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CompletedNCT03167242Updated Feb 10, 2022Results posted

Efficacy and Safety of KAF156 in Combination With LUM-SDF in Adults and Children With Uncomplicated Plasmodium Falciparum Malaria

A Phase 2 interventional study of KAF156 and Coartem in Acute Uncomplicated Plasmodium Falciparum Malaria, sponsored by Novartis Pharmaceuticals. Completed at 11 sites in 9 countries. Open to participants aged 2 Years and older. Per ClinicalTrials.gov, last updated 2022-02-10.

Sponsored by Novartis Pharmaceuticals · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
524
Allocation
Randomized
Ages
2 Years and older
Sex
All
01

Study summary

This study was designed to determine the most effective and tolerable dose at the shortest dosing regimen of the investigational drug KAF156 in combination with a solid dispersion formulation of lumefantrine (LUM-SDF) in adult/adolescent and pediatric patients with uncomplicated Plasmodium falciparum malaria.

There is unmet medical need for anti-malarial treatment with new mechanism of action to reduce probability of developing resistance, and for duration shorter than 3 days of treatment and/or reduced pill burden.

Read the detailed description

This was a Phase 2 multi-center and open-label study with a single cohort pharmacokinetic (PK) Run-in Part followed by 2 randomized parallel-group parts, Part A and Part B, in adults and children with confirmed and uncomplicated Plasmodium falciparum malaria. Each part (PK Run-in, Part A and Part B) had the same design structure: A screening phase of up to 24 hours where participants were evaluated for eligibility and randomized (Part A and B) into different cohorts. A treatment phase of up to 3 days where participants were treated for 1, 2 or 3 consecutive days. Finally, participants were followed up until Day 43, where the rescue medication was the local standard at the discretion of the Investigator and participants

PK Run-in part: Adult/adolescent participants (≥ 12 years old) were dosed with a single dose of 200 mg KAF156 and 960 mg LUM-SDF at Day 1. The purpose of this part was to assess potential PK interactions between the compounds when dosed together.

Part A: Adult/adolescent participants (≥ 12 years old) were randomized into one of seven cohorts in a 2:2:2:2:2:2:1 ratio: six KAF156 and LUM-SDF cohorts at starting doses of 400 mg and 480 mg once daily (QD) for 1 day respectively and a control arm (Coartem twice a day (BID) for 3 days). Upon completion of Part A, all the dosing groups were evaluated in an interim assessment to determine the effective and tolerated KAF156 and LUM-SDF dosing regimen and dosages to be used in Part B.

Part B: Children participants (2 to \< 12 years old) were randomized to three KAF156 and LUM-SDF cohorts at dosages and dosing regimens selected from Part A and the control arm (Coartem) in a 2:2:2:1 ratio.

02

Conditions studied

  • Acute Uncomplicated Plasmodium Falciparum Malaria
03

Who can participate

Ages eligible
2 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Part A: male and female patients ≥ 12 years and with a body weight ≥ 35.0 kg. Part B: after determining the effective/tolerated doses and regimens in adolescent and adult patients, male and female patients ≥ 2 and \< 12 years and with a body weight ≥ 10.0 kg will be included.
  • Microscopic confirmation of P. falciparum by Giemsa-stained thick and thin films.
  • P. falciparum parasitaemia of more than 1000 and less than 150 000 parasites/µL at the time of pre-screening (i.e., Study Visit 1).
  • Axillary temperature ≥ 37.5 ºC or oral/tympanic/rectal temperature ≥ 38.3 ºC; or similar history of fever during the previous 24 hours (history of fever must be documented).
  • Written informed consent must be obtained before any assessment is performed. If the patient is unable to read and write, then a witnessed consent according to local ethical standards is permitted. Patients \< 18 years old, who are capable of providing assent, must provide assent with parental/legal guardian consent or as per local ethical guidelines.

Exclusion criteria

Exclusion Criteria:

  • Mixed Plasmodium infections.
  • Signs and symptoms of severe malaria according to WHO (World Health Organization) 2015 criteria unless characterized by high parasitaemia only.
  • Patients with concurrent febrile illnesses (e.g., typhoid fever).
  • Severe vomiting, defined as more than 3 times in the 24 hours prior to inclusion in the study or severe diarrhea defined as more than 3 watery stools per day.
  • Pregnant or nursing (lactating) women.
  • Clinically relevant abnormalities of electrolyte balance which require correction, e.g., hypokalemia, hypocalcemia or hypomagnesemia.
  • Anemia (Hemoglobin level \< 8 g/dL).
  • Patients with prior antimalarial therapy or antibiotics with antimalarial activity within minimum of their five (5) plasma half-lives (or within 4 weeks of screening if half-life is unknown).
  • History or family history of long QT syndrome or sudden cardiac death, or any other clinical condition known to prolong the QTc (heart rate-corrected QT) interval, such as history of symptomatic cardiac arrhythmias, clinically relevant bradycardia or severe heart disease.
  • Any surgical or medical condition which might significantly alter the absorption, distribution, metabolism, or excretion of drugs, or which may jeopardize the patient in case of participation in the study. The investigator should make this determination in consideration of the patient's medical history and/or clinical or laboratory evidence of any of the following:
  • AST/ALT > 2 x the upper limit of normal range (ULN), regardless of the level of total bilirubin
  • AST/ALT > 1.5 and ≤ 2 x ULN and total bilirubin is > ULN
  • Total bilirubin > 2 x ULN, regardless of the level of AST/ALT
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
524 participants (actual)

Study arms

  • Experimental
    Part A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 day

    Participants received a single oral dose of KAF156 400 mg and LUM-SDF 960 mg

    Drug: KAF156 · Drug: Lumefantrine Solid Dispersion Formulation

  • Experimental
    Part A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 day

    Participants received a single oral dose of KAF156 800 mg and LUM-SDF 960 mg

    Drug: KAF156 · Drug: Lumefantrine Solid Dispersion Formulation

  • Experimental
    Part A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 days

    Participants received KAF156 400 mg and LUM-SDF 960 mg once daily via oral administration for 2 days

    Drug: KAF156 · Drug: Lumefantrine Solid Dispersion Formulation

  • Experimental
    Part A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 days

    Participants received KAF156 200 mg and LUM-SDF 480 mg once daily via oral administration for 3 days

    Drug: KAF156 · Drug: Lumefantrine Solid Dispersion Formulation

  • Experimental
    Part A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 days

    Participants received KAF156 400 mg and LUM-SDF 480 mg once daily via oral administration for 3 days

    Drug: KAF156 · Drug: Lumefantrine Solid Dispersion Formulation

  • Experimental
    Part A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 days

    Participants received KAF156 400 mg and LUM-SDF 960 mg once daily via oral administration for 3 days

    Drug: KAF156 · Drug: Lumefantrine Solid Dispersion Formulation

  • Active comparator
    Part A - Cohort 7: Coartem

    Participants received Coartem twice daily via oral administration for 3 days

    Drug: Coartem

  • Experimental
    PK Run-in Cohort: KAF 200 mg and LUM 960 mg QD for 1 day

    Participants received a single oral dose of KAF156 200 mg and LUM-SDF 960 mg

    Drug: KAF156 · Drug: Lumefantrine Solid Dispersion Formulation

  • Experimental
    Part B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 day

    Participants received a single oral dose of KAF156 400 mg and LUM-SDF 960 mg

    Drug: KAF156 · Drug: Lumefantrine Solid Dispersion Formulation

  • Experimental
    Part B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 days

    Participants received KAF156 400 mg and LUM-SDF 960 mg once daily via oral administration for 2 days

    Drug: KAF156 · Drug: Lumefantrine Solid Dispersion Formulation

  • Experimental
    Part B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 days

    Participants received KAF156 400 mg and LUM-SDF 960 mg once daily via oral administration for 3 days

    Drug: KAF156 · Drug: Lumefantrine Solid Dispersion Formulation

  • Active comparator
    Part B - Cohort 4: Coartem

    Participants received Coartem twice daily via oral administration for 3 days

    Drug: Coartem

Interventions

  • DrugKAF156

    KAF156 comes in 100 mg tablets for oral administration. KAF156 was administered in combination with LUM-SDF once daily (QD) for 1, 2 or 3 days at 200 mg, 400 mg or 800 mg doses.

    Also known as: KAF

  • DrugCoartem

    Coartem comes as 20/120 mg dispersible tablets or 80/480 mg tablets for oral administration. Coartem was administered twice daily for 3 days as active comparator.

  • DrugLumefantrine Solid Dispersion Formulation

    LUM-SDF comes in 240 mg or 480 mg sachets for oral administration. LUM-SDF was administered in combination with KAF156 once daily (QD) for 1, 2 or 3 days at 480 mg or 960 mg doses.

