial action despite not having malaria parasites, or did not have a 6 month assessment. The number of participants with recurrence-free efficacy at 6 months has been summarized.
Time frame: 6 months post dose
Population: Microbiologic intent to treat (mITT) Population-all randomized participants who received at least one dose of study medication, who have at least one P vivax parasite assessment after randomization, and who have a positive parasite smear for P vivax at Baseline.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| CQ Only | Number of Participants With Recurrence-free Efficacy at 6 Months Post Dose | 35 Participants |
| TQ + CQ | Number of Participants With Recurrence-free Efficacy at 6 Months Post Dose | 155 Participants |
| PQ + CQ | Number of Participants With Recurrence-free Efficacy at 6 Months Post Dose | 83 Participants |
p-value: <0.00195% CI: [0.222, 0.404]Cox Proportional Hazards Model
p-value: <0.00195% CI: [0.178, 0.387]Cox Proportional Hazards Model
p-value: <0.00195% CI: [0.152, 0.382]Regression, Logistic
p-value: <0.00195% CI: [0.117, 0.335]Regression, Logistic
Secondary
Change From Baseline in Percent Methemoglobin
Methemoglobin assessment was made with the aid of a non-invasive signal extraction pulse CO-Oximeter handheld machine (Masimo). The change from Baseline in percent methemoglobin by treatment, time and sex has been summarized. The last assessment performed prior to the first dose of study medication (CQ or randomized treatment) was considered as Baseline. Change from Baseline was calculated as the post baseline assessment minus the Baseline assessment for percent methemoglobin. Only those participants with data available at the specified data points were analyzed.
Time frame: Baseline and up to Day 120
Population: Safety Population
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 29, Male | -0.10 Percent Methemoglobin | Standard Deviation 1.428 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 8, Female | -0.16 Percent Methemoglobin | Standard Deviation 0.857 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 2, Male | -0.18 Percent Methemoglobin | Standard Deviation 1.525 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 22, Female | -0.05 Percent Methemoglobin | Standard Deviation 0.467 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 11, Male | -0.07 Percent Methemoglobin | Standard Deviation 1.348 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 3, Female | -0.20 Percent Methemoglobin | Standard Deviation 0.902 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 22, Male | 0.07 Percent Methemoglobin | Standard Deviation 1.211 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 11, Female | -0.13 Percent Methemoglobin | Standard Deviation 0.676 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 120, Female | 0.10 Percent Methemoglobin | Standard Deviation 1.332 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 15, Female | -0.08 Percent Methemoglobin | Standard Deviation 0.684 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 15, Male | 0.12 Percent Methemoglobin | Standard Deviation 1.404 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 60, Female | 0.19 Percent Methemoglobin | Standard Deviation 1.08 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 5, Male | -0.28 Percent Methemoglobin | Standard Deviation 1.329 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 120, Male | 0.20 Percent Methemoglobin | Standard Deviation 1.783 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 60, Male | 0.44 Percent Methemoglobin | Standard Deviation 1.925 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 5, Female | -0.20 Percent Methemoglobin | Standard Deviation 0.789 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 3, Male | -0.15 Percent Methemoglobin | Standard Deviation 1.256 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 29, Female | -0.18 Percent Methemoglobin | Standard Deviation 0.927 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 8, Male | -0.12 Percent Methemoglobin | Standard Deviation 1.135 |
| CQ Only | Change From Baseline in Percent Methemoglobin | Day 2, Female | -0.22 Percent Methemoglobin | Standard Deviation 0.895 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 60, Female | 0.03 Percent Methemoglobin | Standard Deviation 0.7 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 2, Male | -0.03 Percent Methemoglobin | Standard Deviation 1.246 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 2, Female | 0.10 Percent Methemoglobin | Standard Deviation 0.83 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 3, Male | -0.01 Percent Methemoglobin | Standard Deviation 1.254 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 3, Female | 0.26 Percent Methemoglobin | Standard Deviation 0.781 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 5, Male | 0.42 Percent Methemoglobin | Standard Deviation 1.633 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 5, Female | 1.37 Percent Methemoglobin | Standard Deviation 1.263 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 8, Male | 0.98 Percent Methemoglobin | Standard Deviation 1.87 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 8, Female | 2.04 Percent Methemoglobin | Standard Deviation 1.716 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 11, Male | 1.17 Percent Methemoglobin | Standard Deviation 2.074 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 11, Female | 2.13 Percent Methemoglobin | Standard Deviation 1.667 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 15, Male | 0.94 Percent Methemoglobin | Standard Deviation 1.963 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 15, Female | 1.67 Percent Methemoglobin | Standard Deviation 1.349 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 22, Male | 0.54 Percent Methemoglobin | Standard Deviation 1.431 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 22, Female | 0.93 Percent Methemoglobin | Standard Deviation 1.042 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 29, Male | 0.23 Percent Methemoglobin | Standard Deviation 1.35 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 29, Female | 0.24 Percent Methemoglobin | Standard Deviation 0.717 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 60, Male | -0.10 Percent Methemoglobin | Standard Deviation 1.362 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 120, Male | 0.07 Percent Methemoglobin | Standard Deviation 1.503 |
