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Safety, Tolerability and Chemoprotective Activity of P218 in PfSPZ Challenge Model

A Single Centre, Randomised, Double-blind, Placebo-controlled, Phase Ib Study to Evaluate the Safety, Tolerability and Chemoprotective Antimalarial Activity of P218 Against Controlled Human Malaria Infection With Plasmodium Falciparum Sporozoite Challenge in Non-immune Healthy Adult Volunteers

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03707041
Enrollment
32
Registered
2018-10-16
Start date
2018-11-16
Completion date
2019-06-03
Last updated
2021-04-09

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

Conditions

Malaria

Keywords

malaria, PfSPZ Challenge, chemoprotection

Brief summary

This was a single centre, randomised, double-blind, placebo-controlled Phase Ib study, to evaluate the safety, tolerability and chemoprotective activity of P218 in a controlled P. falciparum sporozoite infection model. Healthy men and women, aged 18 to 45 years were to be enrolled in 3 study cohorts and to be administered either P218 or placebo twice, 48 hours apart. Subjects in cohorts 2 and 3 were to be inoculated with P. falciparum sporozoites. Enrolment in cohorts was to proceed sequentially, to facilitate review of data by a Safety Review Team (SRT) before proceeding with a subsequent cohort. In cohort 1, safety and tolerability of P218 was assessed. In cohorts 2 and 3, chemoprotective activity of P218 against malaria infection was assessed, as well as the Influence of time of initiation of the P218 treatment on the protective effect.

Detailed description

This was a single centre, randomised, double-blind, placebo-controlled Phase Ib study, to evaluate the safety, tolerability and chemoprotective activity of P218 in a controlled P. falciparum sporozoite infection model. 32 healthy men and women, aged 18 to 45 years were to be enrolled in 3 cohorts of respectively 8, 12 and 12 subjects. A subject could be enrolled in one cohort only and was to be randomised in a 3:1 ratio, to receive two consecutive administrations, 48 hours apart, of either P218 or placebo. Enrolment in cohorts proceeded sequentially, to facilitate review of data by a Safety Review Team (SRT) before populating a subsequent cohort. Cohort 1 consisted of 2 subgroups of subjects, to be enrolled sequentially: subgroup 1 was to be composed of 2 subjects: one to receive two 1000 mg doses of P218 and one to receive placebo twice. Subgroup 2 was to be composed of 6 subjects: five to receive two 1000 mg doses of P218 and one to receive placebo twice. Subjects in subgroup 2 would not be treated until 24 hours after second IMP administration in the last subject of subgroup 1 and only after review of the safety data from subgroup 1 by the PI. Duration of each subject treatment and follow-up in Cohort 1 was 9 days. Progression to Cohort 2 was subject to review of the safety and tolerability data by a SRT. Cohort 2 consisted of three subgroups of subjects, to be enrolled sequentially. Subgroup 1 was to be composed of 2 subjects: one to receive two 1000 mg doses of P218 and one to receive placebo twice. Subgroups 2 and 3 were to be composed of 5 subjects each: four to receive two 1000 mg doses of P218 and one to receive placebo twice. Subjects in subgroup 2 would not be treated until 24 hours after second IMP administration in the last subject of subgroup 1. On Day 1, each subject in Cohort 2 would be administered 3200 P. falciparum sporozoites (PfSPZ Challenge) by direct venous inoculation (DVI). First administration of 1000 mg of P218 or placebo will take place 2 hours after PfSPZ Challenge DVI; second administration of 1000 mg of P218 or placebo would take place 48 hours later. As of Day 7, parasitemia in every subject was to be assessed daily until the installation of malarial infection or until Day 28. Overall duration of each subject observation in Cohort 2 was 35 days. Progression to Cohort 3 was subject to assessment of safety and parasitemia data, as well as malaria signs and symptoms by a SRT. Cohort 3 was to consist of two subgroups each with 6 subjects, to be enrolled sequentially. Treatment was to be allocated in a ratio of 3 active: 1 placebo. In each subgroup, at least 1 subject was to receive placebo and the remaining subjects would receive two 100 mg doses of P218 48 hours apart. Subjects in subgroup 2 would not be inoculated until 24 hours after second IMP administration in the last subject of subgroup 1. On Day 1, subjects were to be administered 3200 P. falciparum sporozoites by DVI. As of Day 7, parasitemia in every subject was to be assessed daily until the installation of malarial infection or until Day 28. Overall duration of each subject observation in Cohort 3 is 35 days. All subjects in Cohorts 2 and 3 would receive antimalarial rescue therapy, either upon installation of malarial infection or on Day 28 or if leaving the study prematurely. In Cohort 1, safety and tolerability of two 1000 mg doses of P218 administered 48 hours apart was to be assessed over 9 days of observation. Pharmacokinetic assessments of P218 and its main metabolites were to take place over 9 days of observation. In Cohorts 2 and 3, chemoprotective activity of two doses P218 (1000 mg or 100 mg respectively) administered 48 hours apart, were to be assessed over 28 days. Safety and tolerability of two doses of P218 (1000 mg or 100 mg respectively) administered 48 hours apart were to be assessed over 35 days of observation. Pharmacokinetic assessments of P218 would take place over 9 days of observation.

