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SNCTP000000985 | NCT01782131

Eine Studie zur Beurteilung der Wirksamkeit und Sicherheit von Posaconazol im Vergleich zu Voriconazol bei Patienten die unter einer akuten, invasiven Aspergillose (Pilzerkrankung) leiden.

Data source: BASEC (Imported from 03.05.2024), WHO (Imported from 03.05.2024)
Changed: Feb 1, 2024, 1:00 AM
Disease category: Infections and Infestations

Brief description of trial (Data source: BASEC)

Im Rahmen dieser weltweit durchgeführten doppelblinden, randomisierten Studie werden die Sicherheit und die Wirksamkeit von Posaconazol im Vergleich zu Voriconazol bei erwachsenen Patienten untersucht, die unter einer akuten invasiven Aspergillose leiden. An der Studie werden etwa 600 Personen teilnehmen und die Studie wird pro Patient/In 6 Monate dauern mit etwa 10 Besuchen am Studienzentrum. Die Patienten/Innen werden zufällig einer von zwei Behandlungsgruppen (Posaconazol einmal täglich oder Voriconazol zweimal täglich) in einem Verhältnis von 1 zu 1 zugeordnet. Die Behandlung wird verblindet, d.h. weder der Patient/In noch der Studienarzt wissen, welche Behandlung verabreicht wird. Für die meisten Patienten/Innen werden die Medikamente am Anfang intravenös verabreicht. Aber so bald sie klinisch stabil und fähig sind, Tabletten einzunehmen, werden sind zur oralen Therapie wechseln. Falls Patienten/Innen das Studienmedikament zu Hause einnehmen, notieren sie jede Einnahme auf einer Dosierungskarte.

Health conditions investigated(Data source: BASEC)

Invasive Aspergillose ist eine Infektion verursacht durch den Schimmelpilz Aspergillus. Diese Pilzinfektion tritt vor allem in den Atemwegen von immungeschwächten Hochrisikopatienten (z.B. bei Patienten unter einer Chemotherapie oder nach einer Transplantation) auf.

Health conditions (Data source: WHO)

Fungal Infections;Invasive Pulmonary Aspergillosis

Rare disease (Data source: BASEC)

No

Intervention investigated (e.g. drug, therapy or campaign) (Data source: BASEC)

Posaconazol wie auch Voriconazol sind Medikamente, welche gegen Pilzinfektionen wirken. Die Wirkung von Posaconazol und Voriconazol besteht darin, dass sie einige Pilzarten (u.a. Aspergillose), die Infektionen beim Menschen verursachen können, abtöten oder deren Wachstum hemmen.

Interventions (Data source: WHO)

Drug: Posaconazole;Drug: Voriconazole;Drug: Placebo

Criteria for participation in trial (Data source: BASEC)

- Alter ≥ 18 Jahre und Körpergewicht > 40 kg und ≤ 150 kg zum Randomisierungszeitpunkt.
- Versteht und befolgt die Abläufe der Studie und willigt durch Abgabe einer schriftlichen Einwilligungserklärung freiwillig in die Teilnahme ein
- Akute Invasive Aspergillose, definiert als Bestehen des klinischen Syndroms seit < 30 Tagen
- Erfüllt die EORTC/MSG-Kriterien (2008) einer gesicherten, wahrscheinlichen oder möglichen Invasiven Aspergillose
- Bei Patienten mit möglicher Invasiven Aspergillose: Bereitschaft innerhalb von 7 Tagen zu weiteren Tests, zur Diagnostizierung einer gesicherten oder wahrscheinlichen Invasiven Aspergillose.

Exclusion criteria (Data source: BASEC)