| TQ + CQ | Change From Baseline in Percent Methemoglobin | Day 120, Female | -0.03 Percent Methemoglobin | Standard Deviation 0.906 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 2, Female | -0.01 Percent Methemoglobin | Standard Deviation 0.438 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 22, Female | 1.86 Percent Methemoglobin | Standard Deviation 1.494 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 8, Male | 3.01 Percent Methemoglobin | Standard Deviation 3.214 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 120, Female | 0.37 Percent Methemoglobin | Standard Deviation 1.552 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 29, Male | 0.58 Percent Methemoglobin | Standard Deviation 1.835 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 5, Female | 0.90 Percent Methemoglobin | Standard Deviation 0.885 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 120, Male | 0.37 Percent Methemoglobin | Standard Deviation 2.153 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 29, Female | 0.49 Percent Methemoglobin | Standard Deviation 0.502 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 5, Male | 1.28 Percent Methemoglobin | Standard Deviation 2.619 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 2, Male | -0.10 Percent Methemoglobin | Standard Deviation 1.372 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 60, Male | 0.20 Percent Methemoglobin | Standard Deviation 1.94 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 3, Female | 0.11 Percent Methemoglobin | Standard Deviation 0.443 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 15, Male | 3.51 Percent Methemoglobin | Standard Deviation 3.369 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 11, Female | 3.41 Percent Methemoglobin | Standard Deviation 2.659 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 3, Male | -0.02 Percent Methemoglobin | Standard Deviation 1.454 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 15, Female | 3.63 Percent Methemoglobin | Standard Deviation 2.678 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 11, Male | 3.61 Percent Methemoglobin | Standard Deviation 3.498 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 60, Female | 0.16 Percent Methemoglobin | Standard Deviation 0.62 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 22, Male | 1.96 Percent Methemoglobin | Standard Deviation 2.401 |
| PQ + CQ | Change From Baseline in Percent Methemoglobin | Day 8, Female | 2.58 Percent Methemoglobin | Standard Deviation 2.565 |
Secondary
Cost Associated With Recurrence Episode of P Vivax Malaria
Health outcomes were evaluated based on the total costs spent on treatment, transport, medication and tests. The cost was summarized according to the place at which the participant went to for care (drug shop, trial clinic, other clinic, hospital (inpatient/outpatient), traditional healer, other). The reported costs by type and by site has been summarized. Where costs have not been reported at a visit, the number of participants analyzed is given as 0. Only those participants with data available at the specified data points were analyzed.
Time frame: Up to Day 180
Population: Safety Population
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| CQ Only | Cost Associated With Recurrence Episode of P Vivax Malaria | Peru (Other location for care) | 0.72 US Dollars (USD) | Standard Deviation 0.41 |
| CQ Only | Cost Associated With Recurrence Episode of P Vivax Malaria | Brazil (Drug shop for care) | 4.76 US Dollars (USD) | Standard Deviation 3.24 |
| CQ Only | Cost Associated With Recurrence Episode of P Vivax Malaria | Brazil (Enrollment clinic for care) | 6.17 US Dollars (USD) | Standard Deviation 2.39 |
| CQ Only | Cost Associated With Recurrence Episode of P Vivax Malaria | Peru (Attended another clinic) | 2.71 US Dollars (USD) | Standard Deviation 4.69 |
| CQ Only | Cost Associated With Recurrence Episode of P Vivax Malaria | Thailand (Drug shop for care) | 4.60 US Dollars (USD) | Standard Deviation 0 |
| CQ Only | Cost Associated With Recurrence Episode of P Vivax Malaria | Thailand (Enrollment clinic for care) | 19.15 US Dollars (USD) | Standard Deviation 10.6 |
| CQ Only | Cost Associated With Recurrence Episode of P Vivax Malaria | Thailand (In-hospital care) | 6.13 US Dollars (USD) | Standard Deviation 0 |
| CQ Only | Cost Associated With Recurrence Episode of P Vivax Malaria | Brazil (other location for care) | 4.23 US Dollars (USD) | Standard Deviation 0 |
| CQ Only | Cost Associated With Recurrence Episode of P Vivax Malaria | Peru (Drug shop for care) | 1.47 US Dollars (USD) | Standard Deviation 1.3 |
| CQ Only | Cost Associated With Recurrence Episode of P Vivax Malaria | Peru (Enrollment clinic for care) | 8.78 US Dollars (USD) | Standard Deviation 7.94 |
| TQ + CQ | Cost Associated With Recurrence Episode of P Vivax Malaria | Brazil (Enrollment clinic for care) | 6.15 US Dollars (USD) | Standard Deviation 2.14 |
| TQ + CQ | Cost Associated With Recurrence Episode of P Vivax Malaria | Peru (Enrollment clinic for care) | 8.54 US Dollars (USD) | Standard Deviation 8.52 |
| TQ + CQ | Cost Associated With Recurrence Episode of P Vivax Malaria | Peru (Other location for care) | 1.30 US Dollars (USD) | Standard Deviation 0 |
| TQ + CQ | Cost Associated With Recurrence Episode of P Vivax Malaria | Peru (Attended another clinic) | 3.94 US Dollars (USD) | Standard Deviation 1.42 |
Secondary
Cost Incurred With Purchase of Medications Associated With Recurrence Episode of Malaria
Health outcomes were evaluated based on the cost of medications purchased. The reported total medication cost for paracetamol associated with recurrence episode of P vivax malaria has been reported by site. Where costs have not been reported at a visit, the number of participants analyzed is given as 0. Medications recorded as Other and medications without costs are excluded from the analysis. Only those participants with data available at the specified data points were analyzed.
