ClinicalTrials.gg
CompletedNCT04150250CASTUpdated Mar 25, 2021Results posted

Cholera Anti-Secretory Treatment Trial

A Phase 2 interventional study of iOWH032 and Placebo in Cholera, sponsored by PATH. Completed at 1 site in United States. Open to participants aged 18 Years to 44 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-03-25.

Sponsored by PATH · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
47
Allocation
Randomized
Ages
18 Years to 44 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 12 studies in Cholera with a site in United States — 2 open to participants now, 2 under way, none of them phase 3. Cholera · United States.

Enrollment
10th of 12
47 · median 132
Started
2019
the only one that year
Phase 2
2 of 12
none open now
Registered
11th of 12
by date
Lead sponsor
1 of 12
PATH

Among the 12 studies in Cholera with a site in United States, this one is the 10th largest by enrollment, is the only one that started in 2019, is one of 2 in phase 2, and was the 11th registered.

By phase

12 studies; the count open now beside each. This study's row is marked.

Phase 13 · 1 open
Phase 33 · 0 open
Phase 43 · 1 open
Phase 2this study2 · 0 open
No phase1 · 0 open

By the year they started

First in 2008; this study’s year is marked. 1 started in 2019.

Size and results

Median enrollment 132 across the 12 interventional studies. Of the 10 that completed or were terminated, 8 (80%) have results posted.

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Watch this landscapeDownload CSVWith an account: a weekly mail of what changed among 12 studies in Cholera with a site in United States, or all of them as a file.
02

Study summary

This trial was designed to assess safety and preliminary efficacy of oral doses of iOWH032 on diarrhea output and clinical symptoms after a cholera challenge in healthy adult participants.

Read the detailed description

The study consists of a screening phase, an inpatient containment period with challenge with Vibrio cholerae on Day 1 followed by treatment with iOWH032 or placebo and a post-challenge observation period until discharge, an outpatient follow-up period of at least 28 days, and a final follow-up (by telephone) 6 months post-challenge (Day 180) for the collection of serious adverse events.

Participants will be randomized 1:1 to receive either iOWH032 500 mg every 8 hours for three days or matching placebo. Blinded therapeutic dosing will start at the onset of diarrhea or by 48 hours after ingesting the challenge inoculum of V. cholerae. The observation and management of cholera diarrhea and symptomatology will occur on an inpatient isolation research ward over a duration of approximately 11 days, including a three-day course of antibiotics to treat all participants prior to discharge from the inpatient unit.

03

Conditions studied

  • Cholera

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04

Who can participate

Ages eligible
18 Years to 44 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

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.

Inclusion criteria

  1. Willing and able to understand and provide written
  2. Healthy male and female adults, age 18 to 44 years (inclusive), without medical history, physical or clinical laboratory abnormalities (as per protocol-defined acceptable ranges), and protocol-defined abnormal results at screening
  3. All women must have a negative serum pregnancy test at screening and one day prior to challenge.
  4. Agreement by participants to use an adequate method of * during the study and for 4 weeks before and after the challenge.
  5. Able to pass a written examination (comprehension assessment test) with a score of ≥ 70%, in order to demonstrate their comprehension of this study. If a participant scores at least 50%, then they will be given one more opportunity to re-test after further re-education.
  6. Willing and able to comply with the study requirements and procedures.

    • Adequate contraception is defined as a contraceptive method with failure rate of less than 1% per year when used consistently and correctly and when applicable, in accordance with the product label; includes, but is not limited to, barrier with additional spermicidal foam or jelly, intrauterine device, hormonal contraception (started at least 4 weeks prior to study enrollment), or women who have intercourse limited to men who underwent vasectomy.

