A Phase 3 interventional study of Nifurtimox (Lampit, BAYA2502) and Placebo in Chagas Disease, sponsored by Bayer. Completed at 25 sites in 3 countries. Open to participants aged Up to 17 Years. Per ClinicalTrials.gov, last updated 2024-08-19.
Sponsored by Bayer · Phase 3, Interventional, and Treatment
Researchers are looking for a better way to treat children who have an infectious disease caused by the parasite Trypanosoma cruzi (Chagas' disease).
Chagas'disease is an inflammatory, infectious disease caused by the parasite Trypanosoma cruzi. This parasite is mainly spread by insects called triatomine bug. If Chagas' disease is left untreated, it can later cause serious heart and digestive problems.
The study treatment nifurtimox has been used for more than 50 years to treat Chagas' disease. When used early after infection, it kills the parasite. In people who have long-term Chagas' disease, it's no longer possible to kill the parasite. However, nifurtimox may help slow the progression of the disease and its most serious complications.
Nifurtimox was developed for use in adults only, but has also been used in children (off-label) for over 40 years. Currently it is available for doctors to give to adults and to children. However, there are not enough data about nifurtimox in children.
The main purpose of this study is to learn how well nifurtimox works in children aged 8 months to less than 18 years with Chagas' disease. To answer this, the researchers will compare the amount of antibodies against the parasite Trypanosoma cruzi in the serum (fluid from blood without the clotting factors) between children treated with nifurtimox for 60 days with untreated children from the past (control group):
73 studies on the registry are indexed under Chagas Disease; 5 are open to participants now.
This study's enrollment of 330 is above the median of 87 across 49 interventional studies indexed under Chagas Disease.
Browse Chagas Disease studies →Bayer is the lead sponsor of 1,674 studies on the registry; 51 are open to participants now.
Of its 214 completed or terminated interventional studies of FDA-regulated products, 132 (62%) have results posted.
Counted across the registry records on this site, refreshed daily.
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.
Part 1:
Part 2:
Exclusion Criteria:
Part 1:
Part 2:
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.
Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.
Read whether the line is about a condition or about medicines, and which medicines and doses it means.
Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.
Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.
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.
Clinically significant
Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Immunosuppression
A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.
Read whether the line is about a condition or about medicines, and which medicines and doses it means.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Corticosteroids (steroids)
Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.
Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Nifurtimox tablets administered three times daily for 60 days (Days 1 - 60, active nifurtimox treatment)
Drug: Nifurtimox (Lampit, BAYA2502)
Nifurtimox tablets administered three times daily for 30 days, followed by placebo administered three times daily for 30 days (Days 1 - 30, active nifurtimox treatment; Days 31 - 60, placebo)
Drug: Nifurtimox (Lampit, BAYA2502) · Drug: Placebo
For pediatric participants with body weight ≤ 40 kg: dosage 10 to 20 mg/kg/day in three divided doses. For pediatric participants with body weight \> 40 kg: 8 - 10 mg/kg/day in three divided doses. 60 days or 30 days of nifurtimox treatment
Matching placebo
Part 1 - Percentage of Sero-reduction or Sero-conversion (Cured Subjects)
Cure is defined as sero-reduction (in subjects ≥8 months to \<18 years of age at randomization) or sero-conversion (in all subjects). Sero-reduction is defined as a ≥20% reduction in optical density \[OD\]) measured by two conventional ELISA serology tests and sero-conversion is defined as negative Immunoglobulin G (IgG) concentration measured by two conventional ELISA serology tests. Subjects who have missing conventional serology results at the 12 month time point were treated as failures (ie, no cure). For the primary objective in the study, superiority over placebo was confirmed if the lower limit of the 95% Confidence Interval (CI) for the nifurtimox (60-day regimen) cure rate is greater than 16%, the larger of the upper limits of the 95% CIs for historical placebo control.
Time frame: At 12 months post-treatment
Part 2 - Incidence Rate of Seronegative Conversion in Subjects Received at Least One Dose of the 60-day Nifurtimox Treatment Regimen.
Seronegative conversion measured by two types of assay (recombinant ELISA and indirect hemagglutination assay \[IHA\]) in subjects who were randomized and received at least one dose of the 60-day nifurtimox treatment regimen compared to an external control group of historical placebo patients with Chagas' disease. Incidence rate is the number of new cases of seronegative conversion over the study period (i.e., 4 years after end of nifurtimox treatment) divided by the person-time at risk. It was modelled using a Poisson distribution with a 2-sided 95% exact CI. Number of participants with events were reported.
Time frame: Subjects participating in Part 2 were followed up for another 3 years, for a total follow-up period of 4 years after end of nifurtimox treatment in Part 1
Part 1 - Nifurtimox Concentration Over Time in Plasma at Visit 2
Measured in sub-population.
Time frame: At Visit 2 (Day 1): Pre-dose and Post-dose at 5-10 minutes, 10-120 minutes, 2-4 hours, and 4-8 hours
Part 1 - Nifurtimox Concentration Over Time in Plasma at Visit 3
Measured in sub-population.
Time frame: At Visit 3 (Day 7): Pre-dose and Post-dose at 5-10 minutes, 10-120 minutes, 2-4 hours, and 4-8 hours
Part 1 - Nifurtimox Concentration Over Time in Plasma at Visit 6
The evaluation was based on clinical examinations. Measured in sub-population.
Time frame: At Visit 6 (Day 30): Pre-dose and Post-dose at 5-10 minutes, 10-120 minutes, 2-4 hours, and 4-8 hours
Part 1 - Nifurtimox Concentration Over Time in Plasma at Visit 8
Measured in sub-population.
Time frame: At Visit 8 (Day 60): Pre-dose and Post-dose at 5-10 minutes, 10-120 minutes, 2-4 hours, and 4-8 hours
Part 2 - Incidence Rate of Seronegative Conversion in Subjects Who Received at Least One Dose of the 30-day Nifurtimox Treatment Regimen
Seronegative conversion measured by two types of assay (recombinant ELISA and indirect hemagglutination assay \[IHA\]) in subjects who were randomized and received at least one dose of the 30-day nifurtimox treatment regimen. Incidence rate is the number of new cases of seronegative conversion over the study period (i.e., 4 years after end of nifurtimox treatment) divided by the person-time at risk. It was modelled using a Poisson distribution with a 2-sided 95% exact CI. Number of participants with events were reported.
