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Status unknownNCT02369978CHICAMOCHA-3Updated Jul 21, 2017

CHICAMOCHA 3 - Equivalence of Usual Interventions for Trypanosomiasis (EQUITY)

A Phase 2/3 interventional study of Nifurtimox and Benznidazole in Chagas Disease, sponsored by Universidad Autónoma de Bucaramanga. Status unknown at 1 site in Colombia. Open to participants aged 20 Years to 55 Years. Per ClinicalTrials.gov, last updated 2017-07-21.

Sponsored by Universidad Autónoma de Bucaramanga · Phase 2/3, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Jul 2017), so the status shown — last known as Recruiting — may be out of date.
Phase
Phase 2/3
Study type
Interventional
Enrollment
500
Allocation
Randomized
Ages
20 Years to 55 Years
Sex
All
01

Study summary

This randomized, blind, parallel-group trial will evaluate the efficacy and safety of Nifurtimox (NFX) and Benznidazole (BZN), the two usual interventions to treat the parasite Trypanosoma cruzi.

The investigators will test whether NFX is an effective trypanocidal agent (by comparison with placebo) and equivalent to BZN (as active comparator) in terms of both parasite-related and safety outcomes.

Individuals found seropositive and without clinical signs of dilated cardiomyopathy will receive either of the active treatments or matching placebo. Participants allocated to NFX or BZN will receive either a 60-day (full-dose) or a 120-day (half-dose) active treatment, whereas the control group will receive placebo for 120 days. There will be thus four arms of active treatment (NFX60, NFX120, BZN60 and BZN120), and a fifth control arm receiving placebo (1:1:1:1:1 allocation ratio) where every participant in the trial will take 120 days of study drug (the groups receiving full-dose will complete a 120-day masked treatment with placebo).

The study plans to enroll 500 participants from Colombia (in two different geographical areas) and Argentina, in order to explore regional differences in the treatment effects.

Read the detailed description

The specific aims of this multi-center randomized trial include:

  1. To evaluate the feasibility of conducting a multinational trial in terms of

    1. the ability to identify and recruit T. cruzi-infected individuals without clinical disease in a relatively short period
    2. the standardization of procedures to test the parasitic load using polymerase chain reaction (PCR)
  2. To evaluate, in the study population, the efficacy of a treatment with NFX using conventional (full) dose (8/mg/Kg/day) or half-dose for a variable duration (full-dose for 60 days versus half-dose for 120 days) in terms of the presence of positive PCR tests one year after treatment, as compared with placebo.
  3. To evaluate the equivalence (in terms of non-inferiority of its impact over the PCR testing) of two treatment schedules with NFX: a full-dose treatment for 60 days and a half-dose treatment for 120 days.
  4. To evaluate the equivalence of two treatment schedules with BZN: A conventional (full) dose of 5 mg/Kg/day) for 60 days, as compared with half-dose treatment for 120 days.
  5. To evaluate the equivalence of the treatment schedules with NFX as compared with those with BZN 5
  6. To evaluate the safety (in terms of reporting of mild symptoms, limitation of daily activities or hospitalizations, biochemical or blood abnormalities commonly reported by individuals taking these treatments) and adherence to the allocated treatments among individuals receiving NFX or BZN for varying duration and dose, as compared with placebo
  7. To explore differences in the impact of active treatments on the PCR among four subgroups of interest (geographical origin, T. cruzi discrete type unit found, parasitic load at baseline and age of participants).
  8. To explore, among individuals treated with placebo, the level of agreement in the tests of parasitic load at baseline and during the follow up.
02

Conditions studied

  • Chagas Disease

Keywords

  • Trypanocidal therapy
  • Benznidazole
  • Nifurtimox
  • Polymerase chain reaction
  • Randomized trial
03

Who can participate

Ages eligible
20 Years to 55 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Positive serology status to Trypanosoma cruzi
  • No clinical signs of dilated cardiomyopathy

Exclusion criteria

Exclusion Criteria:

  • Unacceptable risk of re-infection, based on the investigators judgment
  • Previous treatment with NFX or BZN
  • History of peripheral neuropathy
  • Health condition limiting the mobility, cognitive function or life expectancy within two years of the enrollment visit
  • Pregnancy / Unwilling to use reliable contraceptive methods during childbearing age
04

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
500 participants (estimated)

Study arms

  • Experimental
    Nifurtimox (NFX)

    60 days of active treatment with full-dose, or 120 days of active treatment with half-dose (allocation ratio 1:1). The 60-day group will receive active treatment in the first or second half of a 120-day treatment window, as per random allocation. The active treatment period will be followed/preceded by matching placebo (see placebo arm below)

