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HealthyPhase 4NCT03690453

Effect of Ivermectin Metabolites on Mosquito Survival

A Phase 4 study testing Ivermectin in people with Healthy, run by University of Oxford at 1 site in Thailand.

Completed

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

Official record
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Trial summary

This clinical trial will be designed to capture the full duration of mosquito-lethal effect of single dose Ivermectin to aid efforts to characterize metabolites with mosquito-lethal effect. Read more about this study

Who is it for?
Ages 18 to 60 yearsHealthy volunteers can take part
Conditions the study is for
Healthy
What is being tested?
Ivermectin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteThailand
Study dates
4 Feb 2019to 5 Apr 2022
Phase
Phase 4
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 18 to 60 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Healthy as judged by a responsible physician with no abnormality identified on a medical evaluation including medical history and physical examination.
  • Males and Females aged between 18 years to 60 years.
  • Males and Females weight between 36-75 kilograms.
  • A female is eligible to enter and participate in this study if she is:
  • of non-childbearing potential including pre-menopausal females with documented (medical report verification) hysterectomy or double oophorectomy
  • or postmenopausal defined as 12 months of spontaneous amenorrhea or 6 months of spontaneous amenorrhea with serum follicle stimulating hormone levels >40 mIU/mL or 6 weeks postsurgical bilateral oophorectomy with or without hysterectomy
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  • or of childbearing potential, has a negative serum pregnancy test at screening and prior to start the study drug in each period, and abstain from sexual intercourse or agrees to using effective contraceptive methods (e.g., intrauterine device, hormonal contraceptive drug, tubal ligation or female barrier method with spermicide) during the study until completion of the follow-up procedures
  • A male is eligible to enter and participate in this study if he: agrees to abstain from (or use a condom during) sexual intercourse with females of childbearing potential or lactating females; or is willing to use a condom/spermicide, during the study until completion of the follow-up procedures.
  • Provide a signed and dated written informed consent prior to study participation.
  • Willingness and ability to comply with the study protocol for the duration of the trial.
  • Able to tolerate direct mosquito feeding.
  • Blood hemoglobin in males >13 g/dL and females >12 g/dL.
  • Normal electrocardiogram (ECG) with QTc <450 msec.
  • Healthy as judged by a responsible physician with no abnormality identified on a medical evaluation including medical history and physical examination.
  • Males and Females aged between 18 years to 60 years.
  • Males and Females weight between 36-75 kilograms.
  • Provide a signed and dated written informed consent prior to study participation.
  • Willingness and ability to donate blood.

