Trial Outcomes & Findings for Safety and Efficacy of Pyronaridine Artesunate Vs Chloroquine in Children and Adult Patients With Acute Vivax Malaria (NCT NCT04368910)

NCT ID: NCT04368910

Last Updated: 2022-01-26

Results Overview

Percentage of subjects with crude cure rate at Day 14, defined as absence of parasitaemia on Day 14, irrespective of body temperature without previously meeting any of the criteria of treatment failure

Recruitment status

TERMINATED

Study phase

PHASE3

Target enrollment

30 participants

Primary outcome timeframe

Day 14

Results posted on

2022-01-26

Participant Flow

Participant milestones

Participant milestones
Measure
Pyronaridine - Artesunate
Oral pyronaridine artesunate (180:60 mg tablets), plus chloroquine-placebo once a day for 3 consecutive days.
Chloroquine
Oral chloroquine (155 mg tablets), plus pyronaridine artesunate-placebo, once a day for 3 consecutive days.
Overall Study
STARTED
15
15
Overall Study
COMPLETED
15
15
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Safety and Efficacy of Pyronaridine Artesunate Vs Chloroquine in Children and Adult Patients With Acute Vivax Malaria

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Pyronaridine - Artesunate
n=15 Participants
Oral pyronaridine artesunate (180:60 mg tablets), plus chloroquine-placebo once a day for 3 consecutive days. For patients who complete the study up to Day 28 and who have normal G-6-PD activity, a 14-day course of primaquine (15 mg/day) shall be administered starting on Day 28, after all required assessments have been performed, to complete their radical cure. Patients who are deficient in G-6-PD and who complete the study up to Day 28 will be treated as per country policy. Pyronaridine - artesunate: Oral pyronaridine artesunate (180:60 mg tablets), plus chloroquine-placebo once a day for 3 consecutive days.
Chloroquine
n=15 Participants
Oral chloroquine (155 mg tablets), plus pyronaridine artesunate-placebo, once a day for 3 consecutive days. For patients who complete the study up to Day 28 and who have normal G-6-PD activity, a 14-day course of primaquine (15 mg/day) shall be administered starting on Day 28, after all required assessments have been performed, to complete their radical cure. Patients who are deficient in G-6-PD and who complete the study up to Day 28 will be treated as per country policy. Chloroquine: Oral chloroquine (155 mg tablets), plus pyronaridine artesunate-placebo, once a day for 3 consecutive days.
Total
n=30 Participants
Total of all reporting groups
Age, Continuous
38.2 years
STANDARD_DEVIATION 14.03 • n=99 Participants
42.3 years
STANDARD_DEVIATION 11.79 • n=107 Participants
40.3 years
STANDARD_DEVIATION 12.90 • n=206 Participants
Sex: Female, Male
Female
2 Participants
n=99 Participants
4 Participants
n=107 Participants
6 Participants
n=206 Participants
Sex: Female, Male
Male
13 Participants
n=99 Participants
11 Participants
n=107 Participants
24 Participants
n=206 Participants
Race/Ethnicity, Customized
Asian/Oriental
15 Participants
n=99 Participants
15 Participants
n=107 Participants
30 Participants
n=206 Participants

PRIMARY outcome

Timeframe: Day 14

Population: Efficacy evaluable population: completed a full course of study medication, did not miss a dose, did not use a concomitant medication that may have interfered with the treatment outcome up to D14, did not have a concomitant disease which may have interfered with the classification of the treatment outcome, did not have major protocol deviations.