    Drug: Nifurtimox

  • Active comparator
    Benznidazole (BZN)

    60 days of active treatment with full-dose, or 120 days of active treatment with half-dose (allocation ratio 1:1). The 60-day group will receive active treatment in the first or second half of a 120-day treatment window, as per random allocation. The active treatment period will be followed/preceded by matching placebo (see placebo arm below)

    Drug: Benznidazole

  • Placebo comparator
    Placebo

    120 days of treatment with matching placebo

    Drug: Placebo

Interventions

  • DrugNifurtimox

    Full dose: 8 mg/Kg/day, assuming an average weight of 60 Kg: 240 mg B.I.D Half-dose: 120 mg B.I.D

    Also known as: Lampit (Bayer)

  • DrugBenznidazole

    Full dose: 5 mg/Kg/day, assuming an average weight of 60 Kg: 150 mg B.I.D Half dose: 75 mg B.I.D

    Also known as: Radanil (Roche), Rochagan (Roche), Abarax (ELEA)

  • DrugPlacebo

    Two capsules of matching placebo (contaning Magnesium stearate and cellulose) B.I.D

    Also known as: Control group

05

What researchers measure

Primary outcomes

  1. Quantitative Polymerase Chain Reaction (qPCR) for Trypanosoma cruzi

    Proportion of participants with at least one out of three positive tests (performed at least one week apart from each other)

    Time frame: 12 - 18 months after starting therapy

Secondary outcomes

  1. T. cruzi positive serology status

    Proportion of participants with positive T. cruyzi serology status

    Time frame: 12 months after starting therapy

  2. Mean change in T. cruzi antibody titers

    Mean change (before-after) in antibody readings as measured with ELISA serology

    Time frame: 12 months after starting therapy

Other outcomes

  1. Reported adverse reactions

    Proportion of participants with at least one of the following a) Reporting hospitalization or inability to work b) Stopping study treatment because of adverse reactions /intolerance c) having abnormal levels of at least two biochemical or blood markers

    Time frame: 60 days after starting therapy

06

Study locations

1 of 1 sites recruiting
  • Fundación Oftalmológica de Santander - Clínica Ardila Lulle (FOSCAL)
    Bucaramanga, Santander, Colombia
    Recruiting
07

References and documents

Publications

  • Villar JC, Perez JG, Cortes OL, Riarte A, Pepper M, Marin-Neto JA, Guyatt GH. Trypanocidal drugs for chronic asymptomatic Trypanosoma cruzi infection. Cochrane Database Syst Rev. 2014 May 27;2014(5):CD003463. doi: 10.1002/14651858.CD003463.pub2. PubMed 24867876 ↗
  • Villar JC, Herrera VM, Perez Carreno JG, Vaquiro Herrera E, Castellanos Dominguez YZ, Vasquez SM, Cucunuba ZM, Prado NG, Hernandez Y. Nifurtimox versus benznidazole or placebo for asymptomatic Trypanosoma cruzi infection (Equivalence of Usual Interventions for Trypanosomiasis - EQUITY): study protocol for a randomised controlled trial. Trials. 2019 Jul 15;20(1):431. doi: 10.1186/s13063-019-3423-3. Erratum In: Trials. 2019 Aug 20;20(1):516. doi: 10.1186/s13063-019-3630-y. PubMed 31307503 ↗
08

Registry details

Key details

Study ID
NCT02369978
Lead sponsor
Universidad Autónoma de Bucaramanga
Collaborators
Fundación Cardioinfantil Instituto de Cardiología, Instituto Nacional de Salud, Colombia, Instituto Nacional de Parasitologia Dr. Mario Fatala Chaben
Responsible party
Juan Carlos Villar, MD, PhD (Professor, Department of Medicine, Universidad Autónoma de Bucaramanga) — Principal investigator
First posted
Feb 24, 2015
Start date
Aug 2015
Primary completion
Aug 2018 (estimated)
Completion
Feb 2019 (estimated)
Last update
Jul 21, 2017

Study contacts

Juan C Villar, MD, PhD
Contact
jvillar@unab.edu.co
+5776436111 ext. 514
Bernardo I Useche, PhD
Contact
buseche@unab.edu.co
+5776436111 ext. 539
Juan C Villar, MD, PhD
principal investigator · Universidad Autónoma de Bucaramanga

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is status unknown, as verified in Jul 2017. You cannot join it, but the record below documents what was studied.

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