Time frame: Subjects participating in Part 2 were followed up for another 3 years, for a total follow-up period of 4 years after end of nifurtimox treatment in Part 1
Part 2 - ECG Signs of Established Chagas-related Cardiomyopathy
Summary of subjects by evidence of established Chagas-related cardiomyopathy as measured by electrocardiogram (ECG). Evidence of established Chagas-related cardiomyopathy: Total
Time frame: Subjects participating in Part 2 were followed up for another 3 years, for a total follow-up period of 4 years after end of nifurtimox treatment in Part 1
Part 2 - Serological Response of Established Chagas-related Cardiomyopathy
Summary of subjects by evidence of established Chagas-related cardiomyopathy as measured by Serological response. Evidence of established Chagas-related cardiomyopathy: Total
Time frame: Subjects participating in Part 2 were followed up for another 3 years, for a total follow-up period of 4 years after end of nifurtimox treatment in Part 1
Part 1 + Part 2 - Serial Reduction of Optical Density Values Measured by Total Purified Antigen ELISA
Summary and change from baseline of optical density values measured by total purified antigen ELISA. Optical density is the measure of absorbance, and is defined as the ratio of the intensity of light falling upon a material and the intensity transmitted.
Time frame: Baseline and Subjects participating in Part 2 were followed up for another 3 years, for a total follow-up period of 4 years after end of nifurtimox treatment in Part 1
Part 1 + Part 2 - Serial Reduction of Optical Density Values Measured by Recombinant ELISA
Summary and change from baseline of optical density values measured by recombinant ELISA. Optical density is the measure of absorbance, and is defined as the ratio of the intensity of light falling upon a material and the intensity transmitted.
Time frame: Baseline and Subjects participating in Part 2 were followed up for another 3 years, for a total follow-up period of 4 years after end of nifurtimox treatment in Part 1
Part 1 - Number of Subjects With Clinical Signs/ Symptoms of Chagas Disease at Visit 1
The evaluation was based on clinical examinations.
Time frame: At Visit 1 (before treatment started)
Part 1 - Number of Subjects With Clinical Signs/ Symptoms of Chagas Disease at Visit 3
The evaluation was based on clinical examinations.
Time frame: Up to 7 days (Visit 3)
Part 1 - Number of Subjects With Clinical Signs/ Symptoms of Chagas Disease at Visit 6
The evaluation was based on clinical examinations.
Time frame: Up to 30 days (Visit 6)
Part 1 - Number of Subjects With Clinical Signs/ Symptoms of Chagas Disease at Visit 8
The evaluation was based on clinical examinations.
Time frame: Up to 60 days (Visit 8; end of treatment)
Part 1 - Number of Subjects With Clinical Signs/ Symptoms of Chagas Disease at Visit 9
The evaluation was based on clinical examinations.
Time frame: Up to 90 days (Visit 9 post-treatment)
Part 1 - Number of Subjects With Clinical Signs/ Symptoms of Chagas Disease at Visit 10
The evaluation was based on clinical examinations.
Time frame: Up to 240 days (Visit 10 post-treatment)
Part 1 - Number of Subjects With Clinical Signs/ Symptoms of Chagas Disease at Visit 11
The evaluation was based on clinical examinations.
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Number of Subjects With Positive Results in Concentration Test for T. Cruzi (for Subjects <8 Months of Age)
Time frame: Up to 90 days (Visit 9 post-treatment)
Part 1 - Number of Subjects With a Positive Serological Response Using Non-conventional Enzyme-linked Immunosorbent Assay-F29 (ELISAF29) Test
The non-conventional ELISA-F29 test is considered an early marker of treatment efficacy in chronic Chagas disease.
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Number of Subjects With Positive Quantitative Polymerase Chain Reaction (qPCR) Results
The qPCR is molecular technique, considered a tool to diagnose acute and congenital Chagas disease, as well as a marker to measure treatment failure when demonstrating positive (detectable) results
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Number of Subjects With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)
TEAEs comprised events which first occurred or worsened at or after first application of study drug during the course of the study up to and including 7 days after last application of study drug
Time frame: up to 7 days after last application of study drug
Part 2 - Number of Subjects With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)
TEAEs comprised events which first occurred or worsened at study start up to end of study in part 2. In Part 2, only AEs considered at least possibly related to nifurtimox (administered in part 1) and those caused by protocol-related procedures were reported.
Time frame: Subjects participating in Part 2 were followed up for another 3 years, for a total follow-up period of 4 years after end of nifurtimox treatment in Part 1
Part 1 - Number of Subjects With Treatment-emergent High Blood Chemistry Abnormalities by Treatment
The Number Analyzed represents the number of subjects at baseline with a normal or lower than normal laboratory assessment who also had at least one valid laboratory value after start of treatment. The number of subjects represents subjects with at least one high laboratory assessment after start of treatment who had a normal or lower than normal laboratory assessment at baseline.
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Number of Subjects With Treatment-emergent Low Blood Chemistry Abnormalities by Treatment
The number analyzed represents the number of subjects at baseline with a normal or higher than normal laboratory assessment who also had at least one valid laboratory value after start of treatment. The number of subjects represents subjects with at least one low laboratory assessment after start of treatment who had a normal or higher than normal laboratory assessment at baseline.
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Number of Subjects With Treatment-emergent High Hematology Abnormalities by Treatment
The number analyzed represents the number of subjects at baseline with a normal or lower than normal laboratory assessment who also had at least one valid laboratory value after start of treatment. Subjects with missing or high abnormal values at baseline are not included in the number analyzed. The number of subjects represents subjects with at least one high laboratory assessment after start of treatment who had a normal or lower than normal laboratory assessment at baseline.
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Number of Subjects With Treatment-emergent Low Hematology Abnormalities by Treatment
The number analyzed represents the number of subjects at baseline with a normal or lower than normal laboratory assessment who also had at least one valid laboratory value after start of treatment. Subjects with missing or low abnormal values at baseline are not included in the number analyzed. The number of subjects represents subjects with at least one low laboratory assessment after start of treatment who had a normal or higher than normal laboratory assessment at baseline.
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Number of Subjects With Treatment-emergent High Coagulation Abnormalities by Treatment
The Number Analyzed represents the number of subjects at baseline with a normal or lower than normal laboratory assessment who also had at least one valid laboratory value after start of treatment. The number of subjects represents subjects with at least one high laboratory assessment after start of treatment who had a normal or lower than normal laboratory assessment at baseline.
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Number of Subjects With Treatment-emergent Low Coagulation Abnormalities by Treatment
The number analyzed represents the number of subjects at baseline with a normal or higher than normal laboratory assessment who also had at least one valid laboratory value after start of treatment. The number of subjects represents subjects with at least one low laboratory assessment after start of treatment who had a normal or higher than normal laboratory assessment at baseline.
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Number of Subjects With Abnormal Urinalysis Findings Considered as Clinically Significant or Reported as Adverse Events (AEs)
Urinalysis was performed and the following parameters evaluated: bilirubin, blood (red blood cells, white blood cells), chorionic gonadotropin β, glucose, ketones, leukocytes, nitrite, pH, protein, specific gravity, and urobilinogen.
