- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01773876
Empirical Antifungal Treatment in ICUS (EMPIRICUS)
Micafungin Versus Placebo in the Nosocomial Sepsis in Patients Multi-colonized With Candida, Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
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Aix en Provence, France, 13616
- Hospital Aix en Provence
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Besançon, France, 67091
- Hospital University of Besançon
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Bobigny, France, 93009
- University Hospital of Avicennes
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Bordeaux, France, 33000
- Hospital University of Bordeaux
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Clermont Ferrand, France, 63003
- Hospital University of Clermont Ferrand
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Clichy, France, 92110
- University Hospital of Beaujon
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Dijon, France, 21000
- University Hospital of Dijon
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Draguignan, France, 83300
- Hospital of Draguignan
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Grenoble, France, 38043
- Hospital University of Grenoble
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Le Chesnay, France, 78150
- Hospital of Versailles
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Lyon, France, 96433
- University Hospital Edouard Herriot
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Montpellier, France, 34295
- Hospital University of Montpellier
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Montreuil, France, 93105
- Interegional Hospital André Grégoire
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Paris, France, 75010
- University Hospital Saint Louis
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Paris, France, 75013
- University Hospital of La Pitié Salpetrière
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Paris, France, 75014
- Hospital St Joseph
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Paris, France, 75877
- Hospital University of Bichat
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Pontoise, France, 95303
- Hospital of Pontoise
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Reims, France, 51092
- Hospital University of Reims
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Roche Sur Yon, France, 85925
- Departemental Hospital of Roche sur Yon
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Saint Etienne, France, 42055
- University Hospital of Saint Etienne
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Strasbourg, France, 67091
- University Hospital of Strasbourg
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age ≥ 18 years
- Persistent sepsis without documented invasive candidiasis:
systemic inflammatory response syndrome (SIRS) presence of two signs on the 4 [temperature <36 ° C or> 38 ° C, heart rate> 90/min, respiratory rate> 20/min or PaCO2 <32 mmHg, leukocytosis> 12,000 / mm3, <4.000/mm3 or presence of circulating immature forms (> 10% of cells)] mechanical ventilation (intubation or tracheostomy) for over 4 days (96 hours) central line use of broad-spectrum antibacterial for more than 4 calendar days (96 hours) in the previous week presence of at least one extra-digestive site colonized by Candida sp. (Urine, mouth, throat, upper and lower respiratory tract, skin folds, and suction drains after surgery ...), not lower digestive tract, are not taken into account the positive samples of rectal swabs and / or stool cultures, absence of proven bacterial infections untreated no evidence of invasive fungal infections (positive blood culture, positive culture of a surgical site, deep biopsy with fungal) infection or mold according to the criteria of the group "fungal infection of the EORTC" organ failure
- Hospitalization in intensive care for over 5 days (120 hours)
- Giving a free, informed and in writing. In the absence of the person of trust or a family member (if present)consent to emergency possible.
- Receiving a social security system,
- Negative pregnancy test for patients of childbearing age
Exclusion Criteria:
- Proven invasive fungal infection (positive blood culture, positive culture of a surgical site, deep biopsy with fungal infection), including aspergillosis requiring antifungal therapy at the time of randomization
- Prognosis of less than 48 hours (for which the patient outcome will be fatal whatever treatment),
- Echinocandin antifungal treatment by more than one day or another antifungal for over 72 hours in the week before the inclusion visit,
- Allergy, hypersensitivity or known intolerance to echinocandins antifungal or any of the excipients of the drug
- Neutropenia (ANC <500/mm3)
- History of organ and bone marrow,
- Recent chemotherapy (less than 6 months)
- Systemic immunosuppressive therapy in progress, other than with corticosteroids at doses below 2 mg / kg / day of prednisolone or equivalent
- Participation in another interventional study in the same ICU stay or making treatment being evaluated within 28 days prior to randomization
- Any clinical investigator deems incompatible with the conduct of the study in acceptable security conditions
- Pregnant and lactating women,
- Adults subject to a legal protection measure
- Persons deprived of their liberty by a judicial or administrative decision, those hospitalized without consent, persons admitted to a health facility or social purposes other than research
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: TRIPLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Micafungin
MYCAMINE 100 mg intravenous an injection of 24 hours
|
MYCAMINE 100 mg intravenous 100 mg of powder reconstituted in a 100 ml infusion bag of sodium chloride 0.9% infusion over 24 hours for 14 days discontinuation of treatment if proven invasive candidiasis |
PLACEBO_COMPARATOR: PLACEBO
0.9% sodium chlorides 100ml infusion
|
solution of sodium chloride 0.9% 100 ml for intravenous infusion infusion over 24 hours for 14 days discontinuation of placebo if proven invasive candidiasis
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
survival to 28 days without proven fungal infection (a fungal infection occurring within 48 hours after inclusion will be considered available for inclusion)
Time Frame: 28 days follow-up
|
breakthrough infection defined as a proven infection occurs at least 48 hours after initiation of treatment Proven infection is considered purchased after enrollment if the first significant positive levy occurs after the 48 th hour after enrollment.