Who cannot join

  • Females who are pregnant, trying to get pregnant, or are lactating.
  • A positive hepatitis B surface antigen, positive hepatitis C antibody, or positive human immunodeficiency virus-1 (HIV-1) antibody result at screening.
  • Subjects with a personal history of cardiac disease, symptomatic or asymptomatic arrhythmias, syncopal episodes, or additional risk factors for torsades de pointes (heart failure, hypokalemia) or with a family history of sudden cardiac death.
  • A creatinine clearance <70 mL/min as determined by Cockcroft-Gault equation:
  • Clcr (mL/min) = (140 - age) Wt / (72 Scr) (multiply answer by 0.85 for females) Where age is in years, weight (wt) is in kg, and serum creatinine (Scr) is in units of mg/dL [Cockcroft, 1976].
  • History of alcohol or substance abuse or dependence within 6 months of the study.
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  • The subject has evidence of active substance abuse that may compromise safety, pharmacokinetics, or ability to adhere with protocol instructions
  • Use of prescription (especially CYP3A4 inhibitors or inducers) or non-prescription drugs except paracetamol at doses of up to 2 grams/day, including vitamins (especially vitamin C), herbal and dietary supplements (including St. John's Wort) within 7 days (or 14 days if the drug is a potential enzyme inducer) or 5 times the drug half-life (whichever is longer) prior to the first dose of study medication until the completion of the follow-up procedure, unless in the opinion of investigator, the medication will not interfere with the study procedures or compromise subject safety; the investigator will take advice from the manufacturer representative as necessary.
  • The subject has participated in a clinical trial and has received a drug or a new chemical entity within 30 days or 5 half-lives, or twice the duration of the biological effect of any drug (whichever is longer) prior to the first dose of study medication.
  • The subject is unwilling to abstain from ingesting alcohol within 48 hours prior to the first dose of study medication until collection of the final pharmacokinetic sample.
  • Subjects who have donated blood to the extent that participation in the study would result in more than 300 mL blood donated within a 30-day period. Plasma donation during the study is not acceptable.
  • Subjects who have a history of allergy to IVM, or a history of drug or other allergy that, in the opinion of the investigator, contraindicates participation in the trial. In addition, if heparin is used during pharmacokinetic sampling, subjects with a history of sensitivity to heparin or heparin-induced thrombocytopenia should not be enrolled.
  • Lack of suitability for participation in this study, including but not limited to, unstable medical conditions, systemic disease manifested by tendency to granulocytopenia e.g. rheumatoid arthritis and lupus erythematosus that in the opinion of the investigator would compromise their participation in the trial.
  • AST or ALT >1.5 upper limit of normal (ULN)
  • Subjects with history of renal disease, hepatic disease, and/or cholecystectomy
  • History of IVM or other drug treatments known to be CYP3A4 inducers or inhibitors (e.g. piperaquine, ritonavir, rifampicin) within 3 months.
  • The subject is unwilling to abstain from the consumption of food containing vitamin C (e.g. fruits, juices, papaya salad) 12 hours before and after drug ingestion.
  • History of travel to West or Central Africa, unless it can be verified that subject does not have Loa loa infection.
  • History or suspected of hypersensitivity/anaphylaxis to mosquito bites and other insect bites/sting (e.g. history of cellulitis-like cutaneous inflammation, anaphylaxis, hives)
  • Females who are pregnant, trying to get pregnant, or are lactating (determined by verbally asking and urine pregnancy test).
  • The subject has evidence of active substance abuse that may compromise safety or ability to adhere with protocol instructions.
  • A positive hepatitis B surface antigen, positive hepatitis C antibody, or positive human immunodeficiency virus-1 (HIV-1) antibody result at screening.
  • History of alcohol or substance abuse or dependence within 6 months of the study.
  • Any known blood disorders (e.g. thalassemia, sickle cell anemia)
  • Use of prescription (especially CYP3A4 inhibitors or inducers) or non-prescription drugs except paracetamol at doses of up to 2 grams/day, including vitamins (especially vitamin C), herbal and dietary supplements (including St. John's Wort) within 7 days (or 14 days if the drug is a potential enzyme inducer) or 5 times the drug half-life (whichever is longer) prior to blood collection unless in the opinion of investigator, the medication will not interfere with the study procedures or compromise subject safety; the investigator will take advice from the manufacturer representative as necessary.
  • The subject has participated in a clinical trial and has received a drug (particularly IVM or any drug known to be a CYP3A4 inducer or inhibitor) or a new chemical entity within 90 days prior to blood collection.
  • The subject is unwilling to abstain from ingesting alcohol within 48 hours prior to blood collection.
  • The subject is unwilling to abstain from consumption of food containing vitamin C (e.g. fruits, juices, papaya salad within 12 hours prior to blood collection.
  • Subjects who have donated blood to the extent that participation in the study would result in more than 300 mL blood donated within a 30-day period.

Trial locations and contacts

1 site in 1 country.

Thailand1 site
  • Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University

    Bangkok, 10400

Other trials in Thailand

About this study

Official title: Open-Label Study to Evaluate Pharmacokinetic Properties and Mosquito-Lethal Effect of Ivermectin Metabolites in Healthy Adult Subjects

This clinical trial will be designed to capture the full duration of mosquito-lethal effect of single dose Ivermectin to aid efforts to characterize metabolites with mosquito-lethal effect. Ivermectin and its metabolites likely have antiparasitic properties against asexual and sexual stage Plasmodium parasites that will be investigated with plasma samples from this study.