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Number of Subjects With Abnormal ECG Findings Considered as Clinically Significant by Investigators
Clinical significance of abnormal ECG was based on the judgement of the investigator
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Mean Changes in Vital Signs (Systolic Blood Pressure) Between the Treatment Groups From Baseline
Systolic Blood Pressure
Time frame: Baseline and up to 420 days (Visit 11 post-treatment)
Part 1 - Mean Changes in Vital Signs (Diastolic Blood Pressure) Between the Treatment Groups From Baseline
Diastolic Blood Pressure
Time frame: Baseline and up to 420 days (Visit 11 post-treatment)
Part 1 - Mean Changes in Vital Signs (Respiratory Rate) Between the Treatment Groups From Baseline
Respiratory Rate
Time frame: Baseline and up to 420 days (Visit 11 post-treatment)
Part 1 - Mean Changes in Vital Signs (Heart Rate) Between the Treatment Groups From Baseline
Heart Rate
Time frame: Baseline and up to 420 days (Visit 11 post-treatment)
Part 1 - Mean Changes in Vital Signs (Body Temperature) Between the Treatment Groups From Baseline
Temperature
Time frame: Baseline and up to 420 days (Visit 11 post-treatment)
Part 1: Number of Participants Cured With 60-day Regimen Compared With Historical Active Control (Benznidazole)
This exploratory efficacy analysis evaluated the cure rate assessed as seroconversion of nifurtimox after 1-year post-treatment follow-up with that of published data for benznidazole (Sosa Estani et al. 1998 and de Andrade et al. 1996) at 4- and 3-year post-treatment follow-up, respectively, used as historical control.
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Relationship of Conventional Serology (Total Purified Antigen ELISA) and qPCR Testing by Visit
Using frequencies of matches and mismatches to assess agreement Reactive = Reac ELISA Detectable = Detec qPCR Non-reactive = Nonreac ELISA Non-detectable = Nondetec qPCR Non evaluable = Noneval qPCR qPCR Missing = Miss qPCR Missing conventional testing = Miss ELISA
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Relationship of Conventional Serology (Total Purified Antigen ELISA) and Non-conventional (ELISA-F29) Serologic Testing by Visit
Using frequencies of matches and mismatches to assess agreement Reactive = Reac ELISA Reactive = Reac F29 Non-reactive = Nonreac ELISA Non-reactive = Nonreac F29
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Relationship of Conventional Serology (Recombinant ELISA) and Non-conventional (ELISA-F29) Serologic Testing by Visit
Using frequencies of matches and mismatches to assess agreement Reactive = Reac ELISA Reactive = Reac F29 Non-reactive = Nonreac ELISA Non-reactive= Nonreac F29
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Relationship of Conventional Serology (ELISA) to Indirect Hemagglutination Assay (IHA) Results
Sero-reduction is defined as a =\> 20% reduction in optical density \[OD\]) using two conventional ELISA serology tests in subjects =\> 8 months to \< 18 years of age at randomization; Others: reactive results that are not sero-reduction in subjects =\> 8 months to \< 18 years of age at randomization; or reactive results in subjects \< 8 months of age at randomization. Non-reactive ELISA = Nonreac ELISA Non-reactive IHA = Nonreac IHA Reactive IHA decrease = Reac IHA dec React IHA nochange = Reac IHA nochange Reactive ELISA: seroreduction = Reac ELISA reduc Reactive ELISA: others = Reac ELISA other
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 - Relationship Between Conventional ELISA Results in Terms of Cure or No Cure and IHA Results in All Patients
Cure is defined as sero-reduction (in subjects =\> 8 months to \< 18 years of age at randomization) or sero-conversion (in all subjects). Sero-reduction is defined as a =\> 20% reduction in optical density \[OD\]) measured by two conventional ELISA serology tests and sero-conversion is defined as negative Immunoglobulin G \[IgG\] concentration measured by two conventional ELISA serology tests. Cure = Cure Non reactive/reactive decreasing = Nonreac/reac dec Reactive non-decreasing = Reac nondec No cure = No Cure Missing IHA testing = IHA missing
Time frame: Up to 420 days (Visit 11 post-treatment)
Part 1 of the study was conducted from 27 JAN 2016 (First subject first visit) to 25 JUL 2018 (Last subject last visit) in Argentina, Bolivia and Colombia. Part 2 of the study was conducted from 26 SEP 2018 (First subject first visit) to 10 AUG 2021 (Last subject last visit) in Argentina, Bolivia and Colombia.
| Milestone | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Started | 219 | 111 |
| Received treatment | 219 | 111 |
| Completed | 210 | 108 |
| Not completed | 9 | 3 |
| Withdrew: Lost to follow-up | 9 | 3 |
| Milestone | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Started | 197 | 98 |
| Completed | 191 | 91 |
| Not completed | 6 | 7 |
| Withdrew: Lost to follow-up | 4 | 6 |
| Withdrew: Other, including due to the covid-19 pandemic | 2 | 1 |
Cure is defined as sero-reduction (in subjects ≥8 months to \<18 years of age at randomization) or sero-conversion (in all subjects). Sero-reduction is defined as a ≥20% reduction in optical density \[OD\]) measured by two conventional ELISA serology tests and sero-conversion is defined as negative Immunoglobulin G (IgG) concentration measured by two conventional ELISA serology tests. Subjects who have missing conventional serology results at the 12 month time point were treated as failures (ie, no cure). For the primary objective in the study, superiority over placebo was confirmed if the lower limit of the 95% Confidence Interval (CI) for the nifurtimox (60-day regimen) cure rate is greater than 16%, the larger of the upper limits of the 95% CIs for historical placebo control.
| Percentage of subjects | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Part 1 - Percentage of Sero-reduction or Sero-conversion (Cured Subjects) | 32.9 (26.4 to 39.3) | 18.9 (11.2 to 26.7) |
Seronegative conversion measured by two types of assay (recombinant ELISA and indirect hemagglutination assay \[IHA\]) in subjects who were randomized and received at least one dose of the 60-day nifurtimox treatment regimen compared to an external control group of historical placebo patients with Chagas' disease. Incidence rate is the number of new cases of seronegative conversion over the study period (i.e., 4 years after end of nifurtimox treatment) divided by the person-time at risk. It was modelled using a Poisson distribution with a 2-sided 95% exact CI. Number of participants with events were reported.
| Participants | Nifurtimox 60 Days / Arm 1 |
|---|---|
| Part 2 - Incidence Rate of Seronegative Conversion in Subjects Received at Least One Dose of the 60-day Nifurtimox Treatment Regimen. | 16 |
Measured in sub-population.