Time frame: Up to Day 180
Population: Safety Population
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| CQ Only | Cost Incurred With Purchase of Medications Associated With Recurrence Episode of Malaria | Peru, n=23, 3 | 0.49 USD | Standard Deviation 0.1941 |
| CQ Only | Cost Incurred With Purchase of Medications Associated With Recurrence Episode of Malaria | Brazil, n=6, 0 | 1.70 USD | Standard Deviation 0.144 |
| TQ + CQ | Cost Incurred With Purchase of Medications Associated With Recurrence Episode of Malaria | Peru, n=23, 3 | 0.32 USD | Standard Deviation 1 |
Secondary
Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores
Ophthalmic assessments were carried out at pre-qualified sites (Manaus) prior to randomization and at Days 29 and 90 and at withdrawal. Assessments were carried out at Day 180 if the Day 90 assessments showed abnormalities. The last assessment performed on the day of randomization or earlier was considered Baseline. Best corrected visual acuity was assessed individually for each eye. Scores were recorded as a ratio. The values were used to derive a logMAR score for statistical analysis where logMAR=-1x log10 (ratio score). The mean and standard deviation of logMAR score for each treatment group has been summarized. High scores were associated with worse vision, and low scores with better vision. Only those participants with data available at the specified data points were analyzed.
Time frame: Up to Day 180
Population: Ophthalmic Safety Population. Day 180 was not a required follow up assessment, hence, data was not collected for most participants.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| CQ Only | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Baseline; left eye | 0.048 logMAR scores | Standard Deviation 0.0859 |
| CQ Only | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 29; left eye | 0.032 logMAR scores | Standard Deviation 0.058 |
| CQ Only | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 29; right eye | 0.039 logMAR scores | Standard Deviation 0.0906 |
| CQ Only | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 90; left eye | 0.041 logMAR scores | Standard Deviation 0.0599 |
| CQ Only | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 90; right eye | 0.044 logMAR scores | Standard Deviation 0.0928 |
| CQ Only | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Baseline; right eye | 0.041 logMAR scores | Standard Deviation 0.0825 |
| TQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Baseline; left eye | 0.039 logMAR scores | Standard Deviation 0.0652 |
| TQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Baseline; right eye | 0.046 logMAR scores | Standard Deviation 0.1045 |
| TQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 90; right eye | 0.038 logMAR scores | Standard Deviation 0.1083 |
| TQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 90; left eye | 0.028 logMAR scores | Standard Deviation 0.0971 |
| TQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 180; right eye | 0.033 logMAR scores | Standard Deviation 0.0577 |
| TQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 29; right eye | 0.049 logMAR scores | Standard Deviation 0.1159 |
| TQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 180; left eye | 0.033 logMAR scores | Standard Deviation 0.0577 |
| TQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 29; left eye | 0.032 logMAR scores | Standard Deviation 0.0565 |
| PQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 180; left eye | 0.000 logMAR scores | — |
| PQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Baseline; right eye | 0.029 logMAR scores | Standard Deviation 0.0461 |
| PQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Baseline; left eye | 0.048 logMAR scores | Standard Deviation 0.1306 |
| PQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 29; right eye | 0.021 logMAR scores | Standard Deviation 0.0412 |
| PQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 29; left eye | 0.045 logMAR scores | Standard Deviation 0.1325 |
| PQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 90; right eye | 0.016 logMAR scores | Standard Deviation 0.0374 |
| PQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 90; left eye | 0.041 logMAR scores | Standard Deviation 0.1303 |
| PQ + CQ | Incidence of Visual Field Abnormalities Based on Best Corrected Visual Acuity Test Scores | Day 180; right eye | 0.000 logMAR scores | — |
Secondary
Number of Participants Who Received Blood Transfusion
The number of participants who received blood transfusion as a result of hemoglobin decline has been summarized.
Time frame: Up to Day 180
Population: Safety Population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| CQ Only | Number of Participants Who Received Blood Transfusion | 0 Participants |
| TQ + CQ | Number of Participants Who Received Blood Transfusion | 0 Participants |
| PQ + CQ | Number of Participants Who Received Blood Transfusion | 0 Participants |
Secondary
Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria
Health outcomes were evaluated based on the actions taken by the participants to treat recurrence episode of P vivax malaria. The reported action taken by site is summarized. Where no action by site have been reported at a visit, the number of participants analyzed is given as 0. Only those participants with data available at the specified data points were analyzed.
Time frame: Up to Day 180
Population: Safety Population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Thailand, In hospital | 1 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Brazil, Nothing | 21 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Brazil, Drug shop | 2 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Brazil, Trial clinic | 62 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Brazil, Other | 2 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Cambodia, Nothing | 13 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Ethiopia, Nothing | 12 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Ethiopia, Other | 1 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Ethiopia, Trial clinic | 0 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Peru, Nothing | 1 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Peru, Drug shop | 8 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Peru, Trial clinic | 61 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Peru, Another clinic | 10 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Peru, Other | 15 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Philippines, Nothing | 1 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Thailand, Nothing | 1 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Thailand, Drug shop | 1 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Thailand, Trial clinic | 13 Participants |
| CQ Only | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Ethiopia, Another clinic | 1 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Peru, Nothing | 0 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Brazil, Nothing | 5 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Thailand, Drug shop | 0 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Brazil, Drug shop | 0 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Peru, Drug shop | 0 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Brazil, Trial clinic | 76 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Thailand, In hospital | 0 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Brazil, Other | 0 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Peru, Trial clinic | 63 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Cambodia, Nothing | 14 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Thailand, Nothing | 16 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Ethiopia, Nothing | 13 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Ethiopia, Another clinic | 0 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Peru, Another clinic | 54 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Ethiopia, Other | 0 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Thailand, Trial clinic | 0 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Ethiopia, Trial clinic | 1 Participants |
| TQ + CQ | Number of Participants With Action Taken to Treat Recurrence Episode of P Vivax Malaria | Peru, Other | 1 Participants |
Secondary
Number of Participants With Acute Renal Failure
There were no participants with acute renal failure in the study.
