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Micafungin Pharmacokinetics in Obese Patients (MICADO)

Primary Purpose

Morbid Obesity

Status
Completed
Phase
Phase 4
Locations
Netherlands
Study Type
Interventional
Intervention
Micafungin
Sponsored by
Radboud University Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Morbid Obesity

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria

  1. Subjects BMI:

    • obese groups: subject must have a BMI > 40 kg/m2 at the time of inclusion,
    • non-obese group: subject must have a BMI ≥18.5 and < 25kg/m2 at the time of inclusion.
  2. Subject is at least 18 of age on the day of screening and not older than 65 years of age on the day of dosing;
  3. If a woman, is neither pregnant nor able to become pregnant and is not nursing an infant;
  4. Subject is able and willing to sign the Informed Consent before screening evaluations.

    For the non-obese subjects the following additional exclusion criteria apply:

  5. Subject is in good age-appropriate health condition as established by medical history, physical examination, electrocardiography, results of biochemistry, hematology and urinalysis testing within 4 weeks prior to study drug administration. Results of biochemistry, hematology and urinalysis testing should be within the laboratory's reference ranges. If laboratory results are not within the reference ranges, the subject is included based on the investigator's judgment that the observed deviations are not clinically relevant. This should be clearly recorded;
  6. Subject has a normal blood pressure and pulse rate, determined by the investigator;
  7. Subject does not smoke more than 10 cigarettes, 2 cigars, or 2 pipes per day for at least 3 months prior to study drug administration.

Exclusion Criteria:

  1. Documented history of sensitivity to medicinal products or excipients similar to those found in the micafungin preparation;
  2. History of, or known abuse of drugs, alcohol or solvents (up until a maximum of three months before study drug administration);
  3. Inability to understand the nature of the trial and the procedures required;
  4. Use of medication that has known interaction with study drug as determined by the investigator up to 4 weeks prior to study drug administration.

    For the non-obese subjects the following additional exclusion criteria apply:

  5. Evidence of organ dysfunction or any clinically significant deviation from normal in physical examination, vital signs or clinical laboratory determinations;
  6. Clinical relevant liver enzymes (alkaline phosphatase, alanine aminotransferase, aspartate transaminase) abnormalities at screening;
  7. Donation of blood or plasma to a blood bank or in a clinical study (except a screening visit) within 4 weeks prior to study drug administration;
  8. Blood transfusion within 8 weeks prior to study drug administration;
  9. Inability to be venipunctured and/or tolerate venous access;
  10. Relevant history or presence of pulmonary disorders (especially COPD), cardiovascular disorders, neurological disorders (especially seizures and migraine), psychiatric disorders, gastro-intestinal disorders, renal disorders, hepatic disorders (Child-Pugh B or C), hormonal disorders (especially diabetes mellitus), coagulation disorders;
  11. Any other sound medical, psychiatric and/or social reason as determined by the investigator.

Sites / Locations

  • St Antoniusziekenhuis
  • Radboudumc CRCN

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Active Comparator

Arm Label

Obese subjects 100mg

Obese subjects 200mg

non-obese subjects

Arm Description

8 subjects with a BMI>40kg/m2 will receive 100mg Micafungin

8 subjects with a BMI>40kg/m2 will receive 200mg Micafungin

8 non obese subjects with a BMI >18.5 and <25 kg/m2 will receive 100mg Micafungin

Outcomes

Primary Outcome Measures

Micafungin concentration in plasma to examen the area under the plasma concentration versus time curve (AUC0-48)
The exposure to micafungin in obese will be compared with that in non-obese subjects.

Secondary Outcome Measures

Long-term exposure to micafungin after repeated dose
Predict long-term exposure (AUC0-tau) after repeated dosing by popPK modeling and simulation.

Full Information

First Posted
January 5, 2017
Last Updated
October 16, 2020
Sponsor
Radboud University Medical Center
Collaborators
St. Antonius Hospital, Astellas Pharma Inc
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1. Study Identification

Unique Protocol Identification Number
NCT03102658
Brief Title
Micafungin Pharmacokinetics in Obese Patients
Acronym
MICADO
Official Title
Micafungin (Mycamine®) Pharmacokinetics Given as a Single Intravenous Dose to Obese Patients (MICADO).
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
January 2017 (Actual)
Primary Completion Date
July 2017 (Actual)
Study Completion Date
July 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Radboud University Medical Center
Collaborators
St. Antonius Hospital, Astellas Pharma Inc

