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Completed

NCT Number: NCT04218851

Posaconazole (MK-5592) Intravenous and Oral in Children With Invasive Aspergillosis (IA) (MK-5592-104)

This study will evaluate the safety, efficacy, and pharmacokinetics of posaconazole (POS) intravenous (IV) and oral formulations in pediatric participants 2 to <18 years of age with invasive aspergillosis (IA).

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Key information

Age range

2 year–17 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

UCL St Luc ( Site 1000), Brussels, Bruxelles-Capitale, Region de, Belgium

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Has a diagnosis of possible, probable, or proven IA per modified 2008/2020 European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) disease definitions
  • Has one or more of pre-defined risks as per modified 2008 EORTC/MSG disease definitions
  • Has a central line (e.g., central venous catheter, peripherally-inserted central catheter) in place or planned to be in place prior to beginning IV study treatment.
  • Has clinical symptoms consistent with an acute episode of IA, defined as duration of clinical syndrome of <30 days.
  • Participants weigh at least 10 kg, and may be of any race/ethnicity.
  • During the intervention period and for at least 30 days after the last dose of study treatment, males agree to be abstinent from heterosexual intercourse or use contraception unless confirmed to be azoospermic (vasectomized or secondary to medical cause).
  • Female is not pregnant or breastfeeding, and is not a woman of child bearing potential (WOCBP) or is a WOCBP using a highly effective contraceptive method. A WOCBP must have a negative highly sensitive pregnancy test (urine or serum as required by local regulations) within 24 hours before the first dose of study intervention.

Exclusion criteria

  • Has chronic (≥30 days' duration) IA, relapsed/recurrent IA, or refractory IA that has not responded to prior antifungal treatment.
  • Has cystic fibrosis, pulmonary sarcoidosis, aspergilloma, or allergic bronchopulmonary aspergillosis
  • Has a known hypersensitivity or other serious adverse reaction to any azole antifungal therapy, or to any other ingredient of the study treatment used.
  • Has any known history of torsade de pointes, unstable cardiac arrhythmia or proarrhythmic conditions, a history of recent myocardial infarction, congenital or acquired QT prolongation, or cardiomyopathy in the context of cardiac failure within 90 days of time of first dose of study treatment.
  • Has known hereditary fructose intolerance.
  • Has a known hereditary problem of galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption.
  • Is or has an immediate family member (eg, spouse, parent/legal guardian, sibling, or child) who is investigational site or Sponsor staff directly involved with this study.
  • Is on artificial ventilation at the time of first dose of study treatment.
  • Has received any treatment prohibited by the protocol.
  • Has enrolled previously in the current study and been discontinued.
  • Is not expected, in the opinion of the investigator, to survive for at least 1 month after the initiation of study treatment.

Treatment and study plan

Posaconazole IV

Drug

Posaconazole (POS) 6 mg/kg body weight by IV infusion

Other names: MK-5592, SCH 056592, Noxafil®

Posaconazole PFS

Drug

Dosing based on weight-band taken orally

Other names: MK-5592, SCH 056592, Noxafil®

Posaconazole tablet

Drug

POS tablet 300 mg taken orally

Other names: MK-5592, SCH 056592, Noxafil®

Primary outcomes

  1. Percentage of Participants Who Experience One or More Treatment-related Adverse Events (AEs)

    Time frame: Up to 14 days after treatment (up to Day 102)

    An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention. Treatment-related AEs were determined by the investigator to be related to the drug. The 95% confidence interval (CI) was based on the exact binomial method by Clopper- Pearson.

Secondary outcomes

  1. Percentage of Participants Who Have a Favorable Global Clinical Response Through Week 6

    Time frame: Up to week 6

    A global clinical response is assessed by the investigator as favorable if the participant is alive and has a complete response (CR) or partial response (PR). CR is defined as survival within the prespecified period of observation, resolution of all attributable symptoms and signs of disease, resolution of radiological lesion(s), and documented clearance of infected sites that are accessible to repeated sampling. PR is defined as survival within the prespecified period of observation, improvement in attributable symptoms and signs of disease, improvement of radiological lesion(s), and evidence of clearance of infected sites that are accessible to repeated sampling.

  2. Percentage of Participants Who Have a Favorable Global Clinical Response Through Week 12

    Time frame: Up to Week 12

    A global clinical response is assessed by the investigator as favorable if the participant is alive and has a complete response (CR) or partial response (PR). CR is defined as survival within the prespecified period of observation, resolution of all attributable symptoms and signs of disease, resolution of radiological lesion(s), and documented clearance of infected sites that are accessible to repeated sampling. PR is defined as survival within the prespecified period of observation, improvement in attributable symptoms and signs of disease, improvement of radiological lesion(s), and evidence of clearance of infected sites that are accessible to repeated sampling.

  3. Percentage of Participants Who Have a Relapse of Invasive Aspergillosis (IA) at Any Point After Achieving Favorable Global Clinical Response

    Time frame: Up to 28 days post-treatment (up to Day 116)

    In participants who achieved favorable global clinical response, relapse of IA is defined as the re-emergence of clinical, radiographic, or other relevant abnormalities indicating IA.

  4. Average Plasma Concentration (Cavg) of POS by Age Cohorts

    Time frame: Pre-dose, Day 1, Weeks 1, 2, 4, 6, 9 and 12

    Steady state Cavg was determined by population PK analysis of plasma concentrations obtained pre-dose up to Week 12 for each of Cohorts 1 and 2, as well as the pooled Cohorts 1 and 2. Some participants had 2 Cavg parameter values (1 for IV dosing, 1 for oral dosing).

