POS vs FLU for First Line Treatment of Coccidioidomycosis (Study P04558Am1)(COMPLETED)

NCT00423267 | Completed Phase 3 Results

• 1 other identifier: P04558
• Study Type: interventional
• Target: 16
• Locations: 0 countries
• Sites: N/A

Brief Summary

To evaluate the safety of posaconazole (POS) in the treatment of coccidioidomycosis. Period A consisted of 2 blinded arms, posaconazole and fluconazole. Recruitment was stopped, and participants in Period A may have been eligible to roll over to an open-label, non-comparitive Period B. During Period B, participants received posaconazole for a treatment duration not to exceed 12 months.

Conditions

Coccidioidomycosis

Outcome Measures

Primary Outcomes (2)

• Number of Participants With Treatment-related Treatment-emergent Adverse Events (TRAEs) That Occurred With Posaconazole (POS) or Fluconazole (FLU) in Period A

  Treatment-emergent adverse events are defined as new events that occur following subject entry into the study or events that worsen following study entry state. Treatment-related adverse events are defined as new events that occur following subject entry into the study or events that worsen following study entry state and are judged by the investigator to be possibly, probably or definitely related to study medication.

  12 months

• Number of Participants With Treatment-related Treatment-emergent Adverse Events (TRAEs) That Occurred With Posaconazole (POS) in Period B

  Treatment-emergent adverse events are defined as new events that occur following subject entry into the study or events that worsen following study entry state. Treatment-related adverse events are defined as new events that occur following subject entry into the study or events that worsen following study entry state and are judged by the investigator to be possibly, probably or definitely related to study medication.

  12 months

Secondary Outcomes (6)

• Number of Participants With Treatment-emergent Adverse Events (TEAEs)That Occurred With POS or FLU in Period A

  12 months

• Number of Participants With Treatment-emergent Adverse Events (TEAEs) That Occurred With POS in Period B

  12 months

• Number of Participants With Laboratory Test Abnormalities (at Least a 1 Grade Shift From Baseline) That Occurred With POS or FLU in Period A

  12 months

• Number of Participants With Laboratory Abnormalities (at Least a 1 Grade Shift From Baseline) That Occurred With POS in Period B

  12 months

• Number of Participant Discontinuations Due to Adverse Events and/or Laboratory Evaluations of Safety in Period A

  12 months

Study Arms (2)

Posaconazole

EXPERIMENTAL

Eligible subjects will be stratified at Baseline by disease site (skeletal, lung, or soft tissue) and by immune status (immunocompromised or non-immunocompromised) and will then be randomly assigned to receive Posaconazole 400 mg orally (PO) (oral suspension 40 mg/mL) administered twice daily with meals or oral nutritional supplements for 12 months.

Drug: Posaconazole

Fluconazole

ACTIVE COMPARATOR

Eligible subjects will be stratified at Baseline by disease site (skeletal, lung, or soft tissue) and by immune status (immunocompromised or non-immunocompromised) and will then be randomly assigned to receive Fluconazole 400 mg PO (given as two 200-mg oral encapsulated tablets) administered once daily for 12 months. Fluconazole treatment or placebo only occurred during Period A.

Drug: Fluconazole

Interventions

Posaconazole DRUG

Posaconazole 400 mg orally (PO) (oral suspension 40 mg/mL) administered twice daily with meals or oral nutritional supplements for 12 months

Posaconazole

Fluconazole DRUG

Fluconazole 400 mg PO (given as two 200-mg oral encapsulated tablets) administered once daily for 12 months

Fluconazole

Eligibility Criteria

• Age: 13 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Thirteen years of age or older, 34 kg (75 lb) or more, either sex, and any race;
• Coccidioides immitis (C. immitis) or Coccidioides posadasii (C. posadasii) identified by culture or microscopic examination from skeletal disease, chronic active pulmonary disease, or soft tissue disease;
• Coccidioidomycosis score of \>=6;
• Clinical laboratory safety tests within normal limits or clinically acceptable to the sponsor;
• Free of any clinically significant disease that would interfere with study evaluations;
• Willing to give written informed consent and able to adhere to study medication dose, mandatory procedures (including human immunodeficiency virus (HIV) testing), and visit schedules;
• Able to swallow food or a nutritional supplement;
• Use of a medically accepted method of contraception;
• Negative serum pregnancy test at Screening and negative urine pregnancy test at Randomization;
• Women of childbearing potential not currently sexually active must agree to use a medically accepted method of contraception should they become sexually active while participating in the study.

You may not qualify if:

• Excluded Medications at Enrollment
• Medications that are known to interact with POS or FLU and that may lead to serious or life threatening side effects within 7 days prior to initiating study drug;
• Medications known to lower the serum concentration/efficacy of azole antifungals within 7 days prior to study drug start;
• Prior investigational drug use or biologic product administration within 30 days before study drug start;
• Prior antifungal treatment for the current episode of infection with a total cumulative dose of \>=8 g of any azole, \>=4 mg/kg of amphotericin B deoxycholate, or \>=20 mg/kg of lipid amphotericin B;
• Antiretrovirals that are substrates of CYP3A4 administered to HIV-positive subjects, as it is not currently known how POS or FLU may affect such drugs or the potential to cause adverse reactions.
• Excluded Concomitant Conditions
• Immediately life-threatening coccidioidomycosis;
• Confirmed or suspected meningeal coccidioidomycosis;
• Pulmonary coccidioidomycosis in HIV-negative subjects for less than 3 months;
• Any condition requiring use of prohibited drugs;
• Cluster of Differentiation 4 (CD4) count of \<200 cells/mm3 or any auto-immune deficiency syndrome (AIDS)-defining illness in HIV-positive subjects in the prior 30 days.
• Excluded Baseline Laboratory Studies
• Moderate or severe liver dysfunction (aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \> 5 times upper limit of normal (ULN)) or a total bilirubin level or direct bilirubin \> 3 times ULN plus ALT or AST \>2 times ULN (Hy's Rule);
• Moderate or severe renal dysfunction (creatinine clearance (CrCl) \<20 mL/min) or dialysis required or expected to be required within the study period;

Sponsors & Collaborators

• Merck Sharp & Dohme LLC: lead

MeSH Terms

Conditions

Coccidioidomycosis

Interventions

posaconazole; Fluconazole

Condition Hierarchy (Ancestors)

Mycoses; Bacterial Infections and Mycoses; Infections

Intervention Hierarchy (Ancestors)

Triazoles; Azoles; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds

Results Point of Contact

• Title: Senior Vice President, Global Clinical Development
• Organization: Merck Sharp & Dohme Corp.

ClinicalTrialsDisclosure@merck.com

Publication Agreements

• PI is Sponsor Employee: No
• Restriction Type: OTHER
• Restrictive Agreement: Yes

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 17, 2007
• First Posted: January 18, 2007
• Study Start: May 1, 2007
• Primary Completion: May 1, 2009
• Study Completion: May 1, 2009
• Last Updated: April 11, 2017
• Results First Posted: June 30, 2010

Record last verified: 2017-03

Data Sharing

• IPD Sharing: Will share