| ug/L | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Predose | NA (NA to 26.8) | NA (NA to NA) |
| 5 - 10 MIN POST | NA (NA to 154.8) | 21.1 (NA to 695.0) |
| 10 - 120 MIN POST | 78.2 (5.8 to 847.5) | 49.0 (NA to 524.3) |
| 2 - 4 HOURS POST | 215.4 (77.9 to 516.3) | 300.7 (106.9 to 533.5) |
| 4 - 8 HOURS POST | 267.6 (40.2 to 508.1) | 289.6 (103.2 to 301.0) |
Measured in sub-population.
| ug/L | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Predose | 47.7 (NA to 407.6) | 38.3 (NA to 472.3) |
| 5 - 10 MIN POST | 82.6 (NA to 561.6) | 56.0 (NA to 442.8) |
| 10 - 120 MIN POST | 250.6 (13.8 to 1035.6) | 232.3 (13.9 to 706.3) |
| 2 - 4 HOURS POST | 497.2 (57.1 to 1027.4) | 257.7 (46.3 to 660.2) |
| 4 - 8 HOURS POST | 427.5 (141.2 to 778.2) | 267.0 (NA to 339.6) |
The evaluation was based on clinical examinations. Measured in sub-population.
| ug/L | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Predose | 23.8 (NA to 459.3) | 40.8 (NA to 284.3) |
| 5 - 10 MIN POST | 71.7 (NA to 153.7) | 73.7 (NA to 266.7) |
| 10 - 120 MIN POST | 135.0 (NA to 932.4) | 172.7 (14.1 to 387.3) |
| 2 - 4 HOURS POST | 369.5 (92.1 to 1277.0) | 103.8 (12.3 to 1107.2) |
| 4 - 8 HOURS POST | 249.7 (70.9 to 504.3) | 165.2 (84.9 to 1089.3) |
Measured in sub-population.
| ug/L | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Predose | NA (NA to 258.7) | NA (NA to NA) |
| 5 - 10 MIN POST | 92.4 (15.9 to 255.1) | NA (NA to NA) |
| 10 - 120 MIN POST | 139.1 (23.6 to 711.4) | NA (NA to 21.5) |
| 2 - 4 HOURS POST | 395.6 (166.9 to 883.0) | NA (NA to NA) |
| 4 - 8 HOURS POST | 300.6 (28.5 to 1217.2) | NA (NA to NA) |
Seronegative conversion measured by two types of assay (recombinant ELISA and indirect hemagglutination assay \[IHA\]) in subjects who were randomized and received at least one dose of the 30-day nifurtimox treatment regimen. Incidence rate is the number of new cases of seronegative conversion over the study period (i.e., 4 years after end of nifurtimox treatment) divided by the person-time at risk. It was modelled using a Poisson distribution with a 2-sided 95% exact CI. Number of participants with events were reported.
| Participants | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|
| Part 2 - Incidence Rate of Seronegative Conversion in Subjects Who Received at Least One Dose of the 30-day Nifurtimox Treatment Regimen | 8 |
Summary of subjects by evidence of established Chagas-related cardiomyopathy as measured by electrocardiogram (ECG). Evidence of established Chagas-related cardiomyopathy: Total
| Participants | Nifurtimox 60 Days: Chagas-related Cardiomyopathy | Nifurtimox 30 Days: Chagas-related Cardiomyopathy |
|---|---|---|
| YES | 0 | 0 |
| NO | 189 | 90 |
| MISSING | 8 | 8 |
Summary of subjects by evidence of established Chagas-related cardiomyopathy as measured by Serological response. Evidence of established Chagas-related cardiomyopathy: Total
| Participants | Nifurtimox 60 Days: Chagas-related Cardiomyopathy | Nifurtimox 30 Days: Chagas-related Cardiomyopathy |
|---|---|---|
| Non Reactive | 14 | 6 |
| Reactive | 176 | 84 |
| Missing | 7 | 8 |
Summary and change from baseline of optical density values measured by total purified antigen ELISA. Optical density is the measure of absorbance, and is defined as the ratio of the intensity of light falling upon a material and the intensity transmitted.
| Optical density | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Part 1 - Baseline (Visit 1) | 1.47 ± 0.55 | 1.52 ± 0.55 |
| Part 1 - Up to 420 days post-treatment (Visit 11) | 1.24 ± 0.62 | 1.30 ± 0.61 |
| Part 1 - Change from Baseline (Visit 11) | -0.24 ± 0.29 | -0.23 ± 0.41 |
| Part 2 - Year 2: (FU Visit 1) | 1.23 ± 0.59 | 1.29 ± 0.61 |
| Part 2 - Year 2: Change from Baseline (FU Visit 1) | -0.25 ± 0.41 | -0.23 ± 0.49 |
| Part 2 - Year 3 (FU Visit 3) | 1.16 ± 0.58 | 1.23 ± 0.58 |
| Part 2 - Year 3: Change from Baseline (FU Visit 3) | -0.30 ± 0.42 | -0.30 ± 0.50 |
| Part 2 - Year 4 (FU Visit 5) | 1.12 ± 0.57 | 1.23 ± 0.59 |
| Part 2 - Year 4: Change from Baseline (FU Visit 5) | -0.35 ± 0.40 | -0.30 ± 0.46 |
Summary and change from baseline of optical density values measured by recombinant ELISA. Optical density is the measure of absorbance, and is defined as the ratio of the intensity of light falling upon a material and the intensity transmitted.
