Trial Outcomes & Findings for A Pharmacokinetic Analysis of Posaconazole in Lung Transplant Recipients (MK-5592-105) (NCT NCT01667107)

NCT ID: NCT01667107

Last Updated: 2018-10-09

Results Overview

Blood samples for measurement of serum posaconazole were collected approximately 4 hours after the first daily dose on Days 1-12 and every Monday and Thursday on Days 13-43. The time to reach 90% of the steady state serum posaconazole concentration was to be estimated from fitting a linear model to the concentration data over time. The data did not permit estimation of the endpoint from the modeling proposed in the protocol.

Recruitment status

TERMINATED

Study phase

PHASE4

Target enrollment

26 participants

Primary outcome timeframe

Four hours after the first daily dose on Days 1-12 and every Monday and Thursday on Days 13-43

Results posted on

2018-10-09

Participant Flow

Participant milestones

Participant milestones
Measure
Cystic Fibrosis Participants
Cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Non-Cystic Fibrosis Participants
Non-cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Overall Study
STARTED
8
18
Overall Study
COMPLETED
4
11
Overall Study
NOT COMPLETED
4
7

Reasons for withdrawal

Reasons for withdrawal
Measure
Cystic Fibrosis Participants
Cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Non-Cystic Fibrosis Participants
Non-cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Overall Study
Adverse Event
4
3
Overall Study
Tolerability issues
0
2
Overall Study
Protocol Violation
0
1
Overall Study
Lack of Efficacy
0
1

Baseline Characteristics

A Pharmacokinetic Analysis of Posaconazole in Lung Transplant Recipients (MK-5592-105)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Cystic Fibrosis Participants
n=8 Participants
Cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Non-Cystic Fibrosis Participants
n=18 Participants
Non-cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Total
n=26 Participants
Total of all reporting groups
Age, Continuous
30.0 Years
STANDARD_DEVIATION 7.82 • n=93 Participants
52.4 Years
STANDARD_DEVIATION 10.39 • n=4 Participants
45.5 Years
STANDARD_DEVIATION 14.22 • n=27 Participants
Sex: Female, Male
Female
5 Participants
n=93 Participants
7 Participants
n=4 Participants
12 Participants
n=27 Participants
Sex: Female, Male
Male
3 Participants
n=93 Participants
11 Participants
n=4 Participants
14 Participants
n=27 Participants

PRIMARY outcome

Timeframe: Four hours after the first daily dose on Days 1-12 and every Monday and Thursday on Days 13-43

Population: The population to be analyzed included participants who complied with the protocol sufficiently to ensure that the results would exhibit the effects of treatment

Blood samples for measurement of serum posaconazole were collected approximately 4 hours after the first daily dose on Days 1-12 and every Monday and Thursday on Days 13-43. The time to reach 90% of the steady state serum posaconazole concentration was to be estimated from fitting a linear model to the concentration data over time. The data did not permit estimation of the endpoint from the modeling proposed in the protocol.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: Up to Day 42

Population: The population analyzed included all enrolled participants who had BAL and serum samples collected at the time of bronchoscopy and analyzed for posaconazole concentration. A participant could have more than 1 pair of samples (BAL and serum) included in the analysis.

Concurrent BAL and serum samples for measurement of posaconazole concentration were to be collected during any clinically-indicated bronchoscopy. A participant could have more than 1 bronchoscopy.

Outcome measures

Outcome measures
Measure
Cystic Fibrosis Participants
n=9 paired BAL and serum samples
Cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Non-Cystic Fibrosis Participants
n=11 paired BAL and serum samples
Non-cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Concentration of Posaconazole in Bronchoalveolar Lavage (BAL) and Serum
BAL
1.116 mg/L
Standard Deviation 1.1699
0.764 mg/L
Standard Deviation 0.800
Concentration of Posaconazole in Bronchoalveolar Lavage (BAL) and Serum
Serum
0.829 mg/L
Standard Deviation 0.3742
0.7488 mg/L
Standard Deviation 0.3131

SECONDARY outcome

Timeframe: Up to Day 84

Population: Participants were analyzed according to the group in which they were enrolled

Invasive fungal infection was assessed using the Mycoses Study Group/European Organisation for Research and Treatment of Cancer (MSG/EORTC) criteria. Infections counted in the analysis were those classified as 'proven', 'probable', or 'possible' according to the criteria.

Outcome measures

Outcome measures
Measure
Cystic Fibrosis Participants
n=8 Participants
Cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Non-Cystic Fibrosis Participants
n=18 Participants
Non-cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Percentage of Participants Who Develop Invasive Fungal Infection
12.5 Percentage of participants
Interval 2.2 to 47.1
16.7 Percentage of participants
Interval 5.8 to 39.2

POST_HOC outcome

Timeframe: Four hours after the first daily dose on Days 1-12 and every Monday and Thursday on Days 13-43

Population: The population analyzed included all enrolled participants who reached and maintained posaconazole concentration of \>=0.5 mg/L

Blood samples for measurement of serum posaconazole were collected approximately 4 hours after the first daily dose on Days 1-12 and every Monday and Thursday on Days 13-43. A posaconazole concentration \>=0.5 mg/L is the therapeutic level, the concentration thought to lead to antifungal efficacy. The time at which the serum posaconazole concentration reached \>=0.5 mg/mL and remained at that level for all subsequent assessments was recorded.

