search
Back to results

A Study of Intravenous and Oral Isavuconazonium Sulfate in Pediatric Patients

Primary Purpose

Hematological Malignancy

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
isavuconazonium sulfate - intravenous
isavuconazonium sulfate - oral
Sponsored by
Astellas Pharma Global Development, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hematological Malignancy focused on measuring invasive fungal disease, Cresemba®, Hematological malignancy, isavuconazonium sulfate, ASP9766, isavuconazole, pediatric population

Eligibility Criteria

1 Year - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subject has sufficient venous access to permit administration of study drug (for the IV cohorts), collection of pharmacokinetic samples and monitoring of safety laboratories.
  • Female subject must either:

    • Be of non-childbearing potential: Clearly premenarchal or documented surgically sterile
    • Or, if of childbearing potential: Agree not to try to become pregnant during the study and for 28 days after the final study drug administration; and have a negative urine or serum pregnancy test at screening; and, if heterosexually active, agree to consistently use 2 forms of highly effective birth control (at least one of which must be a barrier method) starting at screening and throughout the study and for 28 days after the final study drug administration.
  • Female subject who is of childbearing potential must agree not to breastfeed starting at screening and throughout the study and for 28 days after the final study drug administration.
  • Female subject who is of childbearing potential must not donate ova starting at screening and throughout the study and for 28 days after the final study drug administration.
  • Male subject who is of childbearing potential and their female spouse/partner who is of childbearing potential must be using highly effective contraception consisting of 2 forms of birth control (at least one of which must be a barrier method) starting at screening and continue throughout the study, and for 90 days after the final study drug administration.
  • Male subject who is of childbearing potential must not donate sperm starting at screening and throughout the study and, for 90 days after the final study drug administration.
  • Subject and subject's parent(s) or legal guardian agree that the subject will not participate in another interventional study while on treatment.
  • For oral cohorts: subject is able to swallow the oral capsule medication.

Exclusion Criteria:

  • Subject has familial short QT syndrome, is receiving medications that are known to shorten the QT interval, or has a clinically significant abnormal electrocardiogram (ECG).
  • Subject has evidence of hepatic dysfunction defined as:

    • Total bilirubin ≥ 3 times the upper limit of normal (ULN)
    • Alanine transaminase or aspartate transaminase ≥ 5 times the ULN
    • Known cirrhosis or chronic hepatic failure
  • Subject has used strong cytochrome P450 (CYP) 3A4 inhibitors or inducers such as ketoconazole, rifampin/rifampicin, long acting barbiturates, carbamazepine and St. John's wort in the 5 days prior to the first administration of study drug.
  • Subject has known history of allergy, hypersensitivity, or any serious reaction to any of the azole class antifungals.
  • Subject has any condition which makes the subject unsuitable for study participation.
  • Subject is unlikely to survive 30 days.
  • Subject has received investigational therapy, with the exception of oncology drug trials, within 28 days or 5 half-lives, whichever is longer, prior to screening.
  • For oral cohorts: The subject has gastrointestinal disease or has had a procedure that is expected to interfere with the oral absorption or tolerance of the study drug (e.g., functionally relevant gastrointestinal obstruction, mucositis/stomatitis, or frequent vomiting).
  • Subject previously dosed with isavuconazonium sulfate.

Sites / Locations

  • Miller Children's Hospital
  • Children's Hospital Los Angeles
  • CHOC Children's Hospital of Orange County
  • Nicklaus Children's Hospital
  • Emory University School of Medicine
  • Ann & Robert H Lurie Children's Hospital of Chicago
  • University of Louisville
  • Children's Hospitals and Clinics of Minnesota
  • Children's Mercy Kansas City
  • Duke University Medical Center
  • Cincinnati Children's Hospital Medical Center
  • University Hospital of Cleveland
  • Children's Hospital of Philadelphia
  • The Children's Hospital at TriStar Centennial Medical Center
  • University of Texas Southwestern Medical Center
  • Texas Children's Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

isavuconazonium sulfate IV cohort 1: 1 to < 6 years of age

isavuconazonium sulfate IV cohort 2: 6 to < 12 years of age

isavuconazonium sulfate IV cohort 3: 12 to < 18 years of age

isavuconazonium sulfate oral cohort 4: 6 to < 12 years of age

isavuconazonium sulfate oral cohort 5: 12 to < 18 years of age

Arm Description

Patients will receive an intravenous (IV) loading regimen of isavuconazonium sulfate, which consists of a dose every 8 hours (+/- 2 hours) on days 1 and 2, followed by once daily IV maintenance dosing for up to 26 additional days (for a maximum of 28 days of dosing).

Patients will receive an IV loading regimen of isavuconazonium sulfate, which consists of a dose every 8 hours (+/- 2 hours) on days 1 and 2, followed by once daily IV maintenance dosing for up to 26 additional days (for a maximum of 28 days of dosing).