Time frame: Up to Day 180
Population: Safety Population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| CQ Only | Number of Participants With Acute Renal Failure | 0 Participants |
| TQ + CQ | Number of Participants With Acute Renal Failure | 0 Participants |
| PQ + CQ | Number of Participants With Acute Renal Failure | 0 Participants |
Secondary
Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range
Blood samples were collected for the evaluation of clinical chemistry parameters including Alanine Aminotransferase (ALT), Alkaline Phosphatase (Alk. Phos), Aspartate Aminotransferase (AST), bilirubin, creatine kinase, creatinine, glomerular filtration rate (GFR), indirect bilirubin and urea. The number of participants with clinical chemistry laboratory data outside the extended normal range (F3) was presented. The upper and lower limits for F3 range were defined by multiplying the normal range limits by different factors. High and low indicated that the participants had values flagged as high and low respectively for the particular parameter any time on-treatment. Only those participants with data available at the specified data points were analyzed.
Time frame: Up to Day 120
Population: Safety Population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| CQ Only | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Creatine kinase, High | 8 Participants |
| CQ Only | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | ALT, High | 11 Participants |
| CQ Only | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | GFR, Low | 0 Participants |
| CQ Only | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Creatinine, High | 0 Participants |
| CQ Only | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Alk Phos, High | 3 Participants |
| CQ Only | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Urea, High | 42 Participants |
| CQ Only | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Bilirubin, High | 18 Participants |
| CQ Only | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | AST, High | 5 Participants |
| CQ Only | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Indirect bilirubin | 11 Participants |
| TQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Creatinine, High | 1 Participants |
| TQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Alk Phos, High | 1 Participants |
| TQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | AST, High | 7 Participants |
| TQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Bilirubin, High | 23 Participants |
| TQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Creatine kinase, High | 5 Participants |
| TQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | GFR, Low | 1 Participants |
| TQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Indirect bilirubin | 22 Participants |
| TQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Urea, High | 85 Participants |
| TQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | ALT, High | 10 Participants |
| PQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Bilirubin, High | 12 Participants |
| PQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Alk Phos, High | 1 Participants |
| PQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Indirect bilirubin | 8 Participants |
| PQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | AST, High | 2 Participants |
| PQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | ALT, High | 5 Participants |
| PQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Creatinine, High | 0 Participants |
| PQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Creatine kinase, High | 8 Participants |
| PQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | Urea, High | 46 Participants |
| PQ + CQ | Number of Participants With Clinical Chemistry Laboratory Data Outside the Reference Range | GFR, Low | 0 Participants |
Secondary
Number of Participants With Gastrointestinal Disorders
Gastrointestinal tolerability was analyzed by the number of par experiencing gastrointestinal disorders such as abdominal pain, heartburn, diarrhea, constipation, nausea, and vomiting. The number of participants with gastrointestinal disorders for each treatment group has been summarized.
Time frame: Up to Day 180
Population: Safety Population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| CQ Only | Number of Participants With Gastrointestinal Disorders | Abdominal pain | 5 Participants |
| CQ Only | Number of Participants With Gastrointestinal Disorders | Dyspepsia | 5 Participants |
| CQ Only | Number of Participants With Gastrointestinal Disorders | Vomiting | 9 Participants |
| CQ Only | Number of Participants With Gastrointestinal Disorders | Abdominal pain upper | 13 Participants |
| CQ Only | Number of Participants With Gastrointestinal Disorders | Nausea | 12 Participants |
| CQ Only | Number of Participants With Gastrointestinal Disorders | Diarrhoea | 6 Participants |
| TQ + CQ | Number of Participants With Gastrointestinal Disorders | Nausea | 21 Participants |
| TQ + CQ | Number of Participants With Gastrointestinal Disorders | Abdominal pain | 8 Participants |
| TQ + CQ | Number of Participants With Gastrointestinal Disorders | Vomiting | 22 Participants |
| TQ + CQ | Number of Participants With Gastrointestinal Disorders | Abdominal pain upper | 11 Participants |
| TQ + CQ | Number of Participants With Gastrointestinal Disorders | Dyspepsia | 6 Participants |
| TQ + CQ | Number of Participants With Gastrointestinal Disorders | Diarrhoea | 15 Participants |
| PQ + CQ | Number of Participants With Gastrointestinal Disorders | Dyspepsia | 2 Participants |
| PQ + CQ | Number of Participants With Gastrointestinal Disorders | Vomiting | 11 Participants |
| PQ + CQ | Number of Participants With Gastrointestinal Disorders | Abdominal pain upper | 7 Participants |
| PQ + CQ | Number of Participants With Gastrointestinal Disorders | Diarrhoea | 5 Participants |
| PQ + CQ | Number of Participants With Gastrointestinal Disorders | Abdominal pain | 6 Participants |
| PQ + CQ | Number of Participants With Gastrointestinal Disorders | Nausea | 9 Participants |
Secondary
Number of Participants With Hematology Laboratory Data Outside the Reference Range
Blood samples were collected for the evaluation of hematology parameters including eosinophils, leukocytes, lymphocytes, neutrophils, platelets, reticulocytes and methemoglobin. The number of participants with hematology laboratory data outside the extended normal range (F3) was presented. The upper and lower limits for F3 range were defined by multiplying the normal range limits by different factors. High and low indicated that the participants had values flagged as high and low respectively for the particular parameter any time on-treatment. Only those participants with data available at the specified data points were analyzed.