Interventions

DRUGP218 (1000 mg) Oral Capsules

1000 mg P218 (4 x 250 mg capsules)

Placebo capsules matched to the P218 capsules with regard to appearance and taste

DRUGP218 (100 mg) Oral Capsules

100 mg P218 (2 x 50 mg capsules)

BIOLOGICALPfSPZ Challenge

3200 P. falciparum Sporozoites by direct venous inoculation (DVI)

Sponsors

SGS Life Sciences, a division of SGS Belgium NV
CollaboratorOTHER
Institute of Tropical Medicine, Belgium
CollaboratorOTHER
Washington University School of Medicine
CollaboratorOTHER
Swiss BioQuant
CollaboratorINDUSTRY
PrimeVigilance Ltd., UK
CollaboratorINDUSTRY
Biologic LLP, UK
CollaboratorINDUSTRY
Sanaria Inc.
CollaboratorINDUSTRY
FGK Representative Service B.V., The Netherlands
CollaboratorINDUSTRY
Medicines for Malaria Venture
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Masking description

Placebo capsules matched to the drug product with regard to appearance and taste

Intervention model description

In each of the three treatment cohorts, subjects will be randomly allocated to receive either P218 or placebo.

Eligibility

Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
Yes

Inclusion criteria

Subjects meeting all of the following criteria are eligible to participate in this study: 1. Informed Consent Form signed voluntarily before any study-related procedure is performed, indicating that the subject understands the purpose of and procedures required for the study and is willing to participate in the study, including administration of rescue treatment. 2. Male or female, between 18 and 45 years old (extremes included) at screening. 3. Body weight of at least 50 kg and a body mass index (BMI) of 19 to 30 kg/m2 (extremes included). 4. Good general health without clinically relevant medical illness, physical exam findings including vital signs, and laboratory abnormalities as determined by the investigator. 5. Willing to adhere to the prohibitions and restrictions (see Section 4.3) specified in this protocol, including willingness to stay confined to the inpatient unit for required duration and willingness to avoid to travel outside of Benelux during the study period. 6. Female subjects should fulfil one of the following criteria: 1. At least 1 year post-menopausal (amenorrhea \>12 months and follicle-stimulating hormone (FSH) \>30 mIU/mL) prior to screening; 2. Surgically sterile (bilateral oophorectomy, hysterectomy or tubal ligation); 3. Will use contraceptives as outlined in inclusion criteria 7 and 8. 7. Female subjects of childbearing potential must agree to the use of a highly effective method of birth control from screening visit to until 40 days after the last dose of IMP (covering a full menstrual cycle of 30 days starting after 5 half-lives of last dose of IMP). Note: Highly effective birth control methods include: combined (estrogen and progestogen containing) oral/intravaginal/transdermal hormonal contraception associated with inhibition of ovulation, progestogen-only oral/injectable/implantable hormonal contraception associated with inhibition of ovulation, intrauterine device, intrauterine hormone-releasing system, bilateral tubal occlusion, vasectomised partner or sexual abstinence. 8. Male subjects who are sexually active with a female partner of childbearing potential must agree to the use of an effective method of birth control from the day of the first IMP dose until 100 days thereafter (covering a full sperm cycle of 90 days starting after 5 half-lives of last dose of IMP). Note: Medically acceptable methods of contraception that may be used by the subject and/or partner include sterilization and vasectomy or a double barrier option combining oral contraceptive, contraceptive vaginal ring, contraceptive injection, intrauterine device or etonogestrel implant. 9. Female subject has a negative pregnancy test at screening and upon admission in the clinical unit. Note: Pregnancy testing will consist of a serum β-human chorionic gonadotropin (β-HCG) test at screening and urine β-HCG tests at other visits, in all women. Inclusion Criteria - CHMI (controlled human malaria infection) specific: 10. Different ways of being reachable 24/7 (e.g. by mobile phone, regular phone or electronic mail) during the whole study period. Subjects meeting any of the following criteria are excluded from participation in this study: 1. Nursing (lactating) women. 2. Participation in any other clinical drug or vaccine study within 30 days (or five half-lives for drugs) preceding the first dose of IMP (whichever is longer), or plans to participate in other investigational drug or vaccine research during the study period. 