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NCT05421858PHASE3Recruiting

A Phase 3 Efficacy and Safety Study of Fosmanogepix for the Treatment of Adult Participants With Candidemia and/or Invasive Candidiasis.

Basilea Pharmaceutica

Start Date

12/11/2024

Completion Date

1/30/2028

Summary

The purpose of this clinical trial is to learn about the safety and effects of the study medicine (called Fosmanogepix) for the potential treatment of candidemia and/or invasive candidiasis, a life-threatening fungal infection caused by several species of yeast called Candida. The study is seeking patients who have a diagnosis of candidemia and/or invasive candidiasis. Two-thirds of all patients will receive the study medication fosmanogepix Intravenous (IV) infusion followed by optional fosmanogepix tablets. One-third of all patients will receive a standard of care regimen of caspofungin Intravenous (IV) infusion followed by optional fluconazole capsules. Fosmanogepix or caspofungin will first be given as an Intravenous (IV) infusion directly into a vein in the arm each day at the study clinic. Fosmanogepix tablets or fluconazole capsules will be taken orally by mouth daily either at the study clinic, or at home if patients are well enough to be discharged from the hospital. The treatment effect in patients receiving fosmanogepix to those receiving caspofungin/ fluconazole will be compared. The primary aim is to show that fosmanogepix is not inferior (not worse) to caspofungin/ fluconazole with a noninferiority margin of 15%. The duration of study treatment and number of study visits will vary depending on how long the patient will be treated for the infection. Treatment will continue for a maximum of 6 weeks depending on when the infection is cleared and whether other symptoms related to the infection have improved. There will also be a follow-up visit 6 weeks after the study treatment was stopped.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: 1. Patients ≥ 18 years (or the minimum country-specific age of consent if \> 18) at Screening who have provided signed informed consent indicating that they understand the purpose of, and procedures required for, the study, and are willing to participate in the study. If the patient is unable to consent for himself/herself, a legally authorized representative must provide informed consent on his/her behalf. 2. Diagnosis of candidemia and/or invasive candidiasis based on a blood or non-blood specimen obtained within ≤ 96 hours (4 days) before randomization, and on clinical criteria judged attributable to candidemia/invasive candidiasis occurring at any time from ≤ 12 hours prior to the qualifying positive index culture being taken through to randomization. 3. Patient's condition allows for appropriate infection source control measures, including removal of pre-existing intravascular catheters and devices, if necessary. Exclusion Criteria: 1. Existing infection 1. Infection known to be due to Candida krusei, in blood or any other normally sterile site. 2. Inappropriate fungal infection source control. 3. Diagnosis of certain deep-seated Candida infections. 2. Life expectancy of \< 72 hours in the opinion of the investigator. 3. Requirement, or expected requirement, for hemodialysis, peritoneal dialysis, or hemofiltration. 4. Ongoing neurological disorders, including specified conditions presenting with a CTCAE Grade ≥ 2 (neurological symptoms that are considered to be a consequence of the current episode of candidemia / invasive candidiasis are not exclusionary). 5. Patients with known human immunodeficiency virus infection, who have CD4+ count \< 200/mm3 or viral load \> 400 copies/mL), or who have had an active opportunistic infection within 6 months prior to Screening. 6. Other medical or psychiatric condition or laboratory abnormality that may increase the risk of study participation or make the patient inappropriate for the study. 7. Current use of any prohibited concomitant medications or those unwilling/unable to use a permitted concomitant medication. 8. Received \> 2 days (\> 48 hours) equivalent of prior systemic antifungal treatment at approved doses and frequency to treat the current episode of candidemia and/or invasive candidiasis (e.g., \> 2 doses of a once daily antifungal agent or \> 4 doses of a twice daily antifungal agent), within the 96 hours prior to randomization (except for non-susceptible Candida spp. and for patients who develop candidemia or invasive candidiasis while on prophylaxis with an azole or amphotericin B). 9. Previous administration with an investigational drug or investigational vaccine within 30 days or 5 half-lives preceding the first dose of study drug used in this study (whichever is longer). 10. Prior participation in this or any previous study of fosmanogepix. 11. Moderate or severe hepatic impairment, known active viral hepatitis B or C, ALT or AST ≥ 5 × ULN or total bilirubin \> 3 × ULN unless this is due to isolated hyperbilirubinemia or documented Gilbert's syndrome. 12. Female patient is pregnant or lactating. 13. Known hypersensitivity to fosmanogepix, manogepix, caspofungin, any echinocandin, fluconazole or to any of their excipients. 14. Investigator site staff directly involved in the conduct of the study and their family members, site staff otherwise supervised by the investigator, and Sponsor and Sponsor delegate employees directly involved in the conduct of the study and their family members.

