NCT03671109

Brief Summary

Trial to evaluate the safety and efficacy of DHA-PPQ for Intermittent Preventive Treatment (IPTp) in HIV-infected pregnant women receiving cotrimoxazole prophylaxis (CTXp) and antiretroviral (ARV) drugs and using long lasting insecticide treated nets will be conducted in Mozambique and Gabon where malaria and HIV infection are moderate to highly prevalent. In addition, the possibility for a PK interaction between DHA-PPQ and ARV drugs will be assessed in a sub-sample of participants. Women will receive ARV therapy according to national guidelines and their infants will be followed until one year of age to evaluate the impact of DHA-PPQ on MTCT-HIV.

Trial Health

90
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
666

participants targeted

Target at P75+ for phase_3

Timeline
Completed

Started Sep 2019

Typical duration for phase_3

Geographic Reach
2 countries

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 6, 2018

Completed
8 days until next milestone

First Posted

Study publicly available on registry

September 14, 2018

Completed
1 year until next milestone

Study Start

First participant enrolled

September 18, 2019

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 19, 2022

Completed
11 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 19, 2023

Completed
Last Updated

October 1, 2024

Status Verified

September 1, 2024

Enrollment Period

2.8 years

First QC Date

September 6, 2018

Last Update Submit

September 30, 2024

Conditions

Keywords

MalariaDihydroartemisinin-piperaquineHIVPregnancyTreatmentPrevention

Outcome Measures

Primary Outcomes (1)

  • Maternal parasitaemia at delivery

    Presence of Plasmodium falciparum (P. falciparum) asexual parasites of any density in peripheral blood (determined by microscopy)

    Delivery

Secondary Outcomes (29)

  • Incidence of clinical malaria

    On average six months follow up during pregnancy

  • Incidence of all-cause admissions

    On average six months follow up during pregnancy

  • Incidence of all-cause outpatient attendances

    On average six months follow up during pregnancy

  • Frequency and severity of adverse events

    On average six months follow up during pregnancy

  • Mean haemoglobin concentration

    At delivery

  • +24 more secondary outcomes

Study Arms (2)

IPTp-DHA-PPQ

EXPERIMENTAL

Monthly IPTp-DHA-PPQ over three days plus daily ARVs and cotrimoxazole prophylaxis

Drug: Dihydroartemisinin-piperaquine (DHA-PPQ)

IPTp-Placebo

PLACEBO COMPARATOR

Monthly IPTp-placebo over three days plus daily ARVs and cotrimoxazole prophylaxis

Drug: Placebo Oral Tablet

Interventions

Following physical examination, recruited women with more than 13 weeks of gestational age will receive IPTp-DHA-PPQ under supervision

IPTp-DHA-PPQ

Following physical examination, recruited women with more than 13 weeks of gestational age will receive IPTp-Placebo under supervision

IPTp-Placebo

Eligibility Criteria

Sexfemale
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Permanent resident in the study area
  • Gestational age at the first antenatal visit ≤ 28 weeks
  • HIV seropositive status
  • Agreement to deliver in the study site's maternity(ies) wards

You may not qualify if:

  • Residence outside the study area or planning to move out in the following 10 months from enrolment
  • Gestational age at the first antenatal visit \> 28 weeks of pregnancy
  • Known history of allergy to CTX
  • Known history of allergy or contraindications to DHA-PPQ
  • Participating in other intervention studies

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Centre de Recherches Médicales de Lambaréné (CERMEL)

Lambaréné, Gabon

Location

Centro de Investigação em Saúde de Manhiça (CISM)

Manhiça, Mozambique

Location

Related Publications (3)

  • Gonzalez R, Nhampossa T, Mombo-Ngoma G, Mischlinger J, Esen M, Tchouatieu AM, Mendes A, Figueroa-Romero A, Zoleko-Manego R, Lell B, Lagler H, Stoeger L, Dimessa LB, El Gaaloul M, Sanz S, Mendez S, Piqueras M, Sevene E, Ramharter M, Saute F, Menendez C; MAMAH study group. Safety and efficacy of dihydroartemisinin-piperaquine for intermittent preventive treatment of malaria in pregnant women with HIV from Gabon and Mozambique: a randomised, double-blind, placebo-controlled trial. Lancet Infect Dis. 2024 May;24(5):476-487. doi: 10.1016/S1473-3099(23)00738-7. Epub 2024 Jan 12.

  • Gonzalez R, Nhampossa T, Mombo-Ngoma G, Mischlinger J, Esen M, Tchouatieu AM, Pons-Duran C, Dimessa LB, Lell B, Lagler H, Garcia-Otero L, Zoleko Manego R, El Gaaloul M, Sanz S, Piqueras M, Sevene E, Ramharter M, Saute F, Menendez C. Evaluation of the safety and efficacy of dihydroartemisinin-piperaquine for intermittent preventive treatment of malaria in HIV-infected pregnant women: protocol of a multicentre, two-arm, randomised, placebo-controlled, superiority clinical trial (MAMAH project). BMJ Open. 2021 Nov 23;11(11):e053197. doi: 10.1136/bmjopen-2021-053197.

  • Pons-Duran C, Wassenaar MJ, Yovo KE, Marin-Carballo C, Briand V, Gonzalez R. Intermittent preventive treatment regimens for malaria in HIV-positive pregnant women. Cochrane Database Syst Rev. 2024 Sep 26;9(9):CD006689. doi: 10.1002/14651858.CD006689.pub3.

Related Links

MeSH Terms

Conditions

MalariaAcquired Immunodeficiency Syndrome

Condition Hierarchy (Ancestors)

Protozoan InfectionsParasitic DiseasesInfectionsMosquito-Borne DiseasesVector Borne DiseasesHIV InfectionsBlood-Borne InfectionsCommunicable DiseasesSexually Transmitted Diseases, ViralSexually Transmitted DiseasesLentivirus InfectionsRetroviridae InfectionsRNA Virus InfectionsVirus DiseasesSlow Virus DiseasesGenital DiseasesUrogenital DiseasesImmunologic Deficiency SyndromesImmune System Diseases

Study Officials

  • Clara Menendez, MD, PhD

    Barcelona Institute for Global Health

    STUDY DIRECTOR

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
Double blind placebo-controlled
Purpose
PREVENTION
Intervention Model
PARALLEL
Model Details: Superiority clinical trial
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

September 6, 2018

First Posted

September 14, 2018

Study Start

September 18, 2019

Primary Completion

July 19, 2022

Study Completion

June 19, 2023

Last Updated

October 1, 2024

Record last verified: 2024-09

Data Sharing

IPD Sharing
Will share

The main findings of the clinical trial will be submitted for publication in a peer reviewed journal within 12 months of study completion through an open access mechanism, or otherwise made available publicly in compliance with H2020 open access requirements. Primary project raw data will be published in the project website. This approach is taken to protect in particular the interests of the endemic country researchers and institutions and in acknowledgment of the primary research oversight by endemic country ethics review boards. At no stage will data containing personal information of research participants be released.

Shared Documents
STUDY PROTOCOL, SAP, ICF
Time Frame
Project metadata will be made available in formal reports to key stakeholders as soon as possible and to the wider public within 12 months after the end of the project. The announcement of the availability of the project metadata will be posted in the project website.
Access Criteria
Open Access

Locations