A Phase 2 interventional study of KAE609 and Coartem in Malaria, sponsored by Novartis Pharmaceuticals. Completed at 9 sites in 5 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-10-11.
Sponsored by Novartis Pharmaceuticals · Phase 2, Interventional, and Treatment
KAE609 will be evaluated primarily for hepatic safety of single and multiple doses in sequential cohorts with increasing doses.This study aims to determine the maximum safe dose of the investigational drug KAE609 in malaria patients.
KEY Inclusion Criteria:
KEY Exclusion Criteria:
Other protocol-defined inclusion/exclusion criteria may apply
KAE609 10 mg once daily (QD) for 1 day
Drug: KAE609
KAE609 25 mg once daily (QD) for 1 day
Drug: KAE609
KAE609 10 mg (QD) for 3 days
Drug: KAE609
KAE609 50 mg once daily (QD) for 1 day
Drug: KAE609
KAE609 25 mg once daily (QD) for 3 days
Drug: KAE609
KAE609 75 mg once daily (QD) for 1 day
Drug: KAE609
KAE609 50 mg once daily (QD) for 3 days
Drug: KAE609
KAE609 150 mg once daily (QD) for 1 day
Drug: KAE609
Coartem® control
Drug: Coartem
Exploration of different doses of KAE609 to establish safety profile.
Also known as: Cipargamin
Control Arm
Also known as: Artemether Lumefantrine
Number of Participants With at Least 2 CTCAE Grades Increase From Baseline in Alanine Aminotransferase (ALT) or Aspartate Aminotransferase (AST)
The occurrence of at least 2 CTCAE grades increase from baseline in ALT or AST during the 4 weeks study period was evaluated to characterize hepatic safety aspects of single and multiple ascending doses of KAE609 in adult malaria subjects for treatment of uncomplicated malaria caused by plasmodium falciparum. If 2 patients in a 10 patient cohort (Cohorts 1 and 2) or 3 patients in a 20 patient cohort (Cohorts 3, 4 and 5) had at least 2 CTCAE grades increase from Baseline in ALT or AST, recruitment was suspended and a review of liver safety (and any other relevant data) by safety review committee was initiated. Any further progression of the study was based on the decision by the safety review committee.
Time frame: Day 29
Percentage of Participants With Polymerase Chain Reaction (PCR)-Corrected and Uncorrected Adequate Clinical and Parasitological Response (ACPR) at Day 15 and Day 29
PCR-corrected and PCR-uncorrected were evaluated at Days 15 and 29 (i.e., 14 and 28 days post-dose). The presence of parasitaemia after 7 days due to reinfection was considered as PCR-corrected ACPR. Missing blood smear data at Day 15 visit and thereafter were not considered as responder for the visit unless there was a later blood smear test indicating no parasitaemia.
Time frame: Day 15, Day 29
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 patient received rescue medication before (parasite) clearance, the time to event was censored at the first use of rescue medication.
Time frame: Day 29
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 patient received rescue medication before (fever) clearance, the time to event was censored at the first use of rescue medication.
Time frame: Day 29
Time to Recrudescence and Reinfection at Study Day 29
Time to recrudescence is calculated from the date of first study medication to the date of first event. Participants without recrudescence/reinfection after Day 7 are censored at the time of treatment failure or at the time of last parasite assessment if no treatment failure occured.
Time frame: Day 29
Maximum Peak Observed Concentration (Cmax)
Maximum Peak Observed Concentration (Cmax)
Time frame: Day 1, Day 3
Tmax
Tmax
Time frame: Day 1, Day 3
AUC0-24
AUC0-24
Time frame: Day 1, Day 3
Half-life (T^1/2)
Half-life (T\^1/2)
Time frame: Upto day 15 post dose
This study was conducted in 10 centers in 5 countries: Mali (2), Uganda (3), Ghana (2), Gabon (1), Rwanda (2).
| Milestone | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD | Pooled Coartem Control |
|---|---|---|---|---|---|---|---|---|---|
| Started | 10 | 10 | 12 | 20 | 22 | 20 | 21 | 22 | 51 |
| Completed | 9 | 10 | 12 | 20 | 21 | 19 | 21 | 22 | 51 |
| Not completed | 1 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 |
| Withdrew: Technical problems | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 |
| Withdrew: Subject/guardian decision | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 |
| Milestone | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD | Pooled Coartem Control |
|---|---|---|---|---|---|---|---|---|---|
| Started | 9 | 10 | 12 | 20 | 21 | 19 | 21 | 22 | 51 |
| Completed | 9 | 10 | 12 | 20 | 21 | 19 | 20 | 22 | 50 |
| Not completed | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 |
| Withdrew: Subject/guardian decision | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 |
The occurrence of at least 2 CTCAE grades increase from baseline in ALT or AST during the 4 weeks study period was evaluated to characterize hepatic safety aspects of single and multiple ascending doses of KAE609 in adult malaria subjects for treatment of uncomplicated malaria caused by plasmodium falciparum. If 2 patients in a 10 patient cohort (Cohorts 1 and 2) or 3 patients in a 20 patient cohort (Cohorts 3, 4 and 5) had at least 2 CTCAE grades increase from Baseline in ALT or AST, recruitment was suspended and a review of liver safety (and any other relevant data) by safety review committee was initiated. Any further progression of the study was based on the decision by the safety review committee.
