Micafungin Versus AmBisome in Invasive Candidiasis and Candidemia - Full Text View

Purpose

The purpose of this study is to determine the efficacy and safety of micafungin (FK463) versus liposomal amphotericin B (AmBisome) in treating neutropenic and non-neutropenic patients with confirmed invasive candidiasis or candidemia. Enrollment will include adult and pediatric patients.

Condition	Intervention	Phase
Candidiasis	Drug: Micafungin Drug: Liposomal Amphotericin B	Phase 3


Study Type:	Interventional
Study Design:	Allocation: Randomized Intervention Model: Parallel Assignment Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment
Official Title:	A Multicenter, Double Blind, Comparative, Randomized Study to Evaluate the Efficacy and Safety of Micafungin (FK463) Versus Liposomal Amphotericin B (AmBisome) in the Treatment of Invasive Candidiasis and Candidemia

Resource links provided by NLM:

MedlinePlus related topics: Yeast Infections

Drug Information available for: Amphotericin B Micafungin sodium Micafungin Liposomal Amphotericin B

Genetic and Rare Diseases Information Center resources: Systemic Candidiasis

U.S. FDA Resources

Further study details as provided by Astellas Pharma Inc:

Primary Outcome Measures:

Investigator's assessment of overall treatment success. Success is defined as clinical (complete or partial) and mycological (eradication or presumed eradication) response at the End of Therapy. [ Time Frame: 6 and 12 weeks post treatment ]

Secondary Outcome Measures:

Clinical response (complete, partial, stabilization, progression) during the treatment period and the post-treatment period [ Time Frame: During the 2 to 8 week treatment period and the 12 week post treatment followup period ]
Mycological response (eradication, presumed eradication, persistence) during the treatment period and the post-treatment period [ Time Frame: During the 2 to 8 week treatment period and the 12 week post treatment followup period ]
Overall incidence of emergent and recurrent fungal infections at the End of Study [ Time Frame: End of the 12 week post treatment followup peroid ]
Independent Efficacy Review Committee's assessment of overall treatment success [ Time Frame: Prior to database lock ]
Peak change of estimated glomerular filtration rate during the treatment period compared to Baseline [ Time Frame: During the 2 to 8 week treatment period ]
Incidence of acute infusion related reactions as pre-defined [ Time Frame: During the 2 to 8 week treatment period ]
Patient survival at the End of Therapy and at the End of Study [ Time Frame: End of the 2 to 8 week treatment period and end of the 12 week post treatment followup period ]
Overall incidence of Adverse Events (AE) [ Time Frame: Throughout study and post treatment followup period ]


Enrollment:	637
Study Start Date:	January 2003
Study Completion Date:	December 2005
Primary Completion Date:	December 2005 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: 1	Drug: Micafungin IV Other Names: Mycamine FK463
Active Comparator: 2	Drug: Liposomal Amphotericin B IV Other Name: AmBisome

Detailed Description:

A phase III, multicenter, double-blind, comparative, parallel, randomized study. Enrollment will include adult and pediatric patients. The adult population is sized to test for non-inferiority. For the pediatric population, descriptive analyses are planned.

Eligibility


Ages Eligible for Study:	Child, Adult, Senior
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Patients either non-neutropenic with absolute neutrophil counts >= 500 cells/mm3 or neutropenic with absolute neutrophil counts < 500 cells/mm3 must have:

Candidemia or invasive candidiasis,
Confirmation and typical clinical signs and symptoms by fungal culture and/or histology,
Positive culture obtained no more than four days prior to the first dose of study medication.

Exclusion Criteria:

Patient is pregnant or nursing
Patients with evidence of liver disease as defined by: a) SGOT/AST or SGPT/ALT > 10 times the upper limit of normal (ULN); or b) Total bilirubin > 5 times ULN.
Patients whose sole diagnosis is oropharyngeal and/or esophageal candidiasis and/or with positive cultures of urine specimens, sputum specimens, bronchoalveolar-lavage specimens or samples from indwelling drains.
Patients who have received prophylactic/empiric therapy with azoles or conventional amphotericin B for more than three days within one week prior to enrollment. Neutropenic patients, however, may have received prophylactic azoles without time restrictions.

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00106288

Hide Study Locations

Locations


United States, Alabama

Birmingham, Alabama, United States, 35294-0006
United States, California

Orange, California, United States, 92868
United States, Colorado

Denver, Colorado, United States, 80218
United States, District of Columbia

Washington, DC, District of Columbia, United States, 20010-2970
United States, Florida