This is an open-label pharmacokinetic study. Ten healthy participants will be admitted in the inpatient ward to receive a single oral dose of IVM (400 µg/kg).

Read more

Another 10 healthy participants will be donate blood up to 42 ml each times for up to 3 times. There is no drug administration for these participants.

The total duration for each volunteer's participation in the study is approximately 2 months.

Read the detailed description

HEALTHY PARTICIPANT FOR CLINICAL TRIAL

Study will enroll 10 Thai healthy participants, 5 male and 5 female, aged 18-60 years.

Participants will be admitted in the inpatient ward to receive a single oral dose of IVM (400 µg/kg).

After a volunteert has provided written informed consent, the investigator will determine if the volunteer is eligible for enrollment in the study. This will be done by reviewing the inclusion and exclusion criteria and completing all of the screening assessments. Screening assessments may be carried out over more than one day, provided that all required assessments are completed within the 14 days prior to admission for Ivermectin administration.

The blood collection for Standard Membrane Feeding Assay, Direct Feeding Assays, Pharmacokinetic analysis, Plasma for Plasmodium assays and mosquito IgG assays should be obtained at the scheduled times relative to when the participant was dosed.

The total duration for each volunteer's participation in the study is approximately 2 months.

HEALTHY PARTICIPANT FOR BLOOD DONOR

Study will enroll 10 healthy participants, aged 18-60 years. Each participant will donate blood up to 42 ml via venipuncture up to three blood donations. There will be at least 28 days between each blood donation from the same subject.

Blood will be maintained at 37°C in a warm water bath until mixed with ivermectin compounds or metabolites by Pharmacology staff and fed to mosquitoes by Armed Forces Research Institute of Medical Sciences (AFRIMS) staff. Any remaining blood after SMFAs will be discarded. No blood samples will be transferred to AFRIMS. Participants for blood donation should not be the same participants enrolled in the clinical trial above.

Conditions
Healthy
Being tested
Ivermectin

What participants receive

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

  • IvermectinDrug

    single dose of Ivermectin

Study groups in NCT03690453
Study groupRoleWhat they receive
Healthy volunteer for Clinical TrialExperimentalNot described
Receives: Drug: Ivermectin
Healthy volunteer for blood donorNo interventionNot described

What is being measured

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

  1. Area under the concentration-time curve for Ivermectin and its metabolites

    Pharmacokinetic parameters (area under the concentration-time curve [(AUC∞ and AUCLAST] for Ivermectin and its metabolites.

    Measured: 41 days

  2. Maximum concentration for Ivermectin and its metabolites

    Pharmacokinetic parameters (maximum concentration [CMAX]) for Ivermectin and its metabolites.

    Measured: 41 days

  3. Time to maximum concentration for Ivermectin and its metabolites

    Pharmacokinetic parameters (time to maximum concentration [TMAX]) for Ivermectin and its metabolites.

    Measured: 41 days

  4. Terminal elimination half-life for Ivermectin and its metabolites

    Pharmacokinetic parameters (terminal elimination half-life [t1/2]) for Ivermectin and its metabolites.

    Measured: 41 days

  5. Concentration associated with half maximum mosquito killing effect [LC50] for Ivermectin and its metabolites

    Pharmacodynamic parameters (concentration associated with half maximum mosquito killing effect [LC50]) for Ivermectin and its metabolites.

    Measured: 41 days

Secondary outcomes (9)
  1. Duration of mosquito survivorship

    Duration of mosquito survivorship following standard membrane feeding assay (SMFA) to determine duration of time post drug administration that IVM-treated volunteers are lethal to An. dirus and An. minimus.

    Measured: 14 days

  2. Compare Maximum Blood Concentrations (Cmax) for ivermectin components and metabolites measured between venous and capillary blood

    Pharmacokinetic differences for Ivermectin and metabolites in venous and capillary blood.

