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Trial registered on ANZCTR
Registration number
ACTRN12609000846224
Ethics application status
Approved
Date submitted
28/09/2009
Date registered
30/09/2009
Date last updated
30/09/2009
Type of registration
Prospectively registered
Titles & IDs
Public title
Multiple-dose pharmacokinetics and ex vivo pharmacodynamics of the fixed-dosed artemisinin based combination therapies (ACTs) of the antimalarial drugs Artequick (artemisinin-piperaquine) and Coarsucam (artesunate-amodiaquine) in healthy male Vietnamese volunteers
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Scientific title
Multiple-dose pharmacokinetics and ex vivo pharmacodynamics of the fixed-dosed combinations of Artequick (artemisinin-piperaquine) and Coarsucam (artesunate-amodiaquine) in healthy male Vietnamese volunteers
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Characterization of the pharmacokinetics (absorption, metabolism, distribution and elimination) of the components of the antimalarial drugs Artequick and Coarsucam in healthy Vietnamese volunteers will provide important data for dose optimization and measurement of interindividual variability in plasma drug concentrations.
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Condition category
Condition code
Infection
252115
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0
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Other infectious diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Two groups of 22 healthy male Vietnamese volunteers will be recruited to receive 3-day courses of either Artequick or Coarsucam. Group 1 healthy volunteers (n=22) will be administered a daily dose of two tablets of Artequick (each tablet contains 62.5 mg artemisinin and 375 mg piperaquine) for 3 days. Group 2 healthy volunteers (n=22) will be administered a daily dose of two tablets of Coarsucam (each tablet contains 100 mg artesunate and 270 mg amodiaquine) for 3 days.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
The tolerability and safety of Artequick and Coarsucam in healthy subjects will be compared. Also the ex vivo pharmacodynamics of plasma artemisinin-piperaquine and artesunate-amodiaquine concentrations collected from the volunteers will be compared against the chloroquine-sensitive D6 and chloroquine-resistant K1 strains of Plasmodium falciparum, in vitro.
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Control group
Active
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Outcomes
Primary outcome [1]
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The pharmacokinetics of the components of Artequick (artemisinin-piperaquine) and Coarsucam (artesunate-amodiaquine) will be derived from plasma concentration versus time curves generated from the analysis of plasma samples collected from healthy volunteers.
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Assessment method [1]
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Timepoint [1]
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For pharmacokinetic analysis plasma samples will be measured at day 0 (pre-dose), 1, 3, and 6 hours after the first and second day of Artequick or Coarsucam administration. Plasma sample will also be measured before the third dose (day 2) and then at 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10 and 12 hours after the last dose. Additional plasma samples will be measured at days 3, 4, 7, 14, 21, 28, 35 and 42 after commencement of Artequick administration and at days 3, 4, 5, 7, 10, 14, 21 and 28 after starting Coarsucam administration.
Plasma concentrations of artemisinin, piperaquine, artesunate and its active metabolite, dihydroartemisinin and amodiaquine and its active metabolite desethylamodiaquine will be measured by liquid chromatography-tandem mass spectrometry. Non-compartmental analysis will be used to determine the pharmacokinetics of the drugs.
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Primary outcome [2]
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The tolerability and safety of the two ACTs will be compared. Possible adverse events can be gastrointestinal disturbances such as vomiting, nausea and abdominal discomfort. Other adverse events can be abnormal biochemical and haematological indices.
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Assessment method [2]
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Timepoint [2]
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Adverse events will be monitored before drug administration and at 24 hours after each dose.
Blood samples for biochemical and haematological analysis will be collected before drug administration and at day 7 after commencement of the 3-day course.
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Secondary outcome [1]
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Ex vivo antimalarial activivity will be carried out on plasma artemisinin-piperaquine and artesunate-amodiaquine concentrations collected from the volunteers against two Plasmodium falciparum isolates (D6 and K1).