Exclusion criteria

Exclusion Criteria:

  1. history of immunodeficiency, cardiovascular disease, respiratory disease, endocrine disorder, liver disease, renal disease, gastrointestinal disease, anal or rectal disorders, neurologic disease,
  2. Current nicotine use or drug, alcohol abuse within the past 6 months
  3. Recipient of bone marrow or solid organ transplant
  4. Use of systemic chemotherapy in the past 5 years
  5. Has a (excluding localized non-melanoma skin cancers) or lymphoproliferative disorders diagnosed or treated within the past 5 years
  6. Received or plans to receive systemic therapy, radiation therapy, parenteral or high-dosage inhaled (> 800 µg/day of beclomethasone dipropionate or equivalent) within 6 months prior to the enrollment through 28 days after challenge
  7. Have a history of hospitalization for psychiatric illness, suicide attempt, or confinement for danger to self or others, within the past 10 years. Participants with a psychiatric disorder (not meeting exclusion criteria, e.g., attention-deficit hyperactivity disorder) that is controlled for a minimum of 3 months and the investigator has determined that the participant's mental status will not compromise the participant's ability to comply with protocol requirements may be enrolled
  8. Have an elevated blood pressure, systolic ≥ 150 mmHg or diastolic ≥ 90 mmHg, before challenge
  9. Taking any of the the protocol-defined drugs that are metabolized by CYP2C9 or any of the following psychiatric medications: aripiprazole, carbamazepine, chlorpromazine, chlorprothixene, clozapine, divalproex sodium, fluphenazine, haloperidol, lithium carbonate, lithium citrate, loxapine, mesoridazine, molindone, olanzapine, perphenazine, pimozide, quetiapine, risperidone, thioridazine, thiothixene, trifluoperazine, triflupromazine, or ziprasidone
  10. History of Guillain-Barré Syndrome
  11. Too low or too high a (BMI \< 18.5 or > 39)
  12. Has an abnormal stool pattern defined as fewer than 3 stools per week or more than 2 stools per day within the past 6 months, and any loose stools (grade 3 or higher) during the 1-2 day acclimation period before challenge
  13. Has regularly used laxatives in the past 6 months
  14. Has a history of eating disorders (e.g. anorexia or bulimia) within the past 10 years
  15. Known allergy or previous severe adverse effect to all of the following antibiotics: ciprofloxacin (or quinolones), azithromycin and doxycycline.
  16. Previously received a licensed or cholera vaccine, within 10 years
  17. History of cholera or enterotoxigenic Escherichia coli (ETEC) infection (lab-confirmed natural infection or experimental challenge), within 10 years
  18. Travel to a cholera-endemic area in the past 5 years
  19. Pregnant or nursing
  20. Positive serology for (HIV), antigen, or antibody
  21. Protocol-defined clinically abnormal 12-lead (ECG) at screening in the judgment of the Investigator, or based on the formal 12-lead ECG reading by a cardiologist; history of any cardiac abnormalities, including conduction abnormalities such as Wolff-Parkinson-White, dysrhythmias, or coronary artery disease
  22. Presence of a clinically significant abnormality on physical examination, including (but not limited to): pathologic heart murmur, lymphadenopathy, hepatosplenomegaly, large abdominal scar of unclear origin
  23. Has poor venous access, defined as the inability to obtain screening blood tests after three attempts
  24. Currently on, or plans to be on, antibiotics (e.g., doxycycline) within 14 days prior to challenge and through 28 days after challenge
  25. Presence of an acute illness or fever (> 100.4°F) within 72 hours of admission to the inpatient Clinical Research Unit
  26. Taking any prescription or over-the-counter medications that contain aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), antacids, proton pump inhibitors (PPIs), anti-diarrheals, etc. within 72 hours prior to challenge
  27. Received an investigational product within 30 days prior to randomization (90 days prior to randomization for monoclonal antibodies) or planned to participate in another research study involving an investigational product during the conduct of this study
  28. Participants must not have donated blood in 8 weeks prior to study entry and agreed to not donate blood during and for 4 weeks following their active participation in this study
  29. Lack of ability to fully understand the
  30. Any other condition(s) that in the opinion of the investigator would jeopardize the safety or rights of a participant participating in the trial or would render the participant unable to comply with the protocol
Terms in these criteria, in plain language(12)

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.

