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Peer reviewedOpen accessMalaria

Safety and efficacy of the monoclonal antibody L9LS for malaria prevention in children exposed to perennial malaria transmission in Kenya: a randomised, double-blind, placebo-controlled, phase 2 trial

The Lancet·

Laura C Steinhardt, Titus K Kwambai, Martina Oneko, Eunice Ouma, Ruth Njoroge, Viviane Callier, Zonghui Hu, Julie R Gutman, Reuben Yego, Kephas Otieno, Kelvin Onoka, Lilian Otieno, Kennedy Oduol, Leonid Serebryannyy, Bob C Lin, Will Adams, Somia Hickman, Anne C Preston, Kevin Carlton, Michael Holdsworth, Yan Xiao, Feiko O ter Kuile, Wycliffe Odongo, Sean C Murphy, Tuan M Tran, Simon Kariuki, Peter D Crompton, Robert A Seder, Steven Achieng, Fredrick Adhola, Eliakim Agono, Elizabeth Ambululi, Lynn Amondi, Mary Awuor, Benard Ayatta, Dennis Bii, Lilian Chemada, Linedi Chemwok, Miriam Chomba, Gentrix Indoshi, Lwanga Karoli, Martha Kimungui, Franklin Komino, Nypha M’mayi, Judy Magoma, Sharon N’getich, George N’gonga, Nancy Nyamache, Joshua Obiya, Louizah Ochola, Telephorus Odawo, Patricia Odera Ojwang, Maureen Odhiambo, Ronald Odhiambo, Clevers Odhiambo, Leonard Odipo, Esther Odongo, Beatrice Odoyo, Kennedy Oduol, Charles Oduor, Kevin Ogamba, Willis Ogillo, Veronicah Okuna, Damaris Okwiri, Edwin Olweny, Dennis Omondi, Postine Omwalo, Mary Omwalo, Francis Orwa, Shaltone Osele, Benard Otero, Daniel Ouko, Felix Ouko, Diana Owera, Ann Owino, Faith Oyier, Linet Sewe, Martin Apgar, Mimi Campbell, Robin Carroll, Mike Castro, Jason Gall, Wesley Goss-Geffrard, Janel Holland-Linn, Yogita Jethmalani, Rachel Kazmierski, Richard A. Koup, Jeffery Liao, Kwang Low, Allen Mueller, Madeeha Mughal, Sandeep Narpala, Leigh Stephens, Laxmi Buyyani, Kanwaldeep Bajwa, Michael Holdsworth, Harish Kandaswamay, Diane Rock Kress, Mariam Namawejje, Pengchong Tang, Neelam Gulati, Liam Harmon, Shirley Jankelevich, Yvonne Jato, Aaren King, Stacy Kopka, Valerie Opher, John Tierney, Susan Vogel, Saran Wells, Kristin Young, Sammi Cheung, Annette M. Seilie, Weston Staubus, Ashley Subijanto

DOI
10.1016/s0140-6736(26)00258-8
PMID
42035777
PMCID
PMC13266303
OpenAlex
W7155420337
Study type
Randomised controlled trial
Publisher
Elsevier BV
Article type
journal-article
Integrity
current

Why this research matters now

These outcomes indicate that targeted immunoprophylaxis may serve as a supplementary preventive measure for youth in endemic zones, though current dosing regimens require optimization for maximum impact.

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Structured evidence summary

Research question

What is the safety profile and protective effectiveness of the monoclonal antibody L9LS against Plasmodium falciparum infection in pediatric patients residing in an area with continuous disease circulation?

Study design

Researchers conducted a double-blind, randomized, placebo-controlled phase 2 evaluation utilizing sequential dosing cohorts and extended clinical monitoring. Participants received either the investigational biologic or saline solution under centralized allocation procedures.

Population and setting

Healthy children between five months and ten years old participated in the assessment within Siaya county, Kenya, a region experiencing year-round pathogen exposure.

Main findings

Children receiving two administrations of the antibody experienced a lower rate of confirmed infections compared to those given saline, yielding roughly forty-three percent protection over one year. Mild treatment-related reactions occurred occasionally and resolved completely, while no severe complications linked to the study protocol were documented.

Public-health relevance

These outcomes indicate that targeted immunoprophylaxis may serve as a supplementary preventive measure for youth in endemic zones, though current dosing regimens require optimization for maximum impact.

Important limitations

The investigation was restricted to a single Kenyan district and monitored participants for only twelve months following initial administration. Furthermore, the measured protective effect did not reach the magnitude typically desired for intensive transmission environments.

GIDS interpretation

This peer-reviewed report documents early-stage clinical testing of a biological countermeasure for a tropical infectious disease. The dataset offers structured reference points for tracking therapeutic development trajectories and understanding regional pediatric health interventions.

02

Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 11 auditable classifier relationships to diseases, places, topics, and study design.

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