A Phase 3 Efficacy and Safety Study of Fosmanogepix for the Treatment of Adult Participants With Candidemia and/or Invasive Candidiasis.

NCT ID: NCT05421858

Last Updated: 2025-12-19

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

450 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-11

Study Completion Date

2028-01-30

Brief Summary

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The purpose of this clinical trial is to learn about the safety and effects of the study medicine (called Fosmanogepix) for the potential treatment of candidemia and/or invasive candidiasis, a life-threatening fungal infection caused by several species of yeast called Candida.

The study is seeking patients who have a diagnosis of candidemia and/or invasive candidiasis.

Two-thirds of all patients will receive the study medication fosmanogepix Intravenous (IV) infusion followed by optional fosmanogepix tablets. One-third of all patients will receive a standard of care regimen of caspofungin Intravenous (IV) infusion followed by optional fluconazole capsules.

Fosmanogepix or caspofungin will first be given as an Intravenous (IV) infusion directly into a vein in the arm each day at the study clinic. Fosmanogepix tablets or fluconazole capsules will be taken orally by mouth daily either at the study clinic, or at home if patients are well enough to be discharged from the hospital.

The treatment effect in patients receiving fosmanogepix to those receiving caspofungin/ fluconazole will be compared. The primary aim is to show that fosmanogepix is not inferior (not worse) to caspofungin/ fluconazole with a noninferiority margin of 15%.

The duration of study treatment and number of study visits will vary depending on how long the patient will be treated for the infection. Treatment will continue for a maximum of 6 weeks depending on when the infection is cleared and whether other symptoms related to the infection have improved. There will also be a follow-up visit 6 weeks after the study treatment was stopped.

Detailed Description

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Conditions

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Candidemia Candidiasis, Invasive

Keywords

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Fungal infection Candida Anti-fungal Yeast

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Fosmanogepix IV/oral

Fosmanogepix will be administered as an Intravenous (IV) infusion given directly into a vein. There is an option to switch from the IV infusion to the oral form of fosmanogepix which is taken by mouth.

Matching placebos for caspofungin and fluconazole will also be administered (a placebo does not have any medicine in it but looks just like the caspofungin and fluconazole).

Group Type EXPERIMENTAL

Fosmanogepix

Intervention Type DRUG

IV infusion

Fosmanogepix

Intervention Type DRUG

Oral tablet

Placebo

Intervention Type DRUG

Matching placebo for caspofungin (IV infusion)

Placebo

Intervention Type DRUG

Matching placebo for fluconazole (oral capsule)

Caspofungin IV/ Fluconazole oral

Caspofungin will be administered as an intravenous (IV) infusion given directly into a vein. There is an option to switch from the IV infusion to oral fluconazole which is taken by mouth.

Matching placebos for fosmanogepix will also be administered (a placebo does not have any medicine in it but looks just like the medicine fosmanogepix being studied).

Group Type ACTIVE_COMPARATOR

Caspofungin

Intervention Type DRUG

IV infusion

Fluconazole

Intervention Type DRUG

Fluconazole oral capsule

Placebo

Intervention Type DRUG

Matching placebo for fosmanogepix (IV infusion)

Placebo

Intervention Type DRUG

Matching placebo for fosmanogepix (oral tablet)

Interventions

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Fosmanogepix

IV infusion

Intervention Type DRUG

Fosmanogepix

Oral tablet

Intervention Type DRUG

Caspofungin

IV infusion

Intervention Type DRUG

Fluconazole

Fluconazole oral capsule

Intervention Type DRUG

Placebo

Matching placebo for caspofungin (IV infusion)

Intervention Type DRUG

Placebo

Matching placebo for fluconazole (oral capsule)

Intervention Type DRUG

Placebo

Matching placebo for fosmanogepix (IV infusion)

Intervention Type DRUG

Placebo

Matching placebo for fosmanogepix (oral tablet)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Patients ≥ 18 years (or the minimum country-specific age of consent if \> 18) at Screening who have provided signed informed consent indicating that they understand the purpose of, and procedures required for, the study, and are willing to participate in the study. If the patient is unable to consent for himself/herself, a legally authorized representative must provide informed consent on his/her behalf.
2. Diagnosis of candidemia and/or invasive candidiasis based on a blood or non-blood specimen obtained within ≤ 96 hours (4 days) before randomization, and on clinical criteria judged attributable to candidemia/invasive candidiasis occurring at any time from ≤ 12 hours prior to the qualifying positive index culture being taken through to randomization.
3. Patient's condition allows for appropriate infection source control measures, including removal of pre-existing intravascular catheters and devices, if necessary.

