Overview

A Study Comparing the Efficacy of Intravenous Followed by Oral Itraconazole With Intravenous Caspofungin For Empiric Antifungal Therapy in Neutropenic Participants With Hematological Malignancy

Status:
Terminated
Trial end date:
2018-05-02
Target enrollment:
0
Participant gender:
All
Summary
The purpose of this study is to investigate the hypothesis that the efficacy of intravenous (IV) itraconazole followed by oral itraconazole is non-inferior to that of intravenous caspofungin as empiric therapy for suspected fungal infection participants with fever and neutropenia.
Phase:
Phase 4
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Xian-Janssen Pharmaceutical Ltd.
Treatments:
Antifungal Agents
Caspofungin
Echinocandins
Hydroxyitraconazole
Itraconazole
Miconazole
Criteria
Inclusion Criteria:

- Participant must be hospitalized with hematologic malignancy treated by
myelosuppressive therapy and/or Hematopoietic stem cell transplantation

- Participant must have a diagnosis of neutropenia with neutrophil count <
500/microliters (mcL) (0.5 × 10^9/ liters [L]) for at least 96 hours at screening

- Participant must have a diagnosis of fever and meet the following criteria: 1)
Oral/rectal temperature greater than or equal to (>=) 38 degree celsius or axillary
temperature (>=) 37.5 degree celsius and is not considered related to blood products
transfusion or drug fever, 2) Not responding to broad-spectrum gram-positive and
gram-negative antibiotics for 4-7 days with or without signs and symptoms that
potentially attributable to deep fungal infection and 3) Defervescence within 3 days
after the first broad-spectrum antibiotics but recurrence afterwards.

- A woman of childbearing potential must have a negative serum (beta human chorionic
gonadotropin [b hCG]) and pregnancy test at screening

- A woman must agree not to donate eggs (ova, oocytes) for the purposes of assisted
reproduction during the study period and until the menstrual period following the end
of study treatment

Exclusion Criteria:

- Is concomitantly using other systematic antifungal drugs as empirical treatment

- Has evidence of inadequately managed bacterial infection

- Is currently receiving any Cytochrome P450 3A4
(CYP3A4)-metabolized/P-glycoprotein-transported drugs (including but not limited to
cisapride, pimozide, quinidine, dofetilide, levacetylmethadol, terfenadine,
astemizole, mizolastine, bepridil, sertindole, 3-hydroxy-3-methyl-glutaryl-coenzyme A
reductase (HMG-CoA reductase) inhibitor [for example, simvastatin, lovastatin], oral
midazolam, triazolam, ergot alkaloids [eg, dihydroergotamine, ergonovine, ergotamine,
methylergonovine] and nisoldipine) that should be prohibited in this study

- Has known allergy, intolerance or hypersensitivity to azole and echinocandin
antifungals or its excipients

- Has a contraindication to the use of sodium chloride injection