Interventions

DRUG

Fosmanogepix

DRUG

Fosmanogepix

DRUG

Caspofungin

DRUG

Fluconazole

DRUG

Placebo

DRUG

Placebo

DRUG

Placebo

DRUG

Placebo

Interested in This Trial?

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Conditions

CandidemiaCandidiasis, Invasive

Locations

University of Alabama at Birmingham School of Medicine, Department of Medicine

Birmingham, Alabama 35294-0006

United States

City of Hope

Duarte, California 91010

United States

David Geffen School of Medicine at UCLA

Los Angeles, California 90095

United States

UC Davis Medical Center

Sacramento, California 95817

United States

Emory University Hospital - Clifton Road

Atlanta, Georgia 30322

United States

Augusta University Medical Center

Augusta, Georgia 30912-5563

United States

Indiana University Methodist Hospital

Indianapolis, Indiana 46202

United States

University of Kentucky College of Medicine

Lexington, Kentucky 40506

United States

Johns Hopkins Hospital

Baltimore, Maryland 21287

United States

University of Michigan Health System (UMHS) - A. Alfred Taubman Health Care Center

Ann Arbor, Michigan 48109-5000

United States

DMC Harper University Hospital

Detroit, Michigan 48201

United States

Henry Ford Hospital, Department of Medicine, Division of Infectious Diseases

Detroit, Michigan 48202

United States

University of Minnesota

Minneapolis, Minnesota 55455

United States

Washington University School of Medicine, Infectious Diseases Clinical Research Unit

St Louis, Missouri 63110

United States

Weill Cornell Medical College - NewYork-Presbyterian Hospital

New York, New York 10065

United States

University of North Carolina at Chapel Hill

Chapel Hill, North Carolina 27514

United States

University of Pennsylvania School of Medicine

Philadelphia, Pennsylvania 19104-6243

United States

UPMC Presbyterian

Pittsburgh, Pennsylvania 15213-2582

United States

Houston Methodist Hospital - Texas Medical Center

Houston, Texas 77030

United States

The University of Texas Health Science Center at Houston

Houston, Texas 77030

United States

U.T. MD Anderson Cancer Center

Houston, Texas 77030

United States

University of Texas Health Science Center at San Antonio

San Antonio, Texas 78229

United States

Carilion Clinic

Roanoke, Virginia 24014

United States

Central Hospital de San Isidro Melchor Posse

Buenos Aires, B1641

Argentina

Buenos Aires Italian Hospital, Department of Infectious Diseases

Buenos Aires, C1199ABB

Argentina

Cordoba Private University Hospital, Department of Infectious Diseases

Córdoba, X5016KEH

Argentina

Italian Hospital of La Plata, Department of Infectious Diseases

La Plata, B1900

Argentina

Central Hospital Mendoza

Mendoza, M5500IDN

Argentina

British Sanatorium SA

Rosario, S2000CVB

Argentina

Westmead Hospital

Sydney, New South Wales 2145

Australia

Princess Alexandra Hospital

Woolloongabba, Queensland 4102

Australia

Peter MacCallum Cancer Center, State

Melbourne, Victoria 3000

Australia

The Alfred Hospital

Melbourne, Victoria 3004

Australia

Royal Melbourne Hospital

Parkville, Victoria 3050

Australia

Monash Medical Center Clayton

Clayton, 3168

Australia

University Hospital Graz, Department of Internal Medicine

Graz, 1100

Austria

Kepler University Hospital GmbH, Department of Pulmonology, Clinical Department of Infectious Diseases

Linz, 4021

Austria

Medical University Vienna

Vienna, 1090

Austria

Hospital Favoriten, Department of Internal Medicine IV - Infectious Diseases and Tropical Medicine

Vienna, 1100

Austria

General Hospital Saint-Jan

Bruges, 8000

Belgium

University Hospital Brussels

Brussels, 1090

Belgium

Saint Luc University Hospital, Department of Internal Medicine

Brussels, 1200

Belgium

Erasme Hospital, Department of Infectious and Tropical Diseases

Brussels, B-1070

Belgium

Jessa Hospital

Hasselt, 3500

Belgium

University Hospitals Leuven, Campus Gasthuisberg, Department of Infectious Diseases