    Also known as: LUM-SDF and LUM

05

What researchers measure

Primary outcomes

  1. Part A and Part B: Number of Participants With Polymerase Chain Reaction (PCR)-Corrected Adequate Clinical and Parasitological Response (ACPR) at Day 29

    PCR-corrected ACPR defined as the absence of parasitaemia was evaluated at Day 29 (i.e., 28 days post first dose) based on the short half-life of the study drugs. Microscopic species identification was confirmed and determined by PCR genotyping methods to establish malaria recrudescence/reinfection. A participant was considered as PCR-corrected ACPR at Day 29 if the participant did not meet any of the criteria of early treatment failure, late clinical failure or late parasitological failure and was absence of parasitaemia on Day 29 irrespective of axillary temperature unless the presence of parasitaemia after 7 days was due to reinfection based on PCR. A presence of parasitaemia after 7 days of treatment initiation was considered as a reinfection only if the parasitaemia was clear before Day 8 and none of the parasite strain(s) detected on Day 8 or later matched with the parasite strain at baseline based on PCR.

    Time frame: 28 days post first dose

  2. PK Run-in: Area Under the Blood Concentration-time Curve Over the Last 24 Hours After Treatment Dose (AUC0-24h) of KAF156

    Pharmacokinetic (PK) parameters were calculated based on KAF156 blood concentrations determined by a validated liquid chromatography and tandem mass spectrometry (LC-MS/MS) method. AUC0-24h was determined using non-compartmental methods.

    Time frame: 0, 1, 3, 6, 12, 18 and 24 hours post-dose

Secondary outcomes

  1. Part A and Part B: Number of Participants With Polymerase Chain Reaction (PCR)-Uncorrected Adequate Clinical and Parasitological Response (ACPR)

    PCR-uncorrected ACPR defined as the absence of parasitaemia was evaluated at days 15, 29 and 43 (i.e., 14, 28 and 42 days post first dose). A participant was considered as PCR-uncorrected ACPR at Days 15, 29 or 43 if the participant did not meet any of the criteria of early treatment failure, late clinical failure or late parasitological failure and was absence of parasitaemia on Days 15, 29 or 43 irrespective of axillary temperature.

    Time frame: 14, 28 and 42 days post first dose

  2. Part A and Part B: Number of Participants With Polymerase Chain Reaction (PCR)-Corrected Adequate Clinical and Parasitological Response (ACPR)

    PCR-corrected ACPR defined as the absence of parasitaemia was evaluated at days 15 and 43 (i.e., 14 and 42 days post first dose). Microscopic species identification was confirmed and determined by PCR genotyping methods to establish malaria recrudescence/reinfection. A participant was considered as PCR-corrected ACPR at Day 15 or Day 43 if the participant did not meet any of the criteria of early treatment failure, late clinical failure or late parasitological failure and was absence of parasitaemia on Day 15 or Day 43 irrespective of axillary temperature unless the presence of parasitaemia after 7 days was due to reinfection based on PCR. A presence of parasitaemia after 7 days of treatment initiation was considered as a reinfection only if the parasitaemia was clear before Day 8 and none of the parasite strain(s) detected on Day 8 or later matched with the parasite strain at baseline based on PCR.

    Time frame: 14 and 42 days post first dose

  3. Part A and Part B: Number of Participants With Recrudescence Events

    Recrudescence is defined as appearance of asexual parasites after clearance of initial infection with a genotype identical to that of parasites present at baseline. Recrudescence must be confirmed by PCR analysis.

    Time frame: 42 days post first dose

  4. Part A and Part B: Number of Participants With Reinfection Events

    Reinfection is defined as appearance of asexual parasites after clearance of initial infection with a genotype different from those parasites present at baseline. Reinfection must be confirmed by PCR analysis.

    Time frame: 42 days post first dose

  5. Part A and Part B: Fever Clearance Time (FCT)

    Fever Clearance Time (FCT) is defined as the time from the first dose until the first time the axillary body temperature decreased below and remained below 37.5°C axillary or 38.0°C oral/tympanic/rectal for at least a further 24 hours. In case a participant received rescue medication before (fever) clearance, the time to event was censored at the first use of rescue medication.

    Time frame: 42 days post first dose

  6. PK Run-in, Part A and Part B: Parasite Clearance Time (PCT)

    Parasite Clearance Time (PCT) is defined as the time from the first dose until the first total and continued disappearance of asexual parasite forms which remained at least a further 48 hours. In case a participant received rescue medication before (parasite) clearance, the time to event was censored at the first use of rescue medication.

    Time frame: 42 days post first dose

  7. PK Run-in, Part A and Part B: Number of Participants With Parasitaemia

    Parasitaemia is the quantitative content of parasites in the blood determined by microscopy examination validated methods. Only Plasmodium Falciparum asexual form is used for parasitaemia assessments.

    Time frame: 12, 24 and 48 hours post last dose

  8. Part A and Part B: Area Under the Blood Concentration-time Curve Over the Last 24 Hours After Last Treatment Dose (AUC0-24h) of KAF156

    Pharmacokinetic (PK) parameters were calculated based on KAF156 blood concentrations determined by a validated liquid chromatography and tandem mass spectrometry (LC-MS/MS) method. AUC0-24h was determined using non-compartmental methods.

    Time frame: 3, 6, 18 and 24 hours post last dose

  9. Part A and Part B: Maximum Peak Observed Concentration (Cmax) of KAF156

    Pharmacokinetic (PK) parameters were calculated based on KAF156 blood concentrations determined by a validated liquid chromatography and tandem mass spectrometry (LC-MS/MS) method. Cmax was determined using non-compartmental methods.

    Time frame: 3, 6, 18, 24, 27, 30, 48, 51, 54, 68, 72 and 168 hours post last dose

  10. PK Run-in and Part A: Elimination Half-life (T½) of KAF156

    Pharmacokinetic (PK) parameters were calculated based on KAF156 blood concentrations determined by a validated liquid chromatography and tandem mass spectrometry (LC-MS/MS) method. T½ was determined using non-compartmental methods.

    Time frame: 0, 1, 3, 6, 12, 18, 24, 27, 30, 36, 48, 72, 96 and 168 hours post last dose

  11. PK Run-in and Part A (Cohorts 1 and 2): Time to Reach Maximum Blood Concentrations (Tmax) of KAF156

    Pharmacokinetic (PK) parameters were calculated based on KAF156 blood concentrations determined by a validated liquid chromatography and tandem mass spectrometry (LC-MS/MS) method. Tmax was determined using non-compartmental methods.

    Time frame: 0, 1, 3, 6, 12, 18, 24, 30, 48, 96 and 168 hours post last dose

06

Results

Posted Feb 10, 2022

Participant flow

Participants were recruited from 13 sites in 10 countries.

Participant flow — Overall Study
MilestonePK Run-in Cohort: KAF 200 mg and LUM 960 mg QD for 1 DayPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A - Cohort 7: CoartemPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 4: Coartem
Started125151515451522753534524
Full analysis set (fas)125151515451522752534524
Pharmacokinetics (pk) analysis set124751464846452448464124
Per-protocol set (pps)125048484744432548464022
Rich pharmacokinetics (pk) analysis subset12566612500000
Completed125048505349502652534323
Not completed013112211021
Withdrew: Patient/guardian decision012111000010
Withdrew: Lost to follow-up001001210011
Withdrew: Reason not provided000000001000

Outcome measures

PrimaryPart A and Part B: Number of Participants With Polymerase Chain Reaction (PCR)-Corrected Adequate Clinical and Parasitological Response (ACPR) at Day 29

PCR-corrected ACPR defined as the absence of parasitaemia was evaluated at Day 29 (i.e., 28 days post first dose) based on the short half-life of the study drugs. Microscopic species identification was confirmed and determined by PCR genotyping methods to establish malaria recrudescence/reinfection. A participant was considered as PCR-corrected ACPR at Day 29 if the participant did not meet any of the criteria of early treatment failure, late clinical failure or late parasitological failure and was absence of parasitaemia on Day 29 irrespective of axillary temperature unless the presence of parasitaemia after 7 days was due to reinfection based on PCR. A presence of parasitaemia after 7 days of treatment initiation was considered as a reinfection only if the parasitaemia was clear before Day 8 and none of the parasite strain(s) detected on Day 8 or later matched with the parasite strain at baseline based on PCR.

Time frame:
28 days post first dose
Reported as:
Count of participants · Participants
Part A and Part B: Number of Participants With Polymerase Chain Reaction (PCR)-Corrected Adequate Clinical and Parasitological Response (ACPR) at Day 29
ParticipantsPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A - Cohort 7: CoartemPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 4: Coartem
Part A and Part B: Number of Participants With Polymerase Chain Reaction (PCR)-Corrected Adequate Clinical and Parasitological Response (ACPR) at Day 294645474744422537423821
PrimaryPK Run-in: Area Under the Blood Concentration-time Curve Over the Last 24 Hours After Treatment Dose (AUC0-24h) of KAF156

Pharmacokinetic (PK) parameters were calculated based on KAF156 blood concentrations determined by a validated liquid chromatography and tandem mass spectrometry (LC-MS/MS) method. AUC0-24h was determined using non-compartmental methods.

Time frame:
0, 1, 3, 6, 12, 18 and 24 hours post-dose
Reported as:
Geometric mean · hours*μg/mL
PK Run-in: Area Under the Blood Concentration-time Curve Over the Last 24 Hours After Treatment Dose (AUC0-24h) of KAF156
hours*μg/mLPK Run-in Cohort: KAF 200 mg and LUM 960 mg QD for 1 Day
PK Run-in: Area Under the Blood Concentration-time Curve Over the Last 24 Hours After Treatment Dose (AUC0-24h) of KAF1565.35 ± 34.8
SecondaryPart A and Part B: Number of Participants With Polymerase Chain Reaction (PCR)-Uncorrected Adequate Clinical and Parasitological Response (ACPR)

PCR-uncorrected ACPR defined as the absence of parasitaemia was evaluated at days 15, 29 and 43 (i.e., 14, 28 and 42 days post first dose). A participant was considered as PCR-uncorrected ACPR at Days 15, 29 or 43 if the participant did not meet any of the criteria of early treatment failure, late clinical failure or late parasitological failure and was absence of parasitaemia on Days 15, 29 or 43 irrespective of axillary temperature.

Time frame:
14, 28 and 42 days post first dose
Reported as:
Count of participants · Participants
Part A and Part B: Number of Participants With Polymerase Chain Reaction (PCR)-Uncorrected Adequate Clinical and Parasitological Response (ACPR)
ParticipantsPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A - Cohort 7: CoartemPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 4: Coartem
Day 14 post first dose4947515350512751524324
Day 28 post first dose4640485145472634413615
Day 42 post first dose4236454541451929333111
SecondaryPart A and Part B: Number of Participants With Polymerase Chain Reaction (PCR)-Corrected Adequate Clinical and Parasitological Response (ACPR)

PCR-corrected ACPR defined as the absence of parasitaemia was evaluated at days 15 and 43 (i.e., 14 and 42 days post first dose). Microscopic species identification was confirmed and determined by PCR genotyping methods to establish malaria recrudescence/reinfection. A participant was considered as PCR-corrected ACPR at Day 15 or Day 43 if the participant did not meet any of the criteria of early treatment failure, late clinical failure or late parasitological failure and was absence of parasitaemia on Day 15 or Day 43 irrespective of axillary temperature unless the presence of parasitaemia after 7 days was due to reinfection based on PCR. A presence of parasitaemia after 7 days of treatment initiation was considered as a reinfection only if the parasitaemia was clear before Day 8 and none of the parasite strain(s) detected on Day 8 or later matched with the parasite strain at baseline based on PCR.

Time frame:
14 and 42 days post first dose
Reported as:
Count of participants · Participants
Part A and Part B: Number of Participants With Polymerase Chain Reaction (PCR)-Corrected Adequate Clinical and Parasitological Response (ACPR)
ParticipantsPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A - Cohort 7: CoartemPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 4: Coartem
Day 14 post first dose4846484744432547454022
Day 42 post first dose4544464643412436373720
SecondaryPart A and Part B: Number of Participants With Recrudescence Events

Recrudescence is defined as appearance of asexual parasites after clearance of initial infection with a genotype identical to that of parasites present at baseline. Recrudescence must be confirmed by PCR analysis.

Time frame:
42 days post first dose
Reported as:
Count of participants · Participants
Part A and Part B: Number of Participants With Recrudescence Events
ParticipantsPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A - Cohort 7: CoartemPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 4: Coartem
Part A and Part B: Number of Participants With Recrudescence Events431102012732
SecondaryPart A and Part B: Number of Participants With Reinfection Events

Reinfection is defined as appearance of asexual parasites after clearance of initial infection with a genotype different from those parasites present at baseline. Reinfection must be confirmed by PCR analysis.

Time frame:
42 days post first dose
Reported as:
Count of participants · Participants
Part A and Part B: Number of Participants With Reinfection Events
ParticipantsPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A - Cohort 7: CoartemPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 4: Coartem
Part A and Part B: Number of Participants With Reinfection Events37478281110910
SecondaryPart A and Part B: Fever Clearance Time (FCT)

Fever Clearance Time (FCT) is defined as the time from the first dose until the first time the axillary body temperature decreased below and remained below 37.5°C axillary or 38.0°C oral/tympanic/rectal for at least a further 24 hours. In case a participant received rescue medication before (fever) clearance, the time to event was censored at the first use of rescue medication.

