A Phase II Study To Assess Safety and Efficacy Of Short-Course Regimens Of Amphotericin B Emulsion In Kala-Azar

Banaras Hindu University

Status and phase: Completed; Phase 2

Conditions: Visceral Leishmaniasis

Treatments: Drug: Amphotericin B in fat emulsion; Drug: Amphotericin B fat emulsion in visceral leishmaniasis; Drug: Amphotericin B fat emulsion

Study type: Interventional

Funder types: Other

Identifiers

NCT00497601

BSV-AMBE II-KA-706

Details and patient eligibility

About

The purpose of this study is:

1. To evaluate the Safety and Efficacy of four different short-course regimens of Amphotericin B emulsion in treatment of Kala-azar (visceral leishmaniasis) subjects who are either treatment naive or treatment resistant to other antileishmanial drugs except amphotericin B containing preparations.
2. To assess the safety and efficacy of single-bolus infusion of Amphotericin B emulsion in treatment of Kala-azar.

Full description

1. To evaluate the Safety and Efficacy of four different short-course regimens of Amphotericin B emulsion in treatment of Kala-azar (visceral leishmaniasis) subjects who are either treatment naive or treatment resistant to other antileishmanial drugs except amphotericin B containing preparations.
2. To assess the safety and efficacy of single-bolus infusion of Amphotericin B emulsion in treatment of Kala-azar.

Subjects will be administered the study drug in either of the following four dose levels in an ascending manner, starting with the first dosage regimen:

• 7.5 mg/kg on day 1 and day3 (Regimen 1)
• 10 mg/kg on day 1, followed by 5 mg/kg on day 3 (Regimen 2)
• 12.5 mg/kg on day 1, followed by 2.5 mg/kg on day 3 (Regimen 3)
• Single-bolus infusion of 15 mg/kg over 2-4 hours on day 1 (Regimen 4)

Enrollment: 60 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Male or female subjects between 18 years and 65 years of age (both inclusive).
2. Subject/subject's legally acceptable representative is willing and able to give written informed consent to participate in the study.
3. Treatment naive subjects having symptoms and/or signs of visceral leishmaniasis with parasitological confirmation of Kala-azar (by splenic or bone marrow aspirate smear examination).

If subjects are previously treated with other antileishmanial drugs except amphotericin B containing preparations, they will be enrolled in the study only after clinical and parasitological evidence that the disease is unresponsive to adequate treatment with other drugs, and after an appropriate wash out period

Exclusion criteria

1. Subjects with past history of treatment with Amphotericin B for Kala-azar.
2. Subjects positive for HIV infection.
3. Concomitant life threatening or serious disease.
4. Concurrent malaria (malarial parasite test to be negative prior to study treatment administration), tuberculosis or bacterial pneumonia.
5. Haemoglobin < 6 gm/dl, total leukocyte count < 1,500/cmm, platelet count < 50,000/cmm
6. Abnormal liver and renal functions (BUN and serum creatinine > 1.5 times upper limit of normal (ULN), AST/ALT > 2.5 times ULN, and bilirubin > 1.5 times ULN).
7. Pregnant or nursing women.
8. Known hypersensitivity to Amphotericin B or inactive ingredients of study drug formulation.
9. Subjects receiving any of the medications prohibited by the study protocol.
10. Evidence of significant haematological, cardiac, hepatic, renal, respiratory, neurological or metabolic disease or any condition which, in the opinion of the investigator, might interfere with the evaluation of the study objectives.
11. Simultaneous participation in another trial or received any investigational product < 30 days prior to enrolment.

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 4 patient groups

A

Experimental group

Description:

Amphotericin B in fat emulsion (Amphomul) 7.5 mg/kg on day 1 and 3

Treatment:

Drug: Amphotericin B fat emulsion

Drug: Amphotericin B in fat emulsion

Drug: Amphotericin B fat emulsion in visceral leishmaniasis

B

Experimental group

Description:

Amphotericin B in fat emulsion (Amphomul) 10 mg/kg on day 1 and 5 mg/kg on day 3

Treatment:

Drug: Amphotericin B fat emulsion

Drug: Amphotericin B in fat emulsion

Drug: Amphotericin B fat emulsion in visceral leishmaniasis

C

Experimental group

Description:

Amphotericin B in fat emulsion (Amphomul) 12.5 mg/kg on day 1 and 2.5 mg/kg on day 3

Treatment:

Drug: Amphotericin B fat emulsion

Drug: Amphotericin B in fat emulsion

Drug: Amphotericin B fat emulsion in visceral leishmaniasis

D

Experimental group

Description:

Amphotericin B in fat emulsion (Amphomul) 15 mg/kg in a single dose administration on day 1

Treatment:

Drug: Amphotericin B fat emulsion

Drug: Amphotericin B in fat emulsion

Drug: Amphotericin B fat emulsion in visceral leishmaniasis