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.

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.

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.

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.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

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.

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.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

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.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

05

Study design

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

Study arms

  • Experimental
    iOWH032

    On Day 1, participants were challenged with 10\^6 colony-forming units (CFU) of freshly-harvested wild-type V. cholerae. At the onset of diarrhea, or at 48 hours after challenge, whichever occurred first, participants received oral iOWH032 500 mg tablets every 8 hours for 3 days. Participants received a 3-day course of antibiotics starting 4 days post-challenge, or sooner if the participant met the criterion for severe cholera diarrhea.

    Drug: iOWH032 · Other: V. cholerae Challenge · Drug: Antibiotics

  • Placebo comparator
    Placebo

    On Day 1, participants were challenged with 10\^6 CFU of freshly-harvested wild-type V. cholerae. At the onset of diarrhea, or at 48 hours after challenge, whichever occurred first, participants received oral matching iOWH032 placebo tablets every 8 hours for 3 days. Participants received a 3-day course of antibiotics starting 4 days post-challenge, or sooner if the participant met the criterion for severe cholera diarrhea.

    Drug: Placebo · Other: V. cholerae Challenge · Drug: Antibiotics

Interventions

  • Anti-secretory synthetically manufactured small molecule designed to inhibit the cystic fibrosis transmembrane conductance regulator chloride channel.

  • DrugPlacebo

    Oral tablets matching iOWH032 on taste, appearance, dissolution time with the same excipients but no active ingredients.

  • OtherV. cholerae Challenge

    Freshly-harvested, wild-type Vibrio (V.) cholerae El Tor Inaba strain N16961,10\^6 cfu suspended in 30 mL of sodium bicarbonate solution ingested orally.

  • DrugAntibiotics

    Antibiotic therapy may include: * Ciprofloxacin 500 mg, twice daily; * Azithromycin 500 mg, once daily (for those persons who are allergic to fluoroquinolones); * Doxycycline 300 mg, once daily (for those persons who are allergic to fluoroquinolones)

06

What researchers measure

Primary outcomes

  1. Diarrheal Stool Output Rate

    Diarrheal stool output rate is defined as the total volume of diarrheal stools (in mL, Grade 3 and above) divided by the number of hours between initiation of study drug (iOWH032 or placebo) and initiation of antibiotic therapy. Stools were graded based on consistency as follows: * Grade 1 - well formed (normal stool, does not take the shape of the container) * Grade 2 - soft (normal stool, does not take the shape of the container) * Grade 3 - thick liquid (diarrhea, takes the shape of the container readily) * Grade 4 - opaque watery diarrhea * Grade 5 - rice water diarrhea (clear watery) The definition of diarrhea is a grade 3 or higher stool.

    Time frame: Day 1 - Day 5 (up to first dose of antibiotic therapy)

  2. Diarrheal Stool Output Rate Including Participants With Symptom Onset After 48 Hours

    Stools were graded based on consistency as follows: * Grade 1 - well formed (normal stool, does not take the shape of the container) * Grade 2 - soft (normal stool, does not take the shape of the container) * Grade 3 - thick liquid (diarrhea, takes the shape of the container readily) * Grade 4 - opaque watery diarrhea * Grade 5 - rice water diarrhea (clear watery) The definition of diarrhea is a grade 3 or higher stool. For participants with symptom onset within 48 hours of challenge diarrheal stool output rate is defined as the total volume of diarrheal stools (mL, Grade 3 and above) divided by the number of hours between initiation of study product dosing and initiation of antibiotic therapy. For participants with symptom onset after 48 hours diarrheal stool output rate is defined as the total volume of diarrheal stools (mL, Grade 3 and above) divided by the number of hours between onset of symptoms and initiation of antibiotic therapy.