Percentage of subjects with crude cure rate at Day 14, defined as absence of parasitaemia on Day 14, irrespective of body temperature without previously meeting any of the criteria of treatment failure

Outcome measures

Outcome measures
Measure
Pyronaridine - Artesunate
n=13 Participants
Oral pyronaridine artesunate (180:60 mg tablets), plus chloroquine-placebo once a day for 3 consecutive days.
Chloroquine
n=15 Participants
Oral chloroquine (155 mg tablets), plus pyronaridine artesunate-placebo, once a day for 3 consecutive days.
Crude Cure Rate on Day 14
100 percentage of participants
Interval 75.3 to 100.0
100 percentage of participants
Interval 78.2 to 100.0

SECONDARY outcome

Timeframe: Day 28

Population: Efficacy evaluable population: completed a full course of study medication, did not miss a dose, did not use a concomitant medication that may have interfered with the treatment outcome up to D14, did not have a concomitant disease which may have interfered with the classification of the treatment outcome, did not have major protocol deviations.

Percentage of subjects with crude cure rate at Day 28, defined as absence of parasitaemia on Day 28, irrespective of body temperature without previously meeting any of the criteria of treatment failure

Outcome measures

Outcome measures
Measure
Pyronaridine - Artesunate
n=13 Participants
Oral pyronaridine artesunate (180:60 mg tablets), plus chloroquine-placebo once a day for 3 consecutive days.
Chloroquine
n=15 Participants
Oral chloroquine (155 mg tablets), plus pyronaridine artesunate-placebo, once a day for 3 consecutive days.
Crude Cure Rate on Day 28
100 percentage of participants
Interval 75.3 to 100.0
100 percentage of participants
Interval 78.2 to 100.0

SECONDARY outcome

Timeframe: Days 0, 3, 7, 14, 21, 28, 35, and 42 (or on any other day if the subject spontaneously returned within the 42-day period)

Population: Efficacy evaluable population: completed a full course of study medication, did not miss a dose, did not use a concomitant medication that may have interfered with the treatment outcome up to D14, did not have a concomitant disease which may have interfered with the classification of the treatment outcome, did not have major protocol deviations.

Parasite clearance time is defined as the time from first dosing to the time of first blood draw with parasite clearance. Parasite clearance was defined as zero presence of asexual parasites for 2 consecutive negative readings taken between 7 and 25 hours apart

Outcome measures

Outcome measures
Measure
Pyronaridine - Artesunate
n=13 Participants
Oral pyronaridine artesunate (180:60 mg tablets), plus chloroquine-placebo once a day for 3 consecutive days.
Chloroquine
n=15 Participants
Oral chloroquine (155 mg tablets), plus pyronaridine artesunate-placebo, once a day for 3 consecutive days.
Parasite Clearance Time (PCT)
32.0 hours
Interval 24.0 to 40.0
63.9 hours
Interval 55.9 to 160.8

SECONDARY outcome

Timeframe: Day 0 and every 8 hours over ≥72 hours following first study drug administration or temperature normalization for ≥2 readings between 7 and 25 hours apart, then at each visit (Days 7, 14, 28 and 42)

Population: Efficacy evaluable population: completed a full course of study medication, did not miss a dose, did not use a concomitant medication that may have interfered with the treatment outcome up to D14, did not have a concomitant disease which may have interfered with the classification of the treatment outcome, did not have major protocol deviations.

Fever clearance time is defined as the time from first dosing to the first normal reading of temperature for 2 consecutive normal temperature readings taken between 7 and 25 hours apart

Outcome measures

Outcome measures
Measure
Pyronaridine - Artesunate
n=13 Participants
Oral pyronaridine artesunate (180:60 mg tablets), plus chloroquine-placebo once a day for 3 consecutive days.
Chloroquine
n=15 Participants
Oral chloroquine (155 mg tablets), plus pyronaridine artesunate-placebo, once a day for 3 consecutive days.
Fever Clearance Time (FCT)
16.0 hours
Interval 15.9 to 24.0
31.9 hours
Interval 23.5 to 39.8

SECONDARY outcome

Timeframe: Days 1, 2, and 3

Population: Efficacy evaluable population: completed a full course of study medication, did not miss a dose, did not use a concomitant medication that may have interfered with the treatment outcome up to D14, did not have a concomitant disease which may have interfered with the classification of the treatment outcome, did not have major protocol deviations.