3. Blood product donation to any blood bank during the 8 weeks (whole blood) or 4 weeks (plasma and platelets) prior to admission in the clinical unit. 4. ECG outside normal range and deemed clinically relevant by the investigator. Examples of clinically significant ECG abnormalities for this study include: 1. PR-interval \>220 ms; 2. QRS-complex \>120 ms; 3. QT interval corrected according to Bazett's formula (QTcB) or QT interval corrected according to Fridericia's formula \[3\] (QTcF) \>450 ms; 4. Pathologic Q wave; 5. Significant ST-T wave changes; 6. Left or right ventricular hypertrophy; 7. Non-sinus rhythm except isolated premature atrial contractions and ventricular extrasystole \<2 per 10 s ECG lead; 8. Incomplete left bundle branch block, or complete or intermittent right or left bundle branch block; 9. Second or third degree A-V heart block. 5. Seropositive human immunodeficiency virus (HIV) (antibody and antigen), hepatitis B virus (HBV) (hepatitis B surface antigen \[HBsAg\]) or hepatitis C virus (HCV) (antibody) tests. 6. History or presence of diagnosed food or known drug allergies (including but not limited to allergy to any of the antimalarial rescue medications to be used in the study, see Section 5.2), or history of anaphylaxis or other severe allergic reactions. Note: Subjects with seasonal allergies/hay fever, house dust mite or allergy to animals that are untreated and asymptomatic at the time of dosing can be enrolled in the study. 7. History of convulsion or severe head trauma. Note: A medical history of a single febrile convulsion during childhood is not an

Exclusion criteria

. 8. History of serious psychiatric condition that may affect participation in the study or preclude compliance with the protocol, including but not limited to past or present psychoses, disorders requiring lithium, a history of attempted or planned suicide, more than one previous episode of major depression, any previous single episode of major depression lasting for or requiring treatment for more than 6 months, or any episode of major depression during the 5 years preceding screening. Note: The Beck Depression Inventory (Attachment 2) will be used as an objective tool for the assessment of depression at screening. In addition to the conditions listed above, subjects with a score of 20 or more on the Beck Depression Inventory and/or a response of 1, 2 or 3 for item 9 of this inventory (related to suicidal ideation) will not be eligible for participation. Subjects with a Beck score of 17 to 19 may be enrolled at the discretion of the Investigator if they do not have a history of the psychiatric conditions mentioned in this criterion and their mental state is not considered to pose additional risk to the health of the volunteer or to the execution of the study and interpretation of the data gathered. 9. A medical, occupational or family problem as a result of alcohol or illicit drug abuse during the past 12 months or current alcohol or illicit drug abuse or addiction (positive alcohol breath test or positive drug screen for amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine or opiates at screening or upon check-in at the clinical unit). Note: Excessive use of alcohol is an intake of \>21 units per week for males and \>14 units per week for females where one alcohol unit is defined as 10 mL or 8 g of pure alcohol. A single unit is equal to one 25-mL (single) measure of whisky (alcohol by volume \[ABV\] 40%), or a third of a pint of beer (190 mL; ABV 5-6%) or half a standard (175 mL) glass of wine (ABV 12%). 10. Subjects are non-smokers or ex-smokers for more than 90 days prior to screening or smoke no more than 5 cigarettes per day. If users of nicotine products (i.e. spray, patch, e-cigarette, etc.) they should use the equivalent of no more than 5 cigarettes per day. Subjects must agree to abstain from smoking while in the unit. 11. Use of any prescription drugs, herbal supplements (e.g. St John's Wort) or over-the-counter medication within 7 days or five half-lives (whichever is longer) prior to the first IMP administration, or an anticipated requirement for the use of these during the course of the study (See Section 6.2). Note: If necessary, the incidental use of non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol (2g/day, 10 gr/week), vitamins and topical treatments may be acceptable after approval by the study Sponsor and will be documented in the eSource system. The use of nutritional supplements during this time that are not believed to have the potential to affect subject safety nor the overall results of the study, may be permitted on a case-by-case basis following approval by the Sponsor in consultation with the Investigator. 12. Any surgical or medical condition possibly affecting drug absorption (e.g. cholecystectomy, gastrectomy, bowel disease), distribution, metabolism or excretion. 13. Any history of gallbladder disease, including cholecystitis and/or cholelithiasis. 14. History of megaloblastic anaemia or folate deficiency. 15. Personnel (e.g. investigator, sub-investigator, research assistant, pharmacist, study coordinator or anyone mentioned in the delegation log) directly involved in the conduct of the study. 16. Any condition that in the opinion of the investigator would jeopardize the safety or rights of a person participating in the trial or would render the person unable to comply with the protocol.