Time frame:
42 days post first dose
Reported as:
Mean · Hours
Part A and Part B: Fever Clearance Time (FCT)
HoursPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A - Cohort 7: CoartemPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 4: Coartem
Part A and Part B: Fever Clearance Time (FCT)18.7 ± 3.0922.5 ± 6.0920.3 ± 4.9216.6 ± 3.4817.5 ± 2.6519.2 ± 2.9226.3 ± 7.6723.5 ± 10.2617.3 ± 7.413.8 ± 3.6822.9 ± 12.78
SecondaryPK Run-in, Part A and Part B: Parasite Clearance Time (PCT)

Parasite Clearance Time (PCT) is defined as the time from the first dose until the first total and continued disappearance of asexual parasite forms which remained at least a further 48 hours. In case a participant received rescue medication before (parasite) clearance, the time to event was censored at the first use of rescue medication.

Time frame:
42 days post first dose
Reported as:
Mean · Hours
PK Run-in, Part A and Part B: Parasite Clearance Time (PCT)
HoursPK Run-in Cohort: KAF 200 mg and LUM 960 mg QD for 1 DayPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A - Cohort 7: CoartemPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 4: Coartem
PK Run-in, Part A and Part B: Parasite Clearance Time (PCT)49.9 ± 4.3548.4 ± 3.546.6 ± 3.9339.9 ± 2.4651.4 ± 3.9749.7 ± 3.7248.1 ± 4.2450.0 ± 12.8242.6 ± 2.6247.0 ± 2.7941.9 ± 2.5835.6 ± 2.82
SecondaryPK Run-in, Part A and Part B: Number of Participants With Parasitaemia

Parasitaemia is the quantitative content of parasites in the blood determined by microscopy examination validated methods. Only Plasmodium Falciparum asexual form is used for parasitaemia assessments.

Time frame:
12, 24 and 48 hours post last dose
Reported as:
Count of participants · Participants
PK Run-in, Part A and Part B: Number of Participants With Parasitaemia
ParticipantsPK Run-in Cohort: KAF 200 mg and LUM 960 mg QD for 1 DayPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A - Cohort 7: CoartemPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 4: Coartem
12 hours post last dose124646445249492248484222
24 hours post last dose113941384642341441423617
48 hours post last dose31398121011441051
SecondaryPart A and Part B: Area Under the Blood Concentration-time Curve Over the Last 24 Hours After Last Treatment Dose (AUC0-24h) of KAF156

Pharmacokinetic (PK) parameters were calculated based on KAF156 blood concentrations determined by a validated liquid chromatography and tandem mass spectrometry (LC-MS/MS) method. AUC0-24h was determined using non-compartmental methods.

Time frame:
3, 6, 18 and 24 hours post last dose
Reported as:
Geometric mean · hours*μg/mL
Part A and Part B: Area Under the Blood Concentration-time Curve Over the Last 24 Hours After Last Treatment Dose (AUC0-24h) of KAF156
hours*μg/mLPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 Days
Part A and Part B: Area Under the Blood Concentration-time Curve Over the Last 24 Hours After Last Treatment Dose (AUC0-24h) of KAF1569.84 ± 41.521.7 ± 41.79.95 ± 131.95.91 ± 29.211 ± 79.310.9 ± 57.411 ± 47.7——
SecondaryPart A and Part B: Maximum Peak Observed Concentration (Cmax) of KAF156

Pharmacokinetic (PK) parameters were calculated based on KAF156 blood concentrations determined by a validated liquid chromatography and tandem mass spectrometry (LC-MS/MS) method. Cmax was determined using non-compartmental methods.

Time frame:
3, 6, 18, 24, 27, 30, 48, 51, 54, 68, 72 and 168 hours post last dose
Reported as:
Geometric mean · ng/mL
Part A and Part B: Maximum Peak Observed Concentration (Cmax) of KAF156
ng/mLPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 Days
Part A and Part B: Maximum Peak Observed Concentration (Cmax) of KAF156653 ± 43.91470 ± 46.51060 ± 83.9665 ± 30.31470 ± 30.91320 ± 32.7714 ± 49.41060 ± 48.41380 ± 29.7
SecondaryPK Run-in and Part A: Elimination Half-life (T½) of KAF156

Pharmacokinetic (PK) parameters were calculated based on KAF156 blood concentrations determined by a validated liquid chromatography and tandem mass spectrometry (LC-MS/MS) method. T½ was determined using non-compartmental methods.