| Optical density | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Part 1 - Baseline (Visit 1) | 2.74 ± 0.63 | 2.73 ± 0.63 |
| Part 1 - Up to 420 days post-treatment (Visit 11) | 2.27 ± 0.98 | 2.31 ± 1.00 |
| Part 1 - Change from Baseline (Visit 11) | -0.47 ± 0.74 | -0.41 ± 0.79 |
| Part 2 - Year 2: (FU Visit 1) | 2.5 ± 0.95 | 2.57 ± 0.88 |
| Part 2 - Year 2: Change from Baseline (FU Visit 1) | -0.23 ± 0.87 | -0.17 ± 0.90 |
| Part 2 - Year 3 (FU Visit 3) | 2.17 ± 0.98 | 2.25 ± 0.91 |
| Part 2 - Year 3: Change from Baseline (FU Visit 3) | -0.56 ± 0.86 | -0.45 ± 0.87 |
| Part 2 - Year 4 (FU Visit 5) | 2.09 ± 1.01 | 2.22 ± 1.00 |
| Part 2 - Year 4: Change from Baseline (FU Visit 5) | -0.64 ± 0.89 | -0.48 ± 0.87 |
The evaluation was based on clinical examinations.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Part 1 - Number of Subjects With Clinical Signs/ Symptoms of Chagas Disease at Visit 1 | 2 | 0 |
The evaluation was based on clinical examinations.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Anemia | 1 | 0 |
| Chagas disease | 2 | 0 |
| Hepatomegaly | 1 | 0 |
| Known ECG abnormality | 4 | 0 |
The evaluation was based on clinical examinations.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Known ECG abnormality | 1 | 0 |
| Romana sign | 0 | 1 |
The evaluation was based on clinical examinations.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Anemia | 1 | 0 |
| Chagas disease | 1 | 0 |
| Known ECG abnormality | 1 | 0 |
| Lymphadenopathy | 1 | 0 |
The evaluation was based on clinical examinations.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Part 1 - Number of Subjects With Clinical Signs/ Symptoms of Chagas Disease at Visit 9 | 1 | 0 |
The evaluation was based on clinical examinations.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Part 1 - Number of Subjects With Clinical Signs/ Symptoms of Chagas Disease at Visit 10 | 1 | 0 |
The evaluation was based on clinical examinations.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Part 1 - Number of Subjects With Clinical Signs/ Symptoms of Chagas Disease at Visit 11 | 3 | 3 |
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Visit 1|Positive | 12 | 7 |
| Visit 3|Positive | 1 | 1 |
| Visit 6|Positive | 0 | 0 |
| Visit 8|Positive | 0 | 0 |
| Visit 9|Positive | 1 | 0 |
| Visit 1|Negative | 0 | 0 |
| Visit 3|Negative | 11 | 5 |
| Visit 6|Negative | 12 | 7 |
| Visit 8|Negative | 12 | 7 |
| Visit 9|Negative | 11 | 7 |
| Visit 1|Missing | 0 | 0 |
| Visit 3|Missing | 0 | 1 |
| Visit 6|Missing | 0 | 0 |
| Visit 8|Missing | 0 | 0 |
| Visit 9|Missing | 0 | 0 |
The non-conventional ELISA-F29 test is considered an early marker of treatment efficacy in chronic Chagas disease.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Reactive | 96 | 54 |
| Non-reactive | 114 | 54 |
| Missing | 9 | 3 |
The qPCR is molecular technique, considered a tool to diagnose acute and congenital Chagas disease, as well as a marker to measure treatment failure when demonstrating positive (detectable) results
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Visit 1 - Non-detectable | 99 | 53 |
| Visit 1 - Detectable | 117 | 57 |
| Visit 1 - Non-evaluable | 1 | 1 |
| Visit 1 - Missing | 2 | 0 |
| Visit 3 - Non-detectable | 171 | 86 |
| Visit 3 - Detectable | 46 | 21 |
| Visit 3 - Non-evaluable | 0 | 1 |
| Visit 3 - Missing | 2 | 3 |
| Visit 6 - Non-detectable | 207 | 105 |
| Visit 6 - Detectable | 4 | 3 |
| Visit 6 - Non-evaluable | 3 | 2 |
| Visit 6 - Missing | 5 | 1 |
| Visit 8 - Non-detectable | 210 | 105 |
| Visit 8 - Detectable | 3 | 1 |
| Visit 8 - Non-evaluable | 2 | 2 |
| Visit 8 - Missing | 4 | 3 |
| Visit 10 - Non-detectable | 206 | 105 |
| Visit 10 - Detectable | 3 | 2 |
| Visit 10 - Non-evaluable | 2 | 2 |
| Visit 10 - Missing | 8 | 2 |
| Visit 11 - Non-detectable | 205 | 102 |
| Visit 11 - Detectable | 3 | 5 |
| Visit 11 - Non-evaluable | 1 | 1 |
| Visit 11 - Missing | 10 | 3 |
TEAEs comprised events which first occurred or worsened at or after first application of study drug during the course of the study up to and including 7 days after last application of study drug
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Any treatment-emergent adverse event (TEAE) | 147 | 66 |
| Any Serious TEAE | 6 | 3 |
TEAEs comprised events which first occurred or worsened at study start up to end of study in part 2. In Part 2, only AEs considered at least possibly related to nifurtimox (administered in part 1) and those caused by protocol-related procedures were reported.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Any AE | 0 | 0 |
| Any study drug-related AE | 0 | 0 |
| Any AE related to protocol | 0 | 0 |
| Any SAE | 0 | 0 |
| Any study drug-related SAE | 0 | 0 |
| Any SAE related to protocol | 0 | 0 |
| AE with outcome death | 0 | 0 |
The Number Analyzed represents the number of subjects at baseline with a normal or lower than normal laboratory assessment who also had at least one valid laboratory value after start of treatment. The number of subjects represents subjects with at least one high laboratory assessment after start of treatment who had a normal or lower than normal laboratory assessment at baseline.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Creatinine (mg/dL) | 3 | 2 |
| Albumin (g/dL) | 49 | 21 |
| Alkaline Phosphatase (U/L) | 11 | 3 |
| Alanine Aminotransferase (U/L) | 19 | 7 |
| Aspartate Aminotransferase (U/L) | 27 | 7 |
| Bilirubin (mg/dL) | 19 | 9 |
| Direct Bilirubin (mg/dL) | 21 | 9 |
| Blood Urea Nitrogen (mg/dL) | 11 | 3 |
| Urate (mg/dL) | 7 | 1 |
| Glucose (mg/dL) | 15 | 13 |
| Protein (g/dL) | 42 | 14 |
The number analyzed represents the number of subjects at baseline with a normal or higher than normal laboratory assessment who also had at least one valid laboratory value after start of treatment. The number of subjects represents subjects with at least one low laboratory assessment after start of treatment who had a normal or higher than normal laboratory assessment at baseline.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Creatinine (mg/dL) | 22 | 10 |
| Albumin (g/dL) | 14 | 4 |
| Alkaline Phosphatase (U/L) | 4 | 4 |
| Alanine Aminotransferase (U/L) | 6 | 3 |
| Aspartate Aminotransferase (U/L) | 1 | 5 |
| Bilirubin (mg/dL) | 7 | 3 |
| Direct Bilirubin (mg/dL) | 0 | 0 |
| Blood Urea Nitrogen (mg/dL) | 31 | 15 |
| Urate (mg/dL) | 32 | 18 |
| Glucose (mg/dL) | 29 | 18 |
| Protein (g/dL) | 17 | 15 |
