ClinicalTrials.gg
TerminatedNCT03341767Updated Aug 13, 2019

A Phase 2A Evaluation of the Safety, Tolerability, Pharmacokinetics, Efficacy of Clofazimine (CFZ) in Cryptosporidiosis

A Phase 2 interventional study of Clofazimine and Placebo in Cryptosporidiosis, sponsored by University of Washington. Terminated at 1 site in Malawi. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2019-08-13.

Sponsored by University of Washington · Phase 2, Interventional, and Treatment

Why this study was terminated
Insufficient accrual rate

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Phase
Phase 2
Study type
Interventional
Enrollment
33
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

This study evaluates the safety, tolerability, pharmacokinetics, and efficacy of treating Cryptosporidiosis in HIV positive patients with Clofazimine. Half of the HIV positive patients with Cryptosporidiosis enrolled will be treated with Clofazimine while the other half will be given placebo. An additional group of HIV positive patients without Cryptosporidium infection or diarrhea will be given Clofazimine to assess the differences in pharmacokinetics between HIV positive patients with and without Cryptosporidiosis and diarrhea.

Read the detailed description

Cryptosporidiosium infection and diarrhea is a life-threatening infection in children 6-18 months and in immunocompromised patients. However, Nitazoxanide, the only drug approved for treatment of Cryptosporidiosis, showed little-to-no efficacy in HIV positive patients and low efficacy in malnourished children.

Recently, Love MS et al reported that Clofazimine inhibited proliferation of both Cryptosporidium parvum and C. hominis in vitro and reduced shedding in a mouse model of acute C. parvum infection. Clofazimine has been approved for treatment of leprosy for decades and more recently for the treatment of drug-resistant Mycobacterium tuberculosis. Safety and pharmacokinetics of Clofazimine are well documented for a variety of patient populations, but not for HIV positive patients or patients with diarrhea. Thus, this clinical trial seeks to determine the efficacy of 50 or 100 mg of Clofazimine administered 3 times daily for 5 days on fecal shedding of Cryptosporidium oocysts in HIV positive patients, as well as safety, tolerability, and pharmacokinetics in this patient population.

02

Conditions studied

  • Cryptosporidiosis

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Keywords

  • HIV
  • Cryptosporidium
  • Clofazimine
03

In context

Cryptosporidiosis

32 studies on the registry are indexed under Cryptosporidiosis; 6 are open to participants now.

This study's enrollment of 33 is below the median of 40 across 17 interventional studies indexed under Cryptosporidiosis.

Browse Cryptosporidiosis studies →

Lead sponsor

University of Washington is the lead sponsor of 1,434 studies on the registry; 226 are open to participants now.

Of its 158 completed or terminated interventional studies of FDA-regulated products, 136 (86%) have results posted.

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

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

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

Part A:

Inclusion criteria

Inclusion Criteria:

  • Male or Female, Aged 18-65 years old, positive, Cryptosporidium positive by qPCR.
  • HIV infection and on stable anti-retroviral therapy treatment for at least 2 weeks
  • Weight >78 lbs/35.4 kg
  • Presents with diarrhea defined as a condition of three or more loose stools per day that has persisted for 3 days or longer
  • If female, either not of (, or status-post surgical sterilization) or using highly effective (\<1% failure, e.g., intrauterine contraceptive device in place or using injectable contraception) or willing to begin highly effective contraception (probably injectable contraception) and continue for the presumed exposure period of Clofazimine (54 days after initiation of treatment)
  • Willing and able to provide signed written or witnessed oral consent in the case of illiteracy, prior to undertaking any trial-related procedures

Exclusion criteria

Exclusion Criteria:

  • Any condition for which participation in the study, as judged by the investigator, could compromise the well-being of the subject or prevent, limit or confound protocol specified assessments
  • Fever >38.0˚C at presentation
  • Subjects will be screened for evidence of active tuberculosis based on sputum production, fever and chest x-ray. Those with sputum production will be tested by Acid Fast Bacilli stain of sputum smear and/or by GeneXpert testing. Those with positive sputum or chest x-ray suggestive of tuberculosis will be excluded from this study and referred for treatment.
  • Is critically ill, or in the judgment of the investigator has a prognosis that could lead to imminent mortality within 60 days or compromise participation in the trial or endanger the subject by entering the trial.
  • History of allergy or to Clofazimine.
  • Significant cardiac arrhythmia requiring medication.
  • exclusions based on the means from triplicate electrocardiograms performed on Day -1:

