Trial of Combination Antifungal Therapy (Vori+Mica vs. Vori+Placebo) in Invasive Aspergillosis
Aspergillosis
About this trial
This is an interventional treatment trial for Aspergillosis
Eligibility Criteria
Inclusion Criteria:
The patient or legally authorized representative has signed an informed consent/assent.
Assent will be obtained as required by the UAMS IRB.
- The patient has a diagnosis of proven or probable invasive aspergillosis and with positive Aspergillus GM index (≥0.5 ng/ml) provide the patient is not receiving antibiotics, such as piperacillin-tazobactam, that are known to cause false positive GMI
- The patient is 18 years of age or older.
Exclusion Criteria:
- The patient is being treated with an unlicensed investigational drug for aspergillosis.
- The patient has been administered an antifungal agent (voriconazole, itraconazole, posaconazole, caspofungin, micafungin, anidulafungin, amphotericin B, or lipid formulation of amphotericin B) for > 7 days immediately prior to randomization for treatment of the Probable, or Proven invasive aspergillosis for which the patient is being enrolled.
- Patient has invasive aspergillosis but with negative Aspergillus GM index.
- The patient is pregnant or lactating. If the patient is female and of childbearing potential, the patient must have a negative pregnancy test and avoid becoming pregnant while receiving study drug. A pregnancy test should be performed within 14 days prior to the first dose of study drug.
- The patient has alkaline phosphatase, ALT, AST or total bilirubin greater than five times the upper limit of normal.
- The patient has hepatic cirrhosis.
- Patients with creatinine > 3 will be enrolled only if able to receive oral voriconazole (specify oral loading dose is 6 mg/kg PO Q 12 hours for 24 hours) then oral maintenance 200 mg PO q 12 hours).
- The patient is on artificial ventilation, and unlikely to be extubated within 24 hours of study entry.
- The patient has a history of allergy, hypersensitivity, or any serious reaction to the azole or echinocandin class of antifungal agents.
- The patient has previously enrolled into this study.
- The patient has a concomitant medical condition, which in the opinion of the Investigator may create an unacceptable additional risk.
- The patient has an active microbiologically-documented deep infection due to a non-Aspergillus mold.
- The patient has a life expectancy of less than seven days.
Sites / Locations
- UAMS
- University of Arkansas
Arms of the Study
Arm 1
Arm 2
Active Comparator
No Intervention
Voriconazole, Micafungin
Voriconazole+Micafungin or Voriconazole+Placebo
Patients will receive either IV micafungin 100 mg or placebo equivalent daily. Intravenous (IV) Voriconazole will be administered at a loading dose of 6 mg/kg every 12 hours for the first 24 hours followed by a maintenance dose of 4 mg/kg every 12 hours. Patients may be switched to oral voriconazole 200 mg BID provided aspergillosis response is achieved and gastrointestinal functions are intact.
Voriconazole+Micafungin or Voriconazole+Placebo