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出境医 / 临床实验 / Malarone Pharmacokinetics Under Simulated Physiologic Stressors of Deployment (MPUSPSD)

Malarone Pharmacokinetics Under Simulated Physiologic Stressors of Deployment (MPUSPSD)

Study Description
Brief Summary:
A 2x2 randomized crossover of single dose malarone at rest and during moderate intensity exercise under controlled conditions of heat and humidity in healthy adult participants. Statistical analysis of AUC and Cmax will be performed to determine pharmacokinetic changes.

Condition or disease Intervention/treatment Phase
Exercise Pharmacokinetics Drug: Malarone Phase 4

Detailed Description:
A clinical trial under controlled heat exposure and moderate intensity exercise, determined by VO2max testing and calibration, to determine if physiologic changes during heat exposure and exercise change the pharmacokinetics of malarone to a degree that falls outside the range of that which is considered bioequivalent or 80-125% concentration using AUC and Cmax for rate and extent of exposure. Participants will be randomized to order of rest and exercise components. Single dose malarone will be used during both arms. Single dose malarone pharmacokinetics will give insight into risk of toxicity or risk of under treatment during prophylaxis administration.
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Malarone Pharmacokinetics Under Simulated Physiologic Stressors of Deployment
Estimated Study Start Date : May 24, 2019
Estimated Primary Completion Date : May 23, 2021
Estimated Study Completion Date : May 23, 2021
Arms and Interventions
Arm Intervention/treatment
Experimental: Rest
Pharmacokinetics of Single Dose Malarone at Rest
Drug: Malarone
Malarone

Experimental: Exercise
Pharmacokinetics of Single Dose Malarone under exercise in a heat chamber
Drug: Malarone
Malarone

Outcome Measures
Primary Outcome Measures :
  1. AUC [ Time Frame: 216 hours ]
    Area Under the Curve of Atovaquone, Proguanil, Cycloguanil

  2. Cmax [ Time Frame: 216 hours ]
    Cmax of Atovaquone, Proguanil, Cycloguanil


Eligibility Criteria
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Ages Eligible for Study:   18 Years to 44 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

Healthy adult female and male ages 18-44 weighing greater than 40kg with BMI less than 30.

Exclusion Criteria:

17 years old or younger, 45 years old or older, unable to speak and read English, unable to perform exercise tests safely, and/or unable to consent to participate. Unwilling to undergo blood draws. Have known allergy to sunflower butter or are unwilling or unable to consume 2 tbsp or have an allergy to any component of malarone. Also non abstinent females at risk of becoming pregnant or in a heterosexual sexual relationships must be willing to use there chosen and available form of contraception defined as barrier protection, implantable device or hormones, or oral contraceptive pills during time of study up to 2 months after or abstinence unless previously sterile with tubal ligation 1 year or greater prior to screening or hysterectomy.

Those with any of the following conditions will also be excluded from the study: history of any of the following: rhabdomyolysis or heat stroke, heart disease, pulmonary disease, chronic kidney disease, single kidney, chronic hepatitis, diabetes, seizure disorders, multiple sclerosis, COPD, asthma, sickle cell trait or disease, thalassemia, thyroid disease, cancer, chronic infections such as history of HIV, HEP B or HEP C, or rheumatologic disorder; current pregnancy or lactation, systolic blood pressure over 140 mm Hg or diastolic pressure over 90 mm Hg; anemia (hematocrit lower than 36% for women and 38% for men and hemoglobin below 11g/dL for women and 12g/dL for men); diabetes (blood glucose above 110 mg/dL); use of any medications for chronic medical conditions (such as glucose-lowering drugs, prednisone, or beta blockers); or any condition that leads to inability to run safely on a treadmill. Non systemic drugs for skin condition or seasonal allergies will not be a disqualifier. Any volunteers identified during the cardiac risk assessment as above low risk will also be excluded from the study. The ACSM guidelines for exclusion criteria identify low-risk individuals as younger than 45, without history of CVD, and with no more than one risk factor according to the ACSM Risk Stratification Questionnaire for stratification. Risk factors include family history of heart disease, smoking status, hypertension with a blood pressure above 140/90, hypercholesterolemia with cholesterol over 200 mg/dL, fasting glucose over 110 mg/dL, obesity with a percent body fat >25% for men or > 30% for women, and (be consistent throughout including ICD) sedentary lifestyle. The monitoring physician can also exclude a volunteer based on his or her medical opinion given the results of a physical exam and/or EKG results.

Initial screening for history will be performed by phone interview with requested waived consent. Those not able to achieve 80% pass on ICD test in 2 tries or less.

