Platform Study to Evaluate the Efficacy and Safety of Anti-malarial Agents in Participants With Uncomplicated Plasmodium Falciparum Malaria (Cohort C2)

The Cohort C2 of this Platfom study (NCT05750628) is the open-label, randomized, two-arm combination therapy evaluating a single oral dose of up to three anti-malarial agents as a loose combination vs. standard of care (SoC), Coartem in children aged 2 to <12 years.

• KAE609 (Drug), also known as Cipargamin: oral capsules administered in combination with KLU156
• SoC (Coartem) (Drug), also known as Coartem: Standard of Care
• KLU156 (Drug), also known as ganaplacide + lumefantrine solid dispersion formulation: oral sachet formulation (KAF156+LUM-SDF) administered in combination with cipargamin (KAE609)

Primary outcomes

• Polymerase chain reaction (PCR) corrected adequate clinical and parasitological response (ACPR) [Day 29]: ACPR is defined as the absence of parasitemia on Study Day 29 irrespective of axillary temperature, without previously meeting any of the criteria of Early Treatment Failure (ETF) or Late Clinical Failure (LCF) or Late Parasitological Failure (LPF).

Secondary outcomes

• Parasite clearance time (PCT) [up to Day 7]: To assess the parasite clearance time (PCT) of oral anti malarial agent versus the standard of care (SoC) in participants with uncomplicated P. falciparum malaria
• PCR-uncorrected ACPR [Day 29]: To assess the 28-day cure rate of an anti malarial agent administered orally as combination therapy versus the SoC in participants with uncomplicated P. falciparum malaria.
• Area under the concentration-time curve from time zero to the last measurable concentration sampling time (AUClast) [Day 8]: To characterize the pharmacokinetics (PK) of the anti-malarial agent administered orally as combination therapy.
• Maximum observed concentration (Cmax) [Day 8]: To characterize the pharmacokinetics (PK) of the anti-malarial agent administered orally as combination therapy.
• Time to reach maximum observed concentration (Tmax) [Day 8]: To characterize the pharmacokinetics (PK) of the anti-malarial agent administered orally as combination therapy.
• Elimination half-life (T1/2) [Day 8]: To characterize the pharmacokinetics (PK) of the anti-malarial agent administered orally as combination therapy.
• Total body clearance (CL/F) [Day 8]: To characterize the pharmacokinetics (PK) of the anti-malarial agent administered orally as combination therapy.
• Apparent volume of distribution (V/F) [Day 8]: To characterize the pharmacokinetics (PK) of the anti-malarial agent administered orally as combination therapy.
• Area under the concentration-time curve from time zero to infinity (AUCinf) [Day 8]: To characterize the pharmacokinetics (PK) of the anti-malarial agent administered orally as combination therapy.
• Area under the concentration-time curve (AUC0-t) [Day 8]: To characterize the pharmacokinetics (PK) of the anti-malarial agent administered orally as combination therapy.

Sex: All, ages: 2 Years to 12 Years

Inclusion Criteria:

1. Male and female participants 2 to <12 years of age at screening.
2. Participants must have acute uncomplicated P. falciparum malaria mono infection at screening confirmed by a parasite count between 1,000 to 150,000 asexual parasite count/μl of blood for P. falciparum.
3. Participants must weigh at least 10 kg at screening.

Exclusion Criteria:

1. Participants with signs and symptoms of severe/complicated malaria at screening or mixed Plasmodium infection (i.e., infection with more than one malaria species) at screening
2. Moderate to severe anemia, chronic hemoglobinopathy (Hemoglobin level < 8 g/dL), or known chronic underlying disease such as sickle cell disease at screening
3. Known clinically significant liver disease (e.g., chronic hepatitis, liver cirrhosis (compensated or decompensated), history of hepatitis B or C, hepatitis A or B vaccination in the last 3 months, known gallbladder or bile duct disease, acute or chronic pancreatitis. Clinical or laboratory evidence of any of the following at screening:

   * AST/ALT > 3 x the upper limit of normal range (ULN), regardless of the level of total bilirubin
   * AST/ALT > 1.5 and ≤ 2 x ULN and total bilirubin is > ULN
   * Total bilirubin > 2 x ULN, regardless of the level of AST/ALT
4. Any known/suspected immunosuppressive or immunodeficient condition, including human immunodeficiency virus (HIV) infection at screening.
5. History or current diagnosis of ECG abnormalities indicating significant risk of safety for patients participating in the study such as:

   * Concomitant clinically significant cardiac arrhythmias, e.g., sustained ventricular tachycardia, and clinically significant second or third degree AV block without a pacemaker
   * History of familial long QT syndrome or known family history of Torsades de Pointe.
   * Resting heart rate (physical exam or 12 lead ECG) < 50 bpm

Other protocol-defined inclusion/exclusion criteria may apply.