Randomized Study of Caspofungin Prophylaxis Followed by Pre-emptive Therapy for Invasive Candidiasis in the Intensive Care Unit (ICU)

NCT ID: NCT00520234

Last Updated: 2011-05-09

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

222 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-08-31

Study Completion Date

2010-03-31

Brief Summary

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Adults admitted to intensive care units are at risk for a variety of complications. Infections due to the fungus called candida are of particular concern. The study will test the possibility that caspofungin, a new therapy for fungal infections, can successfully reduce the rate of candida infections in subjects at risk. It will also test if caspofungin is useful in treating subjects for this disease when diagnosed using a new blood test that is performed twice weekly, permitting earlier diagnosis than current practice standards.

Detailed Description

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Conditions

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Invasive Candidiasis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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1 prophylaxis

Caspofungin 50 mg Intravenous (IV) daily up to 28 days of therapy

Group Type ACTIVE_COMPARATOR

Caspofungin

Intervention Type DRUG

50 mg IV daily

2 placebo

Normal Saline 100 cc IV daily

Group Type PLACEBO_COMPARATOR

Normal Saline

Intervention Type DRUG

100 cc IV daily

Interventions

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Caspofungin

50 mg IV daily

Intervention Type DRUG

Normal Saline

100 cc IV daily

Intervention Type DRUG

Other Intervention Names

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placebo

Eligibility Criteria

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Inclusion Criteria

* Non-pregnant \>18 yrs of age
* Subjects admitted to ICU during the preceding 3 days and expected to stay in the ICU for at least another 48 hours.Subjects can be enrolled on days 3-5 of ICU admission.
* Subjects meeting the clinical prediction rule

Exclusion Criteria

* Subjects with an allergy/intolerance to caspofungin or echinocandin analog
* absolute neutrophil count \<500/mm3 at study entry or likely to develop such a count during therapy
* acquired immunodeficiency syndrome, aplastic anemia or chronic granulomatous disease
* moderate or severe hepatic insufficiency
* subjects who are pregnant or lactating
* unlikely to survive \< 24 hours
* subjects who have received systemic antifungal therapy within 10 days prior to study entry
* Documented active proven or probable invasive fungal infection upon enrollment
* previously enrolled in this study
* Currently on another investigational agent or have received an investigational agent within 10 days prior to study entry.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role collaborator

Mycoses Study Group

NETWORK

Sponsor Role lead

Responsible Party

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Merck

Principal Investigators

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Luis Ostrosky-Zeichner, MD

Role: PRINCIPAL_INVESTIGATOR

The University of Texas Health Science Center, Houston

Peter G Pappas, MD

Role: PRINCIPAL_INVESTIGATOR

Mycoses Study Group

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

University of Southern California

Los Angeles, California, United States

Site Status

University of Colorado

Denver, Colorado, United States

Site Status

Washington Hospital Center

Washington D.C., District of Columbia, United States

Site Status

Tulane University

New Orleans, Louisiana, United States

Site Status

Harper University Hospital/ Wayne State

Detroit, Michigan, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

St. Patrick's Hospital

Missoula, Montana, United States

Site Status

Cooper University Hospital

Camden, New Jersey, United States

Site Status

The Ohio State University

Columbus, Ohio, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Medical Center of South Carolina

Charleston, South Carolina, United States

Site Status

Countries

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United States

References

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Diekema DJ, Messer SA, Brueggemann AB, Coffman SL, Doern GV, Herwaldt LA, Pfaller MA. Epidemiology of candidemia: 3-year results from the emerging infections and the epidemiology of Iowa organisms study. J Clin Microbiol. 2002 Apr;40(4):1298-302. doi: 10.1128/JCM.40.4.1298-1302.2002.

Reference Type BACKGROUND
PMID: 11923348 (View on PubMed)

Jarvis WR. Epidemiology of nosocomial fungal infections, with emphasis on Candida species. Clin Infect Dis. 1995 Jun;20(6):1526-30. doi: 10.1093/clinids/20.6.1526.

Reference Type BACKGROUND
PMID: 7548503 (View on PubMed)

Goodman JL, Winston DJ, Greenfield RA, Chandrasekar PH, Fox B, Kaizer H, Shadduck RK, Shea TC, Stiff P, Friedman DJ, et al. A controlled trial of fluconazole to prevent fungal infections in patients undergoing bone marrow transplantation. N Engl J Med. 1992 Mar 26;326(13):845-51. doi: 10.1056/NEJM199203263261301.

Reference Type BACKGROUND
PMID: 1542320 (View on PubMed)

Denning DW. Echinocandins: a new class of antifungal. J Antimicrob Chemother. 2002 Jun;49(6):889-91. doi: 10.1093/jac/dkf045. No abstract available.

Reference Type BACKGROUND
PMID: 12039879 (View on PubMed)

Ostrosky-Zeichner L, Shoham S, Vazquez J, Reboli A, Betts R, Barron MA, Schuster M, Judson MA, Revankar SG, Caeiro JP, Mangino JE, Mushatt D, Bedimo R, Freifeld A, Nguyen MH, Kauffman CA, Dismukes WE, Westfall AO, Deerman JB, Wood C, Sobel JD, Pappas PG. MSG-01: A randomized, double-blind, placebo-controlled trial of caspofungin prophylaxis followed by preemptive therapy for invasive candidiasis in high-risk adults in the critical care setting. Clin Infect Dis. 2014 May;58(9):1219-26. doi: 10.1093/cid/ciu074. Epub 2014 Feb 18.

Reference Type DERIVED
PMID: 24550378 (View on PubMed)

Other Identifiers

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MSG-01

Identifier Type: -

Identifier Source: org_study_id

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