Time frame:
0, 1, 3, 6, 12, 18, 24, 27, 30, 36, 48, 72, 96 and 168 hours post last dose
Reported as:
Mean · Hours
PK Run-in and Part A: Elimination Half-life (T½) of KAF156
HoursPK Run-in Cohort: KAF 200 mg and LUM 960 mg QD for 1 DayPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 Days
PK Run-in and Part A: Elimination Half-life (T½) of KAF15625.0 ± 8.8125.4 ± 5.3229.9 ± 9.9531.0 ± 3.8635.8 ± 19.428.4 ± 3.4926.6 ± 4.15
SecondaryPK Run-in and Part A (Cohorts 1 and 2): Time to Reach Maximum Blood Concentrations (Tmax) of KAF156

Pharmacokinetic (PK) parameters were calculated based on KAF156 blood concentrations determined by a validated liquid chromatography and tandem mass spectrometry (LC-MS/MS) method. Tmax was determined using non-compartmental methods.

Time frame:
0, 1, 3, 6, 12, 18, 24, 30, 48, 96 and 168 hours post last dose
Reported as:
Mean · Hours
PK Run-in and Part A (Cohorts 1 and 2): Time to Reach Maximum Blood Concentrations (Tmax) of KAF156
HoursPK Run-in Cohort: KAF 200 mg and LUM 960 mg QD for 1 DayPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 Day
PK Run-in and Part A (Cohorts 1 and 2): Time to Reach Maximum Blood Concentrations (Tmax) of KAF1564.23 ± 1.5539.8 ± 77.35.99 ± 3.11

Adverse events

Collected over Adverse events were reported from Day 1 to Day 43, where Day 43 could be 42, 41 or 40 days after end of treatment depending on whether the participant received treatment during 1, 2 or 3 consecutive days respectively.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
PK Run-in: KAF 200 mg and LUM 960 mg QD for 1 Day0/12 (0%)0/12 (0%)7/12 (58.3%)
Part A: KAF 800 mg and LUM 960 mg QD for 1 Day0/51 (0%)1/51 (2%)37/51 (72.5%)
Part A: KAF 200 mg and LUM 480 mg QD for 3 Days0/54 (0%)2/54 (3.7%)30/54 (55.6%)
Part A: KAF 400 mg and LUM 480 mg QD for 3 Days0/51 (0%)1/51 (2%)32/51 (62.7%)
Part A and Part B: KAF 400 mg and LUM 960 mg QD for 1 Day0/103 (0%)7/103 (6.8%)69/103 (67%)
Part A and Part B: KAF 400 mg and LUM 960 mg QD for 2 Days0/104 (0%)5/104 (4.8%)68/104 (65.4%)
Part A and Part B: KAF 400 mg and LUM 960 mg QD for 3 Days0/97 (0%)2/97 (2.1%)59/97 (60.8%)
Part A and Part B: Coartem0/51 (0%)3/51 (5.9%)30/51 (58.8%)
Most frequent serious events
Showing 10 of 13
Most frequent serious events
EventPK Run-in: KAF 200 mg and LUM 960 mg QD for 1 DayPart A: KAF 800 mg and LUM 960 mg QD for 1 DayPart A: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A and Part B: KAF 400 mg and LUM 960 mg QD for 1 DayPart A and Part B: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A and Part B: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A and Part B: Coartem
Blood alkaline phosphatase increasedInvestigations0/120/511/540/513/1032/1040/973/51
Blood bilirubin increasedInvestigations0/120/510/540/512/1032/1041/972/51
AnaemiaBlood and lymphatic system disorders0/120/510/541/510/1031/1040/970/51
Plasmodium falciparum infectionInfections and infestations0/121/510/540/510/1030/1040/970/51
Alanine aminotransferase increasedInvestigations0/120/510/540/510/1030/1040/971/51
Aspartate aminotransferaseInvestigations0/120/511/540/510/1030/1040/970/51
PneumoniaInfections and infestations0/120/510/540/510/1030/1041/970/51
PetechiaeSkin and subcutaneous tissue disorders0/120/510/540/510/1030/1041/970/51
Hepatitis acuteHepatobiliary disorders0/120/510/540/511/1030/1040/970/51
JaundiceHepatobiliary disorders0/120/510/540/511/1030/1040/970/51
Most frequent other events
Showing 10 of 17
Most frequent other events
EventPK Run-in: KAF 200 mg and LUM 960 mg QD for 1 DayPart A: KAF 800 mg and LUM 960 mg QD for 1 DayPart A: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A and Part B: KAF 400 mg and LUM 960 mg QD for 1 DayPart A and Part B: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A and Part B: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A and Part B: Coartem
MalariaInfections and infestations0/128/514/546/5128/10325/10416/9718/51
Blood phosphorus increasedInvestigations4/120/511/540/510/1030/1040/970/51
HeadacheNervous system disorders0/1210/5115/547/5116/10313/10414/977/51
PyrexiaGeneral disorders0/125/514/546/5120/10318/1049/9713/51
Electrocardiogram QT prolongedInvestigations1/125/519/549/515/1036/1049/973/51
VomitingGastrointestinal disorders0/128/512/543/518/1039/1048/972/51
Upper respiratory tract infectionInfections and infestations0/126/515/543/5115/10312/10412/975/51
Abdominal painGastrointestinal disorders0/123/512/547/513/1035/1044/970/51
ThrombocytopeniaBlood and lymphatic system disorders0/123/511/545/511/1031/1040/972/51
CoughRespiratory, thoracic and mediastinal disorders0/123/513/545/517/10310/1046/974/51

