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Clinical Trials in the USA / NCT05421858
Recruiting Phase 3

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

NCT05421858 · tracked via the Priya Life Science USA tracker
Sponsor
Basilea Pharmaceutica
Phase
Phase 3
Started
2024-12-11
Last updated
2026-09-14

Condition(s) studied

CandidemiaCandidiasis, Invasive

Investigational drug(s) / intervention(s)

FosmanogepixFosmanogepixCaspofunginFluconazolePlaceboPlaceboPlaceboPlacebo

Fosmanogepix: IV infusion

Fosmanogepix: Oral tablet

Caspofungin: IV infusion

Fluconazole: Fluconazole oral capsule

Placebo: Matching placebo for caspofungin (IV infusion)

Placebo: Matching placebo for fluconazole (oral capsule)

Placebo: Matching placebo for fosmanogepix (IV infusion)

Placebo: Matching placebo for fosmanogepix (oral tablet)

Study 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

Sex
ALL
Min age
18 Years
Max age
Healthy volunteers
No
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.

Primary outcome measure(s)

Trial sites (146)

FacilityCityRegionStatus
University of Alabama at Birmingham School of Medicine, Department of Medicine Birmingham Alabama Recruiting
City of Hope Duarte California Recruiting
David Geffen School of Medicine at UCLA Los Angeles California Recruiting
UC Davis Medical Center Sacramento California Recruiting
Emory University Hospital - Clifton Road Atlanta Georgia Recruiting
Augusta University Medical Center Augusta Georgia Recruiting
Indiana University Methodist Hospital Indianapolis Indiana Recruiting
University of Kentucky College of Medicine Lexington Kentucky Suspended
Johns Hopkins Hospital Baltimore Maryland Recruiting
University of Michigan Health System (UMHS) - A. Alfred Taubman Health Care Center Ann Arbor Michigan Recruiting
DMC Harper University Hospital Detroit Michigan Recruiting
Henry Ford Hospital, Department of Medicine, Division of Infectious Diseases Detroit Michigan Recruiting
University of Minnesota Minneapolis Minnesota Recruiting
Washington University School of Medicine, Infectious Diseases Clinical Research Unit St Louis Missouri Recruiting
Weill Cornell Medical College - NewYork-Presbyterian Hospital New York New York Recruiting
University of North Carolina at Chapel Hill Chapel Hill North Carolina Recruiting
University of Pennsylvania School of Medicine Philadelphia Pennsylvania Recruiting
UPMC Presbyterian Pittsburgh Pennsylvania Recruiting
Houston Methodist Hospital - Texas Medical Center Houston Texas Recruiting
The University of Texas Health Science Center at Houston Houston Texas Recruiting
U.T. MD Anderson Cancer Center Houston Texas Recruiting
University of Texas Health Science Center at San Antonio San Antonio Texas Recruiting
Carilion Clinic Roanoke Virginia Recruiting
Central Hospital de San Isidro Melchor Posse Buenos Aires Argentina Recruiting
Buenos Aires Italian Hospital, Department of Infectious Diseases Buenos Aires Argentina Recruiting
Cordoba Private University Hospital, Department of Infectious Diseases Córdoba Argentina Recruiting
Italian Hospital of La Plata, Department of Infectious Diseases La Plata Argentina Recruiting
Central Hospital Mendoza Mendoza Argentina Terminated
British Sanatorium SA Rosario Argentina Recruiting
Westmead Hospital Sydney New South Wales Recruiting
Princess Alexandra Hospital Woolloongabba Queensland Recruiting
Peter MacCallum Cancer Center, State Melbourne Victoria Recruiting
The Alfred Hospital Melbourne Victoria Recruiting
Royal Melbourne Hospital Parkville Victoria Recruiting
Monash Medical Center Clayton Clayton Australia Recruiting
University Hospital Graz, Department of Internal Medicine Graz Austria Recruiting
Kepler University Hospital GmbH, Department of Pulmonology, Clinical Department of Infectious Diseases Linz Austria Recruiting
Medical University Vienna Vienna Austria Recruiting
Hospital Favoriten, Department of Internal Medicine IV - Infectious Diseases and Tropical Medicine Vienna Austria Recruiting
General Hospital Saint-Jan Bruges Belgium Recruiting

+ 106 more sites — see the full list on the official registry below.

More Basilea Pharmaceutica trials in the USA

Official registry record

This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.

View NCT05421858 on ClinicalTrials.gov ↗ ← All trials in the USA