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Safety, Tolerability, and Efficacy of Caspofungin Versus Amphotericin B Deoxycholate in the Treatment of Invasive Candidiasis in Neonates and Infants (MK-0991-064)

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ClinicalTrials.gov Identifier: NCT01945281
Recruitment Status : Terminated (Operational feasibility with low recruitment due to changing epidemiology of disease)
First Posted : September 18, 2013
Results First Posted : August 28, 2018
Last Update Posted : November 25, 2019
Sponsor:
Information provided by (Responsible Party):
Merck Sharp & Dohme Corp.

Brief Summary:
The study will evaluate the safety, tolerability, and efficacy of caspofungin as compared with amphotericin B deoxycholate in the treatment of invasive candidiasis in neonates and infants. The primary hypothesis to be tested in the study is that caspofungin will be superior to amphotericin B deoxycholate with regard to the proportion of participants with fungal-free survival at the 2-week post-therapy follow-up visit.

Condition or disease Intervention/treatment Phase
Candidiasis, Invasive Drug: Caspofungin Drug: Amphotericin B Deoxycholate Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 51 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Multicenter, Double-Blind, Randomized, Comparator-Controlled Study to Evaluate the Safety, Tolerability, and Efficacy of Caspofungin Versus Amphotericin B Deoxycholate in the Treatment of Invasive Candidiasis in Neonates and Infants Less Than 3 Months of Age
Actual Study Start Date : January 15, 2014
Actual Primary Completion Date : January 2, 2018
Actual Study Completion Date : February 28, 2018


Arm Intervention/treatment
Experimental: Caspofungin
Caspofungin 2 mg/kg intravenous once daily for ≥14 days after documented negative culture and improvement of clinical signs and symptoms, for a maximum of 90 days treatment
Drug: Caspofungin
Active Comparator: Amphotericin B Deoxycholate
Amphotericin B deoxycholate 1 mg/kg intravenous once daily for ≥14 days after documented negative culture and improvement of clinical signs and symptoms, for a maximum of 90 days treatment
Drug: Amphotericin B Deoxycholate



Primary Outcome Measures :
  1. Percentage of Participants With Fungal-free Survival Through the 2-week Post-therapy Period [ Time Frame: Up to 104 days ]
    Fungal-free survival is those participants who survived up to 2 weeks post-therapy, and had documented microbiological eradication of Candida species (sp.) from follow-up cultures collected after the initiation of study therapy. Microbiological eradication denotes negative follow-up cultures for Candida sp. from the site of infection. If a culture is not obtained on the day of assessment, the last culture after study entry may be used to assist in the assessment of microbiological eradication. If the last culture is negative for Candida sp., then microbiological eradication would be considered achieved.


Secondary Outcome Measures :
  1. Percentage of Participants With Fungal-free Survival Through the End of Study Treatment [ Time Frame: Up to 90 days ]
    Fungal-free survival is those participants who survived up to end of study treatment, and had documented microbiological eradication of Candida sp. from follow-up cultures collected after the initiation of study therapy. Microbiological eradication denotes negative follow-up cultures for Candida sp. from the site of infection. If a culture is not obtained on the day of assessment, the last culture after study entry may be used to assist in the assessment of microbiological eradication. If the last culture is negative for Candida sp., then microbiological eradication would be considered achieved.

  2. Number of Participants With an Adverse Event (AE) [ Time Frame: 8 weeks after end of study therapy (up to 146 days) ]
    An AE is any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the SPONSOR's product, whether or not considered related to the use of the product. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a preexisting condition which is temporally associated with the use of the SPONSOR's product, is also an AE.



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Ages Eligible for Study:   up to 3 Months   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Culture-confirmed invasive Candida infection

Exclusion Criteria:

  • Candida disease limited to the oropharynx, esophagus, or other mucosal or superficial skin surfaces
  • Positive culture for Candida only from sputum, broncho-alveolar lavage, catheter tip, or previously placed indwelling non-vascular catheters or drains
  • Prosthetic device as the suspected site of Candida infection
  • Active co-infection with a non-Candida fungal organism
  • Received >48 hours of systemic antifungal treatment since the positive Candida index culture was collected as therapy for the present episode of invasive candidiasis
  • Failed prior systemic antifungal therapy for the present episode of invasive candidiasis
  • Diagnosis of acute hepatitis or cirrhosis
  • Scheduled or anticipated to receive rifampin or other systemic antifungal therapy while on study therapy
  • History (including participant's mother) of allergy, hypersensitivity, or any serious reaction to caspofungin or other member of the echinocandin class, or to amphotericin B deoxycholate or other member of the polyene class
  • Severe congenital disorder known to lower immune response

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01945281


Sponsors and Collaborators
Merck Sharp & Dohme Corp.
Investigators
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Study Director: Medical Director Merck Sharp & Dohme Corp.
  Study Documents (Full-Text)

Documents provided by Merck Sharp & Dohme Corp.:
Publications of Results:
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Responsible Party: Merck Sharp & Dohme Corp.
ClinicalTrials.gov Identifier: NCT01945281    
Other Study ID Numbers: 0991-064
2013-002084-26 ( EudraCT Number )
MK-0991-064 ( Other Identifier: Merck Protocol Number )
First Posted: September 18, 2013    Key Record Dates
Results First Posted: August 28, 2018
Last Update Posted: November 25, 2019
Last Verified: November 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
URL: http://engagezone.msd.com/ds_documentation.php
Additional relevant MeSH terms:
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Candidiasis
Candidiasis, Invasive
Mycoses
Invasive Fungal Infections
Amphotericin B
Liposomal amphotericin B
Caspofungin
Amphotericin B, deoxycholate drug combination
Deoxycholic Acid
Amebicides
Antiprotozoal Agents
Antiparasitic Agents
Anti-Infective Agents
Anti-Bacterial Agents
Antifungal Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Cholagogues and Choleretics
Gastrointestinal Agents