Exclusion Criteria

1. Existing infection

1. Infection known to be due to Candida krusei, in blood or any other normally sterile site.
2. Inappropriate fungal infection source control.
3. Diagnosis of certain deep-seated Candida infections.
2. Life expectancy of \< 72 hours in the opinion of the investigator.
3. Requirement, or expected requirement, for hemodialysis, peritoneal dialysis, or hemofiltration.
4. Ongoing neurological disorders, including specified conditions presenting with a CTCAE Grade ≥ 2 (neurological symptoms that are considered to be a consequence of the current episode of candidemia / invasive candidiasis are not exclusionary).
5. Patients with known human immunodeficiency virus infection, who have CD4+ count \< 200/mm3 or viral load \> 400 copies/mL), or who have had an active opportunistic infection within 6 months prior to Screening.
6. Other medical or psychiatric condition or laboratory abnormality that may increase the risk of study participation or make the patient inappropriate for the study.
7. Current use of any prohibited concomitant medications or those unwilling/unable to use a permitted concomitant medication.
8. Received \> 2 days (\> 48 hours) equivalent of prior systemic antifungal treatment at approved doses and frequency to treat the current episode of candidemia and/or invasive candidiasis (e.g., \> 2 doses of a once daily antifungal agent or \> 4 doses of a twice daily antifungal agent), within the 96 hours prior to randomization (except for non-susceptible Candida spp. and for patients who develop candidemia or invasive candidiasis while on prophylaxis with an azole or amphotericin B).
9. Previous administration with an investigational drug or investigational vaccine within 30 days or 5 half-lives preceding the first dose of study drug used in this study (whichever is longer).
10. Prior participation in this or any previous study of fosmanogepix.
11. Moderate or severe hepatic impairment, known active viral hepatitis B or C, ALT or AST ≥ 5 × ULN or total bilirubin \> 3 × ULN unless this is due to isolated hyperbilirubinemia or documented Gilbert's syndrome.
12. Female patient is pregnant or lactating.
13. Known hypersensitivity to fosmanogepix, manogepix, caspofungin, any echinocandin, fluconazole or to any of their excipients.
14. Investigator site staff directly involved in the conduct of the study and their family members, site staff otherwise supervised by the investigator, and Sponsor and Sponsor delegate employees directly involved in the conduct of the study and their family members.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Biomedical Advanced Research and Development Authority

FED

Sponsor Role collaborator

Basilea Pharmaceutica

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Manuel Häckl, MD

Role: STUDY_DIRECTOR

Basilea Pharmaceutica International Ltd, Allschwil

Locations

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University of Alabama at Birmingham School of Medicine, Department of Medicine

Birmingham, Alabama, United States

Site Status RECRUITING

UC Davis Medical Center

Sacramento, California, United States

Site Status RECRUITING

Emory University Hospital - Clifton Road

Atlanta, Georgia, United States

Site Status RECRUITING

Indiana University Methodist Hospital

Indianapolis, Indiana, United States

Site Status RECRUITING

University of Kentucky College of Medicine

Lexington, Kentucky, United States

Site Status RECRUITING

University of Michigan Health System (UMHS) - A. Alfred Taubman Health Care Center

Ann Arbor, Michigan, United States

Site Status RECRUITING

Henry Ford Hospital, Department of Medicine, Division of Infectious Diseases

Detroit, Michigan, United States

Site Status RECRUITING

University of Minnesota

Minneapolis, Minnesota, United States

Site Status RECRUITING

Washington University School of Medicine, Infectious Diseases Clinical Research Unit

St Louis, Missouri, United States

Site Status RECRUITING

University of North Carolina at Chapel Hill

Chapel Hill, North Carolina, United States

Site Status RECRUITING

Houston Methodist Hospital - Texas Medical Center

Houston, Texas, United States

Site Status RECRUITING

The University of Texas Health Science Center at Houston

Houston, Texas, United States

Site Status RECRUITING

Central Hospital de San Isidro Melchor Posse

Buenos Aires, , Argentina

Site Status RECRUITING

Buenos Aires Italian Hospital, Department of Infectious Diseases

Buenos Aires, , Argentina

Site Status RECRUITING

Cordoba Private University Hospital, Department of Infectious Diseases

Córdoba, , Argentina

Site Status RECRUITING

British Sanatorium SA

Rosario, , Argentina

Site Status RECRUITING

Westmead Hospital

Sydney, New South Wales, Australia

Site Status RECRUITING

Princess Alexandra Hospital

Woolloongabba, Queensland, Australia

Site Status RECRUITING

Peter MacCallum Cancer Center, State

Melbourne, Victoria, Australia

Site Status RECRUITING

The Alfred Hospital

Melbourne, Victoria, Australia

Site Status RECRUITING

Royal Melbourne Hospital

Parkville, Victoria, Australia

Site Status RECRUITING

Monash Medical Center Clayton

Clayton, , Australia

Site Status RECRUITING

University Hospital Graz, Department of Internal Medicine

Graz, , Austria

Site Status RECRUITING

Kepler University Hospital GmbH, Department of Pulmonology, Clinical Department of Infectious Diseases