Jacksonville, Florida, United States, 32207
United States, Georgia

Atlanta, Georgia, United States, 30322
United States, Illinois

Hinsdale, Illinois, United States, 60521

Maywood, Illinois, United States, 60153
United States, Kansas

Kansas City, Kansas, United States, 66160
United States, Kentucky

Lexington, Kentucky, United States, 40536-0084
United States, Maryland

Baltimore, Maryland, United States, 21201-1595
United States, Massachusetts

Boston, Massachusetts, United States, 02115

Boston, Massachusetts, United States, 02211
United States, Michigan

Detroit, Michigan, United States, 48201
United States, Minnesota

Minneapolis, Minnesota, United States, 55455
United States, New York

New York, New York, United States, 10021

New York, New York, United States, 10029

New York, New York, United States, 10032

Rochester, New York, United States, 14642

Valhalla, New York, United States, 10595
United States, North Carolina

Durham, North Carolina, United States, 27710
United States, Pennsylvania

Philadelphia, Pennsylvania, United States, 19104

Philadelphia, Pennsylvania, United States, 19107

Philadelphia, Pennsylvania, United States, 19140
United States, Texas

Houston, Texas, United States, 77030

San Antonio, Texas, United States, 78229-3900
United States, Utah

Provo, Utah, United States, 84604
Canada, Alberta

Calgary, Alberta, Canada, T2N 2T9
Canada, British Columbia

Vancouver, British Columbia, Canada, V6Z 1Y6
Canada, Manitoba

Winnipeg, Manitoba, Canada, R3A 1R9
Canada, Nova Scotia

Halifax, Nova Scotia, Canada, B3H 2Y9
Canada, Ontario

Hamilton, Ontario, Canada, L8V 1C3

Toronto, Ontario, Canada, M5S 2N9
Canada, Quebec

Montreal, Quebec, Canada, H1T 2M4

Montreal, Quebec, Canada, H2L 4M1
Canada, Saskatchewan

Regina, Saskatchewan, Canada, S4P OW5
Canada

Quebec, Canada, G1R 2J6

Sponsors and Collaborators

Astellas Pharma Inc

Investigators


Study Chair:	Use Central Contact	Astellas Pharma Europe B.V.

More Information

Additional Information:

Link to Results on JAPIC - enter 140598 in the JapicCTI-RNo. field This link exits the ClinicalTrials.gov site

Publications:

Kuse ER, Chetchotisakd P, da Cunha CA, Ruhnke M, Barrios C, Raghunadharao D, Sekhon JS, Freire A, Ramasubramanian V, Demeyer I, Nucci M, Leelarasamee A, Jacobs F, Decruyenaere J, Pittet D, Ullmann AJ, Ostrosky-Zeichner L, Lortholary O, Koblinger S, Diekmann-Berndt H, Cornely OA; Micafungin Invasive Candidiasis Working Group. Micafungin versus liposomal amphotericin B for candidaemia and invasive candidosis: a phase III randomised double-blind trial. Lancet. 2007 May 5;369(9572):1519-27.

Queiroz-Telles F, Berezin E, Leverger G, Freire A, van der Vyver A, Chotpitayasunondh T, Konja J, Diekmann-Berndt H, Koblinger S, Groll AH, Arrieta A; Micafungin Invasive Candidiasis Study Group. Micafungin versus liposomal amphotericin B for pediatric patients with invasive candidiasis: substudy of a randomized double-blind trial. Pediatr Infect Dis J. 2008 Sep;27(9):820-6. doi: 10.1097/INF.0b013e31817275e6.

Horn DL, Ostrosky-Zeichner L, Morris MI, Ullmann AJ, Wu C, Buell DN, Kovanda LL, Cornely OA. Factors related to survival and treatment success in invasive candidiasis or candidemia: a pooled analysis of two large, prospective, micafungin trials. Eur J Clin Microbiol Infect Dis. 2010 Feb;29(2):223-9. doi: 10.1007/s10096-009-0843-0. Epub 2009 Dec 15.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Shorr AF, Wu C, Kothari S. Outcomes with micafungin in patients with candidaemia or invasive candidiasis due to Candida glabrata and Candida krusei. J Antimicrob Chemother. 2011 Feb;66(2):375-80. doi: 10.1093/jac/dkq446. Epub 2010 Dec 8.

Dupont BF, Lortholary O, Ostrosky-Zeichner L, Stucker F, Yeldandi V. Treatment of candidemia and invasive candidiasis in the intensive care unit: post hoc analysis of a randomized, controlled trial comparing micafungin and liposomal amphotericin B. Crit Care. 2009;13(5):R159. doi: 10.1186/cc8117. Epub 2009 Oct 5.


Responsible Party:	Astellas Pharma Inc
ClinicalTrials.gov Identifier:	NCT00106288 History of Changes
Other Study ID Numbers:	FG-463-21-08
Study First Received:	March 22, 2005
Last Updated:	September 17, 2014

Keywords provided by Astellas Pharma Inc:


Candidaemia Micafungin

Additional relevant MeSH terms:


Candidiasis Candidemia Candidiasis, Invasive Mycoses Fungemia Sepsis Infection Systemic Inflammatory Response Syndrome Inflammation Pathologic Processes	Amphotericin B Liposomal amphotericin B Micafungin Echinocandins Amebicides Antiprotozoal Agents Antiparasitic Agents Anti-Infective Agents Anti-Bacterial Agents Antifungal Agents

ClinicalTrials.gov processed this record on August 18, 2017