Faktorielt Randomisert Klinisk Studie for Histoplasmose Induksjons- og Konsolideringsterapi (Histo-FACT)
Faktorielt randomisert klinisk studie av induksjons- og konsolideringsterapi for histoplasmose (Histo-FACT)
The purpose of the study is threefold:
- Assess the safety and efficacy of a single high-dose intravenous (LAmB 10mg/kg) compared to the SOC daily dosing (3mg/kg) of the same medication for induction therapy in moderate to severe histoplasmosis.
- Assess the safety and efficacy of oral posaconazole 300mg delayed-release tablets three times daily for two days then once daily for consolidation therapy compared to SOC oral itraconazole 200 mg capsules three times daily for three days then twice daily in moderate to severe histoplasmosis
- Assess the safety and efficacy of 6 months of consolidation therapy compared to the SOC 12 months of consolidation therapy in persons with HIV on appropriate antiretroviral therapy.
Studieoversikt
Status
Forhold
Studietype
Registrering (Antatt)
Fase
- Fase 3
Kontakter og plasseringer
Studiekontakt
- Navn: Nathan Bahr, MD
- Telefonnummer: 612-624-9996
- E-post: bahrx026@umn.edu
Studiesteder
-
-
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Porto Alegre, Brasil
- Universidade Federal de Ciências da Saúde de Porto Alegre
-
Ta kontakt med:
- Alessandro Pasqualotto
- E-post: pasqualotto@santacasa.org.br
-
-
-
-
Minnesota
-
Minneapolis, Minnesota, Forente stater, 55455
- University of Minnesota
-
Ta kontakt med:
- Nathan Bahr
- E-post: bahrx026@umn.edu
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- Age ≥18 years
- Hospitalized with suspected histoplasmosis b
- Diagnosis of confirmed or probable histoplasmosis (via positive Histoplasma antigen test, culture, histopathology or microscopy)
- Provision of Informed Consent by participant or surrogate c
Exclusion Criteria:
- Previous diagnosis of histoplasmosis
- Pregnant persons (all persons who could potentially be pregnant will have a pregnancy test prior to enrollment, and if negative, must agree to contraception for the duration of the study)
- Breastfeeding and unable to stop for the duration of the study
- Renal impairment (serum creatinine or blood urea nitrogen (BUN) >2.0x upper limit of normal)
- Allergy or contraindication to a study medicine
- More than one dose of an amphotericin product in the prior 7 days
- Suspected central nervous system involvement of histoplasmosis
- Likely to die in the next 48 hours in the judgment of the investigator
- Unlikely to follow up for the duration of the study in the judgement of the investigator
- Significant drug-drug interaction with itraconazole or posaconazole (such as rifampin in persons with TB)
- Current diagnosis of cryptococcosis or leishmaniasis
- QTc interval consistently >450 milliseconds
- Prisoners
- Unable to take oral medications
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Sekvensiell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: Induction Therapy - Experimental
Single high-dose (10mgkg) of LAmB B |
intravenous liposomal amphotericin B (10mg/kg) |
|
Aktiv komparator: Induction Therapy - Standard of Care
SOC daily standard dose (3mg/kg) LAmB |
daily intravenous liposomal amphotericin B 3mg/kg, for 2 weeks or at least 7 days if felt stable for discharge per the clinician |
|
Eksperimentell: Consolidation Therapy - Experimental
posaconazole |
Posaconazole delayed-release tabs, 300mg twice daily on day 1 then once daily |
|
Aktiv komparator: Consolidation Therapy - Standard of Care
SOC itraconazole |
200mg capsules three times daily x 3 days then twice daily |
|
Eksperimentell: Total Consolidation - Experimental
6 months total (e.g., 0 additional months) of itraconazole or posaconazole based on assignment from Aim 2. |
Posaconazole delayed-release tabs, 300mg twice daily on day 1 then once daily 200mg capsules three times daily x 3 days then twice daily |
|
Aktiv komparator: Total Consolidation - Standard of Care
12 months total (e.g., 6 additional months) of itraconazole or posaconazole based on assignment from Aim 2 |
Posaconazole delayed-release tabs, 300mg twice daily on day 1 then once daily 200mg capsules three times daily x 3 days then twice daily |
Hva måler studien?
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Dødelighet etter 2 uker
Tidsramme: Uke 2
|
Uke 2
|
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Dødelighet etter 26 uker
Tidsramme: Uke 26
|
Uke 26
|
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SAE-fri overlevelse mellom 26 og 52 uker fra induksjonsterapi blant de som overlevde 26 uker
Tidsramme: Uke 52
|
Uke 52
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Aim 1: Hierarchical composite end point
Tidsramme: Week 56
|
Consisting of the following in a hierarchical order: 5: Death within 10 weeks or lost to follow up in the first 1 week 4: Serious Adverse event within 10 weeks 3: Grade 4 laboratory abnormality at week two visit or discontinuation of medication due to intolerance during the first 10 weeks 2: Grade 3 laboratory abnormality at week two visit 1: Alive at the end of the study period without one of the above events |
Week 56
|
|
Aim 2: Hierarchical composite end point
Tidsramme: Week 56
|
Consisting of the following in a hierarchical order: 5: Death within the study period 4: Serious Adverse event within 26 weeks 3: Grade 4 laboratory abnormality through week 26 or discontinuation of medication due to intolerance during the first 26 weeks 2: Grade 3 laboratory abnormality through week 26 or or lost to follow up after the first week 1: Alive at the end of the study period without one of the above events |
Week 56
|
Samarbeidspartnere og etterforskere
Sponsor
Samarbeidspartnere
Etterforskere
- Hovedetterforsker: Nathan Bahr, MD, University of Minnesota
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- IDIM-2025-33491
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
Legemiddel- og utstyrsinformasjon, studiedokumenter
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