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Because micafungin is generally well tolerated and appears to have limited interaction with other drugs, it is a potential important agent in the treatment of invasive fungal infections. Although micafungin is approved for the treatment of invasive candidiasis, dosing guidelines for micafungin in (morbidly) obese patients are not available. Subsequently, the pharmacokinetic profile of micafungin (as well as other echinocandins) in this specific patient population is still largely unknown. To build a valid pharmacokinetic model, obese patients with a BMI ≥ 40 undergoing endoscopic gastric bypass surgery will receive a single dose of 100 mg or 200mg micafungin (besides standard anti-bacterial prophylaxis) and samples for a pharmacokinetic curve will be taken. These PK-values can then be compared to the PK in a normal-weight group which will receive 100mg micafungin
Detailed Description
Obese patients with a BMI ≥ 40 kg/m2 undergoing endoscopic gastric bypass surgery will receive a 100 mg or a 200mg dose of micafungin. A PK curve will be determined after administration at t=0.5, 0.95, 1.25, 1.5, 2, 4, 8, 12, 24, and (if feasible) 48 hours post infusion. Blood samples (4 mL) on PK days will be taken to obtain at least 2.0 mL of plasma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Morbid Obesity

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Obese subjects 100mg
Arm Type
Experimental
Arm Description
8 subjects with a BMI>40kg/m2 will receive 100mg Micafungin
Arm Title
Obese subjects 200mg
Arm Type
Active Comparator
Arm Description
8 subjects with a BMI>40kg/m2 will receive 200mg Micafungin
Arm Title
non-obese subjects
Arm Type
Active Comparator
Arm Description
8 non obese subjects with a BMI >18.5 and <25 kg/m2 will receive 100mg Micafungin
Intervention Type
Drug
Intervention Name(s)
Micafungin
Other Intervention Name(s)
Mycamine
Intervention Description
Administration of study drug
Primary Outcome Measure Information:
Title
Micafungin concentration in plasma to examen the area under the plasma concentration versus time curve (AUC0-48)
Description
The exposure to micafungin in obese will be compared with that in non-obese subjects.
Time Frame
Up to 3 months
Secondary Outcome Measure Information:
Title
Long-term exposure to micafungin after repeated dose
Description
Predict long-term exposure (AUC0-tau) after repeated dosing by popPK modeling and simulation.
Time Frame
Up to 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria Subjects BMI: obese groups: subject must have a BMI > 40 kg/m2 at the time of inclusion, non-obese group: subject must have a BMI ≥18.5 and < 25kg/m2 at the time of inclusion. Subject is at least 18 of age on the day of screening and not older than 65 years of age on the day of dosing; If a woman, is neither pregnant nor able to become pregnant and is not nursing an infant; Subject is able and willing to sign the Informed Consent before screening evaluations. For the non-obese subjects the following additional exclusion criteria apply: Subject is in good age-appropriate health condition as established by medical history, physical examination, electrocardiography, results of biochemistry, hematology and urinalysis testing within 4 weeks prior to study drug administration. Results of biochemistry, hematology and urinalysis testing should be within the laboratory's reference ranges. If laboratory results are not within the reference ranges, the subject is included based on the investigator's judgment that the observed deviations are not clinically relevant. This should be clearly recorded; Subject has a normal blood pressure and pulse rate, determined by the investigator; Subject does not smoke more than 10 cigarettes, 2 cigars, or 2 pipes per day for at least 3 months prior to study drug administration. Exclusion Criteria: Documented history of sensitivity to medicinal products or excipients similar to those found in the micafungin preparation; History of, or known abuse of drugs, alcohol or solvents (up until a maximum of three months before study drug administration); Inability to understand the nature of the trial and the procedures required; Use of medication that has known interaction with study drug as determined by the investigator up to 4 weeks prior to study drug administration. For the non-obese subjects the following additional exclusion criteria apply: Evidence of organ dysfunction or any clinically significant deviation from normal in physical examination, vital signs or clinical laboratory determinations; Clinical relevant liver enzymes (alkaline phosphatase, alanine aminotransferase, aspartate transaminase) abnormalities at screening; Donation of blood or plasma to a blood bank or in a clinical study (except a screening visit) within 4 weeks prior to study drug administration; Blood transfusion within 8 weeks prior to study drug administration; Inability to be venipunctured and/or tolerate venous access; Relevant history or presence of pulmonary disorders (especially COPD), cardiovascular disorders, neurological disorders (especially seizures and migraine), psychiatric disorders, gastro-intestinal disorders, renal disorders, hepatic disorders (Child-Pugh B or C), hormonal disorders (especially diabetes mellitus), coagulation disorders; Any other sound medical, psychiatric and/or social reason as determined by the investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Roger Brüggemann, PharmD, PhD
Organizational Affiliation
Radboud University Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
St Antoniusziekenhuis
City
Nieuwegein
Country
Netherlands
Facility Name
Radboudumc CRCN
City
Nijmegen
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
30649375
Citation
Wasmann RE, Smit C, Ter Heine R, Koele SE, van Dongen EPH, Wiezer RMJ, Burger DM, Knibbe CAJ, Bruggemann RJM. Pharmacokinetics and probability of target attainment for micafungin in normal-weight and morbidly obese adults. J Antimicrob Chemother. 2019 Apr 1;74(4):978-985. doi: 10.1093/jac/dky554.
Results Reference
result
Links:
URL
https://pubmed.ncbi.nlm.nih.gov/30649375/
Description
paper

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Micafungin Pharmacokinetics in Obese Patients

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