Linz, , Austria

Site Status RECRUITING

Medical University Vienna

Vienna, , Austria

Site Status RECRUITING

Hospital Favoriten, Department of Internal Medicine IV - Infectious Diseases and Tropical Medicine

Vienna, , Austria

Site Status RECRUITING

General Hospital Saint-Jan

Bruges, , Belgium

Site Status RECRUITING

University Hospital Brussels

Brussels, , Belgium

Site Status RECRUITING

Saint Luc University Hospital, Department of Internal Medicine

Brussels, , Belgium

Site Status RECRUITING

Erasme Hospital, Department of Infectious and Tropical Diseases

Brussels, , Belgium

Site Status RECRUITING

Jessa Hospital

Hasselt, , Belgium

Site Status RECRUITING

University Hospitals Leuven, Campus Gasthuisberg, Department of Infectious Diseases

Leuven, , Belgium

Site Status RECRUITING

UCL Mont-Godinne University Hospitals

Yvoir, , Belgium

Site Status RECRUITING

Hospital Our Lady of Grace

Curitiba, Paraná, Brazil

Site Status RECRUITING

Porto Alegre Clinical Hospital (HCPA), Infectious Diseases / Internal Medicine

Porto Alegre, Rio Grande do Sul, Brazil

Site Status RECRUITING

Pontifical University Of Rio Grande Do Sul (PUCRS) - St. Luke Hospital

Porto Alegre, Rio Grande do Sul, Brazil

Site Status RECRUITING

Santa Marcelina Hospital

São Paulo, , Brazil

Site Status RECRUITING

Eurohospital University Hospital

Plovdiv, , Bulgaria

Site Status RECRUITING

University Medical Center "N. I. Pirogov", Burns and Plastic Surgery Clinic

Sofia, , Bulgaria

Site Status RECRUITING

University Medical Center "N. I. Pirogov", Clinic of Purulent-Septic Surgery

Sofia, , Bulgaria

Site Status RECRUITING

Somer Clinic

Rionegro, , Colombia

Site Status RECRUITING

Amiens Picardie University Hospital - South, Intensive Care Unit (ICU)

Amiens, , France

Site Status RECRUITING

Victor Dupouy Hospital Center Argenteuil, Intensive Care Unit

Argenteuil, , France

Site Status RECRUITING

Marseille Nord University Hospitals - AP-HM, Medical Intensive Care Unit, Acute Respiratory Distress and Severe Infections

Marseille, , France

Site Status RECRUITING

Nantes University Hospital Center - Hotel Dieu Hospital, Department of Infectious and Tropical Diseases

Nantes, , France

Site Status RECRUITING

Rennes University Hospital Center - Hospital Pontchaillou

Rennes, , France

Site Status RECRUITING

Tours Regional University Hospital Center

Tours, , France

Site Status RECRUITING

University Hospital Ulm, Comprehensive Infectious Diseases Center Ulm (CIDCU)

Ulm, Baden-Wurttemberg, Germany

Site Status RECRUITING

University Hospital Regensburg

Regensburg, Bavaria, Germany

Site Status RECRUITING

Frankfurt University Clinic

Frankfurt am Main, Hesse, Germany

Site Status RECRUITING

University Hospital Giessen and Marburg GmbH

Giessen, Hesse, Germany

Site Status RECRUITING

University Hospital Cologne, Department of Internal Medicine I, Clinical Study Centre II for Infectious Diseases

Cologne, North Rhine-Westphalia, Germany

Site Status RECRUITING

University Hospital Heidelberg, Clinic for Anesthesiology

Heidelberg, , Germany

Site Status RECRUITING

"LAIKO" General Hospital

Athens, , Greece

Site Status RECRUITING

"Sotiria" Chest Diseases Hospital of Athens

Athens, , Greece

Site Status SUSPENDED

General Hospital of Athens "Evangelismos", 5th Department of Internal Medicine and Infectious Diseases Unit

Athens, , Greece

Site Status RECRUITING

Tzaneio General Hospital

Piraeus, , Greece

Site Status RECRUITING

General Hospital of Thessaloniki "Ippokratio"

Thessaloniki, , Greece

Site Status RECRUITING

Rambam Health Care Campus, Institute of Infectious Diseases

Haifa, , Israel

Site Status RECRUITING

Edith Wolfson Medical Center, Department of Infectious Diseases

Holon, , Israel

Site Status RECRUITING

Chaim Sheba Medical Center, Department of Infectious Diseases

Ramat Gan, , Israel

Site Status RECRUITING

The Tel Aviv Sourasky Medical Center, Infectious Diseases Unit

Tel Aviv, , Israel

Site Status RECRUITING

Shamir Medical Center, Department of Infectious Diseases

Ẕerifin, , Israel

Site Status RECRUITING

Hospital "S. Croce e Carle"