Outcome measures

Outcome measures
Measure
Cystic Fibrosis Participants
n=6 Participants
Cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Non-Cystic Fibrosis Participants
n=14 Participants
Non-cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Time to Reach a Serum Concentration of Posaconazole of >=0.5 mg/L
12.2 Days
Standard Deviation 8.82
11.9 Days
Standard Deviation 9.86

POST_HOC outcome

Timeframe: Four hours after the first daily dose on Days 1-12 and every Monday and Thursday on Days 13-43

Population: The population analyzed included all enrolled participants

Blood samples for measurement of serum posaconazole were collected approximately 4 hours after the first daily dose on Days 1-12 and every Monday and Thursday on Days 13-43. The maximum serum concentration of posaconazole was recorded.

Outcome measures

Outcome measures
Measure
Cystic Fibrosis Participants
n=8 Participants
Cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Non-Cystic Fibrosis Participants
n=18 Participants
Non-cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Maximum Serum Concentration of Posaconazole (Cmax)
1.481 mg/L
Standard Deviation 0.6014
1.539 mg/L
Standard Deviation 0.8471

POST_HOC outcome

Timeframe: Four hours after the first daily dose on Days 1-12 and every Monday and Thursday on Days 13-43

Population: The population analyzed included all enrolled participants

Blood samples for measurement of serum posaconazole were collected approximately 4 hours after the first daily dose on Days 1-12 and every Monday and Thursday on Days 13-43. The time required to achieve the maximum serum concentration of posaconazole was recorded.

Outcome measures

Outcome measures
Measure
Cystic Fibrosis Participants
n=8 Participants
Cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Non-Cystic Fibrosis Participants
n=18 Participants
Non-cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Time to Maximum Serum Concentration of Posaconazole (Tmax)
19.5 Days
Standard Deviation 12.39
23.1 Days
Standard Deviation 13.73

Adverse Events

Cystic Fibrosis Participants

Serious events: 6 serious events
Other events: 1 other events
Deaths: 0 deaths

Non-Cystic Fibrosis Participants

Serious events: 10 serious events
Other events: 2 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Cystic Fibrosis Participants
n=8 participants at risk
Cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Non-Cystic Fibrosis Participants
n=18 participants at risk
Non-cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Blood and lymphatic system disorders
Neutropenia
12.5%
1/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
0.00%
0/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Cardiac disorders
Supraventricular tachycardia
12.5%
1/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
0.00%
0/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
General disorders
Systemic inflammatory response syndrome
12.5%
1/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
0.00%
0/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Hepatobiliary disorders
Liver injury
12.5%
1/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
0.00%
0/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Investigations
Immunosuppressant drug level decreased
12.5%
1/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
0.00%
0/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Renal and urinary disorders
Renal failure
12.5%
1/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
0.00%
0/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Respiratory, thoracic and mediastinal disorders
Acute respiratory failure
12.5%
1/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
0.00%
0/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Hepatobiliary disorders
Hepatic function abnormal
0.00%
0/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
5.6%
1/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Immune system disorders
Transplant rejection
0.00%
0/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
5.6%
1/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Infections and infestations
Fungal infection
0.00%
0/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
5.6%
1/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Infections and infestations
Lower respiratory tract infection
0.00%
0/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
11.1%
2/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Infections and infestations
Pneumonia
0.00%
0/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
5.6%
1/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Nervous system disorders
Cerebral infarction
0.00%
0/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
11.1%
2/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Renal and urinary disorders
Renal failure acute
0.00%
0/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
11.1%
2/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.

Other adverse events

Other adverse events
Measure
Cystic Fibrosis Participants
n=8 participants at risk
Cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Non-Cystic Fibrosis Participants
n=18 participants at risk
Non-cystic fibrosis participants received posaconazole 400 mg oral solution twice daily administered with Calogen® to optimize absorption for a total of 6 weeks starting within 12 hours of leaving surgery, thereafter administered in the hospital or as an outpatient; the dose could be changed to posaconazole 200 mg 4 times per day if the participant is unable to meet the conditions for optimal absorption of posaconazole.
Gastrointestinal disorders
Nausea
12.5%
1/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
0.00%
0/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Eye disorders
Vision blurred
0.00%
0/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
5.6%
1/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Investigations
Alanine aminotransferase increased
0.00%
0/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
5.6%
1/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Investigations
Immunosuppressant drug level increased
0.00%
0/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
5.6%
1/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Renal and urinary disorders
Renal failure
0.00%
0/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
5.6%
1/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
Renal and urinary disorders
Renal failure acute
0.00%
0/8 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.
5.6%
1/18 • Up to Day 88
All enrolled participants were assessed for adverse events. Adverse events that were serious and/or related to study drug were collected in the study. Related adverse events were those classified as possibly, probably, or certainly related to study drug.

Additional Information

Senior Vice President, Global Clinical Development

Merck Sharp & Dohme Corp.

Phone: 1-800-672-6372

Results disclosure agreements

  • Principal investigator is a sponsor employee The investigator agrees to provide to the sponsor 45 days prior to submission for publication or presentation, review copies of abstracts or manuscripts for publication that report any results of the trial. The sponsor shall have the right to review and comment with respect to publications, abstracts, slides, and manuscripts and the right to review and comment on the data analysis and presentation.
  • Publication restrictions are in place

Restriction type: OTHER