  5. Minimum Plasma Concentration (Cmin) of POS by Age Cohorts

    Time frame: Pre-dose, Day 1, Weeks 1, 2, 4, 6, 9 and 12

    Steady state Cmin was determined by population PK analysis of plasma concentrations obtained pre-dose up to Week 12 for each of Cohorts 1 and 2, as well as the pooled Cohorts 1 and 2. Some participants had 2 Cmin parameter values (1 for IV dosing, 1 for oral dosing).

  6. Maximum Plasma Concentration (Cmax) of POS by Age Cohorts

    Time frame: Pre-dose, Day 1, Weeks 1, 2, 4, 6, 9 and 12

    Steady state Cmax was determined by population PK analysis of plasma concentrations obtained pre-dose up to Week 12 for each of Cohorts 1 and 2, as well as the pooled Cohorts 1 and 2. Some participants had 2 Cmax parameter values (1 for IV dosing, 1 for oral dosing).

  7. Area Under the Concentration Time Curve Over the Dosing Interval (AUCtau) of POS by Age Cohorts

    Time frame: Pre-dose, Day 1, Weeks 1, 2, 4, 6, 9 and 12

    Steady state AUCtau was determined by population PK analysis of plasma concentrations obtained pre-dose up to Week 12 for each of Cohorts 1 and 2, as well as the pooled Cohorts 1 and 2. Some participants had 2 AUCtau parameter values (1 for IV dosing, 1 for oral dosing).

  8. Time to Reach Cmax (Tmax) of POS by Age Cohorts

    Time frame: Pre-dose, Day 1, Weeks 1, 2, 4, 6, 9 and 12

    Steady state Tmax was determined by population PK analysis of plasma concentrations obtained pre-dose up to Week 12 for each of Cohorts 1 and 2, as well as the pooled Cohorts 1 and 2. Some participants had 2 Tmax parameter values (1 for IV dosing, 1 for oral dosing).

  9. Average Plasma Concentration (Cavg) of POS by Formulation

    Time frame: Pre-dose, Day 1, Weeks 1, 2, 4, 6, 9 and 12

    Steady-state Cavg was determined by population PK analysis from plasma concentration obtained pre-dose up to Week 12 for each of the POS formulations: IV, PFS and tablet. Some participants may have received more than 1 formulation, and results were only reported when N > 2.

  10. Minimum Plasma Concentration (Cmin) of POS by Formulation

    Time frame: Pre-dose, Day 1, Weeks 1, 2, 4, 6, 9 and 12

    Steady-state Cmin was determined by population PK analysis from plasma concentration obtained pre-dose up to Week 12 for each of the POS formulations: IV, PFS and tablet. Some participants may have received more than 1 formulation, and results were only reported when N > 2.

  11. Maximum Plasma Concentration (Cmax) of POS by Formulation

    Time frame: Pre-dose, Day 1, Weeks 1, 2, 4, 6, 9 and 12

    Steady-state Cmax was determined by population PK analysis from plasma concentration obtained pre-dose up to Week 12 for each of the POS formulations: IV, PFS and tablet. Some participants may have received more than 1 formulation, and results were only reported when N > 2.

  12. Area Under the Concentration Time Curve Over the Dosing Interval (AUCtau) of POS by Formulation

    Time frame: Pre-dose, Day 1, Weeks 1, 2, 4, 6, 9 and 12

    Steady-state AUCtau was determined by population PK analysis from plasma concentration obtained pre-dose up to Week 12 for each of the POS formulations: IV, PFS and tablet. Some participants may have received more than 1 formulation, and results were only reported when N > 2.

  13. Time to Reach Cmax (Tmax) of POS by Formulation

    Time frame: Pre-dose, Day 1, Weeks 1, 2, 4, 6, 9 and 12

    Steady-state Tmax was determined by population PK analysis from plasma concentration obtained pre-dose up to Week 12 for each of the POS formulations: IV, PFS and tablet. Some participants may have received more than 1 formulation, and results were only reported when N > 2.

  14. Percentage of Participants With Different Categories of Palatability After First Day of Treatment With the POS PFS Formulation

    Time frame: First day of PFS treatment (Day 8)

    Palatability was categorized on the first day (Day 8) on PFS based on responses by participants to a palatability questionnaire. Per protocol participants were pooled into a single treatment group. Palatability categories for taste are as follows: Very good; Good; Very bad; Neither good nor bad.

  15. Percentage of Participants With Different Categories of Palatability After Last Day of Treatment With the POS PFS Formulation

    Time frame: Last day of PFS treatment (Day 85)

    Palatability was categorized on the last day (Day 85) on PFS based on responses by participants to a palatability questionnaire. Per protocol participants were pooled into a single treatment group Palatability categories for taste are as follows: Very good; Good; Very bad; Neither good nor bad.

Sponsors and collaborators

Lead sponsor

Merck Sharp & Dohme LLC

Industry

Registry information

Official study title

A Phase 2, Open-Label, Non-Comparative Clinical Trial to Study the Safety and Efficacy of Posaconazole (POS, MK-5592) in Pediatric Participants Aged 2 to Less Than 18 Years With Invasive Aspergillosis

Important dates

Study start
2020
Primary completion
2023
Study completion
2023
First posted
Jan 6, 2020
Registry last updated
Jan 14, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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