Parasite clearance is defined as at least 2 consecutive negative smears for asexual parasites obtained within an interval of 7 to 25 hours post-dosing

Outcome measures

Outcome measures
Measure
Pyronaridine - Artesunate
n=13 Participants
Oral pyronaridine artesunate (180:60 mg tablets), plus chloroquine-placebo once a day for 3 consecutive days.
Chloroquine
n=15 Participants
Oral chloroquine (155 mg tablets), plus pyronaridine artesunate-placebo, once a day for 3 consecutive days.
Percentage of Patients Who Had Cleared Parasite on Days 1, 2, and 3
Day 1 (24h after first dose)
30.8 percentage of participants
Interval 5.7 to 55.9
0.0 percentage of participants
Interval 0.0 to 0.0
Percentage of Patients Who Had Cleared Parasite on Days 1, 2, and 3
Day 2 (48h after first dose)
92.3 percentage of participants
Interval 77.8 to 100.0
26.7 percentage of participants
Interval 4.3 to 49.0
Percentage of Patients Who Had Cleared Parasite on Days 1, 2, and 3
Day 3 (72h after first dose)
100.0 percentage of participants
Interval 100.0 to 100.0
60.0 percentage of participants
Interval 35.2 to 84.8

SECONDARY outcome

Timeframe: Days 1, 2, and 3

Population: Efficacy evaluable population: completed a full course of study medication, did not miss a dose, did not use a concomitant medication that may have interfered with the treatment outcome up to D14, did not have a concomitant disease which may have interfered with the classification of the treatment outcome, did not have major protocol deviations.

Fever clearance is defined as at least 2 consecutive normal body temperature measurements (\<37.5 C axillary/tympanic or \<38.0 C oral/rectal) obtained within an interval of 7 to 25 hours postdosing

Outcome measures

Outcome measures
Measure
Pyronaridine - Artesunate
n=13 Participants
Oral pyronaridine artesunate (180:60 mg tablets), plus chloroquine-placebo once a day for 3 consecutive days.
Chloroquine
n=15 Participants
Oral chloroquine (155 mg tablets), plus pyronaridine artesunate-placebo, once a day for 3 consecutive days.
Percentage of Patients Who Had Cleared Fever on Days 1, 2, and 3
Clearance rate (%) at Day 1 (24h after first dose)
76.9 percentage of participants
Interval 54.0 to 99.8
41.7 percentage of participants
Interval 13.8 to 69.6
Percentage of Patients Who Had Cleared Fever on Days 1, 2, and 3
Clearance rate (%) at Day 2 (48h after first dose)
92.3 percentage of participants
Interval 77.8 to 100.0
91.7 percentage of participants
Interval 76.0 to 100.0
Percentage of Patients Who Had Cleared Fever on Days 1, 2, and 3
Clearance rate (%) at Day 3 (72h after first dose)
100.0 percentage of participants
Interval 100.0 to 100.0
100.0 percentage of participants
Interval 100.0 to 100.0

SECONDARY outcome

Timeframe: Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study

Population: Safety population, consisting of all randomised subjects who received any amount of study medication; subjects were analysed as treated.

Number of Participants with AEs, including clinically significant laboratory results, electrocardiogram (ECG), vital signs or physical examination abnormalities

Outcome measures

Outcome measures
Measure
Pyronaridine - Artesunate
n=15 Participants
Oral pyronaridine artesunate (180:60 mg tablets), plus chloroquine-placebo once a day for 3 consecutive days.
Chloroquine
n=15 Participants
Oral chloroquine (155 mg tablets), plus pyronaridine artesunate-placebo, once a day for 3 consecutive days.
Number of Participants With Adverse Events (AEs)
Nr subj. with ≥1 AE
10 Participants
10 Participants
Number of Participants With Adverse Events (AEs)
Nr subj. with ≥1 treatment-related AE
7 Participants
9 Participants
Number of Participants With Adverse Events (AEs)
Nr subj. with ≥1 SAE
0 Participants
0 Participants
Number of Participants With Adverse Events (AEs)
Nr subj. with ≥1 treatment-related SAE
0 Participants
0 Participants
Number of Participants With Adverse Events (AEs)
Nr subj. with ≥1 severe or life-threatening AE
0 Participants
2 Participants
Number of Participants With Adverse Events (AEs)
Nr subj. with ≥1 AE leading to death
0 Participants
0 Participants
Number of Participants With Adverse Events (AEs)
Nr subj. with≥1 AE leading to drug discontinuation
0 Participants
0 Participants
Number of Participants With Adverse Events (AEs)
Nr subj. with ≥1 AE leading to study withdrawal
0 Participants
0 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Day 42