    1. Marked prolongation of /QTc interval, e.g., confirmed demonstration of QTcF or QTcB interval >450 ms
    2. Pathological Q waves (defined as >40 ms or depth >0.4 to 0.5mV);
    3. Electrocardiogram evidence of ventricular pre-excitation
    4. Electrocardiogram evidence of complete or incomplete left bundle branch block or right bundle branch block
    5. Electrocardiogram evidence of second or third degree heart block
    6. Intraventricular conduction delay with QRS duration >120 ms
    7. Bradycardia as defined by sinus rate \<50 bpm.
  • History of additional risk factors for Torsade de Pointes, e.g., heart failure; bradycardia with HR\<50 bpm, untreated hypothyroidism, hypokalemia \<3.0 mEq/L
  • Family history of long QT syndrome
  • Use of concomitant medications that markedly prolong the QT/QTc interval or are predicted to have drug-drug interactions with Clofazimine that may lead to toxicity from the partner drug including Amiodarone, Amprenavir, Atazanavir, Bedaquiline, Bepridil, Chloroquine, Chlorpromazine, Cisapride, Clarithromycin, Cyclobenzaprine, Darunavir, Delamanid, Disopyramide Dofetilide, Domperidone, Droperidol, Erythromycin, Fosamprenavir, Halofantrine, Haloperidol, Ibutilide, Indinavir, Levomethadyl, Lopinavir, Mesoridazine, Methadone, Nelfinavir, Pentamidine, Pimozide, Procainamide, Quinidine, Ritonavir, Simiprinivir, Sotalol, Sparfloxacin, Thioridazine, or Tiprinivir
  • Pregnant and lactating women (screening pregnancy test for females and pregnancy test at the discharge follow up visit)
  • Use of systemic or anti-cryptosporidial treatments within the 28 days preceding Day -1
  • Subjects with laboratory value abnormalities at screening including but not limited to (note: exclusionary results may not be returned until after enrollment but should be confirmed by the time of the beginning of administration of study drug):

    1. \<5 g/dL
    2. Serum potassium \<3.0 mEq/L
    3. or Alanine Aminotransferase ≥3.0 x

Part B:

Same Eligibility Criteria except without diarrhea and is Cryptosporidium negative by qPCR.

Terms in these criteria, in plain language(13)

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.

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.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

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

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

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

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.

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.

Hemoglobin (Hb)

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

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

05

Study design

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

Study arms

  • Experimental
    Clofazimine

    Subjects \>/=50 kg: Clofazimine two 50mg gelatin capsules taken orally every 8 hours for 5 days Subjects \<50 kg: Clofazimine 50mg gelatin capsule taken orally every 8 hours for 5 days

    Drug: Clofazimine

  • Placebo comparator
    Placebo

    Placebo gelatin capsule(s) taken orally every 8 hours for 5 days.

    Drug: Placebo

  • Experimental
    Clofazimine, no diarrhea

    Subjects \>/=50 kg: Clofazimine two 50mg gelatin capsules taken orally every 8 hours for 5 days Subjects \<50 kg: Clofazimine 50mg gelatin capsule taken orally every 8 hours for 5 days

    Drug: Clofazimine

Interventions

  • 50 or 100 mg micronized Clofazimine suspended in an oil-wax base in a gelatin capsule

    Also known as: Lamprene

  • DrugPlacebo

    Oil-wax in gelatin capsule

    Also known as: Placebo (for Clofazimine)

06

What researchers measure

Primary outcomes

  1. Reduction in Cryptosporidium fecal shedding following Clofazimine administration

    The reduction in the (log) number of Cryptosporidium shed in stools in the first collected stool of the day over a 6-day period and compared to placebo recipients, as measured by quantitative polymerase chain reaction (qPCR) in stool samples and analyzed by a mixed effect ANCOVA analysis in subjects treated according to protocol (ATP).

    Time frame: 5 days

  2. Pharmacokinetics (area under curve) of Clofazimine in HIV-infected subjects with Cryptosporidium and diarrhea versus HIV-infected subjects without Cryptosporidium infection or diarrhea

    Clofazimine in plasma will be assessed via area under curve.

    Time frame: 5 days

  3. Peak plasma concentration of Clofazimine in HIV-infected subjects with Cryptosporidium and diarrhea versus HIV-infected subjects without Cryptosporidium infection or diarrhea

    Clofazimine in plasma will be assessed via Cmax and time to reach Cmax (Tmax).

    Time frame: 5 days

  4. Pharmacokinetics (Ke) of Clofazimine in HIV-infected subjects with Cryptosporidium and diarrhea versus HIV-infected subjects without Cryptosporidium infection or diarrhea

    Clofazimine in plasma will be assessed via Ke determined after the last dose on day 5.

    Time frame: 5 days

  5. Stool pharmacokinetics of Clofazimine in HIV-infected subjects with Cryptosporidium and diarrhea versus HIV-infected subjects without Cryptosporidium infection or diarrhea

    The total daily amount of CFZ eliminated in stool will be assessed on Study Day 2 (2nd dose day), Study Day 5 (last dose day), and Study Day 6 (concentration of CFZ in stool before discharge).