Patients will receive an IV loading regimen of isavuconazonium sulfate, which consists of a dose every 8 hours (+/- 2 hours) on days 1 and 2, followed by once daily IV maintenance dosing for up to 26 additional days (for a maximum of 28 days of dosing).

Patients will receive a loading regimen of isavuconazonium sulfate by oral administration, comprising one dose every 8 hours (+/- 2 hours) on days 1 and 2 (a total of six doses), followed by once daily oral maintenance dosing for up to 26 additional days (for a maximum of 28 days of dosing).

Patients will receive a loading regimen of isavuconazonium sulfate by oral administration, comprising one dose every 8 hours (+/- 2 hours) on days 1 and 2 (a total of six doses), followed by once daily oral maintenance dosing for up to 26 additional days (for a maximum of 28 days of dosing).

Outcomes

Primary Outcome Measures

Pharmacokinetics (PK) of isavuconazole in plasma: Cmax at steady state
Maximum concentration at steady state (Cmax) will be derived from the PK plasma samples collected.
PK of isavuconazole in plasma: AUCtau
Area under the concentration time curve from the time of dosing to the start of next dosing interval at multiple dose conditions (AUCtau) will be derived from the PK plasma samples collected.
PK of isavuconazole in plasma: tmax
Time of maximum concentration (tmax) will be derived from the PK plasma samples collected.
PK of isavuconazole in plasma: Ctrough
Concentration - trough level (Ctrough) will be derived from the PK plasma samples collected.
PK of isavuconazole in plasma: CL
Clearance (CL) will be model-derived.
PK of isavuconazole in plasma: Vss
Volume of distribution at steady state (Vss) will be model-derived.
PK of isavuconazole in plasma: AUCss
Area under the concentration-time curve at steady state (AUCss) will be model-derived.
PK of isavuconazole in plasma: t 1/2
Half-life (t1/2) will be model-derived.
Safety assessed by nature, frequency and severity of Treatment Emergent Adverse Events (TEAEs)
A TEAE is defined as an Adverse Event (AE) observed after starting administration of the study drug through follow-up. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA). Number of patients with TEAE's will be summarized.
Number of patients with vital sign abnormalities and/or adverse events
An abnormality identified during a medical test (e.g. vital signs) should be defined as an AE only if the abnormality meets 1 of the following criteria: induces clinical signs or symptoms; requires active intervention; requires interruption or discontinuation of study drug; or the abnormality or test value is clinically significant.
Number of patients with laboratory value abnormalities and/or adverse events
An abnormality identified during a medical test (e.g. laboratory parameter) should be defined as an AE only if the abnormality meets 1 of the following criteria: induces clinical signs or symptoms; requires active intervention; requires interruption or discontinuation of study drug; or the abnormality or test value is clinically significant.
Safety assessed by routine 12- lead electrocardiogram (ECG)
Standard 12-lead ECG recordings will be used for the purposes of safety assessment. A 12-lead, resting ECG is to be recorded. Patients should remain supine for at least 5 minutes prior to all ECGs being performed. The results (normal, abnormal not clinically significant, abnormal clinically significant) are to be recorded.

Secondary Outcome Measures

Full Information

First Posted
August 3, 2017
Last Updated
June 30, 2020
Sponsor
Astellas Pharma Global Development, Inc.
Collaborators
Basilea Pharmaceutica International Ltd
search

1. Study Identification

Unique Protocol Identification Number
NCT03241550
Brief Title
A Study of Intravenous and Oral Isavuconazonium Sulfate in Pediatric Patients
Official Title
A Phase 1, Open-label, Multicenter, Non-comparative Pharmacokinetics and Safety Study of Intravenous and Oral Isavuconazonium Sulfate in Pediatric Patients
Study Type
Interventional

2. Study Status

Record Verification Date
July 2020
Overall Recruitment Status
Completed
Study Start Date
October 2, 2017 (Actual)
Primary Completion Date
July 5, 2019 (Actual)
Study Completion Date
July 5, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Astellas Pharma Global Development, Inc.
Collaborators
Basilea Pharmaceutica International Ltd

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the study is to evaluate the pharmacokinetics (PK), safety and tolerability of multiple doses of intravenous (IV) and oral isavuconazonium sulfate administered daily in pediatric patients. The PK data will be utilized to establish a pediatric population PK model of isavuconazole, the active moiety of isavuconazonium sulfate.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hematological Malignancy
Keywords
invasive fungal disease, Cresemba®, Hematological malignancy, isavuconazonium sulfate, ASP9766, isavuconazole, pediatric population

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
49 (Actual)

8. Arms, Groups, and Interventions

Arm Title
isavuconazonium sulfate IV cohort 1: 1 to < 6 years of age
Arm Type
Experimental
Arm Description
Patients will receive an intravenous (IV) loading regimen of isavuconazonium sulfate, which consists of a dose every 8 hours (+/- 2 hours) on days 1 and 2, followed by once daily IV maintenance dosing for up to 26 additional days (for a maximum of 28 days of dosing).
Arm Title
isavuconazonium sulfate IV cohort 2: 6 to < 12 years of age
Arm Type
Experimental
Arm Description
Patients will receive an IV loading regimen of isavuconazonium sulfate, which consists of a dose every 8 hours (+/- 2 hours) on days 1 and 2, followed by once daily IV maintenance dosing for up to 26 additional days (for a maximum of 28 days of dosing).
Arm Title
isavuconazonium sulfate IV cohort 3: 12 to < 18 years of age
Arm Type
Experimental
Arm Description
Patients will receive an IV loading regimen of isavuconazonium sulfate, which consists of a dose every 8 hours (+/- 2 hours) on days 1 and 2, followed by once daily IV maintenance dosing for up to 26 additional days (for a maximum of 28 days of dosing).
Arm Title
isavuconazonium sulfate oral cohort 4: 6 to < 12 years of age
Arm Type
Experimental
Arm Description
Patients will receive a loading regimen of isavuconazonium sulfate by oral administration, comprising one dose every 8 hours (+/- 2 hours) on days 1 and 2 (a total of six doses), followed by once daily oral maintenance dosing for up to 26 additional days (for a maximum of 28 days of dosing).
Arm Title
isavuconazonium sulfate oral cohort 5: 12 to < 18 years of age
Arm Type
Experimental
Arm Description
Patients will receive a loading regimen of isavuconazonium sulfate by oral administration, comprising one dose every 8 hours (+/- 2 hours) on days 1 and 2 (a total of six doses), followed by once daily oral maintenance dosing for up to 26 additional days (for a maximum of 28 days of dosing).
Intervention Type
Drug
Intervention Name(s)
isavuconazonium sulfate - intravenous
Other Intervention Name(s)
Cresemba®
Intervention Description
IV infusion
Intervention Type
Drug
Intervention Name(s)
isavuconazonium sulfate - oral
Other Intervention Name(s)
Cresemba®
Intervention Description
Oral
Primary Outcome Measure Information:
Title
Pharmacokinetics (PK) of isavuconazole in plasma: Cmax at steady state
Description
Maximum concentration at steady state (Cmax) will be derived from the PK plasma samples collected.
Time Frame
Up to 7 days
Title
PK of isavuconazole in plasma: AUCtau
Description
Area under the concentration time curve from the time of dosing to the start of next dosing interval at multiple dose conditions (AUCtau) will be derived from the PK plasma samples collected.
Time Frame
Up to 7 days
Title
PK of isavuconazole in plasma: tmax
Description
Time of maximum concentration (tmax) will be derived from the PK plasma samples collected.
Time Frame
Up to 7 days
Title
PK of isavuconazole in plasma: Ctrough
Description
Concentration - trough level (Ctrough) will be derived from the PK plasma samples collected.
Time Frame
Up to 28 days
Title
PK of isavuconazole in plasma: CL
Description
Clearance (CL) will be model-derived.
Time Frame
Up to 28 days
Title
PK of isavuconazole in plasma: Vss
Description
Volume of distribution at steady state (Vss) will be model-derived.
Time Frame
Up to 28 days
Title
PK of isavuconazole in plasma: AUCss
Description
Area under the concentration-time curve at steady state (AUCss) will be model-derived.
Time Frame
Up to 28 days
Title
PK of isavuconazole in plasma: t 1/2
Description
Half-life (t1/2) will be model-derived.
Time Frame
Up to 28 days
Title
Safety assessed by nature, frequency and severity of Treatment Emergent Adverse Events (TEAEs)
Description
A TEAE is defined as an Adverse Event (AE) observed after starting administration of the study drug through follow-up. AEs will be coded using the Medical Dictionary for Regulatory Activities (MedDRA). Number of patients with TEAE's will be summarized.
Time Frame
Up to 58 days
Title
Number of patients with vital sign abnormalities and/or adverse events
Description
An abnormality identified during a medical test (e.g. vital signs) should be defined as an AE only if the abnormality meets 1 of the following criteria: induces clinical signs or symptoms; requires active intervention; requires interruption or discontinuation of study drug; or the abnormality or test value is clinically significant.
Time Frame
Up to 28 days
Title
Number of patients with laboratory value abnormalities and/or adverse events
Description
An abnormality identified during a medical test (e.g. laboratory parameter) should be defined as an AE only if the abnormality meets 1 of the following criteria: induces clinical signs or symptoms; requires active intervention; requires interruption or discontinuation of study drug; or the abnormality or test value is clinically significant.
Time Frame
Up to 28 days
Title
Safety assessed by routine 12- lead electrocardiogram (ECG)
Description
Standard 12-lead ECG recordings will be used for the purposes of safety assessment. A 12-lead, resting ECG is to be recorded. Patients should remain supine for at least 5 minutes prior to all ECGs being performed. The results (normal, abnormal not clinically significant, abnormal clinically significant) are to be recorded.
Time Frame
