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CompletedNCT00146627Updated Sep 29, 2016

Efficacy - Safety of Eflornithine-Nifurtimox Combination Versus Eflornithine to Treat Human African Trypanosomiasis

A Phase 3 interventional study of Eflornithine and Nifurtimox in Trypanosomiasis, African, sponsored by Drugs for Neglected Diseases. Completed at 4 sites in 2 countries. Open to participants aged 15 Years to 70 Years. Per ClinicalTrials.gov, last updated 2016-09-29.

Sponsored by Drugs for Neglected Diseases · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
280
Allocation
Randomized
Ages
15 Years to 70 Years
Sex
All
01

Study summary

The purpose of this study is to compare the therapeutic combination of I.V. eflornithine + oral nifurtimox to the standard IV eflornithine regimen in terms of therapeutic efficacy and clinical safety, in patients suffering from Trypanosoma brucei gambiense (Tbg) human African trypanosomiasis (HAT) in the meningoencephalitic phase.

Read the detailed description

Melarsoprol is the most commonly used product for the treatment of patients suffering from human African trypanosomiasis (HAT) in the meningoencephalitic (second, late) phase. This treatment is frequently complicated by fatal reactive encephalopathy, and at the same time resistance is beginning to appear in various countries. Eflornithine is effective and better tolerated, but it is more difficult to use. Nifurtimox, registered in several South American countries for treatment of Chagas' disease but used off label since the 1970's in series of cases of meningo-encephalitic HAT, is at present the only other potential alternative for the treatment of late-stage HAT.

The very limited number of compounds available, the lack of prospects for the development of new products and the emergence of resistance are arguments for the use of therapeutic combinations. Ideally, drug combinations should allow for reductions in the dosages of the drugs used in a way that, in particular in the case of toxic drugs such as those used for second stage HAT, the toxicity of the combination does not exceed that of either monotherapy. Of the three drug combinations nowadays possible: melarsoprol-nifurtimox, melarsoprol-eflornithine and eflornithine-nifurtimox, the last one has (in two different dosing regimens) shown the least treatment-associated toxicity and mortality in the 69 patients treated in one previous and this clinical trial to date. Good tolerability was also observed in a case series of 31 patients. The efficacy data to date suggest that efficacy is comparable to that of eflornithine and that of melarsoprol (in areas without high melarsoprol failure rates).

02

Conditions studied

  • Trypanosomiasis, African

Keywords

  • Human African Trypanosomiasis
  • Combination
  • Trypanosoma brucei gambiense Human African Trypanosomiasis
03

In context

Trypanosomiasis, African

26 studies on the registry are indexed under Trypanosomiasis, African; 1 is open to participants now.

This study's planned enrollment of 280 is above the median of 155 across 24 interventional studies indexed under Trypanosomiasis, African.

Browse Trypanosomiasis, African studies →

Lead sponsor

Drugs for Neglected Diseases is the lead sponsor of 58 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
15 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • confirmed second-stage T.b. gambiense infection : presence of the parasite in blood, lymph node fluid or CSF and >20 white blood cells/µL in CSF. In presence of blood in the CSF, lumbar puncture must be done again or the patient cannot be included in the study (see 10.9.1).
  • and of age 15 years or older.
  • and resident in __________ (each site will define boundaries or maximum distance)
  • and written of the patient or of a legally acceptable representative if the patient is a minor (\<18 years for both genders in Uganda and Angola, \<18 years for males and \<16 years for females in the Democratic Republic of Congo) or unable to communicate.

Exclusion criteria

Exclusion Criteria:

  • pregnant woman (systematic testing of women of )
  • treated for late-stage HAT during the last 36 months. Patients previously treated for first-stage (pentamidine) can be included.
  • unlikely to have access to the treatment centre or be accessible at their place of residence for 18 months after treatment
  • unable to take oral medication
  • suffering from conditions other than second stage HAT that seriously limit the chances of survival over 18 months time
  • Severe anemia (\< 5g/dl)
  • Severe underlying diseases upon admission (e.g. Active tuberculosis and/or being treated for TB; Bacterial or cryptococcal meningitis; Stages 3 or 4 /AIDS according to the WHO clinical definition) (WHO, 1986).
  • Severe renal failure based on clinical examination combined with biochemistry if available: \<20mL/min
  • Severe hepatic failure based on clinical examination combined with biochemistry if available: total >50 µmol/L, ALAT/GPT >70 UI/L, unless these laboratory values are determined by the investigator as likely due to conditions other than hepatic failure.
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
280 participants (estimated)

Interventions

06

Study locations

4 sites
  • MSF-Belgium; PNLTHA, Epicentre
    Isangi, Congo, The Democratic Republic of the
  • PNLTHA, STI, Epicentre
    Katanda, Congo, The Democratic Republic of the
  • PNLTHA, STI, Epicentre
    Mbuyi Maji, Congo, The Democratic Republic of the
  • MSF-Holland
    Nkayi, RoC, Congo
07

References and documents

Publications

  • Opigo J, Woodrow C. NECT trial: more than a small victory over sleeping sickness. Lancet. 2009 Jul 4;374(9683):7-9. doi: 10.1016/S0140-6736(09)61163-6. Epub 2009 Jun 24. No abstract available. PubMed 19559477 ↗
  • Priotto G, Kasparian S, Mutombo W, Ngouama D, Ghorashian S, Arnold U, Ghabri S, Baudin E, Buard V, Kazadi-Kyanza S, Ilunga M, Mutangala W, Pohlig G, Schmid C, Karunakara U, Torreele E, Kande V. Nifurtimox-eflornithine combination therapy for second-stage African Trypanosoma brucei gambiense trypanosomiasis: a multicentre, randomised, phase III, non-inferiority trial. Lancet. 2009 Jul 4;374(9683):56-64. doi: 10.1016/S0140-6736(09)61117-X. Epub 2009 Jun 24. PubMed 19559476 ↗

Related links

08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 29, 2016, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT00146627
Lead sponsor
Drugs for Neglected Diseases
Collaborators
Medecins Sans Frontieres, Netherlands, PNLTHA-DRC;, PNLTHA-RoC, Epicentre, Swiss Tropical & Public Health Institute, World Health Organization
First posted
Sep 7, 2005
Primary completion
Jun 2008
Completion
Jun 2008
Last update
Sep 29, 2016

Study contacts

Els Torreele, PhD
study chair · Drugs for Neglected Diseases
Gerardo Priotto, MD, MPH
study director · Epicentre
View the source record on ClinicalTrials.gov ↗

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Studies of the drugs tested here: Eflornithine · Nifurtimox

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