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Early Clinical Experience With Anidulafungin In Patients With Liver Disease In The United Kingdom

Completed
Conditions
Candidiasis
Interventions
Registration Number
NCT01202253
Lead Sponsor
Pfizer
Brief Summary

The purpose of this study is to describe the real world effectiveness of anidulafungin in clinical practice in a large Liver Unit in the United Kingdom.

Detailed Description

All subjects that have been treated with Anidulafungin according to its licence during the period of July 2009 and September 2010 will be included.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Subjects who have been prescribed anidulafungin between 1st July 2009 and 30th September 2010.

Patients admitted to specialist liver unit wards and the Liver Intensive Therapy Unit during this period

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Exclusion Criteria
  • Patients who participated in any interventional clinical trial during this episode of sepsis.

Patients who received anidulafungin for infection prophylaxis

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Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Anidulafunginanidulafungin-
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With Favorable OutcomeDay 28 post-treatment

Favorable outcome was defined as favorable clinical response and documented or presumed microbial eradication (two negative follow-up blood cultures for bloodstream infections or a successful clinical response without follow-up cultures for other infections). Favorable clinical response was defined as clinical resolution of signs and symptoms of infection and no need to change or add to antifungal therapy, or transition to oral antifungal to complete therapy.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Who Received Water-based and Ethanol-based FormulationBaseline
Percentage of Participants Who Received 200 mg Loading DoseDay 1
Percentage of Participants Who Received 100 mg Dose on Day 2Day 2
Percentage of Participants With Unfavorable OutcomeDay 28 post-treatment

Unfavorable outcome was defined as the need to change to another antifungal agent because of lack of clinical response or death due to the antifungal infection or microbiologic persistence of the fungus or superinfection with a new Candida, Aspergillus or other fungal strain occurring at least 3 days and up to 14 days of anidulafungin therapy, or a lack of follow up data about clinical and microbiologic responses at the end of anidulafungin therapy.

Percentage of Participants Who Died Due to All CausesBaseline up to Day 28 post-treatment

Death due to all causes included death attributable to fungal infection, death unrelated to fungal infection and death due to multiple causes.

Percentage of Participants With Death Unrelated to Fungal InfectionBaseline up to Day 28 post-treatment
Percentage of Participants With Oral Antifungal Started to Complete TherapyBaseline up to Day 28 post-treatment
Percentage of Participants With Resolution of Signs of Infection According to Ultrasound Scan ResultsBaseline up to Day 28 post-treatment

An ultrasound scan was performed and the resultant scan was reviewed for the presence of the infection as per investigator's discretion.

Percentage of Participants Admitted to Liver Intensive Therapy Unit (LITU)Baseline
Percentage of Participants With Documented Body Temperature Above 38.0 Degree Celsius or Below 36.0 Degree Celsius Within 24 Hour Period Prior to Initiation of Drug TherapyBaseline

Lower limit of confidence interval was reported as 0 if the same was calculated as less than 0 and upper limit of confidence interval was reported as 100 if the same was calculated as greater than 100, by standard calculations (outside the valid range of 0 to 100).

Number of Participants Who Received Water-based and Ethanol-based FormulationBaseline
Percentage of Participants With Systolic Blood Pressure More Than 2 Standard Deviations Below the Mean for Age Recorded Within 24 Hour Period Prior to Initiation of Drug TherapyBaseline

Lower limit of confidence interval was reported as 0 if the same was calculated as less than 0 by standard calculations (outside the valid range of 0 to 100).

Number of Participants With Infection Sites as Per Microbiological AnalysisBaseline

Infection sites included blood, chest, urinary tract, intra-abdominal, bile duct, liver, kidney, mouth and esophagus.

Number of Participants With Infection Sites as Per Ultrasound Scan and Computerized Tomography (CT) ScanBaseline
Infecting Organisms by SpeciesBaseline up to Day 14 post-treatment
Percentage of Participants With Prior Colonization With Candida by SpeciesBaseline

Lower limit of confidence interval was reported as 0 if the same was calculated as less than 0 by standard calculations (outside the valid range of 0 to 100).

Percentage of Participants With Prior Colonization With Candida by Colonization IndexBaseline
Percentage of Participants With Other Prior Fungal Infection by Species and Colonization IndexBaseline
Percentage of Participants With Death Attributable to Fungal InfectionBaseline up to Day 28 post-treatment
Percentage of Participants With Favorable Clinical ResponseDay 28 post-treatment

Favorable clinical response was defined as clinical resolution of signs and symptoms of infection and no need to change or add to antifungal therapy, or transition to oral antifungal to complete therapy.

Duration of Stay at Liver Intensive Therapy Unit (LITU)Baseline up to Day 28 post-treatment
Percentage of Participants With Probable or Proven Fungal Infection at the Initiation of Drug TherapyBaseline
Percentage of Participants With Lack of Clinical ResponseDay 28 post-treatment

Favorable clinical response was defined as clinical resolution of signs and symptoms of infection and no need to change or add to antifungal therapy, or transition to oral antifungal to complete therapy.