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Assessment method [1]
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Timepoint [1]
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Blood samples for ex vivo antimalarial activity will be collected collected at 0 (pre-dose), 1, 3, and 6 hours after the first and second day of Artequick or Coarsucam administration. Blood samples will also be collected immediately before the third day of drug administration and then at 1, 3, 6, 12, 24, 48, 120, 288, 456 and 624 hours after the last dose.
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Secondary outcome [2]
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The inhibitory concentration (IC90 for spiked drug samples) and inhibitory dilution (ID90 for patient plasma samples) will be determined using the in vitro tritiated-hypoxanthine assay.
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Assessment method [2]
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Timepoint [2]
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ID90 values will be determined on plasma samples at 0 (pre-dose), 1, 3, and 6 hours after the first and second day of Artequick or Coarsucam administration. Plasma samples will also be collected immediately before the third day of drug administration and then at 1, 3, 6, 12, 24, 48, 120, 288, 456 and 624 hours after the last dose.
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Eligibility
Key inclusion criteria
Inclusion criteria
(i) Males: 17-40 years
(ii) Normal clinical parameters: medical history, physical examination
(iii) Normal haematological and biochemical indices, and electrocardiogram
(iv) The volunteer is willing not to drink alcohol and caffeine containing beverages one day before and after drug administration
(v) Able to understand and willing to provide written informed consent
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Minimum age
17
Years
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Maximum age
40
Years
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Sex
Males
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Exclusion criteria
(i) A history of serious past medical diseases
(ii) A history of drug or alcohol abuse
(iii) Use of regular medications including prescribed and natural therapies
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Two different groups of 22 healthy male Vietnamese volunteers will be recruited to receive 3-day courses of either Artequick or Coarsucam.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Pharmacokinetics / pharmacodynamics
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
10/10/2009
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
44
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Viet Nam
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State/province [1]
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Hanoi
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Australian Department of Defence
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Address [1]
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Department of Defence
International Policy Division
Russell Offices
R1-5-C015
Russell Drive
Canberra
ACT 2600
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
Australian Department of Defence
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Address
Australian Army Malaria Institute
Weary Dunlop Drive
Gallipoli Barracks
Enoggera
Brisbane QLD 4051
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Country
Australia
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Secondary sponsor category [1]
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Government body
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Name [1]
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Vietnam People's Army
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Address [1]
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Military Institute of Hygiene and Epidemiology, 21-Trung Liet, Dong Da, Hanoi, Vietnam
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Country [1]
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Viet Nam
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Australian Defence Human Research Ethics Committee
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Ethics committee address [1]
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ADHREC CP2-6-104 Campbell Park Offices Campbell ACT 2600
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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25/09/2009
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Ethics approval number [1]
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ADHREC 562/09
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Summary
Brief summary
Although Artequick (artemisinin-piperaquine) and Coarcusam (artesunate-amodiaquine) are currently being tested for efficacy in the treatment of uncomplicated falciparum malaria there is a paucity of information on the pharmacokinetics of the two artemisinin based combination therapies. The purpose of the study is to determine the pharmacokinetics and ex vivo antimalarial activity of the fixed-dosed combinations of Artequick and Coarsucam in healthy Vietnamese volunteers. The pharmacokinetic data will be used for dose optimization and to measure the interindividual variability in plasma drug concentrations. The ex vivo antimalarial assessment of the two ACTs will provide information on the relationship between blood drug concentrations and parasiticidal effect, in vitro, without the confounding factor of immunity.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Mike Edstein
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Address
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Australian Army Malaria Institute
Weary Dunlop Drive
Gallipoli Barracks
Enoggera
Brisbane, QLD 4051
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Country
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Australia
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Phone
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61-7-33324930
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Fax
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61-7-33324800
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Mike Edstein
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Address
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Australian Army Malaria Institute
Weary Dunlop Drive
Gallipoli Barracks
Enoggera
Brisbane, QLD 4051
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Country
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Australia
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Phone
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61-7-33324930
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Fax
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61-7-33324800
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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