Time frame: Up to Day 120
Population: Safety Population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| CQ Only | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood eosinophils, High | 18 Participants |
| CQ Only | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood leukocytes, Low | 0 Participants |
| CQ Only | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood lymphocytes, Low | 7 Participants |
| CQ Only | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood lymphocytes, High | 23 Participants |
| CQ Only | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood neutrophils, Low | 2 Participants |
| CQ Only | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood platelets, Low | 14 Participants |
| CQ Only | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood reticulocytes, High | 72 Participants |
| CQ Only | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Methemoglobin, High | 4 Participants |
| TQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood lymphocytes, Low | 4 Participants |
| TQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood reticulocytes, High | 141 Participants |
| TQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood lymphocytes, High | 32 Participants |
| TQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood neutrophils, Low | 5 Participants |
| TQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood platelets, Low | 35 Participants |
| TQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood eosinophils, High | 38 Participants |
| TQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood leukocytes, Low | 3 Participants |
| TQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Methemoglobin, High | 5 Participants |
| PQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood lymphocytes, Low | 0 Participants |
| PQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood leukocytes, Low | 2 Participants |
| PQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood eosinophils, High | 28 Participants |
| PQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood lymphocytes, High | 13 Participants |
| PQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood reticulocytes, High | 85 Participants |
| PQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood platelets, Low | 15 Participants |
| PQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Blood neutrophils, Low | 7 Participants |
| PQ + CQ | Number of Participants With Hematology Laboratory Data Outside the Reference Range | Methemoglobin, High | 11 Participants |
Secondary
Number of Participants With Hemoglobin Decline From Baseline Over First 29 Days
Glucose-6-phosphate dehydrogenase deficiency (G6PD) deficiency is known to be a risk factor for hemolysis in participants treated with 8-aminoquinolines. Blood samples were collected for the evaluation of hemoglobin levels. Hemoglobin decreases of \>=30% or \>3 grams/deciliter (g/dL) from Baseline; or, an overall drop in hemoglobin below 6.0 g/dL in the first 15 days of the study were considered as protocol defined serious adverse events (SAEs). Number of participants with maximum hemoglobin decline from Baseline over first 29 days of study has been summarized. Safety Population consisted of all randomized participants who received at least one dose of study medication.
Time frame: Baseline and up to Day 29
Population: Safety Population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| CQ Only | Number of Participants With Hemoglobin Decline From Baseline Over First 29 Days | >20g/L to <=30 g/L | 11 Participants |
| CQ Only | Number of Participants With Hemoglobin Decline From Baseline Over First 29 Days | <=20 grams/liter (g/L) | 120 Participants |
| CQ Only | Number of Participants With Hemoglobin Decline From Baseline Over First 29 Days | >30 g/L or >=30% | 2 Participants |
| TQ + CQ | Number of Participants With Hemoglobin Decline From Baseline Over First 29 Days | >20g/L to <=30 g/L | 31 Participants |
| TQ + CQ | Number of Participants With Hemoglobin Decline From Baseline Over First 29 Days | <=20 grams/liter (g/L) | 214 Participants |
| TQ + CQ | Number of Participants With Hemoglobin Decline From Baseline Over First 29 Days | >30 g/L or >=30% | 14 Participants |
| PQ + CQ | Number of Participants With Hemoglobin Decline From Baseline Over First 29 Days | <=20 grams/liter (g/L) | 114 Participants |
| PQ + CQ | Number of Participants With Hemoglobin Decline From Baseline Over First 29 Days | >30 g/L or >=30% | 3 Participants |
| PQ + CQ | Number of Participants With Hemoglobin Decline From Baseline Over First 29 Days | >20g/L to <=30 g/L | 12 Participants |
Secondary
Number of Participants With Keratopathy
Ophthalmic assessments were carried out at pre-qualified sites (Manaus) prior to randomization and at Days 29 and 90 and at withdrawal. Assessments were carried out at Day 180 if the Day 90 assessments showed abnormalities. The last assessment performed on the day of randomization or earlier was considered Baseline. The number of participants displaying keratopathy in each eye was summarized for each visit. The number of participants with new keratopathy at any time post Baseline was also reported. Ophthalmic Safety Population comprised of all participants in the Safety Population who have results from any eye assessments. Only those participants with data available at the specified data points were analyzed.