Design outcomes

Primary

MeasureTime frameDescription
Cohort 1: Number of TEAEs9 daysIncidence, severity and relationship to the treatment of observed or self-reported treatment emergent adverse events (TEAEs) after two single doses of 1000 mg P218 administered 48 hours apart in healthy adult volunteers.
Cohorts 2 and 3: Geometric Mean Time From PfSPZ Challenge to First Quantitative Polymerase Chain Reaction (qPCR) Outcome Equal or Greater Than 250 Asexual Parasites Per mL of BloodNumber of days from PfSPZ Challenge DVI to positive parasitaemia, or 28 daysChemoprotective activity of two single doses of 1000 mg P218 administered 2 hours after PfSPZ Challenge and 48 hours later in healthy adult volunteers

Secondary

MeasureTime frameDescription
Cohorts 2 and 3: Malaria Clinical Score at the Time of Introduction of Rescue TherapyOn the day of positive parasitaemia or on Day 28The malaria clinical score consists of 14 signs/symptoms frequently associated with malaria and graded using a 4-point scale (absent: 0; mild: 1; moderate: 2; severe: 3) and summed to generate a total malaria clinical score (maximum score possible is 42): headache, myalgia (muscle ache), arthralgia (joint ache), fatigue/lethargy, malaise (general discomfort/uneasiness), chills/shivering/rigors, sweating/hot spells, anorexia, nausea, vomiting, abdominal discomfort, fever, tachycardia and hypotension. To determine severity of the 14 signs/symptoms the CTCAE grading scale grade 1 - 5 was used. Mild (1) equates to CTCAE grade 1, Moderate (2) equates to CTCAE grade 2 and Severe (3) equates to CTCAE grade 3 or above. Individual scores for each symptom as well as the total score were recorded.
Cohorts 1, 2 and 3: P218 AUC[0-48h] - Day 19 daysArea under the P218 plasma concentration-time curve from first administration to 48 hours after first administration
Cohorts 2 and 3: Number of P218 TEAEs35 daysIncidence, severity and relationship to the P218 treatment of observed or self-reported treatment emergent adverse events in non-immune healthy adult volunteers after two single doses of 1000 mg P218 administered 48 hours apart in a controlled human malaria infection (PfSPZ Challenge)
Cohorts 1, 2 and 3: P218 Cmax - Day 19 daysMaximum observed P218 plasma concentration after each P218 administration
Cohorts 1, 2 and 3: P218 Tmax - Day 19 daysTime to P218 Cmax after each P218 administration
Cohort 1: P218-beta-acyl-glucuronide-OH AUC[48-96h]9 daysArea under the P218-beta-acyl-glucuronide-OH plasma concentration-time curve from 48 hours after first P218 administration to 96 hours after first P218 administration
Cohorts 2 and 3: Number of PfSPZ Challenge TEAEs35 daysIncidence, severity and relationship to the PfSPZ Challenge of observed or self-reported treatment emergent adverse events in non-immune healthy adult volunteers before and after P218 administration

Countries

Belgium

Participant flow

Recruitment details

The study was conducted at the SGS Life Sciences Clinical Pharmacology Unit in Antwerp.

