A Study to Evaluate Isavuconazonium Sulfate for the Treatment of Invasive Aspergillosis (IA) or Invasive Mucormycosis (IM) in Pediatric Participants

NCT ID: NCT03816176

Last Updated: 2024-12-05

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

31 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-08-22

Study Completion Date

2022-12-14

Brief Summary

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The purpose of this study was to evaluate the safety, tolerability, and efficacy of isavuconazonium sulfate in pediatric participants.

Detailed Description

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Treatment began on Day 1 and then participants were followed for 60 days post-last dose for safety. Treatment was administered until the participant had a successful outcome or for a maximum duration of 84 days (IA) or 180 days (IM), whichever occured first.

Participants received a loading regimen of isavuconazonium sulfate (via intravenous or oral administration at the investigator's discretion), which consisted of a dose every 8 hours (± 2 hours) on Days 1 and 2 (for a total of 6 doses), followed by once daily maintenance dosing for up to 84 days (IA) or 180 days (IM) of dosing. The first maintenance dose started 12 to 24 hours after the administration of the last loading dose. Subsequent maintenance doses were administered once daily (24 hours ± 2 hours from the previous maintenance dose). The oral formulation could only be given to participants 6 years to \< 18 years of age and with a body weight of at least 12 kg. Participants who were discharged from the hospital with oral capsules for at-home administration had to return weekly for study drug accountability and to receive new oral dosing supplies. Participants who began oral administration were to complete the oral dosing acceptability assessment after ingesting their first oral dose.

Conditions

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Invasive Mucormycosis Invasive Aspergillosis

Keywords

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ASP9766 Cresemba BAL8557 isavuconazonium sulfate

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Isavuconazonium sulfate

Participants received 10 milligrams/killograms (mg/kg) dose of isavuconazonium sulfate every 8 hours (± 2 hours) on days 1 and 2 for a total of 6 doses (via intravenous or oral administration at the investigator's discretion) followed by once-daily maintenance dose of 10 mg/kg for up to 84 days IA or 180 days IM or until the participant had a successful outcome as judged by the investigator, whichever occured first. The route of administration could have been changed per the investigator's discretion.

Group Type EXPERIMENTAL

Isavuconazonium sulfate

Intervention Type DRUG

Intravenous (IV) infusion

Isavuconazonium sulfate

Intervention Type DRUG

Oral capsule

Interventions

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Isavuconazonium sulfate

Intravenous (IV) infusion

Intervention Type DRUG

Isavuconazonium sulfate

Oral capsule

Intervention Type DRUG

Other Intervention Names

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Cresemba Cresemba

Eligibility Criteria

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Inclusion Criteria

* Subject diagnosed with IA or IM. A positive diagnosis is defined as follows:

* Proven, probable or possible IFI per the European Organisation for Research and Treatment of Cancer/Mycoses Study Group \[EORTC/MSG\], 2008 criteria Note: Subjects with "possible" IFI will be eligible for enrollment; however, diagnostic tests to confirm the invasive fungal disease as "probable" or "proven" according to the EORTC/MSG criteria should be completed within 10 calendar days after the first dose of study drug
* Note: In addition to the criteria set for mycological criteria by the EORTC/MSG in 2008, and only for subjects with an underlying hematologic malignancy or recipients of hematopoietic stem cell transplant (HSCT) who also have clinical and radiologic features consistent with invasive fungal infection, the following are acceptable:
* Galactomannan (GM) levels (optical density index) meeting the below criteria are acceptable mycological evidence for enrollment or upgrading the diagnosis to probable IA:
* 1\. A single value for serum or bronchoalveolar lavage (BAL) fluid of ≥ 1.0 or
* 2\. Two serum GM values of ≥ 0.5 from two separate samples
* Subject has sufficient venous access to permit intravenous administration of study drug or the ability to swallow oral capsules
* A female subject is eligible to participate if not pregnant and at least one of the following conditions applies:

* Not a subject who is of childbearing potential, OR
* Subject who is of childbearing potential who agrees to follow a contraceptive guidance throughout the treatment period and for at least 30 days after the final study drug administration
* Subject and subject's parent(s) or legal guardian agree that the subject will not participate in another interventional study while on treatment with the exception of oncology trials

Exclusion Criteria

* Subject has familial short QT syndrome, is receiving medications that are known to shorten the QT interval, or has a clinically significant abnormal ECG
* Subject has evidence of hepatic dysfunction defined as any of the following:

* Total bilirubin (TBL) ≥ 3 times the upper limit of normal (ULN)
* Alanine transaminase (ALT) or aspartate transaminase (AST) ≥ 5 times the ULN
* Known cirrhosis or chronic hepatic failure
* Subject has used strong cytochrome P450 (CYP3A4) inhibitors or inducers such as ketoconazole, high dose ritonavir, rifampin/rifampicin, long acting barbiturates (e.g., phenytoin), carbamazepine and St. John's Wort in the 5 days prior to the first dose of study drug
* Subject has another IFI other than possible, probably or proven IA or IM
* Subject has chronic aspergillosis, aspergilloma or allergic bronchopulmonary aspergillosis
* Subject has received mould active systemic antifungal therapy, effective against the primary IMI, for more than four days during the seven days preceding the first dose

* Note: Prior use of prophylactic antifungal therapy is acceptable. In case of breakthrough IA while on prophylactic mould-active azole class drugs, additional documentation will be required to be submitted to the sponsor medical monitor or designee to approve subject enrollment
* Subject has known history of allergy, hypersensitivity or any serious reaction to any of the azole class antifungals, or any components of the study drug formulation
* Subject has any condition which makes the subject unsuitable for study participation
* Subject is unlikely to survive 30 days
* Subject has received investigational drug, with the exception of oncology drug trials, or trials with investigational drugs treating graft versus host disease, within 28 days or five half-lives, whichever is longer, prior to screening
Minimum Eligible Age

1 Year

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Astellas Pharma Global Development, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Executive Director

Role: STUDY_DIRECTOR

Astellas Pharma Global Development, Inc.

Locations

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Children's Hospital, Los Angeles

Los Angeles, California, United States

Site Status

University of California - Los Angeles

Los Angeles, California, United States

Site Status

Children's Hospital of Orange County

Orange, California, United States

Site Status

Children's National Medical Center

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

Site Status

Ann & Robert H. Lurie Children's Hospital of Chicago

Chicago, Illinois, United States

Site Status

Site BE32001

Ghent, , Belgium

Site Status

Site BE32002

Leuven, , Belgium

Site Status

Site ES34002

Barcelona, , Spain

Site Status

Site ES34003

Madrid, , Spain

Site Status

Site ES34001

Madrid, , Spain

Site Status

Countries

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Germany United Kingdom United States Belgium Spain

References

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Segers H, Deville JG, Muller WJ, Manzanares A, Desai A, Neely M, Bordon V, Hanisch B, Lassaletta A, Fisher BT, Autmizguine J, Groll AH, Sinnar S, Croos-Dabrera R, Engelhardt M, Jones M, Kovanda LL, Arrieta AC. Safety, outcomes, and pharmacokinetics of isavuconazole as a treatment for invasive fungal diseases in pediatric patients: a non-comparative phase 2 trial. Antimicrob Agents Chemother. 2024 Dec 5;68(12):e0048424. doi: 10.1128/aac.00484-24. Epub 2024 Nov 14.

Reference Type DERIVED
PMID: 39540734 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

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https://www.clinicaltrials.astellas.com/study/9766-CL-0107/

Link to results and other applicable study documents on the Astellas Clinical Trials website

https://www.trialsummaries.com/Study/StudyDetails?id=14553&tenant=MT_AST_9011

Link to plain language summary of the study on the Trial Results Summaries website

Other Identifiers

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2018-003975-36

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

9766-CL-0107

Identifier Type: -

Identifier Source: org_study_id