The number analyzed represents the number of subjects at baseline with a normal or lower than normal laboratory assessment who also had at least one valid laboratory value after start of treatment. Subjects with missing or high abnormal values at baseline are not included in the number analyzed. The number of subjects represents subjects with at least one high laboratory assessment after start of treatment who had a normal or lower than normal laboratory assessment at baseline.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Hematocrit (% | 19 | 8 |
| Hemoglobin (g/dL) | 15 | 3 |
| Erythrocytes (T/L) in Blood | 21 | 9 |
| Ery. Mean Corpuscular Volume (fL) in Blood | 20 | 7 |
| Ery. Mean Corpuscular Hemoglobin (pg) in Blood | 14 | 5 |
| Ery. Mean Corpuscular HGB Conc. (g/dL) in Blood | 23 | 6 |
| Leukocytes (GIGA/L) in Blood | 41 | 16 |
| Neutrophils/Leukocytes (%) | 38 | 12 |
| Neutrophils (GIGA/L) | 36 | 8 |
| Lymphocytes/Leukocytes (%) | 35 | 17 |
| Lymphocytes (GIGA/L) | 21 | 7 |
| Monocytes/Leukocytes (%) | 33 | 17 |
| Monocytes (GIGA/L) | 17 | 15 |
| Eosinophils/Leukocytes (%) | 58 | 26 |
| Eosinophils (GIGA/L) | 53 | 22 |
| Basophils/Leukocytes (%) | 20 | 7 |
| Basophils (GIGA/L) | 10 | 2 |
| Platelets (GIGA/L) in Blood | 27 | 13 |
The number analyzed represents the number of subjects at baseline with a normal or lower than normal laboratory assessment who also had at least one valid laboratory value after start of treatment. Subjects with missing or low abnormal values at baseline are not included in the number analyzed. The number of subjects represents subjects with at least one low laboratory assessment after start of treatment who had a normal or higher than normal laboratory assessment at baseline.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Hematocrit (% | 30 | 17 |
| Hemoglobin (g/dL) | 23 | 17 |
| Erythrocytes (T/L) in Blood | 15 | 9 |
| Ery. Mean Corpuscular Volume (fL) in Blood | 16 | 6 |
| Ery. Mean Corpuscular Hemoglobin (pg) in Blood | 19 | 10 |
| Ery. Mean Corpuscular HGB Conc. (g/dL) in Blood | 29 | 21 |
| Leukocytes (GIGA/L) in Blood | 39 | 18 |
| Neutrophils/Leukocytes (%) | 53 | 27 |
| Neutrophils (GIGA/L) | 46 | 25 |
| Lymphocytes/Leukocytes (%) | 40 | 9 |
| Lymphocytes (GIGA/L) | 5 | 0 |
| Monocytes/Leukocytes (%) | 54 | 28 |
| Monocytes (GIGA/L) | 33 | 22 |
| Eosinophils/Leukocytes (%) | 13 | 5 |
| Eosinophils (GIGA/L) | 14 | 5 |
| Basophils/Leukocytes (%) | 1 | 2 |
| Basophils (GIGA/L) | 1 | 2 |
| Platelets (GIGA/L) in Blood | 6 | 3 |
The Number Analyzed represents the number of subjects at baseline with a normal or lower than normal laboratory assessment who also had at least one valid laboratory value after start of treatment. The number of subjects represents subjects with at least one high laboratory assessment after start of treatment who had a normal or lower than normal laboratory assessment at baseline.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Prothrombin Time (sec) in Plasma | 38 | 23 |
| Activated Partial Thromboplastin | 9 | 10 |
| Time in Plasma Prothrombin Intl. Normalized Ratio | 21 | 13 |
The number analyzed represents the number of subjects at baseline with a normal or higher than normal laboratory assessment who also had at least one valid laboratory value after start of treatment. The number of subjects represents subjects with at least one low laboratory assessment after start of treatment who had a normal or higher than normal laboratory assessment at baseline.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Prothrombin Time (sec) in Plasma | 10 | 5 |
| Activated Partial Thromboplastin | 15 | 2 |
| Time in Plasma Prothrombin Intl. Normalized Ratio | 14 | 5 |
Urinalysis was performed and the following parameters evaluated: bilirubin, blood (red blood cells, white blood cells), chorionic gonadotropin β, glucose, ketones, leukocytes, nitrite, pH, protein, specific gravity, and urobilinogen.
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Part 1 - Number of Subjects With Abnormal Urinalysis Findings Considered as Clinically Significant or Reported as Adverse Events (AEs) | 0 | 0 |
Clinical significance of abnormal ECG was based on the judgement of the investigator
| Participants | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| Part 1 - Number of Subjects With Abnormal ECG Findings Considered as Clinically Significant by Investigators | 0 | 0 |
Systolic Blood Pressure
| mmHg | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| VISIT 1 | 1.09 ± 7.79 | 0.69 ± 7.85 |
| VISIT 2 | -3.75 ± 7.50 | -5.00 ± 7.07 |
| VISIT 3 | 1.08 ± 9.98 | -0.50 ± 8.45 |
| VISIT 6 | -0.74 ± 10.70 | -1.12 ± 9.89 |
| VISIT 8 | -0.41 ± 11.01 | 0.48 ± 11.24 |
| VISIT 9 | -0.13 ± 11.11 | -0.45 ± 10.49 |
| VISIT 10 | -0.02 ± 10.46 | -1.48 ± 10.95 |
| VISIT 11 | 1.20 ± 11.52 | 1.57 ± 10.70 |
Diastolic Blood Pressure
| mmHg | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| VISIT 1 | 1.00 ± 7.72 | 0.90 ± 7.90 |
| VISIT 2 | -1.25 ± 2.50 | -1.00 ± 2.00 |
| VISIT 3 | 0.76 ± 8.36 | 0.26 ± 8.05 |
| VISIT 6 | 0.26 ± 10.87 | -0.14 ± 10.21 |
| VISIT 8 | 0.08 ± 9.91 | 0.93 ± 10.17 |
| VISIT 9 | -0.68 ± 8.81 | -0.21 ± 10.03 |
| VISIT 10 | 0.99 ± 9.90 | 0.85 ± 9.53 |
| VISIT 11 | 2.30 ± 11.06 | 3.25 ± 10.95 |
Respiratory Rate
| BREATHS/MIN | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| VISIT 1 | 0.12 ± 4.10 | 0.47 ± 2.91 |
| VISIT 2 | -1.50 ± 3.42 | -1.00 ± 1.15 |
| VISIT 3 | -0.05 ± 3.15 | -0.14 ± 3.91 |
| VISIT 6 | -0.57 ± 4.16 | -0.06 ± 3.87 |
| VISIT 8 | -0.77 ± 4.04 | 0.04 ± 4.58 |
| VISIT 9 | -1.01 ± 4.06 | -0.50 ± 3.76 |
| VISIT 10 | -1.36 ± 4.50 | -0.24 ± 3.60 |
| VISIT 11 | -1.93 ± 5.10 | -0.74 ± 4.61 |
Heart Rate
| BEATS/MIN | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| VISIT 1 | -1.08 ± 10.19 | 0.26 ± 11.37 |
| VISIT 2 | -6.75 ± 2.22 | -0.75 ± 2.99 |
| VISIT 3 | 0.04 ± 10.11 | -0.51 ± 11.46 |
| VISIT 6 | -0.78 ± 11.49 | -0.75 ± 11.92 |
| VISIT 8 | -1.27 ± 11.65 | -1.34 ± 11.03 |
| VISIT 9 | -1.26 ± 11.97 | -1.63 ± 10.56 |
| VISIT 10 | -3.28 ± 11.87 | -3.28 ± 11.61 |
| VISIT 11 | -3.57 ± 12.57 | -4.66 ± 14.73 |
Temperature
| °C | Nifurtimox 60 Days / Arm 1 | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 |
|---|---|---|
| VISIT 1 | 0.01 ± 0.39 | 0.04 ± 0.36 |
| VISIT 2 | -0.35 ± 0.45 | -0.03 ± 0.39 |
| VISIT 3 | -0.10 ± 0.36 | 0.04 ± 0.43 |
| VISIT 6 | -0.06 ± 0.44 | 0 ± 0.44 |
| VISIT 8 | -0.06 ± 0.45 | 0.05 ± 0.42 |
| VISIT 9 | -0.03 ± 0.44 | 0.02 ± 0.47 |
| VISIT 10 | -0.07 ± 0.49 | -0.01 ± 0.52 |
| VISIT 11 | -0.14 ± 0.51 | -0.10 ± 0.50 |
This exploratory efficacy analysis evaluated the cure rate assessed as seroconversion of nifurtimox after 1-year post-treatment follow-up with that of published data for benznidazole (Sosa Estani et al. 1998 and de Andrade et al. 1996) at 4- and 3-year post-treatment follow-up, respectively, used as historical control.