| Percentage of Participants | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD | Pooled Coartem Control |
|---|---|---|---|---|---|---|---|---|---|
| Number of Participants With at Least 2 CTCAE Grades Increase From Baseline in Alanine Aminotransferase (ALT) or Aspartate Aminotransferase (AST) | 11.1 (0.3 to 48.2) | 0 (0.0 to 30.8) | 0 (0.0 to 26.5) | 0 (0.0 to 16.8) | 0 (0.0 to 16.1) | 0 (0.0 to 17.6) | 0 (0.0 to 16.1) | 4.5 (0.1 to 22.8) | 3.9 (0.5 to 13.5) |
PCR-corrected and PCR-uncorrected were evaluated at Days 15 and 29 (i.e., 14 and 28 days post-dose). The presence of parasitaemia after 7 days due to reinfection was considered as PCR-corrected ACPR. Missing blood smear data at Day 15 visit and thereafter were not considered as responder for the visit unless there was a later blood smear test indicating no parasitaemia.
| Percentage of Participants | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD | Pooled Coartem Control |
|---|---|---|---|---|---|---|---|---|---|
| Day 15: PCR corrected | 90.0 (55.50 to 99.75) | 90.0 (55.50 to 99.75) | 83.3 (51.59 to 97.91) | 95.0 (75.13 to 99.87) | 95.2 (76.18 to 99.88) | 84.2 (60.42 to 96.62) | 90.5 (69.62 to 98.83) | 77.3 (54.63 to 92.18) | 96.1 (86.54 to 99.52) |
| Day 15: PCR uncorrected | 90.0 (55.50 to 99.75) | 90.0 (55.50 to 99.75) | 83.3 (51.59 to 97.91) | 95.0 (75.13 to 99.87) | 95.2 (76.18 to 99.88) | 84.2 (60.42 to 96.62) | 85.7 (63.66 to 96.95) | 77.3 (54.63 to 92.18) | 96.1 (86.54 to 99.52) |
| Day 29: PCR corrected | 80.0 (44.39 to 97.48) | 90.0 (55.50 to 99.75) | 83.3 (51.59 to 97.91) | 90.0 (68.30 to 98.77) | 85.7 (63.66 to 96.95) | 73.7 (48.80 to 90.85) | 81.0 (58.09 to 94.55) | 68.2 (45.13 to 86.14) | 94.1 (83.76 to 98.77) |
| Day 29: PCR uncorrected | 80.0 (44.39 to 97.48) | 90.0 (55.50 to 99.75) | 66.7 (34.89 to 90.08) | 80.0 (56.34 to 94.27) | 81.0 (58.09 to 94.55) | 68.4 (43.45 to 87.42) | 71.4 (47.82 to 88.72) | 59.1 (36.35 to 79.29) | 92.2 (81.12 to 97.82) |
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 patient received rescue medication before (parasite) clearance, the time to event was censored at the first use of rescue medication.
| Hours | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD | Pooled Coartem Control |
|---|---|---|---|---|---|---|---|---|---|
| Parasite Clearance Time (PCT) | 26.8 ± 5.44 | 27.7 ± 4.96 | 14.0 ± 2.63 | 11.4 ± 1.82 | 11.1 ± 1.58 | 9.8 ± 0.97 | 8.7 ± 0.97 | 8.0 ± 1.09 | 36.2 ± 3.72 |
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 patient received rescue medication before (fever) clearance, the time to event was censored at the first use of rescue medication.
| Hours | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD | Pooled Coartem Control |
|---|---|---|---|---|---|---|---|---|---|
| Fever Clearance Time (FCT) | 3.9 ± NA | 2.0 ± 0.02 | NA ± NA | 22.0 ± 14.03 | 2.4 ± 0.93 | 7.2 ± 1.47 | 5.7 ± 2.02 | 9.9 ± 3.88 | 13.0 ± 4.29 |
Time to recrudescence is calculated from the date of first study medication to the date of first event. Participants without recrudescence/reinfection after Day 7 are censored at the time of treatment failure or at the time of last parasite assessment if no treatment failure occured.