    Time frame: 5 days

  6. Frequency and severity of solicited adverse events (AEs)

    Frequency and severity of solicited AEs throughout study product administration

    Time frame: 5 days

  7. Frequency, severity, and relationship to study product of unsolicited AEs

    Frequency, severity, and relationship to study product of unsolicited AEs throughout the course of the study

    Time frame: 55 days

  8. Occurrence of serious adverse events (SAEs), suspected unexpected serious adverse reactions (SUSARs), and adverse events of special interest (AESI).

    Occurrence of SAEs, SUSARs, and AESIs throughout the course of the study. AESI include: QT prolongation measured via 12-lead electrocardiogram, liver toxicity, skin discoloration and other skin related AEs/abnormalities (subjects will be evaluated for discoloration of skin of the palms and of the sclera and oral mucous membranes), GI-related AEs.

    Time frame: 55 days

Secondary outcomes

  1. Evaluation of time to negative ELISA signal in subjects randomized to Clofazimine versus placebo

    Evaluate days required to test negative for Cryptosporidium by ELISA test in subjects randomized to Clofazimine versus placebo.

    Time frame: 6 days

  2. Characterization of the reduction in the number of diarrheal episodes following administration of CFZ relative to placebo.

    To characterize the reduction in the number of diarrheal episodes following administration of CFZ relative to placebo.

    Time frame: 6 days

  3. Characterization of the stool volume following administration of CFZ relative to placebo.

    To characterize the stool volume following administration of CFZ relative to placebo.

    Time frame: 6 days

  4. Characterization of the stool consistency following administration of CFZ relative to placebo.

    To characterize the stool consistency based on a defined diarrheal stool grading scale following administration of CFZ relative to placebo.

    Time frame: 6 days

07

Study locations

1 site
  • Malawi-Liverpool-Wellcome Trust Clinical Research Programme (MLW)
    Blantyre, Malawi
08

References and documents

Publications

  • Love MS, Beasley FC, Jumani RS, Wright TM, Chatterjee AK, Huston CD, Schultz PG, McNamara CW. A high-throughput phenotypic screen identifies clofazimine as a potential treatment for cryptosporidiosis. PLoS Negl Trop Dis. 2017 Feb 3;11(2):e0005373. doi: 10.1371/journal.pntd.0005373. eCollection 2017 Feb. PubMed 28158186 ↗
  • Zhang CX, Love MS, McNamara CW, Chi V, Woods AK, Joseph S, Schaefer DA, Betzer DP, Riggs MW, Iroh Tam PY, Van Voorhis WC, Arnold SLM. Pharmacokinetics and Pharmacodynamics of Clofazimine for Treatment of Cryptosporidiosis. Antimicrob Agents Chemother. 2022 Jan 18;66(1):e0156021. doi: 10.1128/AAC.01560-21. Epub 2021 Nov 8. PubMed 34748385 ↗
  • Iroh Tam P, Arnold SLM, Barrett LK, Chen CR, Conrad TM, Douglas E, Gordon MA, Hebert D, Henrion M, Hermann D, Hollingsworth B, Houpt E, Jere KC, Lindblad R, Love MS, Makhaza L, McNamara CW, Nedi W, Nyirenda J, Operario DJ, Phulusa J, Quinnan GV, Sawyer LA, Thole H, Toto N, Winter A, Van Voorhis WC. Clofazimine for Treatment of Cryptosporidiosis in Human Immunodeficiency Virus Infected Adults: An Experimental Medicine, Randomized, Double-blind, Placebo-controlled Phase 2a Trial. Clin Infect Dis. 2021 Jul 15;73(2):183-191. doi: 10.1093/cid/ciaa421. PubMed 32277809 ↗
  • Nachipo P, Hermann D, Quinnan G, Gordon MA, Van Voorhis WC, Iroh Tam PY. Evaluating the safety, tolerability, pharmacokinetics and efficacy of clofazimine in cryptosporidiosis (CRYPTOFAZ): study protocol for a randomized controlled trial. Trials. 2018 Aug 23;19(1):456. doi: 10.1186/s13063-018-2846-6. PubMed 30139372 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Dec 2017 to primary completion in Apr 2019, 15 months.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 26, 2017
First posted
Nov 14, 2017
StartActual
Dec 14, 2017
Primary completionActual
Apr 1, 2019
CompletionActual
Jul 5, 2019
Last update
Aug 13, 2019
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 13, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03341767
Collaborators
Bill and Melinda Gates Foundation, The Emmes Company, LLC, Calibr, a division of Scripps Research, Liverpool School of Tropical Medicine, University of Virginia, Malawi-Liverpool-Wellcome Trust Clinical Research Programme
Responsible party
Wes Van Voorhis (Professor, School of Medicine, Allergy & Infectious Diseases, University of Washington) — Principal investigator
First posted
Nov 14, 2017
Start date
Dec 14, 2017
Primary completion
Apr 1, 2019
Completion
Jul 5, 2019
Last update
Aug 13, 2019

Study contacts

Wes Van Voorhis, MD, PhD
principal investigator · University of Washington

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Aug 2019. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Clofazimine

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