| Participants | Nifurtimox 60 Days / Arm 1 |
|---|---|
| Part 1: Number of Participants Cured With 60-day Regimen Compared With Historical Active Control (Benznidazole) | 10 |
Using frequencies of matches and mismatches to assess agreement Reactive = Reac ELISA Detectable = Detec qPCR Non-reactive = Nonreac ELISA Non-detectable = Nondetec qPCR Non evaluable = Noneval qPCR qPCR Missing = Miss qPCR Missing conventional testing = Miss ELISA
| Participants | Nifurtimox 60 Days Reactive Detectable | Nifurtimox 60 Days Reactive Non-detectable | Nifurtimox 60 Days Non-reactive Detectable | Nifurtimox 60 Days Non-reactive Non-detectable | Nifurtimox 60 Days Reactive Non Evaluable | Nifurtimox 60 Days Reactive qPCR Missing | Nifurtimox 30 Days Reactive Detectable | Nifurtimox 30 Days Reactive Non-detectable | Nifurtimox 30 Days Non-reactive Detectable | Nifurtimox 30 Days Non-reactive Non-detectable | Nifurtimox 30 Days Reactive Non Evaluable | Nifurtimox 30 Days Missing Conventional Testing Non-detectable |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Visit 1 | 117 | 99 | 0 | 0 | 1 | 2 | 57 | 52 | 0 | 1 | 1 | 0 |
| Visit 8 | 3 | 210 | 0 | 0 | 2 | 0 | 1 | 103 | 0 | 1 | 2 | 1 |
| Visit 10 | 3 | 195 | 0 | 11 | 2 | 0 | 2 | 99 | 0 | 6 | 2 | 0 |
| Visit 11 | 3 | 194 | 0 | 11 | 1 | 1 | 5 | 96 | 0 | 6 | 1 | 0 |
Using frequencies of matches and mismatches to assess agreement Reactive = Reac ELISA Reactive = Reac F29 Non-reactive = Nonreac ELISA Non-reactive = Nonreac F29
| Participants | Nifurtimox 60 Days Reactive and Reactive | Nifurtimox 60 Days Reactive and Non-reactive | Nifurtimox 60 Days Non-reactive and Reactive | Nifurtimox 60 Days Non-reactive and Non-reactive | Nifurtimox 30 Days Reactive and Reactive | Nifurtimox 30 Days Reactive and Non-reactive | Nifurtimox 30 Days Non-reactive and Reactive | Nifurtimox 30 Days Non-reactive and Non-reactive |
|---|---|---|---|---|---|---|---|---|
| Visit 1 | 142 | 77 | 0 | 0 | 72 | 38 | 0 | 1 |
| Visit 3 | 133 | 85 | 0 | 0 | 64 | 43 | 0 | 1 |
| Visit 6 | 131 | 83 | 0 | 0 | 67 | 42 | 0 | 1 |
| Visit 8 | 124 | 91 | 0 | 63 | 63 | 43 | 0 | 1 |
| Visit 10 | 108 | 92 | 2 | 9 | 61 | 42 | 0 | 6 |
| Visit 11 | 93 | 106 | 3 | 8 | 54 | 48 | 0 | 6 |
Using frequencies of matches and mismatches to assess agreement Reactive = Reac ELISA Reactive = Reac F29 Non-reactive = Nonreac ELISA Non-reactive= Nonreac F29
| Participants | Nifurtimox 60 Days Reactive and Reactive | Nifurtimox 60 Days Reactive and Non-reactive | Nifurtimox 60 Days Non-reactive and Reactive | Nifurtimox 60 Days Non-reactive and Non-reactive | Nifurtimox 30 Days Reactive and Reactive | Nifurtimox 30 Days Non-reactive and Reactive | Nifurtimox 30 Days Non-reactive and Non-reactive |
|---|---|---|---|---|---|---|---|
| Visit 1 | 142 | 77 | 0 | 0 | 72 | 0 | 1 |
| Visit 3 | 133 | 85 | 0 | 0 | 64 | 0 | 1 |
| Visit 6 | 131 | 81 | 0 | 2 | 67 | 0 | 1 |
| Visit 8 | 124 | 90 | 0 | 1 | 63 | 0 | 1 |
| Visit 10 | 108 | 91 | 2 | 10 | 59 | 2 | 5 |
| Visit 11 | 93 | 106 | 3 | 0 | 53 | 1 | 6 |
Sero-reduction is defined as a =\> 20% reduction in optical density \[OD\]) using two conventional ELISA serology tests in subjects =\> 8 months to \< 18 years of age at randomization; Others: reactive results that are not sero-reduction in subjects =\> 8 months to \< 18 years of age at randomization; or reactive results in subjects \< 8 months of age at randomization. Non-reactive ELISA = Nonreac ELISA Non-reactive IHA = Nonreac IHA Reactive IHA decrease = Reac IHA dec React IHA nochange = Reac IHA nochange Reactive ELISA: seroreduction = Reac ELISA reduc Reactive ELISA: others = Reac ELISA other
| Participants | Non-reactive ELISA and Non-reactive IHA | Non-reactive ELISA and Reactive IHA Decrease | Non-react ELISA and React IHA Nochange | Reactive ELISA: Sero-reduction and Non-react IHA | Reactive ELISA: Sero Reduction and Reactive IHA Decrease | Reactive ELISA: Sero-reduction and Reactive IHA Nochange | Reactive ELISA: Others and Non-reactive IHA | Reactive ELISA: Others and React IHA Decrease | Reactive ELISA: Others and React IHA Nochange | Reactive ELISA: Others and Missing IHA |
|---|---|---|---|---|---|---|---|---|---|---|
| Nifurtimox 60 days | 8 | 2 | 0 | 2 | 40 | 20 | 1 | 47 | 89 | 1 |
| Nifurtimox 30 days | 4 | 1 | 0 | 0 | 12 | 4 | 1 | 30 | 58 | 0 |