Percentage of Participants With Resolution of Signs of Infection According to Computerized Tomography (CT) Scan ResultsBaseline up to Day 28 post-treatment

A CT scan was performed and the resultant scan was reviewed for the presence of the infection as per investigator's discretion.

Percentage of Participants With Abnormal Results for Liver Function at Initiation of Drug TherapyBaseline

Percentage of participants with abnormal liver function results were based on 4 liver function variables- bilirubin, aspartate transaminase, alkaline phosphatase and gamma glutamyl transferase. Normal reference ranges of these variables are: plasma bilirubin: 3-17 micromoles/L or 2.5-10 mg/L for adults; aspartate transaminase: 6-34 International Units/Liter (IU/L) for females and 8-40 IU/L for males; alkaline phosphatase: 5-38 IU/L for females and 10-50 IU/L for males; gamma glutamyl transferase: 7-32 IU/L for females and 11-50 IU/L for males. Upper limit of confidence interval was reported as 100 if the same was calculated as greater than 100 by standard calculations (outside the valid range of 0 to 100).

Percentage of Participants With Concomitant Bacterial or Viral InfectionBaseline

Upper limit of confidence interval was reported as 100 if the same was calculated as greater than 100 by standard calculations (outside the valid range of 0 to 100).

Dose Changes for Immunosuppressant DrugsBaseline up to Day 28 post-treatment
Percentage of Participants Requiring Change or Additional Antifungal TherapyBaseline up to Day 28 post-treatment

Lower limit of confidence interval was reported as 0 if the same was calculated as less than 0 by standard calculations (outside the valid range of 0 to 100).

Percentage of Participants With Documented Eradication of Infecting SpeciesBaseline

Documented microbial eradication was defined as 2 negative follow-up blood cultures for bloodstream infections.

Percentage of Participants With Abnormal Results for Liver Function at End of Drug TherapyDay 28 post-treatment

Percentage of participants with abnormal liver function results were based on 4 liver function variables- bilirubin, aspartate transaminase, alkaline phosphatase and gamma glutamyl transferase. Normal reference ranges of these variables are: plasma bilirubin: 3-17 micromoles/L or 2.5-10 mg/L for adults; aspartate transaminase: 6-34 IU/L for females and 8-40 IU/L for males; alkaline phosphatase: 5-38 IU/L for females and 10-50 IU/L for males; gamma glutamyl transferase: 7-32 IU/L for females and 11-50 IU/L for males.

Percentage of Participants With Liver Function Test Results at Least Twice the Baseline Value During Period of Drug TherapyBaseline up to Day 28 post-treatment

Percentage of participants with liver function test results at least twice the baseline value during period of drug therapy was calculated for the liver function variables, bilirubin, aspartate transaminase, alkaline phosphatase and gamma glutamyl transferase.

Percentage of Participants With Creatinine Clearance at Least Twice the Baseline Value During Period of Drug TherapyBaseline up to Day 28 post-treatment
Percentage of Participants With Absolute Neutrophil Count Less Than 500 Per Cubic Millimeter (/mm^3) and Greater Than or Equal to 500 /mm^3Baseline

Lower limit of confidence interval was reported as 0 if the same was calculated as less than 0 and upper limit of confidence interval was reported as 100 if the same was calculated as greater than 100, by standard calculations (outside the valid range of 0 to 100).

Percentage of Participants Prescribed With Systemic Antifungal Within 30 Days Before Study StartBaseline

Lower limit of confidence interval was reported as 0 if the same was calculated as less than 0 by standard calculations (outside the valid range of 0 to 100).

Percentage of Participants Who Received 200 mg Dose on Day 1 and 100 mg for All Subsequent DosesBaseline up to Day 28 post-treatment
Number of Participants With Other Dosing PatternsBaseline up to Day 28 post-treatment

The other dosing patterns for anidulafungin included any dosing pattern different from 200 mg loading dose on Day 1 followed by 100 mg doses subsequently starting from Day 2.

Duration of Anidulafungin TherapyBaseline
Number of Serious Adverse Events (SAEs)Baseline up to Day 28 post-treatment

Any untoward medical occurrence in a participant who received study treatment was considered an adverse event (AE) without regard to possibility of causal relationship. An AE resulting in any of the following outcomes, or deemed to be significant for any other reason, was considered to be a SAE: death; initial or prolonged inpatient hospitalization; a life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly.

Percentage of Participants With One or More Drug-related Serious Adverse Events (SAEs)Baseline up to Day 28 post-treatment
Number of Participants With Different Types of Drug-related Serious Adverse EventsBaseline up to Day 28 post-treatment

Trial Locations

Locations (1)

Pfizer Investigational Site

🇬🇧

London, United Kingdom

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