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Anidulafungin vs Amphotericin B Safety in High Risk Hepatic Transplant Recipients

Phase 4
Completed
Conditions
Liver Disease
Fungal Infection
Interventions
Registration Number
NCT01303549
Lead Sponsor
Fundacion SEIMC-GESIDA
Brief Summary

The study is a randomized, open-label safety study comparing the use of anidulafungin (200 mg i.v. as initial dose and 100 mg/d i.v. in subsequent doses) vs liposomal amphotericin B (3 mg/kg/d i.v.) in hepatic transplant recipients who have high risk of fungal infection.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
61
Inclusion Criteria
  • At least 18 years old
  • Signature of ICF
  • Negative pregnancy test (women of child bearing potential)
  • Patients who comply with at least one of the following (A or B):

A: One of the following criteria (major criteria):

  • Re-transplant due to severe dysfunction of a previous hepatic graft
  • Requirement of any renal substitutive therapy, including dialysis or hemofiltration
  • Fulminant hepatitis requiring hepatic transplant

B: Two of the following criteria (minor criteria):

  • Post-transplant renal impairment (defined as CrCl< 50 mL/min) 30 days after transplantation
  • Intra surgery blood transfusion of at least 40 units
  • Choledochal jejunectomy
  • 2 or more Candida sp cultures (nasal, pharynx, rectal) from 48 hours pre- to 48 hours post-hepatic transplant
  • Post transplant re-intervention (laparotomy)
Exclusion Criteria
  • Hypersensibility to amphotericin B or candin
  • Patients who have received any other antifungal (excluding fluconazole or oral nystatin for a maximum of 7 days)
  • Documented or suspected fungal infection
  • Pregnant women of women who do not accept to us a valid anticonceptive method
  • Any other disease or medical condition that makes the patient not adequate to participate in the trial

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
AnidulafunginAnidulafunginAnidulafungin IV once a day: initial dose 200 mg/day, following doses 100 mg/day.
Liposomal Amphotericin BLiposomal amphotericin BLiposomal amphotericin B once a day: 3 mg/kg/day
Primary Outcome Measures
NameTimeMethod
Renal impairment/renal function deterioration14 days

Compare the development of renal imparment or deterioration of baseline renal function in hepatic transplat recipients who receive anidulafungin or liposomal amphotericin B

Number of infusion related adverse events14 days

Compare the development of infusion related adverse events in hepatic transplat recipients who receive anidulafungin or liposomal amphotericin B

Secondary Outcome Measures
NameTimeMethod
Treatment discontinuation14 days

Compare the proportion of patiens who discontinue antifungal profilaxis in both arms

Hepatic toxicity14 days

Compare the emergence of hepatic toxicity in both arms

Invasive fungal infectionWeek 12 and week 24

Compare the incidence of early (first 12 weeks) and delayed (until week 24) invasive fungal infection between both arms

Mortality24 weeks post transplantation

Compare the mortality rate (both global and fungal infection related) between both arms 24 weeks after transplantation

Trial Locations

Locations (12)

Hospital de Bellvitge

🇪🇸

Barcelona, Spain

Hospital Vall d'Hebrón

🇪🇸

Barcelona, Spain

Hospital Clinic i Provincial

🇪🇸

Barcelona, Spain

Hospital Carlos Haya

🇪🇸

Malaga, Spain

Hospital Marqués de Valdecilla

🇪🇸

Santander, Spain

Hospital de Cruces

🇪🇸

Bilbao, Spain

Complexo Hospitalario de A Coruña

🇪🇸

La Coruña, Spain

Hospital Reina Sofia

🇪🇸

Córdoba, Spain

Hospital Doce de Octubre

🇪🇸

Madrid, Spain

Hospital Ramón y Cajal

🇪🇸

Madrid, Spain

Hospital Gregorio Marañón

🇪🇸

Madrid, Spain

Hospital Central de Asturias

🇪🇸

Oviedo, Spain

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