Baseline characteristics

Age, Continuous
Age, Continuous(Years)PK Run-in Cohort: KAF 200 mg and LUM 960 mg QD for 1 DayPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A - Cohort 7: CoartemPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 4: CoartemTotal
Mean17.8 ± 10.2522.3 ± 13.5321.3 ± 10.6921.1 ± 11.0923.3 ± 14.6820.3 ± 11.9020.0 ± 9.4920.9 ± 12.286.6 ± 2.866.2 ± 2.906.9 ± 2.605.9 ± 2.2116.3 ± 12.10
Sex: Female, Male
Sex: Female, Male(Participants)PK Run-in Cohort: KAF 200 mg and LUM 960 mg QD for 1 DayPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A - Cohort 7: CoartemPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 4: CoartemTotal
Female62624212625201331292015256
Male6252730282632142224259268
Race (NIH/OMB)
Race (NIH/OMB)(Participants)PK Run-in Cohort: KAF 200 mg and LUM 960 mg QD for 1 DayPart A - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart A - Cohort 2: KAF 800 mg and LUM 960 mg QD for 1 DayPart A - Cohort 3: KAF 400 mg and LUM 960 mg QD for 2 DaysPart A - Cohort 4: KAF 200 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 5: KAF 400 mg and LUM 480 mg QD for 3 DaysPart A - Cohort 6: KAF 400 mg and LUM 960 mg QD for 3 DaysPart A - Cohort 7: CoartemPart B - Cohort 1: KAF 400 mg and LUM 960 mg QD for 1 DayPart B - Cohort 2: KAF 400 mg and LUM 960 mg QD for 2 DaysPart B - Cohort 3: KAF 400 mg and LUM 960 mg QD for 3 DaysPart B - Cohort 4: CoartemTotal
American Indian or Alaska Native0000000000000
Asian07779774110050
Native Hawaiian or Other Pacific Islander0000000000000
Black or African American124444434544452352524524473
White0001000000001
More than one race0000000000000
Unknown or Not Reported0000000000000
07

Study locations

11 sites
  • Novartis Investigative Site
    Nanoro, Burkina Faso
  • Novartis Investigative Site
    Lambarene, Gabon
  • Novartis Investigative Site
    Ranchi, Jharkhand 834009, India
  • Novartis Investigative Site
    Kombewa, Kenya
  • Novartis Investigative Site
    Siaya, 2300, Kenya
  • Novartis Investigative Site
    Sotuba, Mali
  • Novartis Investigative Site
    Chokwe, Mozambique
  • Novartis Investigative Site
    Tak, 63140, Thailand
  • Novartis Investigative Site
    Masaka, Uganda
  • Novartis Investigative Site
    Tororo, Uganda
  • Novartis Investigative Site
    Binh Phuoc Province, VNM 830000, Vietnam
08

References and documents

Study documents

  • Study protocol · Apr 13, 2018
  • Statistical analysis plan · Nov 8, 2021

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on https://www.clinicalstudydatarequest.com/.

09

Registry details

Key details

Study ID
NCT03167242
Lead sponsor
Novartis Pharmaceuticals
Collaborators
Medicines for Malaria Venture
Responsible party
Sponsor
First posted
May 25, 2017
Start date
Aug 2, 2017
Primary completion
Jun 14, 2021
Completion
Jun 28, 2021
Results posted
Feb 10, 2022
Last update
Feb 10, 2022

Study contacts

Study Director
study director · Novartis Pharmaceuticals

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
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