Contacts and Locations

Locations
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United States, Maryland
Uniformed Services University
Bethesda, Maryland, United States, 20814
Sponsors and Collaborators
Walter Reed Army Institute of Research (WRAIR)
Tracking Information
First Submitted Date  ICMJE June 14, 2019
First Posted Date  ICMJE June 19, 2019
Last Update Posted Date April 30, 2021
Estimated Study Start Date  ICMJE May 24, 2019
Estimated Primary Completion Date May 23, 2021   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: June 17, 2019)
  • AUC [ Time Frame: 216 hours ]
    Area Under the Curve of Atovaquone, Proguanil, Cycloguanil
  • Cmax [ Time Frame: 216 hours ]
    Cmax of Atovaquone, Proguanil, Cycloguanil
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE Not Provided
Original Secondary Outcome Measures  ICMJE Not Provided
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Malarone Pharmacokinetics Under Simulated Physiologic Stressors of Deployment
Official Title  ICMJE Malarone Pharmacokinetics Under Simulated Physiologic Stressors of Deployment
Brief Summary A 2x2 randomized crossover of single dose malarone at rest and during moderate intensity exercise under controlled conditions of heat and humidity in healthy adult participants. Statistical analysis of AUC and Cmax will be performed to determine pharmacokinetic changes.
Detailed Description A clinical trial under controlled heat exposure and moderate intensity exercise, determined by VO2max testing and calibration, to determine if physiologic changes during heat exposure and exercise change the pharmacokinetics of malarone to a degree that falls outside the range of that which is considered bioequivalent or 80-125% concentration using AUC and Cmax for rate and extent of exposure. Participants will be randomized to order of rest and exercise components. Single dose malarone will be used during both arms. Single dose malarone pharmacokinetics will give insight into risk of toxicity or risk of under treatment during prophylaxis administration.
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 4
Study Design  ICMJE Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Exercise
  • Pharmacokinetics
Intervention  ICMJE Drug: Malarone
Malarone
Study Arms  ICMJE
  • Experimental: Rest
    Pharmacokinetics of Single Dose Malarone at Rest
    Intervention: Drug: Malarone
  • Experimental: Exercise
    Pharmacokinetics of Single Dose Malarone under exercise in a heat chamber
    Intervention: Drug: Malarone
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Withdrawn
Actual Enrollment  ICMJE
 (submitted: April 27, 2021)
0
Original Estimated Enrollment  ICMJE
 (submitted: June 17, 2019)
40
Estimated Study Completion Date  ICMJE May 23, 2021
Estimated Primary Completion Date May 23, 2021   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

Healthy adult female and male ages 18-44 weighing greater than 40kg with BMI less than 30.

Exclusion Criteria:

17 years old or younger, 45 years old or older, unable to speak and read English, unable to perform exercise tests safely, and/or unable to consent to participate. Unwilling to undergo blood draws. Have known allergy to sunflower butter or are unwilling or unable to consume 2 tbsp or have an allergy to any component of malarone. Also non abstinent females at risk of becoming pregnant or in a heterosexual sexual relationships must be willing to use there chosen and available form of contraception defined as barrier protection, implantable device or hormones, or oral contraceptive pills during time of study up to 2 months after or abstinence unless previously sterile with tubal ligation 1 year or greater prior to screening or hysterectomy.

Those with any of the following conditions will also be excluded from the study: history of any of the following: rhabdomyolysis or heat stroke, heart disease, pulmonary disease, chronic kidney disease, single kidney, chronic hepatitis, diabetes, seizure disorders, multiple sclerosis, COPD, asthma, sickle cell trait or disease, thalassemia, thyroid disease, cancer, chronic infections such as history of HIV, HEP B or HEP C, or rheumatologic disorder; current pregnancy or lactation, systolic blood pressure over 140 mm Hg or diastolic pressure over 90 mm Hg; anemia (hematocrit lower than 36% for women and 38% for men and hemoglobin below 11g/dL for women and 12g/dL for men); diabetes (blood glucose above 110 mg/dL); use of any medications for chronic medical conditions (such as glucose-lowering drugs, prednisone, or beta blockers); or any condition that leads to inability to run safely on a treadmill. Non systemic drugs for skin condition or seasonal allergies will not be a disqualifier. Any volunteers identified during the cardiac risk assessment as above low risk will also be excluded from the study. The ACSM guidelines for exclusion criteria identify low-risk individuals as younger than 45, without history of CVD, and with no more than one risk factor according to the ACSM Risk Stratification Questionnaire for stratification. Risk factors include family history of heart disease, smoking status, hypertension with a blood pressure above 140/90, hypercholesterolemia with cholesterol over 200 mg/dL, fasting glucose over 110 mg/dL, obesity with a percent body fat >25% for men or > 30% for women, and (be consistent throughout including ICD) sedentary lifestyle. The monitoring physician can also exclude a volunteer based on his or her medical opinion given the results of a physical exam and/or EKG results.

Initial screening for history will be performed by phone interview with requested waived consent. Those not able to achieve 80% pass on ICD test in 2 tries or less.

Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 44 Years   (Adult)
Accepts Healthy Volunteers  ICMJE Yes
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03991208
Other Study ID Numbers  ICMJE Walter_Reed
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: Yes
IPD Sharing Statement  ICMJE Not Provided
Responsible Party Walter Reed Army Institute of Research (WRAIR)
Study Sponsor  ICMJE Walter Reed Army Institute of Research (WRAIR)
Collaborators  ICMJE Not Provided
Investigators  ICMJE Not Provided
PRS Account Walter Reed Army Institute of Research (WRAIR)
Verification Date April 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP