AzTrials
AzTrials

Invasive MucormycosisPhase 2NCT03816176

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

A Phase 2 study testing Isavuconazonium sulfate in people with Invasive Mucormycosis and Invasive Aspergillosis, run by Astellas Pharma Global Development, Inc. at 10 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

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

Who is it for?
Ages 1 year to 17 years
Conditions the study is for
Invasive Mucormycosis, Invasive Aspergillosis
What is being tested?
Isavuconazonium sulfate
Could I receive a placebo?
No, everyone receives an active treatment
How many people
31 participants
Where
10 sitesin 3 countries
Study dates
22 Aug 2019to 14 Dec 2022
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 year to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • 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
Show all 11Show fewer
  • 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

Who cannot join

  • 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
Show all 14Show fewer
  • 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

Trial locations and contacts

10 sites in 3 countries.

10 sites in 3 countries

United States5 sites
  • Ann & Robert H. Lurie Children's Hospital of Chicago

    Chicago, Illinois, 60611

  • Children's Hospital, Los Angeles

    Los Angeles, California, 90027

  • University of California - Los Angeles

    Los Angeles, California, 90095

  • Children's Hospital of Orange County

    Orange, California, 92868

  • Children's National Medical Center

    Washington D.C., District of Columbia, 20010

Other trials in United States

Spain3 sites
  • Site ES34002

    Barcelona, 8035

  • Site ES34003

    Madrid, 28009

  • Site ES34001

    Madrid, 28041

Other trials in Spain

Belgium2 sites
  • Site BE32001

    Ghent, 9000

  • Site BE32002

    Leuven, 3000

Other trials in Belgium

About this study

Official title: A Phase 2, Open-Label, Non-Comparative, Multicenter Study to Evaluate the Safety and Tolerability, Efficacy and Pharmacokinetics of Isavuconazonium Sulfate for the Treatment of Invasive Aspergillosis (IA) or Invasive Mucormycosis (IM) in Pediatric Subjects

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

Read the detailed description

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.

Being tested
Isavuconazonium sulfate
Keywords
ASP9766, Cresemba, BAL8557, isavuconazonium sulfate

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Isavuconazonium sulfateDrug

    Also called Cresemba

    Intravenous (IV) infusion

  • Isavuconazonium sulfateDrug

    Also called Cresemba

    Oral capsule

Study groups in NCT03816176
Study groupRoleWhat they receive
Isavuconazonium sulfateExperimentalParticipants 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.
Receives: Drug: Isavuconazonium sulfate

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Treatment Emergent Adverse Events (TEAEs)

    An AE is any untoward medical occurrence in a participant administered a study drug, which does not have to have a causal relationship with this treatment. It can be any unfavorable sign, symptom, or disease temporally associated with the use of a medicinal product.

    TEAE is defined as an AE observed after starting administration of the study drug through 30 days after the last dose.

    Measured: From first dose to 30 days after the last dose (maximum 210 Days)

  2. Percentage of Participants With All - Cause Mortality Through Day 42

    All - Cause Mortality Through Day 42

    Measured: Baseline up to 42 days

Secondary outcomes (9)
  1. Percentage of Participants With All - Cause Mortality

    EOT was defined as anytime from "day 1 to a maximum of day 180". Data reported in the table below for each category, i.e., Day 84 represented data between Day 1 and Day 84 and for EOT, data represented between Day 1 to the EOT day for each individual. Participants who died after EOT assessment but before reaching Day 84 were included in the data for Day 84 category. Only those deaths that occurred after Day 84 would be included in EOT category if the death occurred during the treatment period (i.e. prior to the EOT).

    Measured: Baseline up to day 84 and end of treatment (EOT) (up to a maximum of 180 days) (Average duration of treatment: 57.7 days)

  2. Percentage of Participants With Overall Response: Adjudication Committee (AC) Assessment

    Overall response was based on a composite of clinical, mycological, and radiological responses with success criteria assessed. Success criteria as assessed by AC in:

    Clinical response:

    • Complete: Resolution of all attributable clinical symptoms and physical findings
    • Partial: Resolution of at Least some of the clinical symptoms and physical findings associated with IFD

    Mycological response:

    • Eradication: No growth of the original (at baseline) causative organism on culture or identified by histology/cytology on post baseline (after day 7) cultures and/or histology/cytology
    • Presumed eradication: Missing post baseline documentation of eradication of the original causative organism at baseline PLUS resolution of all or some clinical symptoms/physical finding

    Radiological response:

    • Complete: ≥ 90% improvement
    • Partial: At least < 25% response at day 42 and at least 50% by Day 84

    Measured: Baseline up to days 42, 84 and EOT (180 days)

  3. Percentage of Participants With Clinical Response: AC Assessment

    AC Assessed Clinical response was defined as follows:

    • Success: Complete (if resolution of all attributable clinical symptoms and physical findings occurs); Partial (if resolution of at least some of the clinical symptoms and physical findings associated with IFD)
    • Failure: Stable (if minor of no change in clinical symptoms and physical findings associated with IFD); Progression (if worsening or new clinical symptoms and physical findings associated with IFD, or if alternative systemic antifungal treatment is required)
    • Not Evaluable: If not assessed or no clinical signs or symptoms at baseline
    • No assessment: Those participants that do not fall under any of the above criteria

    Measured: Baseline up to days 42, 84 and EOT (180 days)

  4. Percentage of Participants With Clinical Response: Investigator Assessment

    Investigator-assessed Clinical Response was defined as follows:

    • Success: if resolution of all attributable signs and symptoms or resolution of attributable clinical symptoms and physical findings
    • Failure: if no resolution of any attributable signs and symptoms or no resolution of any attributable signs and symptoms (no change) or worsening of any attributable signs and symptoms
    • Not Evaluable: if results not available /participant unevaluable or if no attributable signs and symptoms
    • No assessment: Those participants that do not fall under any of the above criteria

    Measured: Baseline up to days 42, 84 and EOT (180 days)

  5. Percentage of Participants With Radiological Response: AC Assessment

    AC-assessed Radiological Response was defined as follows:

    • Success: Complete (if ≥ 90% improvement); Partial (if at least < 25% response at day 42 and at least 50% response by Day 84)
    • Failure: Stable (if minor or no change in radiographic abnormalities associated with IFD, but no signs of progression); Progression (if worsening or new radiological abnormalities associated with IRD)
    • Not Evaluable: if no post baseline radiology available with baseline evidence of radiolical disease Or Radiology not applicable at baseline
    • No assessment: Those participants that do not fall under any of the above criteria

    Measured: Baseline up to days 42, 84 and EOT (180 days)

  6. Percentage of Participants With Radiological Response: Investigator Assessment

    Investigator's assessed radiological response was defined as follows:

    • Success: if ≥ 90% improvement, ≥ 50% to < 90% improvement, ≥ 25% to 50% improvement (for Day 42 only)
    • Failure if < 25% improvement at any time or no signs or radiological Images
    • Not Evaluable if results not evaluable or no radiological data available
    • No assessment: Those participants that do not fall under any of the above criteria

    Measured: Baseline up to days 42, 84 and EOT (180 days)

  7. Percentage of Participants With Mycological Response: AC Assessment

    AC assessed mycological response was defined as follows:

    • Success: Eradicated (no growth of the original [at baseline] causative organism on culture or identified by histology/cytology on post baseline [after day 7] cultures and/or histology/cytology); Presumed Eradicated (missing post baseline documentation of eradication of the original causative organism at baseline PLUS resolution of all or some clinical symptoms/physical finding)
    • Failure: Persistence (persistence of the original causative organism cultured or identified by histological /cytology at baseline); Presumed Persistence (missing post baseline documentation of the persistence of the original causative organism at baseline PLUS no resolution or worsening of any clinical symptoms/physical findings)
    • Not Evaluable - no mycological evidence
    • No assessment: Those participants that do not fall under any of the above criteria

    Measured: Baseline up to days 42, 84 and EOT (180 days)

  8. Percentage of Participats With Mycological Response: Investigator Assessment

    Investigator's assessed mycological response was defined as follows:

    • Success: Eradicated (no growth of the original [at baseline] causative organism on culture or identified by histology/cytology on post baseline [after day 7] cultures and/or histology/cytology); Presumed Eradicated (missing post baseline documentation of eradication of the original causative organism at baseline PLUS resolution of all or some clinical symptoms/physical finding)
    • Failure: Persistence (persistence of the original causative organism cultured or identified by histological /cytology at baseline); Presumed Persistence (missing post baseline documentation of the persistence of the original causative organism at baseline PLUS no resolution or worsening of any clinical symptoms/physical findings)
    • Not Evaluable: Indeterminate/no mycological follow-up or results available
    • No assessment: Those participants that do not fall under any of the above criteria

    Measured: Baseline up to days 42, 84 and EOT (180 days)

  9. Pharmacokinetics of Isavuconazonium Sulphate in Plasma: Trough Concentration (Ctrough)

    Ctrough was defined as the predose concentration at the end of dosing interval.

    Measured: Predose on days 7, and 14

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Jan 2019
  2. Study start22 Aug 2019
  3. Primary completion14 Dec 2022
  4. Study completion14 Dec 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
31 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03816176
Sponsor's protocol ID
9766-CL-0107
Other IDs
2018-003975-36, 2018
Status last verified
Nov 2024
First submitted
23 Jan 2019
Last updated
5 Dec 2024
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: Access to anonymized individual participant level data will not be provided for this trial. Further details on Astellas' data sharing policy can be found at https://www.clinicaltrials.astellas.com/transparency/.

Publications

  • 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.

    PubMed 39540734

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Isavuconazonium sulfate in people with Invasive Mucormycosis and Invasive Aspergillosis, run by Astellas Pharma Global Development, Inc. at 10 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 5 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 10 sites in United States, Spain, Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 21 Sep 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Treatment Emergent Adverse Events (TEAEs) (time frame: From first dose to 30 days after the last dose (maximum 210 Days)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03816176, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Dec 2024.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in