| Event probability | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD | Pooled Coartem Control |
|---|---|---|---|---|---|---|---|---|---|
| Recrudescence | 12.5 (1.86 to 61.30) | 10.0 (1.47 to 52.70) | 16.7 (4.45 to 51.83) | 10.0 (2.60 to 34.40) | 16.0 (5.42 to 41.93) | 26.3 (11.90 to 52.11) | 15.9 (5.40 to 41.67) | 32.5 (16.93 to 56.43) | 2.4 (0.34 to 15.72) |
| Reinfection | — | — | 25.0 (6.91 to 68.52) | 14.3 (3.78 to 46.06) | 5.0 (0.72 to 30.53) | 10.0 (1.47 to 52.70) | 10.3 (2.67 to 35.25) | 13.3 (3.51 to 43.61) | 2.4 (0.34 to 15.72) |
Maximum Peak Observed Concentration (Cmax)
| ng/mL | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD |
|---|---|---|---|---|---|---|---|---|
| Day 1 | 179 ± 38.2 | 185 ± 51.2 | 379 ± 42.1 | 503 ± 44.3 | 773 ± 32.4 | 828 ± 35.4 | 1270 ± 41.3 | 2360 ± 28.5 |
| Day 3 | — | 235 ± 37.0 | — | 655 ± 27.9 | — | 1210 ± 30.7 | — | — |
Tmax
| Hour | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD |
|---|---|---|---|---|---|---|---|---|
| Day 1 | 4.00 (1.02 to 12.10) | 3.92 (1.03 to 6.17) | 4.01 (2.00 to 8.33) | 4.25 (2.00 to 23.80) | 4.12 (1.97 to 10.00) | 4.12 (2.00 to 6.13) | 6.01 (3.97 to 12.30) | 8.07 (1.00 to 24.10) |
| Day 3 | — | 52.7 (50.00 to 60.60) | — | 52.1 (49.90 to 59.60) | — | 52.0 (50.00 to 60.50) | — | — |
AUC0-24
| h*ug/mL | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD |
|---|---|---|---|---|---|---|---|---|
| Day 1 | 2.77 ± 48.9 | 2.59 ± 38.0 | 5.14 ± 52.5 | 8.39 ± 45.1 | 11.6 ± 37.7 | 15.6 ± 27.2 | 21.4 ± 41.5 | 40.4 ± 26.6 |
| Day 3 | — | 3.90 ± 38.5 | — | 10.9 ± 29.7 | — | 21.6 ± 31.3 | — | — |
Half-life (T\^1/2)
| Hour | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD |
|---|---|---|---|---|---|---|---|---|
| Day 1 | 24.4 ± 8.70 | 18.5 ± 6.24 | 35.1 ± 13.9 | 17.4 ± 3.27 | 31.5 ± 17.4 | 32.8 ± 5.05 | 25.3 ± 8.94 | 29.9 ± 12.5 |
| Day 3 | — | 32.4 ± 14.8 | — | 30.1 ± 14.0 | — | 29.9 ± 22.0 | — | — |
Collected over All AEs reported in this record are treatment emergent AEs, collected from date of First Patient First Treatment until the completion of the safety follow-up ( 30 days after the Last Patient Last Treatment ) up to approximately 2 years.. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| KAE609 10mg SD | 0/10 (0%) | 0/10 (0%) | 9/10 (90%) |
| KAE609 10mg QD@3 Days | 0/10 (0%) | 0/10 (0%) | 8/10 (80%) |
| KAE609 25mg SD | 0/12 (0%) | 0/12 (0%) | 10/12 (83.3%) |
| KAE609 25mg QD@3 Days | 0/20 (0%) | 0/20 (0%) | 10/20 (50%) |
| KAE609 50mg SD | 0/21 (0%) | 0/21 (0%) | 9/21 (42.9%) |
| KAE609 50mg QD@3 Days | 0/19 (0%) | 1/19 (5.3%) | 16/19 (84.2%) |
| KAE609 75mg SD | 0/21 (0%) | 2/21 (9.5%) | 15/21 (71.4%) |
| KAE609 150mg SD | 0/22 (0%) | 1/22 (4.5%) | 12/22 (54.5%) |
| Pooled Coartem | 0/51 (0%) | 1/51 (2%) | 25/51 (49%) |
| Event | KAE609 10mg SD | KAE609 10mg QD@3 Days | KAE609 25mg SD | KAE609 25mg QD@3 Days | KAE609 50mg SD | KAE609 50mg QD@3 Days | KAE609 75mg SD | KAE609 150mg SD | Pooled Coartem |