Up to 28 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject has sufficient venous access to permit administration of study drug (for the IV cohorts), collection of pharmacokinetic samples and monitoring of safety laboratories. Female subject must either: Be of non-childbearing potential: Clearly premenarchal or documented surgically sterile Or, if of childbearing potential: Agree not to try to become pregnant during the study and for 28 days after the final study drug administration; and have a negative urine or serum pregnancy test at screening; and, if heterosexually active, agree to consistently use 2 forms of highly effective birth control (at least one of which must be a barrier method) starting at screening and throughout the study and for 28 days after the final study drug administration. Female subject who is of childbearing potential must agree not to breastfeed starting at screening and throughout the study and for 28 days after the final study drug administration. Female subject who is of childbearing potential must not donate ova starting at screening and throughout the study and for 28 days after the final study drug administration. Male subject who is of childbearing potential and their female spouse/partner who is of childbearing potential must be using highly effective contraception consisting of 2 forms of birth control (at least one of which must be a barrier method) starting at screening and continue throughout the study, and for 90 days after the final study drug administration. Male subject who is of childbearing potential must not donate sperm starting at screening and throughout the study and, for 90 days after the final study drug administration. Subject and subject's parent(s) or legal guardian agree that the subject will not participate in another interventional study while on treatment. For oral cohorts: subject is able to swallow the oral capsule medication. Exclusion Criteria: Subject has familial short QT syndrome, is receiving medications that are known to shorten the QT interval, or has a clinically significant abnormal electrocardiogram (ECG). Subject has evidence of hepatic dysfunction defined as: Total bilirubin ≥ 3 times the upper limit of normal (ULN) Alanine transaminase or aspartate transaminase ≥ 5 times the ULN Known cirrhosis or chronic hepatic failure Subject has used strong cytochrome P450 (CYP) 3A4 inhibitors or inducers such as ketoconazole, rifampin/rifampicin, long acting barbiturates, carbamazepine and St. John's wort in the 5 days prior to the first administration of study drug. Subject has known history of allergy, hypersensitivity, or any serious reaction to any of the azole class antifungals. Subject has any condition which makes the subject unsuitable for study participation. Subject is unlikely to survive 30 days. Subject has received investigational therapy, with the exception of oncology drug trials, within 28 days or 5 half-lives, whichever is longer, prior to screening. For oral cohorts: The subject has gastrointestinal disease or has had a procedure that is expected to interfere with the oral absorption or tolerance of the study drug (e.g., functionally relevant gastrointestinal obstruction, mucositis/stomatitis, or frequent vomiting). Subject previously dosed with isavuconazonium sulfate.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Senior Medical Director
Organizational Affiliation
Astellas Pharma Global Development, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Miller Children's Hospital
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
Children's Hospital Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
CHOC Children's Hospital of Orange County
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
Nicklaus Children's Hospital
City
Miami
State/Province
Florida
ZIP/Postal Code
33155
Country
United States
Facility Name
Emory University School of Medicine
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Ann & Robert H Lurie Children's Hospital of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Louisville
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
Children's Hospitals and Clinics of Minnesota
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55404
Country
United States
Facility Name
Children's Mercy Kansas City
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64108
Country
United States
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Cincinnati Children's Hospital Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Facility Name
University Hospital of Cleveland
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
The Children's Hospital at TriStar Centennial Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
University of Texas Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75235
Country
United States
Facility Name
Texas Children's Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Access to anonymized individual participant level data will not be provided for this trial as it meets one or more of the exceptions described on www.clinicalstudydatarequest.com under "Sponsor Specific Details for Astellas."
Citations:
PubMed Identifier
34031051
Citation
Arrieta AC, Neely M, Day JC, Rheingold SR, Sue PK, Muller WJ, Danziger-Isakov LA, Chu J, Yildirim I, McComsey GA, Frangoul HA, Chen TK, Statler VA, Steinbach WJ, Yin DE, Hamed K, Jones ME, Lademacher C, Desai A, Micklus K, Phillips DL, Kovanda LL, Walsh TJ. Safety, Tolerability, and Population Pharmacokinetics of Intravenous and Oral Isavuconazonium Sulfate in Pediatric Patients. Antimicrob Agents Chemother. 2021 Jul 16;65(8):e0029021. doi: 10.1128/AAC.00290-21. Epub 2021 Jul 16.
Results Reference
derived

Learn more about this trial

A Study of Intravenous and Oral Isavuconazonium Sulfate in Pediatric Patients

We'll reach out to this number within 24 hrs