- Chronische Invasive Aspergillose ( > 1 Monat), Rezidiv oder Verschlechterung der Invasiven Aspergillose, oder therapieresistente Invasive Aspergillose
- Sarkoidose, Aspergillom oder allergische bronchopulmonale Aspergillose
- Bekannte invasive Schimmelpilz-Mischinfektion, bei welcher das Prüfpräparat möglicherweise nicht gegen alle Pilze wirksam ist.
- Systemische Antipilztherapie über ≥ 4 Tage
- Aktuelle Durchführung einer präventiven Behandlung gegen Pilze oder Einstufung der aktuellen Infektion während einer mindestens 13-tägigen präventiven Therapie
- Therapie der aktuellen Infektion mit Posaconazol oder Voriconazol über ≥ 4 Tage während der letzten 15 Tagen
- Instabiler Herzrhythmus oder rezenter Myokardinfarkt
- Klinisch relevante Leberfunktionsstörung
- Schwere Nierenfunktionsstörung, bestehende oder geplannte Hämodialyse
- Bekannte angeborene Galaktose-Intoleranz, Lapp-Laktase-Mangel oder Glukose-Galaktose-Malabsorption
- Akute symptomatische oder chronische Pankreatitis
- Vorliegen einer aktiven Hautläsion, Hautkarzinom oder Melanom in den letzten 5 Jahren
- Künstliche Beatmung
- Kurze Überlebenserwartung (< 1 Woche)

Inclusion/Exclusion Criteria (Data source: WHO)

Gender: All
Maximum age: N/A
Minimum age: 13 Years

Inclusion Criteria:

- Weight >40 kg (88 lb) and =150 kg (330 lb); if between 13 and 14 years of age must
weigh >= 50 kg (110 lb)

- Must meet the criteria for proven, probable, or possible IA as per 2008 European
Organization for Research and Treatment of Cancer/Invasive Fungal Infections
Cooperative Group and the National Institute of Allergy and Infectious Diseases
Mycoses Study Group (EORTC/MSG) disease definitions at the time of randomization.
Proven IA will include those participants with the demonstration of fungal elements
(by cytology, microscopy, or culture) in diseased tissue (sterile sampling). Probable
IA includes participants with at least 1 host factor, clinical criteria, as well as
mycological criteria including both direct and indirect methods. Possible IA includes
participants with at least 1 host factor and clinical criteria but without mycological
criteria. A modification to the 2008 EORTC/MSG criteria regarding risk factors has
been made to allow for the inclusion of participants with any duration of neutropenia
as an acceptable inclusion host factor.

- If with possible IA at time of randomization must be willing or be in process of an
ongoing diagnostic work up which is anticipated to result in a mycological diagnosis
of proven or probable IA postrandomization.

- Must have a central line (e.g., central venous catheter, peripherally-inserted central
catheter, etc.) in place or planned to be in place prior to beginning IV study
therapy. If without central catheter access, must be clinically stable and able to
receive oral study therapy.

- Acute IA defined as duration of clinical syndrome of <30 days.

- Must be willing to adhere to dosing, study visit schedule, and mandatory procedures as
outlined in the protocol. The participant must be willing to continue on study therapy
for up to 12 weeks and remain in the study through the 1-month follow-up visit.

- The participant must have the ability to transition to oral study therapy during the
course of the study.

- Female participants of child-bearing potential must be using a medically accepted
method of birth control before beginning study-drug treatment and agree to continue
its use for 30 days after stopping study medication

- Is not taking prohibited antifungal prophylaxis or treatment

Exclusion Criteria:

- Chronic (>1 month duration) IA, relapsed/recurrent IA, or refractory IA which has not
responded to antifungal therapy.

- Has pulmonary sarcoidosis, aspergilloma, or allergic bronchopulmonary aspergillosis
(ABPA).

- Known mixed invasive mold fungal infection including Zygomycetes, and/or a known
invasive Aspergillus fungal infection in which either study drug may not be considered
active.

- Receipt of any systemic (oral, intravenous, or inhaled) antifungal therapy for this
infection episode for 4 or more consecutive days (>= 96 hours) immediately before
randomization.

- Developed the current episode of IA infection during receipt of >13 days of antifungal
prophylaxis with an agent considered to be a mold-active antifungal agent.

- Receipt of posaconazole or voriconazole as empirical treatment for this infection for
4 days (96 hours) or more within the 15 days immediately before randomization.

- Has condition that, in the opinion of the investigator, may interfere with optimal
participation in the study.

- Known hypersensitivity or other serious adverse reaction to any azole antifungal
therapy or to any other ingredient of the study medication used.

- Females who are pregnant, intend to become pregnant, or are nursing at the time of
randomization.

- Known history of Torsade de Pointes, unstable cardiac arrhythmia or proarrhythmic
conditions, or a history of recent myocardial infarction within 90 days of study
entry.

- Has significant liver dysfunction

- Hepatic cirrhosis or a Child-Pugh score of C (severe hepatic impairment) at the time
of randomization.