    Time frame: Day 1 - Day 5 (up to first dose of antibiotic therapy)

  3. Number of Participants With Treatment-emergent Serious Adverse Events

    A serious adverse event (SAE) is any adverse event that resulted in any of the following outcomes: 1. Death 2. A life-threatening event. 3. Required inpatient hospitalization or prolongation of existing hospitalization 4. Resulted in persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions 5. Congenital abnormality or birth defect 6. Important medical event that may not result in one of the above outcomes but may jeopardize the health of the study participant and/or requires medical or surgical intervention to prevent one of the outcomes listed in the above definition of serious adverse event.

    Time frame: Day 1 - Day 180

Secondary outcomes

  1. Percentage of Participants With Moderate to Severe Diarrhea With Onset Within 48 Hours Following Cholera Challenge

    The percentage of participants with moderate to severe diarrhea with onset within 48 hours following cholera challenge. Diarrhea was defined as a grade 3 or higher stool based on the following scale: * Grade 1 - well formed (normal stool, does not take the shape of the container) * Grade 2 - soft (normal stool, does not take the shape of the container) * Grade 3 - thick liquid (diarrhea, takes the shape of the container readily) * Grade 4 - opaque watery diarrhea * Grade 5 - rice water diarrhea (clear watery) Diarrheal stools (Grade 3-5) were graded for severity according to the following: Mild: ≤ 3 liters loose stools; Moderate: \> 3 liters loose stools; Severe: \> 5 liters loose stools.

    Time frame: Day 1 - Day 5 (up to first dose of antibiotic therapy)

  2. Attack Rate of Any Diarrhea Following Cholera Challenge

    Attack rate of any diarrhea following cholera challenge is defined as the number of participants with 2 or more loose stools (Grade 3-5) totaling \> 200 mL or 1 loose (Grade 3-5) stool \> 300 mL, respectively, with onset within 48 hours of cholera challenge.

    Time frame: Day 1 - Day 5 (up to first dose of antibiotic therapy)

  3. Area Under the Curve (AUC) of Diarrheal Stool Volume Between Challenge Dose and Initiation of Antibiotics

    The AUC of diarrheal stool volume and cholera organisms was computed via the trapezoidal rule.

    Time frame: Day 1 to Day 5 (prior to first dose of antibiotic)

  4. Peak Shedding of Cholera Organisms

    Quantitative cultures were performed on the first two stool samples of each 24-hour period prior to the initiation of antibiotics to determine the number of cholera organisms per gram of stool. Peak shedding represents the highest colony-forming unit (CFU) counts observed for each participant.

    Time frame: Day 1 to Day 5 (prior to first dose of antibiotic)

  5. Duration of Diarrheal Episodes

    Duration of diarrheal episodes was calculated using Kaplan-Meier methods as the time from cholera challenge to the time of the first formed stool (Grade 1), after which all following stools were also formed.

    Time frame: Day 1 to Day 5 (prior to first dose of antibiotics)

  6. Total Number of Loose (Grade 3-5) Stools

    Total number of loose stools (Grade 3 and above) per participant during the interval immediately following challenge and prior to initiation of antibiotic therapy.

    Time frame: Day 1 to Day 5 (prior to first dose of antibiotic therapy)

  7. Percentage of Participants With Fever Following Cholera Challenge

    The presence of fever was defined as a body temperature of ≥ 39°C (102.1°F).

    Time frame: Day 1 to Day 5, prior to first dose of antibiotics

  8. Percentage of Participants With Vomiting Following Cholera Challenge

    Time frame: Day 1 to Day 5, prior to first dose of antibiotics

  9. Number of Participants With Solicited Adverse Effects

    Solicited adverse events (AEs) include nausea, abdominal discomfort and pain, abdominal cramps, headache, malaise, anorexia, pollakiuria, micturition urgency, sinus tachycardia, increased alertness, and were collected by interview through 7 days post-challenge (Days 1-8)

    Time frame: Day 1 - Day 8

  10. Number of Participants With Unsolicited Treatment-emergent Adverse Events (TEAE)

    Unsolicited AEs include any AEs reported spontaneously by the participant, observed by the study personnel during study visits or those identified during review of medical records or source documents. Investigators assigned causality of unsolicited AEs to either the study drug, cholera infection, or an alternate etiology.