Population: Efficacy evaluable population: completed a full course of study medication, did not miss a dose, did not use a concomitant medication that may have interfered with the treatment outcome up to D14, did not have a concomitant disease which may have interfered with the classification of the treatment outcome, did not have major protocol deviations.

Proportion of subjects with crude cure rate at Day 42, defined as absence of parasitaemia on Day 42, irrespective of body temperature without previously meeting any of the criteria of treatment failure

Outcome measures

Outcome measures
Measure
Pyronaridine - Artesunate
n=13 Participants
Oral pyronaridine artesunate (180:60 mg tablets), plus chloroquine-placebo once a day for 3 consecutive days.
Chloroquine
n=15 Participants
Oral chloroquine (155 mg tablets), plus pyronaridine artesunate-placebo, once a day for 3 consecutive days.
Crude Cure Rate on Day 42
100 percentage of subjects
Interval 75.3 to 100.0
100 percentage of subjects
Interval 78.2 to 100.0

Adverse Events

Pyronaridine - Artesunate

Serious events: 0 serious events
Other events: 10 other events
Deaths: 0 deaths

Chloroquine

Serious events: 0 serious events
Other events: 10 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Pyronaridine - Artesunate
n=15 participants at risk
Oral pyronaridine artesunate (180:60 mg tablets), plus chloroquine-placebo once a day for 3 consecutive days.
Chloroquine
n=15 participants at risk
Oral chloroquine (155 mg tablets), plus pyronaridine artesunate-placebo, once a day for 3 consecutive days.
Blood and lymphatic system disorders
Anemia
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Cardiac disorders
Left ventricular hypertrophy
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Gastrointestinal disorders
Abdominal pain upper
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Gastrointestinal disorders
Diarrhoea
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Gastrointestinal disorders
Dyspepsia
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Gastrointestinal disorders
Vomiting
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
General disorders
Fatigue
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Infections and infestations
Hordeolum
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Infections and infestations
Nasopharyngitis
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Infections and infestations
Pharyngitis
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Investigations
Alanine aminotransferase increased
26.7%
4/15 • Number of events 4 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
13.3%
2/15 • Number of events 2 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Investigations
Aspartate aminotransferase increased
26.7%
4/15 • Number of events 4 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Investigations
Haemoglobin decreased
13.3%
2/15 • Number of events 2 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
20.0%
3/15 • Number of events 3 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Investigations
Haematocrit decreased
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Investigations
Platelet count decreased
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Investigations
Red blood cell count decreased
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Investigations
White blood cell count increased
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Investigations
Blood alkaline phosphatase increased
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Investigations
Electrocardiogram T wave inversion
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Investigations
Transaminases increased
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Investigations
Weight decreased
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Metabolism and nutrition disorders
Anorexia
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Nervous system disorders
Headache
26.7%
4/15 • Number of events 4 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Nervous system disorders
Paraesthesia
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Respiratory, thoracic and mediastinal disorders
Postnasal drip
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Skin and subcutaneous tissue disorders
Urticaria
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
Vascular disorders
Hypotension
0.00%
0/15 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study
6.7%
1/15 • Number of events 1 • Day 0 to 42. Subjects experiencing AEs at Day 42 were followed for up to 30 days after the end of study

Additional Information

Stephan Duparc, MD

Medicines for Malaria Venture

Phone: +41 22 555 0300

Results disclosure agreements

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