Leuven, 3000

Belgium

UCL Mont-Godinne University Hospitals

Yvoir, 5530

Belgium

HC-UFPR

Curitiba, Paraná 80060-900

Brazil

Hospital Our Lady of Grace

Curitiba, Paraná 80810-040

Brazil

Porto Alegre Clinical Hospital (HCPA), Infectious Diseases / Internal Medicine

Porto Alegre, Rio Grande do Sul 90035-903

Brazil

Pontifical University Of Rio Grande Do Sul (PUCRS) - St. Luke Hospital

Porto Alegre, Rio Grande do Sul 90610-000

Brazil

Santa Marcelina Hospital

São Paulo, São Paulo 08270-070

Brazil

Eurohospital University Hospital

Plovdiv, 4004

Bulgaria

University Medical Center "N. I. Pirogov", Burns and Plastic Surgery Clinic

Sofia, 1606

Bulgaria

University Medical Center "N. I. Pirogov", Clinic of Purulent-Septic Surgery

Sofia, 1606

Bulgaria

China-Japan Friendship Hospital

Beijing, 100029

China

The First Affiliated Hospital of Bengbu Medical College

Bengbu, 233099

China

West China Hospital, Sichuan University

Chengdu, 610041

China

Guangzhou First People's Hospital

Guangzhou, 510180

China

The First Affiliated Hospital of Guangzhou Medical University

Guangzhou, 510230

China

Zhejiang Provincal Hospital of Chinese Medicine

Hangzhou, 310006

China

Zhejiang Provincial People's Hospital

Hangzhou, 310014

China

Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine

Hangzhou, 310016

China

Lishui People's Hospital

Lishui, 323000

China

Liuzhou People's Hospital

Liuzhou, 530021

China

The 1st Affiliated Hospital of Nanchang University

Nanchang, 330006

China

Qingyuan People's Hospital

Qingyuan, 511518

China

Huashan Hospital

Shanghai, 200040

China

Shenzhen Third People's Hospital

Shenzhen, 518112

China

Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences

Tianjin, 301617

China

Central Hospital of Wuhan

Wuhan, 430014

China

Zhongnan Hospital of Wuhan University

Wuhan, 430071

China

Wuxi People's Hospital

Wuxi, 214023

China

The First Affiliated Hospital of Henan University of Science and Technology

Zhengzhou, 471003

China

Cardiomet CEQUIN Foundation, Department of Nephrology

Armenia, 630004

Colombia

Hospital Alma Mater de Antioquia

Medellín, 050012

Colombia

Luz Castro de Gutierrez Medellin General Hospital, Research Center

Medellín, 050015

Colombia

Pablo Tobon Uribe Hospital

Medellín, 050034

Colombia

High Technology Medical Institute S.A.S, IMAT S.A.S.

Montería, 230002

Colombia

Somer Clinic

Rionegro, 54040

Colombia

Amiens Picardie University Hospital - South, Intensive Care Unit (ICU)

Amiens, 80054

France

Victor Dupouy Hospital Center Argenteuil, Intensive Care Unit

Argenteuil, 95107

France

Marseille Nord University Hospitals - AP-HM, Medical Intensive Care Unit, Acute Respiratory Distress and Severe Infections

Marseille, 13015

France

Nantes University Hospital Center - Hotel Dieu Hospital, Department of Infectious and Tropical Diseases

Nantes, 44000

France

Rennes University Hospital Center - Hospital Pontchaillou

Rennes, 35000

France

Tours Regional University Hospital Center

Tours, 37000

France

University Hospital Ulm, Comprehensive Infectious Diseases Center Ulm (CIDCU)

Ulm, Baden-Wurttemberg 89081

Germany

University Hospital Regensburg

Regensburg, Bavaria 93053

Germany

Frankfurt University Clinic

Frankfurt am Main, Hesse 60590

Germany

University Hospital Giessen and Marburg GmbH

Giessen, Hesse 35392

Germany

University Hospital Cologne, Department of Internal Medicine I, Clinical Study Centre II for Infectious Diseases