Pre-assignment details

61 subjects were screened, 32 subjects were enrolled and randomised.

Participants by arm

ArmCount
P218 1000 mg (Oral Capsules) - Cohort 1
Two administrations of 1000 mg P218 (capsules p.o.), 48 hours apart P218 (1000 mg) Oral Capsules: 1000 mg P218 (4 x 250 mg capsules)
6
P218 Placebo Oral Capsules - Cohort 1
Two administrations of P218 placebo (capsules p.o.), 48 hours apart Placebo Oral Capsules: Placebo capsules matched to the P218 capsules with regard to appearance and taste
2
P218 1000 mg (Oral Capsules) - Cohort 2
One administration of 1000 mg P218 (capsules p.o.), 2 hours after PfSPZ Challenge and one administration of 1000 mg P218 (capsules p.o.), 48 hours after first administration. P218 (1000 mg) Oral Capsules: 1000 mg P218 (4 x 250 mg capsules) PfSPZ Challenge: 3200 P. falciparum Sporozoites by direct venous inoculation (DVI)
9
P218 100 mg (Oral Capsules) - Cohort 3
One administration of 100 mg P218 (capsules p.o.), 2 hours after PfSPZ Challenge and one administration of 100 mg P218 (capsules p.o.), 48 hours after first administration. P218 (100 mg) Oral Capsules: 100 mg P218 (2 x 50 mg capsules) PfSPZ Challenge: 3200 P. falciparum Sporozoites by direct venous inoculation (DVI)
9
P218 Placebo Oral Capsule - Cohorts 2 and 3
One administration of P218 placebo (capsules p.o.), 2 hours after PfSPZ Challenge and one administration of P218 placebo (capsules p.o.), 48 hours after first administration. Placebo Oral Capsules: Placebo capsules matched to the P218 capsules with regard to appearance and taste PfSPZ Challenge: 3200 P. falciparum Sporozoites by direct venous inoculation (DVI)
6
Total32

Baseline characteristics

CharacteristicP218 1000 mg (Oral Capsules) - Cohort 1TotalP218 Placebo Oral Capsule - Cohorts 2 and 3P218 100 mg (Oral Capsules) - Cohort 3P218 1000 mg (Oral Capsules) - Cohort 2P218 Placebo Oral Capsules - Cohort 1
Age, Continuous33.5 years29.5 years34.5 years35.0 years36.0 years24.5 years
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants1 Participants0 Participants1 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants1 Participants0 Participants1 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
6 Participants30 Participants6 Participants7 Participants9 Participants2 Participants
Region of Enrollment
Belgium
6 participants32 participants6 participants9 participants9 participants2 participants
Sex: Female, Male
Female
3 Participants12 Participants0 Participants4 Participants4 Participants1 Participants
Sex: Female, Male
Male
3 Participants20 Participants6 Participants5 Participants5 Participants1 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
deaths
Total, all-cause mortality
0 / 60 / 20 / 90 / 90 / 6
other
Total, other adverse events
2 / 61 / 29 / 91 / 96 / 6
serious
Total, serious adverse events
0 / 60 / 20 / 90 / 90 / 6

Outcome results

Primary

Cohort 1: Number of TEAEs

Incidence, severity and relationship to the treatment of observed or self-reported treatment emergent adverse events (TEAEs) after two single doses of 1000 mg P218 administered 48 hours apart in healthy adult volunteers.

