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

Phase 2TerminatedNCT01945281

Merck Sharp & Dohme LLC51 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Candidiasis, Invasive

Interventions

CaspofunginDRUG

Amphotericin B DeoxycholateDRUG

Eligibility

Sex: ALLMax age: 3 Months

Medical Language ↔ Plain English

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

Outcomes

Primary Outcomes

Percentage of Participants With Fungal-free Survival Through the 2-week Post-therapy Period

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.

Time frame: Up to 104 days

Secondary Outcomes

Percentage of Participants With Fungal-free Survival Through the End of Study Treatment

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.

Time frame: Up to 90 days

Number of Participants With an Adverse Event (AE)

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.

Time frame: 8 weeks after end of study therapy (up to 146 days)

Data from ClinicalTrials.gov

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