Caspofungin as Prophylaxis in High Risk Liver Transplantation Recipients

NCT ID: NCT01260974

Last Updated: 2012-07-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

38 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-05-31

Study Completion Date

2012-11-30

Brief Summary

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The aim of the study is to determine viable use of caspofungin in post-OLTx patients, and to demonstrate in particular the effectiveness, understood as the ability to reduce the incidence of invasive fungal infections, and to assess the ability to reduce the risk and incidence of side effects (toxicity) which may arise in transplant patients treated with other drugs, especially in individuals recognized as high risk (e.g. renal failure).

Detailed Description

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The prophylactic use of anti-fungal drugs is crucial in order to decrease the incidence of invasive fungal infections in transplantation patients.

Invasive fungal infections (IFI) ---organ-related or systemic infections--- are in fact one of the most important causes of morbidity and mortality in patients undergoing solid organ transplantation (respectively, 70% and 100%).

The rationale of the proposed study is to evaluate a new protocol for the prevention of IFIs through the use of a newly introduced anti-fungal, caspofungin (commercial name: Cancidas), to be used for primary prophylaxis of fungal infections post-OLTx and to compare to drugs already in use (eg. amphotericin B, fluconazole), until 21 days after liver transplantation.

The aim of this study is determine viable use of caspofungin in post-OLTx patients, and to demonstrate in particular the effectiveness, understood as the ability to reduce the incidence of invasive fungal infections, and to assess the ability to reduce the risk and incidence of side effects (toxicity) which may arise in transplant patients treated with other drugs, especially in individuals recognized as high risk (e.g. renal failure).

The possibility of reducing the risk of fungal infections in liver transplant patients (usually between 7 and 42%) is therefore an important clinical goal.

Conditions

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Fungemia Mycoses

Keywords

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Invasive fungal infections Liver Transplantation Organ Transplantation Mycoses Fungus Diseases Antifungal Agents Invasive Mycosis

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Caspofungin

Study group

Group Type EXPERIMENTAL

Caspofungin

Intervention Type DRUG

50mg/dd for 21dd, starting within 24h from Liver Transplantation.

Interventions

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Caspofungin

50mg/dd for 21dd, starting within 24h from Liver Transplantation.

Intervention Type DRUG

Other Intervention Names

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Cancidas

Eligibility Criteria

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Inclusion Criteria

* patients shortlisted for liver transplantation
* negative pregnancy test for fertile female patients 7 days prior enrollment
* patients who can adequately communicate with study responsibles, who can understand and answer to protocol requirements

At least one of the following criteria:

* MELD score ≥25
* liver transplantation for acute liver failure
* liver re-transplantation
* fever without bacterial or viral infection
* biliodigestive
* re-laparatomy after LTx
* post LTx pancreatitis
* post LTx dialysis or renal insufficiency

Exclusion Criteria

* Patients enrolled in other clinical trial or those having received other experimental drugs 4 weeks prior to enrollment
* Patients with a known fungal infection (based on the EORTC/MSG criteria)
* Patients with history of hypersensitivity to the drug, or other counterindications
* Patients with a diagnosed Severe Hepatic insufficiency (CTP \>9)
* Physical or hematochemical alterations
* Clinically relevant psychological alterations in the 2 weeks preceding enrollment such as to interfere, in the researchers opinion, with the goal of the study
* Patients being treated with Ciclosporin A

Subjects being removed from the trial shall be replaced.
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

Azienda Ospedaliera di Padova

OTHER

Sponsor Role lead

Responsible Party

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Prof. Umberto Cillo

Director of the Hepatobiliary Surgery and Liver Transplantation Unit

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Umberto Cillo, MD

Role: PRINCIPAL_INVESTIGATOR

Azienda Ospedaliera Universitaria di Padova

Daniele Neri, MD

Role: PRINCIPAL_INVESTIGATOR

Azienda Ospedaliera Universitaria di Padova

Locations

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Azienda Ospedaliera di Padova

Padua, Padova, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Umberto Cillo, MD

Role: CONTACT

Phone: +390498218624

Email: [email protected]

Laura Saracino, MBS

Role: CONTACT

Phone: +390498218624

Email: [email protected]

Facility Contacts

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Umberto Cillo, MD

Role: primary

Laura Saracino, MBS

Role: backup

Related Links

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http://www.fegatochirurgia.com/

Hepatobiliary surgery and Liver Transplantation Unit, University Hospital of Padua (Italy)

Other Identifiers

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2008-007950-36

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

1768P

Identifier Type: -

Identifier Source: org_study_id