Time frame: 9 days

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
P218 1000 mg (Oral Capsules) - Cohort 1Cohort 1: Number of TEAEsSubjects with any TEAE2 Participants
P218 1000 mg (Oral Capsules) - Cohort 1Cohort 1: Number of TEAEsSubjects without any TEAE4 Participants
P218 Placebo Oral Capsules - Cohort 1Cohort 1: Number of TEAEsSubjects with any TEAE1 Participants
P218 Placebo Oral Capsules - Cohort 1Cohort 1: Number of TEAEsSubjects without any TEAE1 Participants
Primary

Cohorts 2 and 3: Geometric Mean Time From PfSPZ Challenge to First Quantitative Polymerase Chain Reaction (qPCR) Outcome Equal or Greater Than 250 Asexual Parasites Per mL of Blood

Chemoprotective activity of two single doses of 1000 mg P218 administered 2 hours after PfSPZ Challenge and 48 hours later in healthy adult volunteers

Time frame: Number of days from PfSPZ Challenge DVI to positive parasitaemia, or 28 days

ArmMeasureValue (GEOMETRIC_MEAN)
P218 1000 mg (Oral Capsules) - Cohort 1Cohorts 2 and 3: Geometric Mean Time From PfSPZ Challenge to First Quantitative Polymerase Chain Reaction (qPCR) Outcome Equal or Greater Than 250 Asexual Parasites Per mL of Blood28.000 Days
P218 Placebo Oral Capsules - Cohort 1Cohorts 2 and 3: Geometric Mean Time From PfSPZ Challenge to First Quantitative Polymerase Chain Reaction (qPCR) Outcome Equal or Greater Than 250 Asexual Parasites Per mL of Blood25.822 Days
P218 Placebo Oral Capsule - Cohorts 2 and 3Cohorts 2 and 3: Geometric Mean Time From PfSPZ Challenge to First Quantitative Polymerase Chain Reaction (qPCR) Outcome Equal or Greater Than 250 Asexual Parasites Per mL of Blood10.615 Days
Secondary

Cohort 1: P218-beta-acyl-glucuronide-OH AUC[48-96h]

Area under the P218-beta-acyl-glucuronide-OH plasma concentration-time curve from 48 hours after first P218 administration to 96 hours after first P218 administration

Time frame: 9 days

ArmMeasureValue (MEAN)Dispersion
P218 1000 mg (Oral Capsules) - Cohort 1Cohort 1: P218-beta-acyl-glucuronide-OH AUC[48-96h]27283 h*ng/mLStandard Deviation 7106
Secondary

Cohorts 1, 2 and 3: P218 AUC[0-48h] - Day 1

Area under the P218 plasma concentration-time curve from first administration to 48 hours after first administration

Time frame: 9 days

ArmMeasureValue (MEAN)Dispersion
P218 1000 mg (Oral Capsules) - Cohort 1Cohorts 1, 2 and 3: P218 AUC[0-48h] - Day 116752 h*ng/mLStandard Deviation 6958
P218 Placebo Oral Capsules - Cohort 1Cohorts 1, 2 and 3: P218 AUC[0-48h] - Day 113865 h*ng/mLStandard Deviation 2663
P218 Placebo Oral Capsule - Cohorts 2 and 3Cohorts 1, 2 and 3: P218 AUC[0-48h] - Day 11296 h*ng/mLStandard Deviation 332
Secondary

Cohorts 1, 2 and 3: P218 Cmax - Day 1

Maximum observed P218 plasma concentration after each P218 administration

Time frame: 9 days

ArmMeasureValue (MEAN)Dispersion
P218 1000 mg (Oral Capsules) - Cohort 1Cohorts 1, 2 and 3: P218 Cmax - Day 17482 ng/mLStandard Deviation 3889
P218 Placebo Oral Capsules - Cohort 1Cohorts 1, 2 and 3: P218 Cmax - Day 17241 ng/mLStandard Deviation 2983
P218 Placebo Oral Capsule - Cohorts 2 and 3Cohorts 1, 2 and 3: P218 Cmax - Day 1856 ng/mLStandard Deviation 338
Secondary

Cohorts 1, 2 and 3: P218 Tmax - Day 1

Time to P218 Cmax after each P218 administration

Time frame: 9 days

ArmMeasureValue (MEDIAN)
P218 1000 mg (Oral Capsules) - Cohort 1Cohorts 1, 2 and 3: P218 Tmax - Day 11.00 hours
P218 Placebo Oral Capsules - Cohort 1Cohorts 1, 2 and 3: P218 Tmax - Day 11.00 hours
P218 Placebo Oral Capsule - Cohorts 2 and 3Cohorts 1, 2 and 3: P218 Tmax - Day 11.00 hours
Secondary

