Comparison of Candida Eradication and Serum Cidal Activity of Echinocandins

NCT ID: NCT00839540

Last Updated: 2024-04-30

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

21 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-12-31

Study Completion Date

2010-05-31

Brief Summary

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The purpose of this pharmacokinetic (PK) and pharmacodynamic (PD) study is:

To study the rate and duration of serum cidal activity of caspofungin (CFG) and micafungin (MFG) against Candida isolates from the subject and against Candida glabrata with varying degrees of caspofungin susceptibilities.

This investigation will provide clinicians information supporting the use of caspofungin and micafungin in situations where Candida strains may be a cause of infection.

Detailed Description

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Methods:

Patients - Adult patients with presumptive candidemia. Patients with severe neutropenia (\<500) APACHE II scores \> 20, or significant liver disease will be excluded. All will give written informed consent (Pappas et al. CID. Oct 1, 2007).

Drugs - Patients will receive either CFG: 70 mg loading dose (LD) followed by 50 mg once daily (qd) (8 patients), MFG: 100 mg qd (8 patients) or MFG: 200 mg qd (8 patients). All agents will be given by slow IV infusion (MFG will be supplied by Astellas).

Sera - Blood samples will be collected at the end of the infusion (peak) and at 12 h and 24 h (trough) after the beginning of an infusion (day 3-4).

Each patients sera will be tested (MIC and cidal activity) against their own Candida isolate (if isolated). In addition, recent clinical isolates of C. glabrata will also be tested against patient sera (time-kill) to verify previous in vitro and animal PD studies (Cota. AAC. Nov. 2006; Wiederhold. AAC. May 2007).

Results:

* Patient outcome, including Candida eradication, will be documented for each patient by repeat culture.
* Serum concentrations (lab to be determined) and PK analysis of each echinocandin will be determined for each patient.
* Serum cidal titers will be measured against each of the Candida isolates for each agent at each time period. Median and geometric mean Peak and duration of cidal activity will then be determined and compared.

Conditions

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Candidemia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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micafungin 100

Patients receive Micafungin 100 mg qd

Group Type ACTIVE_COMPARATOR

micafungin

Intervention Type DRUG

100 mg qd by slow IV infusion for 24 h

micafungin 200

Patients receive 200 mg Micafungin qd

Group Type ACTIVE_COMPARATOR

Micafungin

Intervention Type DRUG

200 mg qd by slow IV infusion for 24 h

Caspofungin

Patients receive caspofungin 70 mg LD followed by 50 mg qd

Group Type ACTIVE_COMPARATOR

Caspofungin

Intervention Type DRUG

70 mg LD followed by 50 mg qd by slow IV infusion for 24 h

Interventions

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micafungin

100 mg qd by slow IV infusion for 24 h

Intervention Type DRUG

Micafungin

200 mg qd by slow IV infusion for 24 h

Intervention Type DRUG

Caspofungin

70 mg LD followed by 50 mg qd by slow IV infusion for 24 h

Intervention Type DRUG

Other Intervention Names

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Micamine Micamine Cancidas

Eligibility Criteria

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Inclusion Criteria

* Adult patients with presumptive candidemia

Exclusion Criteria

* Patients with severe neutropenia (\<500)
* Patients with APACHE II scores \> 20
* Patients with severe liver disease
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Astellas Pharma US, Inc.

INDUSTRY

Sponsor Role collaborator

Gary E. Stein, Pharm.D.

OTHER

Sponsor Role lead

Responsible Party

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Gary E. Stein, Pharm.D.

Professor of Medicine

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Gary E Stein, Pharm.D.

Role: PRINCIPAL_INVESTIGATOR

Michigan State University

Locations

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Sparrow Hospital

Lansing, Michigan, United States

Site Status

Countries

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United States

Other Identifiers

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PA-07-004

Identifier Type: -

Identifier Source: org_study_id

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