Cuneo, , Italy

Site Status RECRUITING

IRCCS Policlinic Hospital San Martino

Genoa, , Italy

Site Status RECRUITING

Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda

Milan, , Italy

Site Status RECRUITING

Hospital San Raffaele, IRCCS

Milan, , Italy

Site Status RECRUITING

Big Metropolitan Hospital Niguarda Regional Health Authority

Milan, , Italy

Site Status RECRUITING

University Polyclinic Hospital of Modena

Modena, , Italy

Site Status RECRUITING

Polyclinic San Matteo, IRCCS

Pavia, , Italy

Site Status RECRUITING

University Hospital of Pisa

Pisa, , Italy

Site Status RECRUITING

AOU Senese

Siena, , Italy

Site Status RECRUITING

Giuliano Isontina University Health Authority

Trieste, , Italy

Site Status RECRUITING

National University Hospital

Singapore, , Singapore

Site Status RECRUITING

Singapore General Hospital

Singapore, , Singapore

Site Status RECRUITING

Tan Tock Seng Hospital

Singapore, , Singapore

Site Status RECRUITING

Helen Joseph Hospital

Johannesburg, , South Africa

Site Status RECRUITING

Milpark Hospital

Johannesburg, , South Africa

Site Status RECRUITING

Ryexo Clinical Research

Pretoria, , South Africa

Site Status WITHDRAWN

University of Pretoria / Steve Biko Academic Hospital

Pretoria, , South Africa

Site Status RECRUITING

Practice of R Moodley and MI Sarvan - Umhlanga

Umhlanga, , South Africa

Site Status RECRUITING

Kyungpook National University Hospital

Daegu, , South Korea

Site Status RECRUITING

Severance Hospital, Yonsei University Health System

Seoul, , South Korea

Site Status RECRUITING

Samsung Medical Center

Seoul, , South Korea

Site Status RECRUITING

Ajou University Hospital

Suwon, , South Korea

Site Status RECRUITING

University Hospital Virgen Macarena

Seville, Andalusia, Spain

Site Status RECRUITING

University Hospital Nuestra Senora de Valme

Seville, Andalusia, Spain

Site Status RECRUITING

Hospital del Mar, Department of Infectious Diseases

Barcelona, Catalonia, Spain

Site Status RECRUITING

University Hospital Vall d'Hebron, Intensive Care Unit (ICU)

Barcelona, Catalonia, Spain

Site Status RECRUITING

Hospital Clinic of Barcelona, Department of Infectious Diseases

Barcelona, Catalonia, Spain

Site Status SUSPENDED

University Hospital Ramon y Cajal, Department of Infectious Diseases

Madrid, Madrid, Spain

Site Status RECRUITING

University Hospital Cruces

Barakaldo, , Spain

Site Status RECRUITING

Kaohsiung Medical University Chung-Ho Memorial Hospital

Kaohsiung City, , Taiwan

Site Status RECRUITING

Kaohsiung Chang Gung Memorial Hospital

Kaohsiung City, , Taiwan

Site Status RECRUITING

Far Eastern Memorial Hospital

New Taipei City, , Taiwan

Site Status RECRUITING

China Medical University Hospital

Taichung, , Taiwan

Site Status RECRUITING

Taichung Veterans General Hospital

Taichung, , Taiwan

Site Status RECRUITING

Taipei Medical University Hospital

Taipei, , Taiwan

Site Status RECRUITING

Taipei Veterans General Hospital

Taipei, , Taiwan

Site Status RECRUITING

Linkou Chang Gung Memorial Hospital

Taoyuan, , Taiwan

Site Status RECRUITING

Vajira Hospital

Bangkok, , Thailand

Site Status RECRUITING

Siriraj Hospital

Bangkok, , Thailand

Site Status RECRUITING

Maharaj Nakorn Chiang Mai Hospital

Chiang Mai, , Thailand

Site Status RECRUITING

Songklanagarind Hospital

Hat Yai, , Thailand

Site Status RECRUITING

Srinagarind Hospital

Khon Kaen, , Thailand

Site Status RECRUITING

Countries

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United States Argentina Australia Austria Belgium Brazil Bulgaria Colombia France Germany Greece Israel Italy Singapore South Africa South Korea Spain Taiwan Thailand

Central Contacts

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Manuel Häckl, MD

Role: CONTACT

Phone: +41 76 302 53 10

Email: [email protected]

Marc Engelhardt, MD

Role: CONTACT

Phone: +41 79 701 0551

Email: [email protected]

Other Identifiers

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2022-500455-23-00

Identifier Type: REGISTRY

Identifier Source: secondary_id

FMGX-CS-301

Identifier Type: -

Identifier Source: org_study_id