AzTrials
AzTrials

Lymphatic FilariasesFITNCT03177993

Fiji Integrated Therapy (FIT) - Triple Therapy for Lymphatic Filariasis, Scabies and Soil Transmitted Helminths in Fiji

A study testing 3 drug dose - IDA, 3 drug dose - IDA with second dose of ivermectin and 2 drug dose - DA in people with Lymphatic Filariases and Scabies, run by Washington University School of Medicine at 1 site in Fiji.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Lymphatic Filariasis (LF), scabies and soil transmitted helminths (STH) are common neglected tropical diseases affecting the people of Fiji. There is a dedicated LF eradication program supported by the World Health Organization (WHO), however scabies and STH are currently managed on an individual level with… Read more about this study

Who is it for?
Any ageHealthy volunteers can take part
Conditions the study is for
Lymphatic Filariases, Scabies, Impetigo
What is being tested?
3 drug dose - IDA, 3 drug dose - IDA with second dose of ivermectin and 2 drug dose - DA
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
4,773 participants
Where
1 siteFiji
Study dates
13 Jul 2017to 24 Oct 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • All community members that have given written informed consent to participate

Who cannot join

  • No informed consent

Trial locations and contacts

1 site in 1 country.

Fiji1 site
  • Ministry of Health and Medical Services

    Suva

About this study

Official title: Community Based Safety Study of 2-drug (Diethylcarbamazine and Albendazole) Versus 3-drug (Ivermectin, Diethylcarbamazine and Albendazole) Therapy for Lymphatic Filariasis, Scabies and Soil Transmitted Helminths in Fiji

Lymphatic Filariasis (LF), scabies and soil transmitted helminths (STH) are common neglected tropical diseases affecting the people of Fiji. There is a dedicated LF eradication program supported by the World Health Organization (WHO), however scabies and STH are currently managed on an individual level with symptomatic treatment as required.

In an attempt to reduce the prevalence of LF globally, research is being undertaken into alternative, more effective treatment options. A recent study in Papua New Guinea demonstrated a new triple drug therapy (ivermectin, diethylcarbamazine and albendazole) is superior to the currently recommended two drug therapy (diethylcarbamazine and albendazole) used by WHO LF programs in the Pacific. However, adverse events were more frequent. Despite no serious adverse events being observed, it is necessary to conduct further studies to review the safety of this new triple therapy before it can be endorsed as an effective mass drug administration (MDA) regimen for LF in endemic countries. Fiji's burden of LF, that has been recalcitrant to previous MDA with diethylcarbamazine and albendazole, make it an ideal site to obtain further efficacy and safety data of the triple therapy.

Read more

Ivermectin given to communities as MDA has been proven to be effective in reducing the community prevalence of scabies. What is not known is the effects of one dose versus two doses of ivermectin as MDA. This question will be reviewed within the design of the community randomized study. The prevalence of impetigo in a community is linked to scabies and this will also be reviewed. Ivermectin and albendazole are both effective individually against STH. The effectiveness of this combination of treatment as MDA in Fiji for STH has not been studied. The effectiveness for the individual in the short-term and the community in the longer-term will be reviewed.

In addition, the acceptability and feasibility of the new therapy in communities at risk of these three diseases will be reviewed.

Being tested
3 drug dose - IDA, 3 drug dose - IDA with second dose of ivermectin, 2 drug dose - DA
Medical subject headings
Elephantiasis, Filarial, Scabies, Impetigo

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • 3 drug dose - IDADrug

    Also called IDA

    Lymphatic Filariasis Mass Drug Administration (MDA) with triple drug therapy of ivermectin, diethylcarbamazine, and albendazole (IDA). Participants excluded from ivermectin will receive a topical dose of permethrin cream.

    Exclusion criteria for ivermectin, diethylcarbamazine and albendazole:

    • severe illness (chronic renal insufficiency, severe chronic liver disease, or any illness that is severe enough to interfere with activities of daily living);
    • allergy to ivermectin, diethylcarbamazine or albendazole;
    • pregnant;
    • breastfeeding within 7 days of delivery;
    • less than 2 years old; OR
    • less than 15 kg

    In addition if less than 5 years old excluded from ivermectin.