    Time frame: From first dose of study drug up to Day 29

07

Results

Posted Mar 25, 2021

Participant flow

A total of 47 healthy adults were enrolled at one clinical research site in the United States. Participants were confined in an inpatient isolation research ward for a duration of approximately 11 days until discharge criteria were met.

Participant flow — Overall Study
MilestoneiOWH032Placebo
Started2324
Completed2322
Not completed02
Withdrew: Lost to follow-up02

Outcome measures

PrimaryDiarrheal Stool Output Rate

Diarrheal stool output rate is defined as the total volume of diarrheal stools (in mL, Grade 3 and above) divided by the number of hours between initiation of study drug (iOWH032 or placebo) and initiation of antibiotic therapy. Stools were graded based on consistency as follows: * Grade 1 - well formed (normal stool, does not take the shape of the container) * Grade 2 - soft (normal stool, does not take the shape of the container) * Grade 3 - thick liquid (diarrhea, takes the shape of the container readily) * Grade 4 - opaque watery diarrhea * Grade 5 - rice water diarrhea (clear watery) The definition of diarrhea is a grade 3 or higher stool.

Time frame:
Day 1 - Day 5 (up to first dose of antibiotic therapy)
Reported as:
Median · mL/hour
Diarrheal Stool Output Rate
mL/houriOWH032Placebo
Diarrheal Stool Output Rate25.42 (7.2 to 65.9)32.57 (14.7 to 53.0)
Statistical analysis
  • iOWH032 vs Placebo · Van Elteren test · p = 0.2254 (The threshold to define success on the primary efficacy endpoint at the final analysis is one-sided alpha = 0.0238.) · Difference in median: -7.1 · 95% CI -30.9 to 28.6Stratified by blood type group (O vs. Non-O)
PrimaryDiarrheal Stool Output Rate Including Participants With Symptom Onset After 48 Hours

Stools were graded based on consistency as follows: * Grade 1 - well formed (normal stool, does not take the shape of the container) * Grade 2 - soft (normal stool, does not take the shape of the container) * Grade 3 - thick liquid (diarrhea, takes the shape of the container readily) * Grade 4 - opaque watery diarrhea * Grade 5 - rice water diarrhea (clear watery) The definition of diarrhea is a grade 3 or higher stool. For participants with symptom onset within 48 hours of challenge diarrheal stool output rate is defined as the total volume of diarrheal stools (mL, Grade 3 and above) divided by the number of hours between initiation of study product dosing and initiation of antibiotic therapy. For participants with symptom onset after 48 hours diarrheal stool output rate is defined as the total volume of diarrheal stools (mL, Grade 3 and above) divided by the number of hours between onset of symptoms and initiation of antibiotic therapy.

Time frame:
Day 1 - Day 5 (up to first dose of antibiotic therapy)
Reported as:
Median · mL/hour
Diarrheal Stool Output Rate Including Participants With Symptom Onset After 48 Hours
mL/houriOWH032Placebo
Diarrheal Stool Output Rate Including Participants With Symptom Onset After 48 Hours25.42 (6.3 to 63.8)29.22 (12.5 to 49.6)
Statistical analysis
  • iOWH032 vs Placebo · Van Elteren test · p = 0.2751 · Difference in median: -3.8 · 95% CI -26.3 to 27.4Stratified by blood type group
PrimaryNumber of Participants With Treatment-emergent Serious Adverse Events

A serious adverse event (SAE) is any adverse event that resulted in any of the following outcomes: 1. Death 2. A life-threatening event. 3. Required inpatient hospitalization or prolongation of existing hospitalization 4. Resulted in persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions 5. Congenital abnormality or birth defect 6. Important medical event that may not result in one of the above outcomes but may jeopardize the health of the study participant and/or requires medical or surgical intervention to prevent one of the outcomes listed in the above definition of serious adverse event.

