- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04148287
An Open-label Study of APX001 for Treatment of Patients With Candidemia/Invasive Candidiasis Caused by Candida Auris (APEX)
An Open-Label Study to Evaluate the Efficacy and Safety of APX001 in Patients With Candidemia and/or Invasive Candidiasis Caused by Candida Auris
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Gauteng
-
Alberton, Gauteng, South Africa, 1449
- Netcare Union Hospital Trauma Surgeons
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Johannesburg, Gauteng, South Africa, 2193
- Milpark Academic Trauma Centre
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Limited or no treatment options due to resistance, contraindication, intolerance or lack of clinical response to standard of care antifungal therapy, as advocated by the relevant regional/country treatment guidelines
- Established mycological and clinical diagnosis of candidemia and/or invasive candidiasis caused by Candida auris
- Able to have pre-existing intravascular catheters removed and replaced (if necessary)
- Females of childbearing potential with male partners, and males with female partner(s) of childbearing potential, must agree to use 2 forms of highly effective contraception throughout the duration of the study and for 90 days following the last study drug administration. Females of childbearing potential must have a negative urine pregnancy test within 96 hours prior study entry.
- Wiling to participate in the study, willing to give written informed consent, and willing to comply with the study restrictions; where permitted by local regulations, written informed consent from a legal authorized representative (LAR) will be obtained for patients who are unable to give consent
Exclusion Criteria:
- Life expectancy of less than 7 days in the opinion of the Investigator
- Human immunodeficiency virus-infected patients who are receiving antiretroviral therapy that are moderate to strong inducers of CYP3A4, or who have detectable viremia, or who have had an active opportunistic infection within 6 months prior
- Alanine aminotransferase or aspartate aminotransferase greater than or equal to 5 times the upper limit of normal
- Total bilirubin greater than 3 time the upper limit of normal, unless isolated hyperbilirubinemia or due to documented Gilbert's disease
- Pregnant or lactating female patient
- Inappropriate fungal infection source control
- Investigational drug administered within 30 days prior to dosing or five half-lives whichever is longer
- Diagnosis of deep-seated Candida-related infections causing hardware associated septic arthritis, osteomyelitis, endocarditis, myocarditis, hepatosplenic candidiasis, or a central nervous system infection or site of infection that would require antifungal therapy to exceed the maximal duration of study drug treatment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: APX001
APX001 IV or oral for up to 42 days
|
Day 1: APX001 1000 mg IV BID over a 3-hour infusion Days 2-3: APX001 600 mg IV QD over a 3-hour infusion Days 4 - 42: APX001 600 mg IV QD over a 3-hour infusion or APX001 800 mg QD oral.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of Participants With Treatment Success at End of Study Treatment (EOST) as Determined by Data Review Committee (DRC)
Time Frame: EOST: any day from Day 1 up to maximum of Day 42
|
Treatment success was defined as meeting all of the following criteria: 1) Two consecutive blood cultures negative for Candida species, and/or for participants with a deep-seated site of infection, at least 1 negative tissue culture or aspirate/fluid culture. For participants with a deep-seated site of infection involving visceral organs from which a tissue culture was not obtainable, resolution of the attributable clinical signs of infection recorded at Baseline, and as applicable, radiological improvement associated with the site of infection. 2) Alive at EOST and 3) No concomitant use of any other systemic antifungal therapies through EOST. |
EOST: any day from Day 1 up to maximum of Day 42
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to First Negative Blood Culture
Time Frame: Day 1 up to maximum of Day 42
|
Time to first negative blood culture was defined as the number of days from date of first dose of study drug to the date of first negative blood culture plus 1. Participants without a negative blood culture at post-baseline visits were censored at the last assessment date.
Kaplan-Meier method was used for analysis.
|
Day 1 up to maximum of Day 42
|
Percentage of Participants With Mycological Outcomes at EOST and 2 and 4 Weeks After EOST
Time Frame: EOST: any day from Day 1 up to maximum of Day 42, 2 and 4 weeks after EOST
|
Mycological outcomes were determined based on eradication and presumed eradication.
Eradication was defined as a negative blood (and/or other infection site) culture(s) for Candida species.
Presumed eradication (applicable to invasive candidiasis) was defined as clinical resolution of invasive Candida species infection where tissue samples were unavailable.
These would be applicable only if there were no concomitant or additional systemic antifungal usage.
|
EOST: any day from Day 1 up to maximum of Day 42, 2 and 4 weeks after EOST
|
Percentage of Participants With Treatment Success at EOST Determined by Investigator
Time Frame: EOST: any day from Day 1 up to maximum of Day 42
|
Treatment success was defined as meeting all of the following criteria: 1) Two consecutive blood cultures negative for Candida species, and/or for participants with a deep-seated site of infection, at least 1 negative tissue culture or aspirate/fluid culture. For participants with a deep-seated site of infection involving visceral organs from which a tissue culture was not obtainable, resolution of the attributable clinical signs of infection recorded at Baseline, and as applicable, radiological improvement associated with the site of infection. 2) Alive at EOST and 3) No concomitant use of any other systemic antifungal therapies through EOST. |
EOST: any day from Day 1 up to maximum of Day 42
|
Percentage of Participants With Treatment Success at 2 and 4 Weeks After EOST Determined by Investigator and by the DRC
Time Frame: 2 and 4 weeks after EOST (where EOST is any day from Day 1 up to maximum of Day 42)
|
Treatment success was defined as meeting all of the following criteria: 1) Two consecutive blood cultures negative for Candida species, and/or for participants with a deep-seated site of infection, at least 1 negative tissue culture or aspirate/fluid culture. For participants with a deep-seated site of infection involving visceral organs from which a tissue culture was not obtainable, resolution of the attributable clinical signs of infection recorded at Baseline, and as applicable, radiological improvement associated with the site of infection. 2) Alive at EOST and 3) No concomitant use of any other systemic antifungal therapies through EOST. |
2 and 4 weeks after EOST (where EOST is any day from Day 1 up to maximum of Day 42)
|
All-Cause Mortality Through Study Day 30
Time Frame: Day 1 through Day 30
|
Percentage of participants who died through study Day 30 is reported in this outcome measure.
|
Day 1 through Day 30
|
Number of Participants With Treatment Emergent Adverse Events (TEAEs)
Time Frame: Day 1 up to maximum of 32 days of follow up post last dose of study drug, where maximum treatment duration was 42 days (maximum up to 74 days)
|
An adverse event was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship.
TEAEs were events between first dose of study drug and up to Week 4 (+4 days) post last dose of study drug that were absent before treatment or that worsened relative to pretreatment state.
|
Day 1 up to maximum of 32 days of follow up post last dose of study drug, where maximum treatment duration was 42 days (maximum up to 74 days)
|
Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- APX001-203
- C4791011 (Other Identifier: Alias Study Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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