|---|---|---|---|---|---|---|---|---|---|
| Blood bilirubin increasedInvestigations | 0/10 | 0/10 | 0/12 | 0/20 | 0/21 | 1/19 | 0/21 | 0/22 | 1/51 |
| ThrombocytopeniaBlood and lymphatic system disorders | 0/10 | 0/10 | 0/12 | 0/20 | 0/21 | 0/19 | 1/21 | 0/22 | 0/51 |
| Blood alkaline phosphatase increasedInvestigations | 0/10 | 0/10 | 0/12 | 0/20 | 0/21 | 0/19 | 1/21 | 0/22 | 0/51 |
| Alanine aminotransferase increasedInvestigations | 0/10 | 0/10 | 0/12 | 0/20 | 0/21 | 0/19 | 0/21 | 1/22 | 0/51 |
| Event | KAE609 10mg SD | KAE609 10mg QD@3 Days | KAE609 25mg SD | KAE609 25mg QD@3 Days | KAE609 50mg SD | KAE609 50mg QD@3 Days | KAE609 75mg SD | KAE609 150mg SD | Pooled Coartem |
|---|---|---|---|---|---|---|---|---|---|
| HeadacheNervous system disorders | 3/10 | 5/10 | 1/12 | 1/20 | 2/21 | 2/19 | 5/21 | 0/22 | 9/51 |
| MalariaInfections and infestations | 1/10 | 0/10 | 2/12 | 4/20 | 4/21 | 5/19 | 5/21 | 9/22 | 1/51 |
| Treatment failureGeneral disorders | 0/10 | 1/10 | 3/12 | 1/20 | 0/21 | 1/19 | 0/21 | 0/22 | 2/51 |
| InfluenzaInfections and infestations | 0/10 | 0/10 | 0/12 | 1/20 | 0/21 | 3/19 | 2/21 | 3/22 | 2/51 |
| CoughRespiratory, thoracic and mediastinal disorders | 1/10 | 0/10 | 1/12 | 1/20 | 1/21 | 2/19 | 0/21 | 0/22 | 1/51 |
| LeukopeniaBlood and lymphatic system disorders | 0/10 | 1/10 | 0/12 | 0/20 | 0/21 | 0/19 | 0/21 | 0/22 | 0/51 |
| Abdominal painGastrointestinal disorders | 1/10 | 0/10 | 0/12 | 0/20 | 0/21 | 0/19 | 1/21 | 0/22 | 1/51 |
| DiarrhoeaGastrointestinal disorders | 1/10 | 0/10 | 1/12 | 0/20 | 0/21 | 0/19 | 1/21 | 0/22 | 3/51 |
| DyspepsiaGastrointestinal disorders | 0/10 | 1/10 | 0/12 | 0/20 | 0/21 | 0/19 | 0/21 | 0/22 | 0/51 |
| GastritisGastrointestinal disorders | 1/10 | 0/10 | 0/12 | 0/20 | 0/21 | 0/19 | 0/21 | 0/22 | 0/51 |
Randomized set (RAN)
| Age, Continuous(Years) | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD | Pooled Coartem Control | Total |
|---|---|---|---|---|---|---|---|---|---|---|
| Mean | 31.5 ± 10.48 | 35.4 ± 13.25 | 33.0 ± 14.96 | 31.9 ± 10.67 | 33.9 ± 12.56 | 26.4 ± 7.18 | 28.2 ± 10.25 | 30.6 ± 12.57 | 26.2 ± 9.07 | 29.7 ± 11.07 |
| Sex: Female, Male(Participants) | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD | Pooled Coartem Control | Total |
|---|---|---|---|---|---|---|---|---|---|---|
| Female | 2 | 6 | 8 | 11 | 9 | 8 | 5 | 6 | 18 | 73 |
| Male | 8 | 4 | 4 | 9 | 13 | 12 | 16 | 16 | 33 | 115 |
| Race/Ethnicity, Customized(Participants) | KAE609 10 mg SD | KAE609 10 mg QD 3 Days | KAE609 25 mg SD | KAE609 25 mg QD 3 Days | KAE609 50 mg SD | KAE609 50 mg QD 3 Days | KAE609 75 mg SD | KAE609 150 mg SD | Pooled Coartem Control | Total |
|---|---|---|---|---|---|---|---|---|---|---|
| Black or African American | 10 | 10 | 12 | 20 | 22 | 20 | 21 | 22 | 51 | 188 |
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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 www.clinicalstudydatarequest.com
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