This is an open-label, dose-titration trial to study the efficacy, safety, and pharmacokinetics of oral cochleate amphotericin B (CAMB) in the treatment of mucocutaneous candidiasis infections in patients who are refractory or intolerant to standard non intravenous therapies.
Patients aged 18 to 75 years with mucocutaneous candidiasis (esophageal, oropharyngeal, or vulvovaginal) who are refractory or intolerant to standard non-intravenous therapies will be enrolled. Patients will initially be treated in a short-term dose titration period, where the dose may be increased in patients that do not respond clinically. Patients who do not respond clinically to the highest dose of drug will discontinue the protocol. Patients that respond to treatment and tolerate the study medication will be eligible to enter a long-term extension (up to 60-months).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
4
Oral lipid nanocrystal formulation of amphotericin B
National Institute of Allergy and Infectious Disease (NIAID)
Bethesda, Maryland, United States
Clinical Response to Treatment of Mucocutaneous Candidiasis
Number of subjects with a clinical response of clinical cure or improvement. Clinical cure was defined as absence of signs or symptoms of infection. Clinical improvement was defined as follows: * OPC or EC: partial resolution defined as greater than or equal to 50% of Baseline signs or symptoms * VVC: reduction of greater than or equal to 50% of clinical severity score from Baseline Severity of each symptom was graded on a scale from zero (absence of symptoms) to 3 (severe symptoms). The sum of all scores for all symptoms was used as the clinical severity score. Higher scores mean worse outcomes.
Time frame: 14-days at highest titrated dose
Area Under the Concentration Versus Time Curve From Time 0 to 24 Hours Postdose
Drug concentration in plasma collected at 0, 1, 2, 4, 8, 10, 12, and 24 hours post-dose
Time frame: Single and Multiple Doses (14-days)
Maximum Plasma Concentration (Cmax)
Plasma concentration was measured at 0, 1, 2, 4, 8, 10, 12, and 24 hours post-dose
Time frame: Single and Multiple Doses (14-days)
Time to Reach Maximum Plasma Concentration (Tmax)
Plasma collected at 0, 1, 2, 4, 8, 10, 12, and 24 hours post-dose
Time frame: Single and Multiple Doses (14-days)
Long-term Adverse Events, Changes in Laboratory Parameters
Incidence of nephrotoxicity, defined as an increase of greater than 100% of baseline serum creatinine. Incidence of hypokalemia, defined as serum potassium less than or equal to 3mmol/L during or within 3 weeks of completing treatment.
Time frame: up to 60 months
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