An evaluation of the effectiveness and safety of anidulafungin compared to caspofungin for the treatment of deep tissue infection due to Candida.

• Register: EUCTR
• Last refreshed on: 21 August 2017
• Main ID: EUCTR2008-005278-11-BE
• Date of registration: 22/01/2009
• Prospective Registration: Yes
• Primary sponsor: Pfizer Inc, 235 East 42nd Street, New York, NY 10017
• Public title: An evaluation of the effectiveness and safety of anidulafungin compared to caspofungin for the treatment of deep tissue infection due to Candida.
• Scientific title: EFFICACY AND SAFETY OF ERAXIS™/ECALTA® (ANIDULAFUNGIN) COMPARED TO CANCIDAS® (CASPOFUNGIN) IN PATIENTS WITH CANDIDA DEEP TISSUE INFECTION
• Date of first enrolment: 27/01/2009
• Target sample size: 45
• Recruitment status: Not Recruiting
• URL: https://www.clinicaltrialsregister.eu/ctr-search/search?query=eudract_number:2008-005278-11
• Study type: Interventional clinical trial of medicinal product
• Study design: Controlled: yes Randomised: yes Open: no Single blind: no Double blind: yes Parallel group: no Cross over: no Other: no If controlled, specify comparator, Other Medicinial Product: yes Placebo: no Other: no Number of treatment arms in the trial: 2
• Phase: Human pharmacology (Phase I): no Therapeutic exploratory (Phase II): no Therapeutic confirmatory - (Phase III): yes Therapeutic use (Phase IV): no

Countries of recruitment

Belgium, Bulgaria, Canada, Croatia, Netherlands, Portugal, Romania, Russian Federation, United States

Contacts

• Name: Clinical Trials.gov Call Center
• Affiliation: Pfizer Inc

• Name: Clinical Trials.gov Call Center
• Affiliation: Pfizer Inc

Key inclusion & exclusion criteria

Inclusion criteria:
Subjects must meet all of the following inclusion criteria to be eligible for enrollment into the study:
1. Diagnosis of deep tissue Candida infection, defined as follows: growth of Candida sp.from a culture specimen obtained from a normally sterile site, the sample having been taken within 96 hours before study entry or at screening.
The diagnosis will be based on at least one of the following:
a. Positive culture for Candida sp. from a specimen from a normally sterile site with or without a positive blood culture; b. Positive culture for Candida sp. from a drain placed for < 24 hours in a normally sterile site; or c. Any positive blood culture for Candida sp. plus ophthalmic findings consistent with Candida endophthalmitis.
AND
a. At least one of the following:
1. Fever, defined as an oral or tympanic temperature = 38.0°C (100.4°F);
2. Hypothermia, defined as a temperature less than 36.0°C (96.8°F);
3. Systolic blood pressure less than 100 mmHg, or a decrease in systolic blood pressure of at least 30 mmHg from baseline;
4. Signs and/or symptoms of Candida infection;
5. Radiologic findings consistent with Candida infection.
IMPORTANT NOTES:
• Subjects with a high suspicion of Candida infection are eligible for enrollment band study treatment may be instituted, pending culture results. Examples whereby Candida infection may be suspected include, but is not limited to, the following:
• The presence of severe sepsis, sepsis with muscular pain, or sepsis with disseminated skin or mucosal lesions when any of these observations is made during the course of broad spectrum antibiotic therapy or when cultures for bacteria are negative;
• The presence of clinical and/or radiologic signs of deep-seated Candida infection and culture results are either pending or positive for yeast but Candida sp. not yet identified;
• Positive blood culture for yeast but Candida sp. not yet identified.These subjects may be enrolled provided a culture is obtained either at the screening visit (before study treatment is initiated) or within 96 hours prior to study treatment initiation. If culture results are either negative for Candida sp. or not confirmed within 96 hours after enrollment, these subjects will be discontinued from study treatment (but will remain in the study for safety assessment only) and treated according to local standard practices. These subjects will be deemed “non evaluable” and will not be accrued toward the final recruitment goal.
• A positive yeast or Candida culture from urine in the absence of clinical signs and symptoms of pyelonephritis does not qualify as a positive culture for study entry.
•A positive yeast or Candida culture from sputum, bronchoalveolar lavage (BAL) or endotracheal aspirate, or from gastric drainage or aspiration does not qualify for study entry.
2. Male or female = 16 years of age;
3. Evidence of a personally signed and dated informed consent document indicating that the subject (or a legally authorized representative) has been informed of all pertinent aspects of the study. Informed assent will be required for children who are not of the local legal age;
4. Subjects who are willing and able to comply with the scheduled visits, treatment plan, laboratory tests, and other study procedures;
5. Expected hospitalization for at least fourteen (14) days.
Are the trial subjects under 18? yes
Number of subjects for this age range: 2
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this ag
Exclusion criteria:
Subjects presenting with any of the following will not be included in the study:
1. Females who are pregnant, lactating (breast feeding) or planning a pregnancy during the course of the study, or who are of childbearing potential and not using an acceptable method of birth control (ie, surgically sterile, intrauterine device, oral contraceptive plus barrier contraceptive, hormone delivery system plus barrier contraceptive or condom in combination with contraceptive cream, jelly or foam). Subjects are to continue contraceptive methods during the study and for at least 30 days after receiving their last treatment;
2. Received prior antifungal treatment with either study drug (anidulafungin or caspofungin) within 30 days prior to enrollment in this study;
3. Ongoing antifungal therapy initiated more then 48 hours prior to enrollment.
IMPORTANT NOTE: Prior azole prophylaxis is allowed;
4. Requiring continued treatment with another systemic antifungal agent. IMPORTANT
NOTE: Use of oral non-absorbable azoles (eg, clotrimazole troches) is permitted;
5. Known to be intolerant to fructose or sucrose.
6. Child-Pugh score >9 or with any of the following abnormal laboratory values:
a. Bilirubin >5 times the upper limit of normal;
b. AST or ALT >10 times the upper limit of normal.
7. Poor venous access that would preclude intravenous drug delivery or multiple blood draws;
8. Known hypersensitivity to echinocandin therapy or to any of the excipients used in the formulation of the study drugs;
9. Participated in a study of an investigational drug or device (without any FDA and EMEA approved indications) within 4 weeks of study entry. The investigational use
of licensed agents is permitted if the subject is on a stable regimen for four weeks prior to study start and expected to remain on the same stable regimen for the duration of this study;
10. Life expectancy < 72 hours;
11. Suspected Candida osteomyelitis, endocarditis, meningitis or any other infections of the central nervous system;
12. Having a prosthetic device and/or vascular catheter (including a central venous catheter or an implantable port) at a suspected site of infection unless the device is removed at study entry or soon after randomization (within 24 – 48 hours).
** Please note ** If it is anticipated that the prosthetic devices or vascular catheter cannot be removed within this time frame, the medical monitor must be contacted to discuss enrollment.
13. Having a prosthetic heart valve or vascular graft suspected to be the site of the Candida infection and positive blood cultures;
14.Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study.