Cure is defined as sero-reduction (in subjects =\> 8 months to \< 18 years of age at randomization) or sero-conversion (in all subjects). Sero-reduction is defined as a =\> 20% reduction in optical density \[OD\]) measured by two conventional ELISA serology tests and sero-conversion is defined as negative Immunoglobulin G \[IgG\] concentration measured by two conventional ELISA serology tests. Cure = Cure Non reactive/reactive decreasing = Nonreac/reac dec Reactive non-decreasing = Reac nondec No cure = No Cure Missing IHA testing = IHA missing
| Participants | Cure and Non Reactive/Reactive Decreasing | Cure and Reactive Non-decreasing | No Cure and Non Reactive/Reactive Decreasing | No Cure and Reactive Non-decreasing | No Cure and Missing IHA Testing |
|---|---|---|---|---|---|
| Nifurtimox 60 days | 52 | 20 | 48 | 89 | 1 |
| Nifurtimox 30 days | 17 | 4 | 29 | 58 | 0 |
Collected over Part 1: From first application of study drug up to and including 7 days after last application of study drug Part 2: first occurred or worsened at start of study part 2 up to 3 years.. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Nifurtimox 60-day Regimen | 0/219 (0%) | 6/219 (2.7%) | 128/219 (58.4%) |
| Nifurtimox 30-day Regimen | 0/111 (0%) | 3/111 (2.7%) | 51/111 (45.9%) |
| Event | Nifurtimox 60-day Regimen | Nifurtimox 30-day Regimen |
|---|---|---|
| SeizureNervous system disorders | 2/219 | 0/111 |
| Ear infectionInfections and infestations | 0/219 | 1/111 |
| GastroenteritisInfections and infestations | 0/219 | 1/111 |
| PneumoniaInfections and infestations | 0/219 | 1/111 |
| Febrile convulsionNervous system disorders | 0/219 | 1/111 |
| Abortion inducedSurgical and medical procedures | 0/219 | 1/111 |
| Abdominal painGastrointestinal disorders | 1/219 | 1/111 |
| CellulitisInfections and infestations | 1/219 | 0/111 |
| Chronic tonsillitisInfections and infestations | 1/219 | 0/111 |
| Pelvic inflammatory diseaseInfections and infestations | 1/219 | 0/111 |
| Event | Nifurtimox 60-day Regimen | Nifurtimox 30-day Regimen |
|---|---|---|
| VomitingGastrointestinal disorders | 33/219 | 10/111 |
| HeadacheNervous system disorders | 30/219 | 16/111 |
| NauseaGastrointestinal disorders | 19/219 | 14/111 |
| Decreased appetiteMetabolism and nutrition disorders | 25/219 | 8/111 |
| NasopharyngitisInfections and infestations | 22/219 | 11/111 |
| PyrexiaGeneral disorders | 20/219 | 4/111 |
| Abdominal painGastrointestinal disorders | 19/219 | 9/111 |
| DiarrhoeaGastrointestinal disorders | 16/219 | 6/111 |
| Abdominal pain upperGastrointestinal disorders | 15/219 | 4/111 |
| PharyngitisInfections and infestations | 13/219 | 1/111 |
| Age, Customized(Participants) | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 | Nifurtimox 60 Days / Arm 1 | Total |
|---|---|---|---|
| 0 to 27 days | 3 | 4 | 7 |
| 28 days to younger than 8 months | 4 | 8 | 12 |
| 8 months to younger than 2 years | 8 | 17 | 25 |
| 2 years to younger than 18 years | 96 | 190 | 286 |
| Sex: Female, Male(Participants) | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 | Nifurtimox 60 Days / Arm 1 | Total |
|---|---|---|---|
| Female | 59 | 119 | 178 |
| Male | 52 | 100 | 152 |
| Race/Ethnicity, Customized(Participants) | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 | Nifurtimox 60 Days / Arm 1 | Total |
|---|---|---|---|
| White | 81 | 155 | 236 |
| American Indian or Alaska native | 30 | 64 | 94 |
| Total Purified Antigen enzyme-linked immunosorbent assay (ELISA) test results(Participants) | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 | Nifurtimox 60 Days / Arm 1 | Total |
|---|---|---|---|
| Reactive | 110 | 219 | 329 |
| Non Reactive | 1 | 0 | 1 |
| Total Purified Antigen ELISA optical density (OD) values(No dimension) | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 | Nifurtimox 60 Days / Arm 1 | Total |
|---|---|---|---|
| Mean | 1.532 ± 0.533 | 1.474 ± 0.553 | 1.494 ± 0.546 |
| Recombinant ELISA test results(Participants) | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 | Nifurtimox 60 Days / Arm 1 | Total |
|---|---|---|---|
| Reactive | 110 | 219 | 329 |
| Non Reactive | 1 | 0 | 1 |
| Recombinant ELISA OD values(No dimension) | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 | Nifurtimox 60 Days / Arm 1 | Total |
|---|---|---|---|
| Mean | 2.765 ± 0.605 | 2.735 ± 0.640 | 2.745 ± 0.628 |
| Non conventional ELISA-F29 test results(Participants) | Nifurtimox 30 Days, Then Placebo 30 Days / Arm 2 | Nifurtimox 60 Days / Arm 1 | Total |
|---|---|---|---|
| Reactive | 72 | 142 | 214 |
| Non Reactive | 39 | 77 | 116 |
2 further baseline measures are reported on the registry.
PDFs hosted by the registry, ClinicalTrials.gov.
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Studies of the drug tested here: Nifurtimox