Time frame: Up to Day 180
Population: Ophthalmic Safety Population. Day 180 was not a required follow up assessment, hence, data was not collected for most participants.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| CQ Only | Number of Participants With Keratopathy | Day 90; right eye | 0 Participants |
| CQ Only | Number of Participants With Keratopathy | Baseline; right eye | 0 Participants |
| CQ Only | Number of Participants With Keratopathy | Day 90; left eye | 0 Participants |
| CQ Only | Number of Participants With Keratopathy | Day 1; right eye | 0 Participants |
| CQ Only | Number of Participants With Keratopathy | Any time post Baseline; right eye | 0 Participants |
| CQ Only | Number of Participants With Keratopathy | Any time post Baseline; left eye | 0 Participants |
| CQ Only | Number of Participants With Keratopathy | Day 29; right eye | 0 Participants |
| CQ Only | Number of Participants With Keratopathy | Day 1; left eye | 0 Participants |
| CQ Only | Number of Participants With Keratopathy | Baseline; left eye | 0 Participants |
| CQ Only | Number of Participants With Keratopathy | Day 29; left eye | 0 Participants |
| TQ + CQ | Number of Participants With Keratopathy | Any time post Baseline; left eye | 0 Participants |
| TQ + CQ | Number of Participants With Keratopathy | Day 90; right eye | 1 Participants |
| TQ + CQ | Number of Participants With Keratopathy | Baseline; right eye | 0 Participants |
| TQ + CQ | Number of Participants With Keratopathy | Day 29; left eye | 0 Participants |
| TQ + CQ | Number of Participants With Keratopathy | Day 1; left eye | 0 Participants |
| TQ + CQ | Number of Participants With Keratopathy | Day 90; left eye | 0 Participants |
| TQ + CQ | Number of Participants With Keratopathy | Day 180; left eye | 0 Participants |
| TQ + CQ | Number of Participants With Keratopathy | Day 180; right eye | 0 Participants |
| TQ + CQ | Number of Participants With Keratopathy | Day 29; right eye | 0 Participants |
| TQ + CQ | Number of Participants With Keratopathy | Any time post Baseline; right eye | 1 Participants |
| TQ + CQ | Number of Participants With Keratopathy | Day 1; right eye | 0 Participants |
| TQ + CQ | Number of Participants With Keratopathy | Baseline; left eye | 0 Participants |
| PQ + CQ | Number of Participants With Keratopathy | Any time post Baseline; left eye | 0 Participants |
| PQ + CQ | Number of Participants With Keratopathy | Day 180; right eye | 0 Participants |
| PQ + CQ | Number of Participants With Keratopathy | Day 90; left eye | 0 Participants |
| PQ + CQ | Number of Participants With Keratopathy | Baseline; right eye | 0 Participants |
| PQ + CQ | Number of Participants With Keratopathy | Baseline; left eye | 0 Participants |
| PQ + CQ | Number of Participants With Keratopathy | Day 1; right eye | 0 Participants |
| PQ + CQ | Number of Participants With Keratopathy | Day 1; left eye | 0 Participants |
| PQ + CQ | Number of Participants With Keratopathy | Day 29; right eye | 0 Participants |
| PQ + CQ | Number of Participants With Keratopathy | Day 29; left eye | 0 Participants |
| PQ + CQ | Number of Participants With Keratopathy | Day 90; right eye | 0 Participants |
| PQ + CQ | Number of Participants With Keratopathy | Day 180; left eye | 0 Participants |
| PQ + CQ | Number of Participants With Keratopathy | Any time post Baseline; right eye | 0 Participants |
Secondary
Number of Participants With Recurrence-free Efficacy at 4 Months Post Dose
A participant (par) was considered to have demonstrated recurrence-free efficacy at 4 months if: a) Par had non-zero P vivax asexual parasite count at Baseline. b) Par showed initial clearance of P vivax parasitemia. c) Par had no positive asexual P vivax parasite count at any assessment prior to or on Study Day 130 following initial parasite clearance. d) Par did not take a concomitant medication with anti-malarial activity at any point between Study Day 1 and their last parasite assessment after Study Day 109 (up to and including Study Day 130). e) Par is parasite-free at 4 months defined as a negative asexual P vivax parasite count at the first parasite assessment performed after Study Day 109 (up to and including Study Day 130). Par were censored if they did not have P.vivax at Baseline, or took a drug with anti-malarial action despite not having malaria parasites or did not have a 4 month assessment. The number of par with recurrence-free efficacy at 4 months has been summarized.
Time frame: 4 months post dose
Population: mITT Population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| CQ Only | Number of Participants With Recurrence-free Efficacy at 4 Months Post Dose | 47 Participants |
| TQ + CQ | Number of Participants With Recurrence-free Efficacy at 4 Months Post Dose | 177 Participants |
| PQ + CQ | Number of Participants With Recurrence-free Efficacy at 4 Months Post Dose | 90 Participants |
p-value: <0.00195% CI: [0.195, 0.376]Cox Proportional Hazards Model
p-value: <0.00195% CI: [0.167, 0.39]Cox Proportional Hazards Model
Secondary
Number of Participants With Retinal Changes From Baseline
Ophthalmic assessments were carried out at pre-qualified sites (Manaus) prior to randomization and at Days 29 and 90 and at withdrawal. Assessments were carried out at Day 180 if the Day 90 assessments showed abnormalities. The last assessment performed on the day of randomization or earlier was considered Baseline. Change from Baseline was calculated as the post Baseline assessment minus the Baseline assessment. The number of participants with definite retinal change and questionable (ques) retinal change from Baseline was presented. Only those participants with data available at the specified data points were analyzed.