Age minimum:
Age maximum:
Gender:
Female: yes
Male: yes

Health Condition(s) or Problem(s) studied

INVASIVE CANDIDIA INFECTIONS
MedDRA version: 14.1 Level: LLT Classification code 10064954 Term: Invasive candidiasis System Organ Class: 10021881 - Infections and infestations

Therapeutic area: Diseases [C] - Bacterial Infections and Mycoses [C01]

Intervention(s)

Trade Name: ECALTA ®
Pharmaceutical Form: Powder for solution for infusion
INN or Proposed INN: 1 [(4R,5R)-4,5-dihydroxy-N2-[[4"-(pentyloxy)[1,1':4',1 "-terphenyl]-4-yl]carbonyl]-L-ornithine] echinocandin B
CAS Number: 166663-25-8
Current Sponsor code: PF-03910960
Other descriptive name: Anidulafungin
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 100-
Pharmaceutical form of the placebo: Solution for infusion
Route of administration of the placebo: Intravenous use

Trade Name: CANCIDAS
Pharmaceutical Form: Powder for concentrate for solution for infusion
CAS Number: 179463-17-3
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 70-
Pharmaceutical form of the placebo: Solution for infusion
Route of administration of the placebo: Intravenous use

Trade Name: CANCIDAS
Pharmaceutical Form: Powder for concentrate for solution for infusion
CAS Number: 179463-17-3
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 50-
Pharmaceutical form of the placebo: Solution for infusion
Route of administration of the placebo: Intravenous use

Primary Outcome(s)

Primary end point(s): • The primary efficacy endpoint is the global response at EOT in the MITT evaluable population. Global response is based on the following definitions:
• Success: clinical AND microbiological success;
• Failure: clinical OR microbiological failure.
Clinical and microbiological assessments will be conducted by the Investigator as described in Section 7: Assessments.

Main Objective: • To assess the efficacy of anidulafungin and caspofungin with respect to the
overall global response (clinical and microbiological success) at the EOT in
subjects with a confirmed diagnosis of deep tissue infection due to Candida sp.

Secondary Objective: • To evaluate the safety profile of anidulafungin and of caspofungin in this population;
• To evaluate the clinical and microbiological efficacy of anidulafungin and of caspofungin at various time points.

Timepoint(s) of evaluation of this end point: Global response at end of treatment

Secondary Outcome(s)

Secondary end point(s): • Global response at the 2 week and 6 week FU visits in the MITT population;
• Response based on clinical cure and microbiological success at EOT, and 2 week and 6 week FU visits in the MITT population;
• Clinical response at Day 10;
• Rates of relapse (recurrence) at the 2 week and 6 week FU visits;
• Rates of new infection with an organism not identified at baseline and the 2 week and 6 week FU visits;
• Time to negative blood culture (if subject had a positive blood culture at baseline);
• Safety;
• Time to death;
• All cause mortality during study therapy and FU visits.

Timepoint(s) of evaluation of this end point: 2 and 6 week follow-up visit; clinical response at day 10 will be summarized

Secondary ID(s)

A8851022

2008-005278-11-PT

Source(s) of Monetary Support

Pfizer Inc