    Exclusion criteria for permethrin:

    • allergy to permethrin
    • crusted scabies
  • 3 drug dose - IDA with second dose of ivermectinDrug

    Also called IDA with second dose of ivermectin

    Lymphatic Filariasis Mass Drug Administration (MDA) with triple drug therapy of ivermectin, diethylcarbamazine, and albendazole (IDA). Eight days after treatment participants will be given a second dose of ivermectin alone.

    Participants excluded from ivermectin will receive a topical dose of permethrin cream both on day 0 and day 8.

    Exclusion criteria for ivermectin, diethylcarbamazine and albendazole:

    • severe illness (chronic renal insufficiency, severe chronic liver disease, or any illness that is severe enough to interfere with activities of daily living);
    • allergy to ivermectin, diethylcarbamazine or albendazole;
    • pregnant;
    • breastfeeding within 7 days of delivery;
    • less than 2 years old; OR
    • less than 15 kg

    In addition if less than 5 years old excluded from ivermectin.

    Exclusion criteria for permethrin:

    • allergy to permethrin
    • crusted scabies
  • 2 drug dose - DADrug

    Also called DA

    Lymphatic Filariasis Mass Drug Administration (MDA) with the currently used standard of care combination drug therapy of diethylcarbamazine, and albendazole (DA).

    If scabies is present in the participant or a household member permethrin cream will be provided 8 days after dose of DA.

    Exclusion criteria for diethylcarbamazine and albendazole:

    • severe illness (chronic renal insufficiency, severe chronic liver disease, or any illness that is severe enough to interfere with activities of daily living);
    • allergy to diethylcarbamazine or albendazole;
    • pregnant;
    • breastfeeding within 7 days of delivery;
    • less than 2 years old; OR
    • less than 15 kg

    Exclusion criteria for permethrin:

    • allergy to permethrin
    • crusted scabies
Study groups in NCT03177993
Study groupRoleWhat they receive
IDA 1Experimental* ivermectin, diethylcarbamazine and albendazole Day 0, * permethrin Day 0 if excluded from ivermectin Details of dosing: * ivermectin: 200 mcg/kg oral * diethylcarbazine: 6mg/kg oral * albendazole 400mg oral * permethrin 5% cream topical: apply to whole body and wash o after 4hrs when less than 2 months; apply to whole body and wash off after 8hrs when 2 months and older.
Receives: Drug: 3 drug dose - IDA
IDA 2Experimental* ivermectin, diethylcarbamazine and albendazole Day 0, ivermectin Day 8 * permethrin Day 0 and Day 8 if excluded from ivermectin Details of dosing: * ivermectin: 200 mcg/kg oral * diethylcarbazine: 6mg/kg oral * albendazole 400mg oral * permethrin 5% cream topical: apply to whole body and wash o after 4hrs when less than 2 months; apply to whole body and wash off after 8hrs when 2 months and older.
Receives: Drug: 3 drug dose - IDA with second dose of ivermectin
DAActive comparator* diethylcarbamazine and albendazole Day 0 * permethrin Day 8 if scabies present in participant or household member Details of dosing: * diethylcarbazine: 6mg/kg oral * albendazole 400mg oral * permethrin 5% cream topical: apply to whole body and wash off after 4hrs when less than 2 months; apply to whole body and wash o after 8hrs when 2 months and older.
Receives: Drug: 2 drug dose - DA

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Frequency, type, and severity of adverse events reported by participants following treatment with triple drug therapy (IDA) and standard two drug therapy (DA) in LF infected and uninfected individuals in a community as measured by CTCAE v4.03

    Participants will be interviewed and asked to report their general health status at baseline before receiving treatment and daily for the 2 days following treatment (Active Adverse Event Monitoring phase). For 3 to 7 days following treatment, anyone unwell the preceding day will be actively followed, other participants will be interviewed only if they feel unwell and present to the study team (Passive Adverse Event Monitoring phase).