- Severe renal insufficiency (estimated creatinine clearance <20 mL/min) or on
hemodialysis at the time of randomization or likely to require dialysis during the
study.

- Known hereditary problem of galactose intolerance, Lapp lactase deficiency, or
glucose-galactose malabsorption.

- Acute symptomatic pancreatitis within 6 months of study entry or a diagnosis of
chronic pancreatitis at the time of randomization.

- Active skin lesion consistent with squamous cell carcinoma at the time of
randomization, or a current or prior history of malignant melanoma within 5 years of
study entry.

- On artificial ventilation or receiving acute Continuous Positive Airway Pressure
(CPAP)/Bilevel Positive Airway Pressure (BPAP) at the time of randomization.

- Known or suspected Gilbert's disease at the time of randomization.

- Requires treatment with other medications that cannot be stopped and for which there
is a known contraindication to co-administration of one or more of the study drugs.

Further information on the trial in WHO primary registry

https://clinicaltrials.gov/ct2/show/NCT01782131

Further information on the trial from WHO database (ICTRP)

https://trialsearch.who.int/Trial2.aspx?TrialID=NCT01782131
Further information on trial

Recruitment status

Completed

Academic title (Data source: WHO)

A Phase 3 Randomized Study of the Efficacy and Safety of Posaconazole Versus Voriconazole for the Treatment of Invasive Aspergillosis in Adults and Adolescents (Phase 3; Protocol No. MK-5592-069)

Type of trial (Data source: WHO)

Interventional

Design of the trial (Data source: WHO)

Allocation: Randomized. Intervention model: Parallel Assignment. Primary purpose: Treatment. Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor).

Phase (Data source: WHO)

Phase 3

Primary end point (Data source: WHO)

Percentage of Participants Who Died Through Day 42 in the Intention to Treat Population

Secundary end point (Data source: WHO)

Percentage of Participants Who Died Through Day 42 in the Full Analysis Set Population;Percentage of Participants Who Died Through Day 84 in the ITT Population;Percentage of Participants Who Died Through Day 84 in the FAS Population;Percentage of Participants Achieving Global Clinical Response at Week 12 in the FAS Population;Percentage of Participants Achieving Global Clinical Response at Week 6 in the FAS Population;Number of Participants Experiencing Mortality at Day 42, Day 84, and Day 114 in the FAS Population (Kaplan-Meier Time To Death Estimate);Number of Participants Who Died Due to Invasive Aspergillosis Through Day 42 in the FAS Population;Number of Participants Who Died Due to Invasive Aspergillosis Through Day 84 in the FAS Population;Percentage of Participants With Tier 1 Treatment Emergent Adverse Events;Percentage of Participants With at Least One Adverse Event;Percentage of Participants With at Least One Drug Related Adverse Event;Percentage of Participants With at Least One Serious Adverse Event;Percentage of Participants With at Least One Serious Drug Related Adverse Event;Percentage of Participants Who Discontinued Study Treatment Due to an Adverse Event;Steady State Average Concentration (Cavg) of Posaconazole With Food Intake

Contact information (Data source: WHO)

Please refer to primary and secondary sponsors

Trial results (Data source: WHO)

Results summary

no information available yet

Link to the results in the primary register

https://clinicaltrials.gov/ct2/show/results/NCT01782131

Information on the availability of individual participant data

Yes
http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf

Trial sites

Trial sites in Switzerland (Data source: BASEC)

Basel, Bern, Zurich

Countries (Data source: WHO)

Argentina, Australia, Belgium, Brazil, Canada, Chile, China, Colombia, Croatia, Czechia, Estonia, France, Germany, Greece, Guatemala, Hungary, Israel, Italy, Korea, Lithuania, Malaysia, Mexico, Peru, Poland, Portugal, Republic of, Romania, Russian Federation, Serbia, Singapore, Spain, Switzerland, Taiwan, Turkey, United States

Contact for further information on the trial

Details of contact in Switzerland (Data source: BASEC)

Klaudia Georgi
+ 41 58 618 33 88
klaudia.georgi@msd.com

Contact for general information (Data source: WHO)

Medical Director
Merck Sharp & Dohme LLC

Contact for scientific information (Data source: WHO)

Medical Director
Merck Sharp & Dohme LLC

Further trial identification numbers

Secondary ID (Data source: WHO)

5592-069
2011-003938-14
P06200
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