Time frame: Baseline and up to Day 180
Population: Ophthalmic Safety Population. Day 180 was not a required follow up assessment, hence, data was not collected for most participants.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| CQ Only | Number of Participants With Retinal Changes From Baseline | Day 90, Definite change, right eye | 1 Participants |
| CQ Only | Number of Participants With Retinal Changes From Baseline | Day 180, Ques change, left eye | 0 Participants |
| CQ Only | Number of Participants With Retinal Changes From Baseline | Day 180, Definite change, right eye | 0 Participants |
| CQ Only | Number of Participants With Retinal Changes From Baseline | Day 90, Ques change, right eye | 0 Participants |
| CQ Only | Number of Participants With Retinal Changes From Baseline | Day 29, Definite change, left eye | 1 Participants |
| CQ Only | Number of Participants With Retinal Changes From Baseline | Day 90, Ques change, left eye | 0 Participants |
| CQ Only | Number of Participants With Retinal Changes From Baseline | Day 90, Definite change, left eye | 1 Participants |
| CQ Only | Number of Participants With Retinal Changes From Baseline | Day 29, Ques change, right eye | 0 Participants |
| CQ Only | Number of Participants With Retinal Changes From Baseline | Day 180, Definite change, left eye | 0 Participants |
| CQ Only | Number of Participants With Retinal Changes From Baseline | Day 29, Ques change, left eye | 0 Participants |
| CQ Only | Number of Participants With Retinal Changes From Baseline | Day 29, Definite change, right eye | 1 Participants |
| CQ Only | Number of Participants With Retinal Changes From Baseline | Day 180, Ques change, right eye | 0 Participants |
| TQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 180, Ques change, left eye | 0 Participants |
| TQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 29, Definite change, right eye | 0 Participants |
| TQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 29, Ques change, right eye | 0 Participants |
| TQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 29, Definite change, left eye | 0 Participants |
| TQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 29, Ques change, left eye | 0 Participants |
| TQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 90, Definite change, right eye | 1 Participants |
| TQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 90, Ques change, right eye | 0 Participants |
| TQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 90, Definite change, left eye | 1 Participants |
| TQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 90, Ques change, left eye | 1 Participants |
| TQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 180, Definite change, right eye | 0 Participants |
| TQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 180, Ques change, right eye | 0 Participants |
| TQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 180, Definite change, left eye | 0 Participants |
| PQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 90, Definite change, right eye | 1 Participants |
| PQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 29, Definite change, right eye | 0 Participants |
| PQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 29, Ques change, left eye | 0 Participants |
| PQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 29, Ques change, right eye | 0 Participants |
| PQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 90, Definite change, left eye | 0 Participants |
| PQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 90, Ques change, right eye | 1 Participants |
| PQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 29, Definite change, left eye | 0 Participants |
| PQ + CQ | Number of Participants With Retinal Changes From Baseline | Day 90, Ques change, left eye | 2 Participants |
Secondary
Number of Participants With TEAEs and Serious TEAEs
An AE is defined as any untoward medical occurrence in a participant under clinical investigation, temporarily associated with the use of a medicinal product, whether or not considered related to the medicinal product. SAE is defined as any untoward medical occurrence that, at any dose results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/ birth defect, other situations and is associated with possible drug induced liver injury with hyperbilirubinemia. TEAEs is defined as AEs with an onset date and time on or after that of the start of first dose of study medication (including CQ). Number of participants with TEAEs and serious TEAEs have been presented.
Time frame: Up to Day 180
Population: Safety Population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| CQ Only | Number of Participants With TEAEs and Serious TEAEs | TEAEs | 86 Participants |
| CQ Only | Number of Participants With TEAEs and Serious TEAEs | Serious TEAEs | 6 Participants |
| TQ + CQ | Number of Participants With TEAEs and Serious TEAEs | TEAEs | 164 Participants |
| TQ + CQ | Number of Participants With TEAEs and Serious TEAEs | Serious TEAEs | 21 Participants |
| PQ + CQ | Number of Participants With TEAEs and Serious TEAEs | TEAEs | 76 Participants |
| PQ + CQ | Number of Participants With TEAEs and Serious TEAEs | Serious TEAEs | 4 Participants |
Secondary
Number of Participants With TEAEs by Maximum Intensity
An AE is defined as any untoward medical occurrence in a participant under clinical investigation, temporarily associated with the use of a medicinal product, whether or not considered related to the medicinal product. TEAE is defined as AEs with an onset date and time on or after that of the start of first dose of study medication (including CQ). Number of participants with AEs based on severity has been presented.
Time frame: Up to Day 180
Population: Safety Population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| CQ Only | Number of Participants With TEAEs by Maximum Intensity | Grade 4 | 1 Participants |
| CQ Only | Number of Participants With TEAEs by Maximum Intensity | Severe or Grade 3 | 3 Participants |
| CQ Only | Number of Participants With TEAEs by Maximum Intensity | Moderate or Grade 2 | 52 Participants |
| CQ Only | Number of Participants With TEAEs by Maximum Intensity | Grade 5 | 0 Participants |
| CQ Only | Number of Participants With TEAEs by Maximum Intensity | Mild or Grade 1 | 30 Participants |
| TQ + CQ | Number of Participants With TEAEs by Maximum Intensity | Severe or Grade 3 | 2 Participants |
| TQ + CQ | Number of Participants With TEAEs by Maximum Intensity | Mild or Grade 1 | 70 Participants |
| TQ + CQ | Number of Participants With TEAEs by Maximum Intensity | Moderate or Grade 2 | 89 Participants |
| TQ + CQ | Number of Participants With TEAEs by Maximum Intensity | Grade 4 | 0 Participants |
| TQ + CQ | Number of Participants With TEAEs by Maximum Intensity | Grade 5 | 1 Participants |
| PQ + CQ | Number of Participants With TEAEs by Maximum Intensity | Grade 5 | 0 Participants |
| PQ + CQ | Number of Participants With TEAEs by Maximum Intensity | Grade 4 | 0 Participants |
| PQ + CQ | Number of Participants With TEAEs by Maximum Intensity | Mild or Grade 1 | 38 Participants |
| PQ + CQ | Number of Participants With TEAEs by Maximum Intensity | Severe or Grade 3 | 1 Participants |
| PQ + CQ | Number of Participants With TEAEs by Maximum Intensity | Moderate or Grade 2 | 37 Participants |
Secondary
Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease
TEAEs are defined as adverse events (AEs) with an onset date and time on or after that of the start of first dose of study medication (including CQ). The number of participants with TEAEs potentially related to hemoglobin decrease has been presented.