Cologne, North Rhine-Westphalia 50937

Germany

University Hospital Heidelberg, Clinic for Anesthesiology

Heidelberg, 69120

Germany

"LAIKO" General Hospital

Athens, 115 27

Greece

"Sotiria" Chest Diseases Hospital of Athens

Athens, 11527

Greece

General Hospital of Athens "Evangelismos", 5th Department of Internal Medicine and Infectious Diseases Unit

Athens, PC 10676

Greece

University General Hospital of Heraklion

Heraklion, 715 00

Greece

Tzaneio General Hospital

Piraeus, 185 36

Greece

General Hospital of Thessaloniki "Ippokratio"

Thessaloniki, 54642

Greece

Rambam Health Care Campus, Institute of Infectious Diseases

Haifa, 3109601

Israel

Edith Wolfson Medical Center, Department of Infectious Diseases

Holon, 58100

Israel

Chaim Sheba Medical Center, Department of Infectious Diseases

Ramat Gan, 52621

Israel

The Tel Aviv Sourasky Medical Center, Infectious Diseases Unit

Tel Aviv, 6423906

Israel

Shamir Medical Center, Department of Infectious Diseases

Ẕerifin, 7033001

Israel

Hospital "S. Croce e Carle"

Cuneo, 12100

Italy

IRCCS Policlinic Hospital San Martino

Genoa, 16132

Italy

Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda

Milan, 20122

Italy

Hospital San Raffaele, IRCCS

Milan, 20132

Italy

Big Metropolitan Hospital Niguarda Regional Health Authority

Milan, 20162

Italy

University Polyclinic Hospital of Modena

Modena, 41124

Italy

Polyclinic San Matteo, IRCCS

Pavia, 27100

Italy

University Hospital of Pisa

Pisa, 56124

Italy

AOU Senese

Siena, 53100

Italy

Giuliano Isontina University Health Authority

Trieste, 34125

Italy

National University Hospital

Singapore, 119074

Singapore

Singapore General Hospital

Singapore, 169608

Singapore

Tan Tock Seng Hospital

Singapore, 308433

Singapore

Helen Joseph Hospital

Johannesburg, 2092

South Africa

Milpark Hospital

Johannesburg, 2193

South Africa

Ryexo Clinical Research

Pretoria, 0084

South Africa

University of Pretoria / Steve Biko Academic Hospital

Pretoria, 0084

South Africa

Practice of R Moodley and MI Sarvan - Umhlanga

Umhlanga, 4320

South Africa

Kyungpook National University Hospital

Daegu, 41944

South Korea

Severance Hospital, Yonsei University Health System

Seoul, 03722

South Korea

Samsung Medical Center

Seoul, 06351

South Korea

Ajou University Hospital

Suwon, 16499

South Korea

University Hospital Virgen Macarena

Seville, Andalusia 41009

Spain

University Hospital Nuestra Senora de Valme

Seville, Andalusia 41014

Spain

Hospital del Mar, Department of Infectious Diseases

Barcelona, Catalonia 08003

Spain

University Hospital Vall d'Hebron, Intensive Care Unit (ICU)

Barcelona, Catalonia 08035

Spain

Hospital Clinic of Barcelona, Department of Infectious Diseases

Barcelona, Catalonia 08036

Spain

University Hospital Ramon y Cajal, Department of Infectious Diseases

Madrid, Madrid 28034

Spain

University Hospital Cruces

Barakaldo, 48903

Spain

Kaohsiung Medical University Chung-Ho Memorial Hospital

Kaohsiung City, 807377

Taiwan

Kaohsiung Chang Gung Memorial Hospital

Kaohsiung City, 833401

Taiwan

Far Eastern Memorial Hospital

New Taipei City, 220

Taiwan

China Medical University Hospital

Taichung, 404327

Taiwan

Taichung Veterans General Hospital

Taichung, 407219

Taiwan

Taipei Medical University Hospital

Taipei, 11000

Taiwan

Taipei Veterans General Hospital

Taipei, 112201

Taiwan

Linkou Chang Gung Memorial Hospital

Taoyuan City, 333

Taiwan

Vajira Hospital

Bangkok, 10300

Thailand

Siriraj Hospital

Bangkok, 10700

Thailand

Maharaj Nakorn Chiang Mai Hospital

Chiang Mai, 50200

Thailand

Songklanagarind Hospital

Hat Yai, 90110

Thailand

Srinagarind Hospital

Khon Kaen, 40002

Thailand