ClinicalTrials.gg
Active, not recruitingNCT05555862anal HSIL HIV-Updated May 18, 2025

Artesunate Suppositories for the Treatment of HIV-negative Patients With Intra-anal HSIL

A Phase 2 interventional study of Artesunate and Placebo in Anal High Grade Squamous Intraepithelial Lesion, Anal Precancerous Condition and AIN 2/3, sponsored by Frantz Viral Therapeutics, LLC. Active, not recruiting at 2 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-05-18.

Sponsored by Frantz Viral Therapeutics, LLC · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
17
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a phase II double blind, placebo-controlled, randomized study of Artesunate suppositories for the treatment of HIV-negative men and women who have anal high grade squamous intraepithelial lesions (anal HSIL)

Read the detailed description

Eligible participants in this study are randomized 2:1 to receive either artesunate or placebo suppositories for the treatment of anal HSIL. Both groups receive four 5-day cycles of suppositories, at weeks 0, 2, 4, and 6. At least two of the dosing visits are done in person. The remaining dosing visits may be done as telehealth visits (suppositories are mailed to the patient's home). Participants are followed closely with anoscopy or high resolution anoscopy (HRA) at weeks 8, 18, 30, and 42. After the week 18 HRA visit, participants who have at least partial response will be followed with HRA at week 30.

Participants who are found to be non-responders at week 18 will undergo standard of care ablation.

Participants who are found to have anal HSIL at weeks 30 or 42 will be followed according to standard of care procedures.

Primary Objective: To evaluate the complete and partial histopathologic response to four 5-day cycles of artesunate suppositories in adult patients with biopsy-proven HPV-associated intra-anal HSIL (18 weeks).

Secondary Objectives:

Efficacy:

  • To evaluate the viral clearance after four 5-day cycles of artesunate suppositories in adults with biopsy-proven HPV-associated intra-anal anal HSIL over the study window (42 weeks)
  • To evaluate complete and partial intra-anal histopathologic response after the week 18 time point but over the study window (30 weeks).
  • To evaluate complete and partial peri-anal histopathologic response following artesunate suppositories over the course of the study (42 weeks).
  • To evaluate persistence of response throughout the study window (42 weeks)

Safety:

To evaluate the safety of artesunate suppositories for the treatment of intra-anal HSIL.

02

Conditions studied

  • Anal High Grade Squamous Intraepithelial Lesion
  • Anal Precancerous Condition
  • AIN 2/3
  • HPV Infection
  • Anal Dysplasia
  • HPV Disease

Keywords

  • human papillomavirus
  • non-surgical
  • topical treatment
  • anal HSIL
  • anal cancer prevention
  • treatment study
  • cancer prevention
  • high-risk HPV
  • HPV16
  • suppository
03

In context

Papillomavirus Infections

576 studies on the registry are indexed under Papillomavirus Infections; 132 are open to participants now.

This study's enrollment of 17 is below the median of 235 across 402 interventional studies indexed under Papillomavirus Infections.

Browse Papillomavirus Infections studies →

Lead sponsor

Frantz Viral Therapeutics, LLC is the lead sponsor of 4 studies on the registry; 3 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years and older
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.

Inclusion criteria

  • Adult men and women age ≥ 18 years
  • Capable of
  • -confirmed intra-anal high-grade dysplasia (AIN 2, AIN 3, anal HSIL) by HRA. Patients must have residual anal HSIL lesions after diagnostic biopsies, as documented by HRA. This includes patients who are newly diagnosed with anal HSIL as well as those who have recurrent anal HSIL after medical therapy or surgical therapy. Patients who have intra-anal HSIL and also have peri-anal HSIL may be enrolled in the study.
  • Women of agree to use for the duration of the study.
  • Laboratory values at Screening of:

    1. Serum (SGPT/ALT) \< 5 x (ULN)
    2. Serum aspartate transaminase (SGOT/AST) \< 5 x ULN
    3. Serum (total) \< 2.5 x ULN
    4. Serum Creatinine ≤ 1.5 x ULN
  • (ECG) with no findings as assessed by the Investigator.
  • Weight ≥ 50kg

Exclusion criteria

Exclusion Criteria:

  • Pregnant and nursing women
  • Diagnosis of low-grade anal dysplasia (AIN 1, LSIL), without the concomitant diagnosis of anal HSIL, by HRA
  • Concurrent anal, vulvar, cervical, or penile cancer
  • seropositivity
  • Currently receiving systemic chemotherapy or radiation therapy for another cancer.
  • Patients who are on medical treatment with systemic or (e.g., active disease)
  • Concomitant use of strong Uridine glucuronyl transferases (UGT) inhibitors
  • Concomitant use of imiquimod or 5-fluorouracil (5-FU) for the duration of the study
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.