Time frame: Up to Day 180
Population: Safety Population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| CQ Only | Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Haemoglobin decreased | 2 Participants |
| CQ Only | Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Fatigue | 2 Participants |
| CQ Only | Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Hyperbilirubinaemia | 1 Participants |
| CQ Only | Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Pallor | 0 Participants |
| TQ + CQ | Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Pallor | 1 Participants |
| TQ + CQ | Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Haemoglobin decreased | 14 Participants |
| TQ + CQ | Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Hyperbilirubinaemia | 0 Participants |
| TQ + CQ | Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Fatigue | 1 Participants |
| PQ + CQ | Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Pallor | 0 Participants |
| PQ + CQ | Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Fatigue | 0 Participants |
| PQ + CQ | Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Hyperbilirubinaemia | 0 Participants |
| PQ + CQ | Number of Participants With Treatment Emergent Adverse Events (TEAEs) Potentially Related to Hemoglobin Decrease | Haemoglobin decreased | 2 Participants |
Secondary
Oral Clearance (CL/F) of TQ
Apparent population oral clearance of TQ
Time frame: Day 2, Day 8, Day 15, Day 29 and Day 60
Population: Safety Population
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| CQ Only | Oral Clearance (CL/F) of TQ | 2.96 Liters per hour |
Secondary
Time Lost by Participants or Care Givers From Normal Occupation
Health outcomes were evaluated based on total time lost by participants or care givers due to an episode of malaria. The reported time lost due to recurrence episode of P vivax malaria has been summarized by category and by site. Where categories by site have not been reported at a visit, the number of participants analyzed is given as 0. Only those participants with data available at the specified data points were analyzed.
Time frame: Up to Day 180
Population: Safety Population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Ethiopia, Other | 1 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Ethiopia, Housework | 4 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Peru, Housework | 24 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Brazil, Other | 3 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Peru, Farming | 19 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Ethiopia, Farming | 2.5 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Peru, Student | 1 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Brazil, paid employment | 8 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Peru, Paid employment | 6 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Ethiopia, Student | 3 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Peru, Other | 26 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Cambodia, Farming | 17 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Philippines, Farming | 0 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Thailand, paid employment | 20 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Ethiopia, Paid employment | 2 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Thailand, Other | 1 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Brazil, Housework | 1 Days |
| CQ Only | Time Lost by Participants or Care Givers From Normal Occupation | Brazil, Farming | 8 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Thailand, Other | 0 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Brazil, Housework | 0 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Brazil, Farming | 0 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Brazil, paid employment | 0 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Brazil, Other | 5 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Cambodia, Farming | 24 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Ethiopia, Housework | 3 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Ethiopia, Farming | 3 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Ethiopia, Student | 0 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Ethiopia, Paid employment | 4 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Ethiopia, Other | 7 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Peru, Housework | 29 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Peru, Farming | 28 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Peru, Student | 6 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Peru, Paid employment | 8.5 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Peru, Other | 32 Days |
| TQ + CQ | Time Lost by Participants or Care Givers From Normal Occupation | Thailand, paid employment | 0 Days |
Secondary
Time to Fever Clearance
Fever clearance time was defined as time from first dose of treatment to the time when body temperature falls to normal within Study Days 1-4 and remains normal for at least 48 hours up to the Day 8 visit. Fever clearance was considered to have been achieved once an initial temperature of more than 37.40 degree Celsius is reduced to a value less than or equal to 37.40 degree Celsius and in the absence of value more than 37.40 degree Celsius in the following 48 hours up to the Day 8 visit. The time taken to achieve fever clearance was analyzed using Kaplan Meier Methodology. The median fever clearance time along with 95% confidence interval has been presented for each treatment group.
Time frame: Up to Day 180
Population: mITT Population
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| CQ Only | Time to Fever Clearance | 7 Hours |
| TQ + CQ | Time to Fever Clearance | 7 Hours |
| PQ + CQ | Time to Fever Clearance | 8 Hours |
Secondary
Time to Parasite Clearance
Parasite clearance time was defined as time needed to clear asexual parasite from the blood that is, parasite numbers falling below the limit of detection in the thick blood smear and remaining undetectable after 6 to 12 hours. The time taken to achieve parasite clearance was analyzed using Kaplan Meier Methodology. The median parasite clearance time along with 95% confidence interval has been presented for each treatment group.
Time frame: Up to Day 180
Population: mITT Population
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| CQ Only | Time to Parasite Clearance | 43 Hours |
| TQ + CQ | Time to Parasite Clearance | 45 Hours |
| PQ + CQ | Time to Parasite Clearance | 42 Hours |
Secondary
Time to Recurrence of P Vivax Malaria
Recurrence was defined as the first confirmed presence of P vivax asexual stage parasites after clearance of initial parasitemia following CQ treatment. Time to recurrence was defined as the time (in days) from initial parasite clearance to recurrence. The time to recurrence was analyzed by the Kaplan-Meier method. NA indicates data was not available due to insufficient number of participants with events during the follow up period in the study. The median number of days to recurrence along with 95% confidence interval has been presented for each treatment group.
Time frame: Up to Day 180
Population: mITT Population
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| CQ Only | Time to Recurrence of P Vivax Malaria | 86 Days |
| TQ + CQ | Time to Recurrence of P Vivax Malaria | NA Days |
| PQ + CQ | Time to Recurrence of P Vivax Malaria | NA Days |
Secondary
Volume of Distribution (Vc/F) of TQ
Apparent population central volume of distribution of TQ
Time frame: Day 2, Day 8, Day 15, Day 29 and Day 60
Population: Safety Population
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| CQ Only | Volume of Distribution (Vc/F) of TQ | 915 Liters |