Time frame:
Day 1 - Day 180
Reported as:
Count of participants · Participants
Number of Participants With Treatment-emergent Serious Adverse Events
ParticipantsiOWH032Placebo
Number of Participants With Treatment-emergent Serious Adverse Events01
SecondaryPercentage of Participants With Moderate to Severe Diarrhea With Onset Within 48 Hours Following Cholera Challenge

The percentage of participants with moderate to severe diarrhea with onset within 48 hours following cholera challenge. Diarrhea was defined as a grade 3 or higher stool based on the following scale: * Grade 1 - well formed (normal stool, does not take the shape of the container) * Grade 2 - soft (normal stool, does not take the shape of the container) * Grade 3 - thick liquid (diarrhea, takes the shape of the container readily) * Grade 4 - opaque watery diarrhea * Grade 5 - rice water diarrhea (clear watery) Diarrheal stools (Grade 3-5) were graded for severity according to the following: Mild: ≤ 3 liters loose stools; Moderate: \> 3 liters loose stools; Severe: \> 5 liters loose stools.

Time frame:
Day 1 - Day 5 (up to first dose of antibiotic therapy)
Reported as:
Number · percentage of participants
Percentage of Participants With Moderate to Severe Diarrhea With Onset Within 48 Hours Following Cholera Challenge
percentage of participantsiOWH032Placebo
Percentage of Participants With Moderate to Severe Diarrhea With Onset Within 48 Hours Following Cholera Challenge43.8 (19.8 to 70.1)55.0 (31.5 to 76.9)
Statistical analysis
  • iOWH032 vs Placebo · Cochran-Mantel-Haenszel · p = 0.5145 · Difference: -11.3 · 95% CI -44.1 to 21.6Cochran-Mantel-Haenszel test, stratified by blood type group.
SecondaryAttack Rate of Any Diarrhea Following Cholera Challenge

Attack rate of any diarrhea following cholera challenge is defined as the number of participants with 2 or more loose stools (Grade 3-5) totaling \> 200 mL or 1 loose (Grade 3-5) stool \> 300 mL, respectively, with onset within 48 hours of cholera challenge.

Time frame:
Day 1 - Day 5 (up to first dose of antibiotic therapy)
Reported as:
Number · percentage of participants
Attack Rate of Any Diarrhea Following Cholera Challenge
percentage of participantsiOWH032Placebo
Attack Rate of Any Diarrhea Following Cholera Challenge93.8 (69.8 to 99.8)100.0 (83.2 to 100.0)
Statistical analysis
  • iOWH032 vs Placebo · Cochran-Mantel-Haenszel · p = 0.2636 · Difference: -6.3 · 95% CI -18.1 to 5.6Cochran-Mantel-Haenszel test, stratified by blood type group.
SecondaryArea Under the Curve (AUC) of Diarrheal Stool Volume Between Challenge Dose and Initiation of Antibiotics

The AUC of diarrheal stool volume and cholera organisms was computed via the trapezoidal rule.

Time frame:
Day 1 to Day 5 (prior to first dose of antibiotic)
Reported as:
Median · liters * hours
Area Under the Curve (AUC) of Diarrheal Stool Volume Between Challenge Dose and Initiation of Antibiotics
liters * hoursiOWH032Placebo
Area Under the Curve (AUC) of Diarrheal Stool Volume Between Challenge Dose and Initiation of Antibiotics14.91 (9.3 to 20.8)13.80 (9.3 to 17.7)
Statistical analysis
  • iOWH032 vs Placebo · Van Elteren test · p = 0.5992 · Difference in median: 1.1 · 95% CI -4.5 to 7.8Stratified by blood type group
SecondaryPeak Shedding of Cholera Organisms

Quantitative cultures were performed on the first two stool samples of each 24-hour period prior to the initiation of antibiotics to determine the number of cholera organisms per gram of stool. Peak shedding represents the highest colony-forming unit (CFU) counts observed for each participant.