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.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

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.

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.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

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.

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.

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.

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.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
17 participants (actual)

Study arms

  • Experimental
    Artesunate suppositories

    Four 5-day cycles of artesunate suppositories

    Drug: Artesunate

  • Placebo comparator
    Placebo suppositories

    Four 5-day cycles of placebo suppositories

    Drug: Placebo

Interventions

  • artesunate formulated as intra-anal suppositories

    Also known as: Artesunic acid, dihydroartemisinin (DHA), artemisinin

  • DrugPlacebo

    placebo intra-anal suppository

06

What researchers measure

Primary outcomes

  1. Number of subjects with complete and partial response by week 18

    Number of participants who achieve complete or partial response after 4 5-day cycles of artesunate as determined by HRA-directed biopsy(ies)

    Time frame: 18 weeks

Secondary outcomes

  1. Number of participants who have achieved clearance of detectable human papilloma virus (HPV) over the study window

    Number of participants who had HPV strains detected at study entry which become undetectable within the study window

    Time frame: 42 weeks

  2. Number of participants with complete and partial response after week 18 but over the study window

    Number of participants who achieve complete or partial response after week 18, as documented by HRA-directed biopsy(ies)

    Time frame: 30 weeks

  3. Number of participants who achieve complete and partial response of peri-anal HSIL, following 4 cycles of intra-anal artesunate suppositories, as determined by HRA-directed biopsy

    Number of participants who had both peri-anal and intra-anal HSIL, whose peri-anal HSIL achieves complete or partial response following 4 cycles of intra-anal artesunate suppositories

    Time frame: 42 weeks

  4. Number of participants who undergo complete response who maintain their response over the study window

    Number of participants who complete or partial response who maintain this response over the study window

    Time frame: 42 weeks

Other outcomes

  1. Number of participants with Treatment-Emergent Adverse Events (TEAE)

    Number of participants who had adverse events, as defined by CTCAE v5.0, related to the study intervention

    Time frame: 12 weeks

  2. Number of participants who withdrew from the study due to TEAEs

    Number of participants who were withdrawn from the study due to adverse events related to the study drug

    Time frame: 12 weeks

  3. Changes in vital signs over the study window

    Number of participants who had clinically significant changes in vital signs

    Time frame: 42 weeks

  4. Changes in physical examination abnormalities

    Number of participants who had clinically significant changes in physical examination abnormalities

    Time frame: 42 weeks

  5. Clinically significant changes in ECG between baseline and post dosing

    Number of participants who had clinical significant changes in ECG between pre-dosing and post dosing

    Time frame: 8 weeks

07

Study locations

2 sites
08

References and documents

Individual participant data

Plan to share: No — No protected health information (PHI) will be shared with other researchers.

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Feb 2023 (actual). Primary completion is estimated for Dec 2026, 46 months after the start.

Of 41 phase 2 interventional studies under Papillomavirus Infections, half reached primary completion within 33 months of starting (the median), counting those still running; a quarter within 13 and three quarters within 77. This study's planned 46 months is above that.

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

Registered
Sep 22, 2022
First posted
Sep 27, 2022
StartActual
Feb 10, 2023
Primary completionEst.
Dec 28, 2026
CompletionEst.
Dec 31, 2026
Last update
May 18, 2025
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 May 18, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05555862
Lead sponsor
Frantz Viral Therapeutics, LLC
Collaborators
Amarex CRO, University of California, San Francisco, Anal Dysplasia Clinic MidWest, Laser Surgery Care
Responsible party
Sponsor
First posted
Sep 27, 2022
Start date
Feb 10, 2023
Primary completion
Dec 28, 2026 (estimated)
Completion
Dec 31, 2026 (estimated)
Last update
May 18, 2025

Study contacts

Joel Palefsky, MD
principal investigator · University of California, San Francisco

Oversight

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

Not currently enrolling

This study is active, not recruiting, as verified in May 2025. 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: Artesunate

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