|
28 days follow-up
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
pharmacokinetic parameters: estimated gross exposure indices: AUC, Cmax, Cmin
Time Frame: during 24 hours (between the two first infusions)
|
Reports AUC / MIC and Cmax / MIC will be calculated
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during 24 hours (between the two first infusions)
|
evaluation of tolerance
Time Frame: 3 months
|
For all patients who received at least one dose of treatment:
|
3 months
|
pharmacodynamic parameters: potential serum biomarkers of treatment efficacy (PCR Candida,1,3 β-D-glucan,mannan antigenemia,anti-mannan,Procalcitonin (proCT))
Time Frame: during 28 days
|
during 28 days
|
|
pharmacodynamic parameters: Early prognostic factors of response: J7 survival without proven invasive candidiasis
Time Frame: during 14 days
|
during 14 days
|
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Evaluate the impact of empiric treatment with micafungin in patients with invasive candidiasis possible on all-cause mortality at day 28 (end of study) and J90 (3 months post-randomization)
Time Frame: during 90 days
|
during 90 days
|
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Evaluate the impact of empiric treatment with micafungin in patients with invasive candidiasis can free survival antifungal treatment at day 28
Time Frame: during 28 days
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during 28 days
|
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Evaluate the impact of empiric treatment with micafungin in patients with invasive candidiasis possible evolution of organ failure during the study
Time Frame: during 90 days
|
during 90 days
|
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Evaluate the impact of empiric treatment with micafungin in patients with invasive candidiasis possible the use of mechanical ventilation during the study
Time Frame: during 90 days
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during 90 days
|
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Evaluate the impact of empiric treatment with micafungin in patients with invasive candidiasis possible evolution of the colonization index during study
Time Frame: during 90 days
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during 90 days
|
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Evaluate the impact of empiric treatment with micafungin in patients with invasive candidiasis possible changes in serum biomarkers (1-3 β-D-glucan, mannan antigenemia, anti-mannan Candida PCR) during the study
Time Frame: during 90 days
|
during 90 days
|
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Evaluate the impact of empiric treatment with micafungin in patients with invasive candidiasis possible on the incidence of pneumonia acquired bacterial mechanical ventilation (VAP).
Time Frame: during 90 days
|
during 90 days
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: TIMSIT JFT Jean François, PU-PH, University Hospital, Grenoble
Publications and helpful links
General Publications
- Timsit JF, Azoulay E, Schwebel C, Charles PE, Cornet M, Souweine B, Klouche K, Jaber S, Trouillet JL, Bruneel F, Argaud L, Cousson J, Meziani F, Gruson D, Paris A, Darmon M, Garrouste-Orgeas M, Navellou JC, Foucrier A, Allaouchiche B, Das V, Gangneux JP, Ruckly S, Maubon D, Jullien V, Wolff M; EMPIRICUS Trial Group. Empirical Micafungin Treatment and Survival Without Invasive Fungal Infection in Adults With ICU-Acquired Sepsis, Candida Colonization, and Multiple Organ Failure: The EMPIRICUS Randomized Clinical Trial. JAMA. 2016 Oct 18;316(15):1555-1564. doi: 10.1001/jama.2016.14655.
- Timsit JF, Azoulay E, Cornet M, Gangneux JP, Jullien V, Vesin A, Schir E, Wolff M. EMPIRICUS micafungin versus placebo during nosocomial sepsis in Candida multi-colonized ICU patients with multiple organ failures: study protocol for a randomized controlled trial. Trials. 2013 Nov 21;14:399. doi: 10.1186/1745-6215-14-399.
Study record dates
Study Major Dates
Study Start
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1126
- 2011-005451-14 (OTHER: EudraCT number)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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