Time frame:
Day 1 to Day 5 (prior to first dose of antibiotic)
Reported as:
Mean · CFU/g
Peak Shedding of Cholera Organisms
CFU/giOWH032Placebo
Peak Shedding of Cholera Organisms124960186.25 ± 163145761.682186793500.00 ± 304578375.607
SecondaryDuration of Diarrheal Episodes

Duration of diarrheal episodes was calculated using Kaplan-Meier methods as the time from cholera challenge to the time of the first formed stool (Grade 1), after which all following stools were also formed.

Time frame:
Day 1 to Day 5 (prior to first dose of antibiotics)
Reported as:
Median · hours
Duration of Diarrheal Episodes
hoursiOWH032Placebo
Duration of Diarrheal Episodes156.48 (114.1 to 217.8)169.68 (108.9 to 216.4)
Statistical analysis
  • iOWH032 vs Placebo · Log Rank · p = 0.6527Stratified by blood type group
SecondaryTotal Number of Loose (Grade 3-5) Stools

Total number of loose stools (Grade 3 and above) per participant during the interval immediately following challenge and prior to initiation of antibiotic therapy.

Time frame:
Day 1 to Day 5 (prior to first dose of antibiotic therapy)
Reported as:
Median · loose stools
Total Number of Loose (Grade 3-5) Stools
loose stoolsiOWH032Placebo
Total Number of Loose (Grade 3-5) Stools12.0 (5 to 15)10.5 (8 to 18)
Statistical analysis
  • iOWH032 vs Placebo · Van Elteren test · p = 0.5377 · Difference in median: 1.5 · 95% CI -7.0 to 5.5Stratified by blood type group
SecondaryPercentage of Participants With Fever Following Cholera Challenge

The presence of fever was defined as a body temperature of ≥ 39°C (102.1°F).

Time frame:
Day 1 to Day 5, prior to first dose of antibiotics
Reported as:
Number · percentage of participants
Percentage of Participants With Fever Following Cholera Challenge
percentage of participantsiOWH032Placebo
Percentage of Participants With Fever Following Cholera Challenge6.3 (0.2 to 30.2)5.0 (0.1 to 24.9)
Statistical analysis
  • iOWH032 vs Placebo · Cochran-Mantel-Haenszel · p = 0.8705 · Difference: 1.3 · 95% CI -14.0 to 16.5Cochran-Mantel-Haenszel test, stratified by blood type group.
SecondaryPercentage of Participants With Vomiting Following Cholera Challenge
Time frame:
Day 1 to Day 5, prior to first dose of antibiotics
Reported as:
Number · percentage of participants
Percentage of Participants With Vomiting Following Cholera Challenge
percentage of participantsiOWH032Placebo
Percentage of Participants With Vomiting Following Cholera Challenge6.3 (0.2 to 30.2)25.0 (8.7 to 49.1)
Statistical analysis
  • iOWH032 vs Placebo · Cochran-Mantel-Haenszel · p = 0.1404 · Difference: -18.8 · 95% CI -41.1 to 3.6Cochran-Mantel-Haenszel test, stratified by blood type group
SecondaryNumber of Participants With Solicited Adverse Effects

Solicited adverse events (AEs) include nausea, abdominal discomfort and pain, abdominal cramps, headache, malaise, anorexia, pollakiuria, micturition urgency, sinus tachycardia, increased alertness, and were collected by interview through 7 days post-challenge (Days 1-8)

Time frame:
Day 1 - Day 8
Reported as:
Count of participants · Participants
Number of Participants With Solicited Adverse Effects
ParticipantsiOWH032Placebo
Any solicited adverse event32
Abdominal discomfort20
Headache10
Malaise01
Nausea01
SecondaryNumber of Participants With Unsolicited Treatment-emergent Adverse Events (TEAE)

Unsolicited AEs include any AEs reported spontaneously by the participant, observed by the study personnel during study visits or those identified during review of medical records or source documents. Investigators assigned causality of unsolicited AEs to either the study drug, cholera infection, or an alternate etiology.

