Open, Non-Comparative Study of Fluconazole in Patients With Coccidioidal Meningitis

The study is intended to examine the efficacy of fluconazole for the treatment of coccidioidal meningitis in patients with new onset of infection, relapse of previous infection, or failed previous therapy. Drug efficacy, safety and tolerance will be examined.

Study Overview

• Status: Completed
• Conditions: HIV Infections; Meningitis
• Intervention / Treatment: Drug: Fluconazole

• Study Type: Interventional
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Arizona
    • Tucson, Arizona, United States, 85724
      • Tucson Veterans Administration Med Ctr
  • California
    • San Diego, California, United States, 92102
      • HIV Research Group
  • Texas
    • San Antonio, Texas, United States, 78284
      • Audie L Murphy Veterans Administration Hosp

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 13 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria

Concurrent Medication:

Allowed:

• Immunosuppressive therapy including corticosteroids and/or cytotoxic agents.
• Antiviral therapy (e.g., zidovudine (AZT)).
• Prophylaxis for Pneumocystis carinii pneumonia (PCP).
• Any exceptions to use of concomitant medications must be approved by Pfizer Central Research prior to study entry.

Concurrent Treatment:

Allowed:

• Radiation therapy for mucocutaneous Kaposi's sarcoma.

Patients must:

• Be clinically judged to be in need of treatment for coccidioidal meningitis.
• Have > 1 week life expectancy.
• Allowed:
• Immunocompromised patients.
• Patients with renal disease will have the dose of fluconazole adjusted and serum levels may be monitored.

Prior Medication:

Allowed:

• Amphotericin B.
• Ketoconazole.
• Miconazole.

Exclusion Criteria

Co-existing Condition:

Patients with the following conditions or symptoms are excluded:

• Current antifungal infection that is responding to another agent. Findings of improvement include one of the following, while on other therapy (without subsequent relapse of the item):
• CSF culture conversion from positive to negative.
• OR
• CSF antibody titer decrease of at least one dilution.
• OR
• Improvement in signs and symptoms of meningitis.
• Have received more than minimal systemic antifungal therapy (see Patient Inclusion Criteria), unless they meet criteria for previous treatment failure or relapse. They must not have received this therapy since the time relapse or failure was documented, except for minimal antifungal therapy allowed in Patient Inclusion Criteria.
• Immediately life-threatening coccidioidomycosis defined as infection of such a degree of clinical severity that the patient would be expected to die within 1 week, if untreated, based on clinical judgment.
• Experienced a prior allergic reaction or major side effect from an imidazole or triazole compound.

Concurrent Medication:

Excluded:

• Barbiturates.
• Phenytoin.
• Oral hypoglycemics.
• Coumadin type anticoagulants.
• Other systemic or intrathecal antifungal therapy.
• Other experimental agents with exceptions noted in concomitant medications section.
• Any exceptions to these prohibitions of concomitant medications must be approved by Pfizer Central Research prior to study entry.

Patients with the following are excluded:

• Are responding or are improving on current antifungal therapy with another agent.
• Have received more than minimal systemic antifungal therapy (see Patient Inclusion Criteria), unless they meet criteria for previous treatment failure or relapse. They must not have received this therapy since the time relapse or failure was documented, except for minimal antifungal therapy allowed in Patient Inclusion Criteria.
• Immediately life-threatening coccidioidomycosis defined as infection of such a degree of clinical severity that the patient would be expected to die within 1 week, if untreated, based on clinical judgment.
• Experienced a prior allergic reaction or major side effect from an imidazole or triazole compound.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Masking: None (Open Label)

Collaborators and Investigators

• Sponsor: Pfizer

Study record dates

Study Registration Dates

• First Submitted: November 2, 1999
• First Submitted That Met QC Criteria: August 30, 2001
• First Posted (Estimate): August 31, 2001

Study Record Updates

• Last Update Posted (Estimate): June 24, 2005
• Last Update Submitted That Met QC Criteria: June 23, 2005
• Last Verified: February 1, 1992

More Information

Terms related to this study

• Keywords: Fluconazole; Meningitis; Acquired Immunodeficiency Syndrome; AIDS-Related Opportunistic Infections; Coccidioidomycosis; Coccidioidin
• Additional Relevant MeSH Terms: Central Nervous System Diseases; Nervous System Diseases; Meningitis; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Anti-Infective Agents; Enzyme Inhibitors; Hormones, Hormone Substitutes, and Hormone Antagonists; Cytochrome P-450 Enzyme Inhibitors; Hormone Antagonists; Antifungal Agents; Steroid Synthesis Inhibitors; 14-alpha Demethylase Inhibitors; Cytochrome P-450 CYP2C9 Inhibitors; Cytochrome P-450 CYP2C19 Inhibitors; Fluconazole
• Other Study ID Numbers: 012P; 056-170