This is a Phase 2 trial to evaluate the efficacy of different doses of oxfendazole versus a single dose of albendazole in curing or reducing the egg burden in subjects with T. trichiura infections. 249 subjects will be randomized in a 1:1:1 ratio to one of three dose-groups to receive a single dose of oxfendazole 400 mg or 800 mg, or a single dose of albendazole 400 mg. The study team members and study subjects will not be blinded to the dose group. However, the laboratory assessors evaluating the stool samples will be blinded. Subjects will be recruited in Iquitos, Peru, and surrounding villages where there is a high prevalence of T. trichiura infection. Subjects will be solicited through town hall meetings and local clinics and through recommendations from local care providers. A two-stage screening process will be utilized. If subjects are found on the screening stool exam to have only a stool parasite other than T. trichuria or if the subject chooses not to participate in the study, the subject will be referred to a local health provider. If stool analysis performed at the end of the study period demonstrates stool parasites, the subjects will be contacted and referred to their local health provider where they will receive standard of care treatment. The primary objective is to assess the cure rate of different dose regimens of oxfendazole vs. albendazole in the treatment of T. trichiura infections using the Kato-Katz stool examination method.
This is a Phase 2 trial to evaluate the efficacy of different doses of oxfendazole versus a single dose of albendazole in curing or reducing the egg burden in subjects with T. trichiura infections. 249 subjects will be randomized in a 1:1:1 ratio to one of three dose-groups to receive a single dose of oxfendazole 400 mg or 800 mg, or a single dose of albendazole 400 mg. Water and a snack will be provided to aid in ingestion of the study product and a study team member will observe the ingestion of study product. The study team members and study subjects will not be blinded to the dose group. However, the laboratory assessors evaluating the stool samples will be blinded. Subjects will be recruited in Iquitos, Peru, and surrounding villages where there is a high prevalence of T. trichiura infection. Subjects will be solicited through town hall meetings and local clinics and through recommendations from local care providers. A two-stage screening process will be utilized. If subjects are found on the screening stool exam to have only a stool parasite other than T. trichuria or if the subject chooses not to participate in the study, the subject will be referred to a local health provider. If stool analysis performed at the end of the study period demonstrates stool parasites, the subjects will be contacted and referred to their local health provider where they will receive standard of care treatment. The primary objective is to assess the cure rate of different dose regimens of oxfendazole vs. albendazole in the treatment of T. trichiura infections using the Kato-Katz stool examination method. The secondary objectives are to: 1) assess the cure rate of different dose regimens of oxfendazole vs albendazole in the treatment of T. trichiura infections using the stool concentration examination method, 2) assess the clinical response compared to baseline, as shown by reduction in T. trichiura egg counts using the Kato-Katz stool examination method, 3) assess the clinical response compared to baseline, as shown by reduction in T. trichiura egg counts using the stool concentration method, 4) assess the proportion of subjects with moderate or heavy infection before treatment who had no infection or only light infection after treatment using the Kato-Katz stool examination method, 5) assess the proportion of subjects with moderate or heavy infection before treatment who had no infection or only light infection after treatment using the stool concentration examination method, 6) establish the spectrum of activity of oxfendazole against other intestinal helminths using the Kato-Katz stool examination method, 7) establish the spectrum of activity of oxfendazole against other intestinal helminths using the stool concentration examination method, 8) assess the tolerability of each oxfendazole dose group compared to the albendazole dose group, and 9) assess the safety in subjects treated with oxfendazole.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
249
Albendazole, 5-(prophylthio)-2-benzimidazole carbamate, is a broad-spectrum benzimidazole antihelminthic drug. It is provided as a white to off-white, circular, film-coated tablet with a slightly raised pentagonal projection on either side. This trial will use the 400 mg tablet formulation.
The active pharmaceutical ingredient is methyl-5 (6)-phenylsulfiyl-2-benzimidazole carbamate, which is a broad-spectrum benzimidazole antihelminthic. Oxfendazole is the sulphoxide metabolite of fenbendazole.
Policlinico Asociacion Benefica Prisma
Santa Clara de Nanay, Maynas, Peru
RECRUITINGNumber of infection cures (Clinical Cure) as shown by absence of Trichuris trichiura eggs using the Kato-Katz stool examination method
As measured in each oxfendazole dose group compared to the albendazole dose group. Calculated from two stools samples (each evaluated in duplicate).
Time frame: Day 18 through Day 23
Change from baseline in eggs per gram of stool for helminths other than Trichuris trichiura using the Kato Katz examination method
As measured in each oxfendazole dose group compared to the albendazole dose group. Calculated from two stools samples (each evaluated in duplicate).
Time frame: Day 18 through Day 23
Change from baseline in eggs per gram of stool for helminths other than Trichuris trichiura using the stool concentration examination method
As measured in each oxfendazole dose group compared to the albendazole dose group. Calculated from two stools samples (each evaluated in duplicate).
Time frame: Day 18 through Day 23
Change from baseline in eggs per gram of stool using the Kato-Katz stool examination method
As measured in each oxfendazole dose group compared to the albendazole dose group. Calculated from two stools samples (each evaluated in duplicate).
Time frame: Day 18 through Day 23
Change from baseline in eggs per gram of stool using the stool concentration method
As measured in each oxfendazole dose group compared to the albendazole dose group. Calculated from two stools samples (each evaluated in duplicate).
Time frame: Day 18 through Day 23
Egg reduction rate, relative to egg counts at baseline, measured using the Kato-Katz stool examination method
As measured in each oxfendazole dose group compared to the albendazole dose group. Calculated from egg counts (eggs per gram) from two stool samples (each evaluated in duplicate).
Time frame: Day 18 through Day 23
Egg reduction rate, relative to egg counts at baseline, using the stool concentration method
As measured in each oxfendazole dose group compared to the albendazole dose group. Calculated from egg counts (eggs per gram) from two stool samples (each evaluated in duplicate).
Time frame: Day 18 through Day 23
Number of infection cures (Clinical Cure) as shown by absence of Trichuris trichiura eggs using the stool concentration method
As measured in each oxfendazole dose group compared to the albendazole dose group. Calculated from two stools samples (each evaluated in duplicate).
Time frame: Day 18 through Day 23
Proportion of abnormal laboratory tests
As measured in each oxfendazole dose group compared to the albendazole dose group. Abnormal laboratory tests include hemoglobin (Hgb), white blood cells (WBC), neutrophil and eosinophil counts, platelet counts, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, alkaline phosphatase, and creatinine.
Time frame: Day 1 through Day 23
Proportion of solicited clinical reactogenicity events
As measured in each oxfendazole dose group compared to the albendazole dose group. Solicited clinical reactogenicity events including nausea, vomiting, abdominal pain, diarrhea, and anorexia.
Time frame: Day 1 through Day 23
Proportion of subjects in each dose group with moderate or heavy infection who had no infection or only light infection after treatment based on WHO classes of intensity, measured using the Kato-Katz tool examination method
According to WHO thresholds, infections of 1-999 eggs per gram (epg) are classified as light intensity infections, 1,000-9,999 epg are classified as moderate, and \>/= 10,000 epg are classified as heavy. Classification at baseline will be based on the screening stool sample, and classification post-treatment will be based on two stool samples each oxfendazole dose group compared to the albendazole dose group.
Time frame: Day 18 through Day 23
Proportion of unsolicited adverse events (AEs)
As measured in each oxfendazole dose group compared to the albendazole dose group.
Time frame: Day 1 through Day 23
Serious adverse events (SAEs) related to the study product
As measured in each oxfendazole dose group compared to the albendazole dose group.
Time frame: Day 1 through Day 23
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