Time frame:
From first dose of study drug up to Day 29
Reported as:
Count of participants · Participants
Number of Participants With Unsolicited Treatment-emergent Adverse Events (TEAE)
ParticipantsiOWH032Placebo
Any unsolicited TEAE1821
Study drug-related TEAE43
TEAE leading to discontinuation from study00
TEAE leading to death00

Adverse events

Collected over Serious adverse events and deaths were collected from first dose of study drug up to Day 180. Non-serious adverse events are reported from first dose of study drug up to Day 29.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
iOWH0320/23 (0%)0/23 (0%)18/23 (78.3%)
Placebo0/24 (0%)1/24 (4.2%)21/24 (87.5%)
Most frequent serious events
Most frequent serious events
EventiOWH032Placebo
PyelonephritisInfections and infestations0/231/24
Most frequent other events
Showing 10 of 47
Most frequent other events
EventiOWH032Placebo
HeadacheNervous system disorders8/239/24
NauseaGastrointestinal disorders6/235/24
Sinus tachycardiaCardiac disorders6/231/24
VomitingGastrointestinal disorders1/236/24
DiarrhoeaGastrointestinal disorders5/234/24
PyrexiaGeneral disorders4/235/24
Abdominal discomfortGastrointestinal disorders4/232/24
ChillsGeneral disorders4/232/24
Abdominal painGastrointestinal disorders2/234/24
Decreased appetiteMetabolism and nutrition disorders3/233/24

Baseline characteristics

All enrolled participants

Age, Continuous
Age, Continuous(years)iOWH032PlaceboTotal
Mean32.0 ± 6.1532.3 ± 5.9732.1 ± 6.00
Sex: Female, Male
Sex: Female, Male(Participants)iOWH032PlaceboTotal
Female91120
Male141327
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)iOWH032PlaceboTotal
White257
Black or African American211940
Blood Type
Blood Type(Participants)iOWH032PlaceboTotal
Type O121325
Non-O111122
08

Study locations

1 site
  • Pharmaron
    Baltimore, Maryland 21201, United States
09

References and documents

Publications

  • Erdem R, Ambler G, Al-Ibrahim M, Fraczek K, Dong SD, Gast C, Mercer LD, Raine M, Tennant SM, Chen WH, de Hostos EL, Choy RKM. A Phase 2a randomized, single-center, double-blind, placebo-controlled study to evaluate the safety and preliminary efficacy of oral iOWH032 against cholera diarrhea in a controlled human infection model. PLoS Negl Trop Dis. 2021 Nov 18;15(11):e0009969. doi: 10.1371/journal.pntd.0009969. eCollection 2021 Nov. PubMed 34793441 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Nov 2019 to primary completion in Jul 2020, 8 months.

Results were first posted in Mar 2021, 7 months after primary completion.

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

Registered
Oct 31, 2019
First posted
Nov 4, 2019
StartActual
Nov 4, 2019
Primary completionActual
Jul 27, 2020
CompletionActual
Jul 27, 2020
Results first posted
Mar 25, 2021
Last update
Mar 25, 2021
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 Mar 25, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04150250
Lead sponsor
PATH
Collaborators
University of Maryland, Baltimore, Pharmaron
Responsible party
Sponsor
First posted
Nov 4, 2019
Start date
Nov 4, 2019
Primary completion
Jul 27, 2020
Completion
Jul 27, 2020
Results posted
Mar 25, 2021
Last update
Mar 25, 2021

Oversight

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

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This study is completed, as verified in Feb 2021. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: IOWH-032

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