Cohorts 2 and 3: Malaria Clinical Score at the Time of Introduction of Rescue Therapy

The malaria clinical score consists of 14 signs/symptoms frequently associated with malaria and graded using a 4-point scale (absent: 0; mild: 1; moderate: 2; severe: 3) and summed to generate a total malaria clinical score (maximum score possible is 42): headache, myalgia (muscle ache), arthralgia (joint ache), fatigue/lethargy, malaise (general discomfort/uneasiness), chills/shivering/rigors, sweating/hot spells, anorexia, nausea, vomiting, abdominal discomfort, fever, tachycardia and hypotension. To determine severity of the 14 signs/symptoms the CTCAE grading scale grade 1 - 5 was used. Mild (1) equates to CTCAE grade 1, Moderate (2) equates to CTCAE grade 2 and Severe (3) equates to CTCAE grade 3 or above. Individual scores for each symptom as well as the total score were recorded.

Time frame: On the day of positive parasitaemia or on Day 28

ArmMeasureValue (MEDIAN)
P218 1000 mg (Oral Capsules) - Cohort 1Cohorts 2 and 3: Malaria Clinical Score at the Time of Introduction of Rescue Therapy0.00 Malaria Clinical Score
P218 Placebo Oral Capsules - Cohort 1Cohorts 2 and 3: Malaria Clinical Score at the Time of Introduction of Rescue Therapy0.00 Malaria Clinical Score
P218 Placebo Oral Capsule - Cohorts 2 and 3Cohorts 2 and 3: Malaria Clinical Score at the Time of Introduction of Rescue Therapy1.00 Malaria Clinical Score
Secondary

Cohorts 2 and 3: Number of P218 TEAEs

Incidence, severity and relationship to the P218 treatment of observed or self-reported treatment emergent adverse events in non-immune healthy adult volunteers after two single doses of 1000 mg P218 administered 48 hours apart in a controlled human malaria infection (PfSPZ Challenge)

Time frame: 35 days

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
P218 1000 mg (Oral Capsules) - Cohort 1Cohorts 2 and 3: Number of P218 TEAEsAny P218-related TEAEs1 Participants
P218 1000 mg (Oral Capsules) - Cohort 1Cohorts 2 and 3: Number of P218 TEAEsNo P218-related TEAEs8 Participants
P218 Placebo Oral Capsules - Cohort 1Cohorts 2 and 3: Number of P218 TEAEsNo P218-related TEAEs9 Participants
P218 Placebo Oral Capsules - Cohort 1Cohorts 2 and 3: Number of P218 TEAEsAny P218-related TEAEs0 Participants
P218 Placebo Oral Capsule - Cohorts 2 and 3Cohorts 2 and 3: Number of P218 TEAEsAny P218-related TEAEs0 Participants
P218 Placebo Oral Capsule - Cohorts 2 and 3Cohorts 2 and 3: Number of P218 TEAEsNo P218-related TEAEs6 Participants
Secondary

Cohorts 2 and 3: Number of PfSPZ Challenge TEAEs

Incidence, severity and relationship to the PfSPZ Challenge of observed or self-reported treatment emergent adverse events in non-immune healthy adult volunteers before and after P218 administration

Time frame: 35 days

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
P218 1000 mg (Oral Capsules) - Cohort 1Cohorts 2 and 3: Number of PfSPZ Challenge TEAEsSubjects with any TEAE9 Participants
P218 1000 mg (Oral Capsules) - Cohort 1Cohorts 2 and 3: Number of PfSPZ Challenge TEAEsSubjects without any TEAE0 Participants
P218 Placebo Oral Capsules - Cohort 1Cohorts 2 and 3: Number of PfSPZ Challenge TEAEsSubjects with any TEAE1 Participants
P218 Placebo Oral Capsules - Cohort 1Cohorts 2 and 3: Number of PfSPZ Challenge TEAEsSubjects without any TEAE8 Participants
P218 Placebo Oral Capsule - Cohorts 2 and 3Cohorts 2 and 3: Number of PfSPZ Challenge TEAEsSubjects without any TEAE0 Participants
P218 Placebo Oral Capsule - Cohorts 2 and 3Cohorts 2 and 3: Number of PfSPZ Challenge TEAEsSubjects with any TEAE6 Participants

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