    At any stage if they describe being unwell, further questions to determine type and severity of symptom(s) experienced will be asked and recorded according to pre-defined adverse event table. If participants report moderate to severe symptoms they will have further medical assessments as required.

    LF infection status will be determined by Filiarial Test Strip (FTS) and microfilariae (mf) smears.

    Measured: within 7 days of drug administration

Secondary outcomes (5)
  1. Clearance of microfilariae (mf) and filarial antigenemia following treatment with IDA or DA in LF infected individuals as measured by microfilaria count in 60ul thick blood smears and filarial test strip rapid diagnostic antigen test.

    Methods of assessment: FTS and Dried Blood Spot (DBS) for filarial antigenemia, mf smears for microfilariae

    Measured: Baseline and 12 months

  2. Prevalence of scabies in study population measured at baseline and 12 months after treatment using the WHO Integrated Management of Childhood Illness (IMCI) skin algorithm

    Methods of assessment: Skin examination

    Measured: Baseline and 12 months

  3. Prevalence of STH (hookworm, ascaris, trichuris and strongyloides) as measured by Kato-katz or PCR at baseline and 12 months after treatment

    Methods of assessment: Stool samples will be analysed using Kato-katz method, as well as PCR.

    Measured: Stool collected at baseline (pre-treatment), 4 weeks (individual response), and 12 months (community prevalence).

  4. Acceptability and feasibility of IDA and DA in communities at risk of LF, scabies and STH as assessed by survey and focus group discussions.

    Methods of assessment: Acceptability Survey, designed specifically for the Triple therapy studies, Focus group discussions, Interviews with key informants

    Measured: Approximately 4 weeks following treatment

  5. Prevalence of impetigo measured at baseline and 12 months after treatment using the WHO Integrated Management of Childhood Illness (IMCI) skin algorithm

    Methods of assessment: Skin examination

    Measured: Baseline and 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Jun 2017
  2. Study start13 Jul 2017
  3. Primary completion22 Nov 2017
  4. Study completion24 Oct 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
4,773 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03177993
Sponsor's protocol ID
201607068-2
Acronym
FIT
Status last verified
Dec 2020
First submitted
31 May 2017
Last updated
31 Dec 2020
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Datasets used for published results will be shared publicly through a journal or other open source data repository so that the broader scientific community can access it. Only de-identified data will be shared publicly.

Publications

  • Hardy M, Samuela J, Kama M, Tuicakau M, Romani L, Whitfeld MJ, King CL, Weil GJ, Schuster T, Grobler AC, Engelman D, Robinson LJ, Kaldor JM, Steer AC. Community control strategies for scabies: A cluster randomised noninferiority trial. PLoS Med. 2021 Nov 10;18(11):e1003849. doi: 10.1371/journal.pmed.1003849. eCollection 2021 Nov.

    PubMed 34758017
  • Hardy M, Samuela J, Kama M, Tuicakau M, Romani L, Whitfeld MJ, King CL, Weil GJ, Grobler AC, Robinson LJ, Kaldor JM, Steer AC. Individual Efficacy and Community Impact of Ivermectin, Diethylcarbamazine, and Albendazole Mass Drug Administration for Lymphatic Filariasis Control in Fiji: A Cluster Randomized Trial. Clin Infect Dis. 2021 Sep 15;73(6):994-1002. doi: 10.1093/cid/ciab202.

    PubMed 33728462

Questions about this trial

What is this clinical trial studying?

A study testing 3 drug dose - IDA, 3 drug dose - IDA with second dose of ivermectin and 2 drug dose - DA in people with Lymphatic Filariases and Scabies, run by Washington University School of Medicine at 1 site in Fiji.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 31 Dec 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Fiji. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Frequency, type, and severity of adverse events reported by participants following treatment with triple drug therapy (IDA) and standard two drug therapy (DA) in LF infected and uninfected individuals in a community as measured by CTCAE v4.03 (time frame: within 7 days of drug administration). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03177993, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Dec 2020.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in