    Measured: 41 days

  3. Compare Area-Under-Curve (AUC) for ivermectin components and metabolites measured between venous and capillary blood

    Pharmacokinetic differences for Ivermectin and metabolites in venous and capillary blood.

    Measured: 41 days

  4. Compare mosquito (An. dirus) survival curves to day 14 between Direct Feeding Assay and Standard Membrane Feeding Assays

    Mosquito survival curves to day 14 within a species will be compared between mosquitoes blood fed via Direct Feeding Assay and Standard Membrane Feeding Assays by Log-Rank survival curve analysis (Mantel-Cox method). This will assess if venous blood is more or less lethal to mosquitoes than blood ingested from subdermal capillaries.

    Measured: 14 days

  5. Compare mosquito (An. Minimus) survival curves to day 14 between Direct Feeding Assay and Standard Membrane Feeding Assays

    Mosquito survival curves to day 14 within a species will be compared between mosquitoes blood fed via Direct Feeding Assay and Standard Membrane Feeding Assays by Log-Rank survival curve analysis (Mantel-Cox method). This will assess if venous blood is more or less lethal to mosquitoes than blood ingested from subdermal capillaries.

    Measured: 14 days

  6. The lethal concentration that kills 50% of mosquitoes (LC50) between two strains of An. dirus

    The lethal concentration that kills 50% of mosquitoes (LC50) between two strains of An. dirus will be evaluated. This will assess if one An. dirus strain is more or less susceptible to ivermectin.

    Measured: 14 days

  7. Mosquito survival curves to day 14 between two strains of An. dirus.

    Mosquito survival curves to day 14 between two strains of An. dirus will be evaluated. This will assess if one An. dirus strain is more or less susceptible to ivermectin.

    Measured: 14 days

  8. The lethal concentration that kills 50% of mosquitoes (LC50) for each ivermectin component and synthesized metabolites

    The lethal concentration that kills 50% of mosquitoes (LC50) for each ivermectin component and synthesized metabolites. The LC50s and their corresponding 95% confidence intervals will be evaluated for each ivermectin component and synthesized metabolites. This will assess if any of the ivermectin components or metabolites are more or less lethal to An. dirus.

    Measured: 14 days

  9. The inhibitory concentration that kills 50% of parasites (IC50) for each P. falciparum strain.

    The inhibitory concentration that kills 50% of parasites (IC50) will be evaluated for each P. falciparum strain to determine which strains are more or less susceptible to ivermectin.

    Measured: 48 hours

Timeline

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

  1. First posted1 Oct 2018
  2. Study start4 Feb 2019
  3. Primary completion5 Apr 2022
  4. Study completion5 Apr 2022

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 4
Primary purpose
Health services research
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03690453
Sponsor's protocol ID
MAL18006
Status last verified
Jan 2023
First submitted
18 Sep 2018
Last updated
26 Nov 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: With subject's consent, subject's data and results from blood analyses stored in the database may be shared with other researchers to use in the future.

Publications

  • Kobylinski KC, Tipthara P, Wamaket N, Chainarin S, Kullasakboonsri R, Sriwichai P, Phasomkusolsil S, Hanboonkunupakarn B, Jittamala P, Gemmell R, Boyle J, Wrigley S, Steele J, White NJ, Tarning J. Author Correction: Ivermectin metabolites reduce Anopheles survival. Sci Rep. 2024 Oct 24;14(1):25243. doi: 10.1038/s41598-024-76902-z. No abstract available.

    PubMed 39448768

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Ivermectin in people with Healthy, run by University of Oxford at 1 site in Thailand.

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 18 inclusion and 29 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 26 Nov 2024. 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 Thailand. 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.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

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?

Area under the concentration-time curve for Ivermectin and its metabolites (time frame: 41 days). The study lists 5 primary outcomes in all. 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 NCT03690453, which also lists 1 linked publication.

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 26 Nov 2024.

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