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Micafungin Pharmacokinetics in Obese Patients (MICADO)

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ClinicalTrials.gov Identifier: NCT03102658
Recruitment Status : Completed
First Posted : April 6, 2017
Last Update Posted : October 19, 2020
Sponsor:
Collaborators:
St. Antonius Hospital
Astellas Pharma Inc
Information provided by (Responsible Party):
Radboud University

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


Condition or disease Intervention/treatment Phase
Morbid Obesity Drug: Micafungin Phase 4

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.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 24 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Basic Science
Official Title: Micafungin (Mycamine®) Pharmacokinetics Given as a Single Intravenous Dose to Obese Patients (MICADO).
Actual Study Start Date : January 2017
Actual Primary Completion Date : July 2017
Actual Study Completion Date : July 2017

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Obese subjects 100mg
8 subjects with a BMI>40kg/m2 will receive 100mg Micafungin
Drug: Micafungin
Administration of study drug
Other Name: Mycamine

Active Comparator: Obese subjects 200mg
8 subjects with a BMI>40kg/m2 will receive 200mg Micafungin
Drug: Micafungin
Administration of study drug
Other Name: Mycamine

Active Comparator: non-obese subjects
8 non obese subjects with a BMI >18.5 and <25 kg/m2 will receive 100mg Micafungin
Drug: Micafungin
Administration of study drug
Other Name: Mycamine




Primary Outcome Measures :
  1. Micafungin concentration in plasma to examen the area under the plasma concentration versus time curve (AUC0-48) [ Time Frame: Up to 3 months ]
    The exposure to micafungin in obese will be compared with that in non-obese subjects.


Secondary Outcome Measures :
  1. Long-term exposure to micafungin after repeated dose [ Time Frame: Up to 6 months ]
    Predict long-term exposure (AUC0-tau) after repeated dosing by popPK modeling and simulation.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

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.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03102658


Locations
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Netherlands
St Antoniusziekenhuis
Nieuwegein, Netherlands
Radboudumc CRCN
Nijmegen, Netherlands
Sponsors and Collaborators
Radboud University
St. Antonius Hospital
Astellas Pharma Inc
Investigators
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Principal Investigator: Roger Brüggemann, PharmD, PhD Radboud University
Additional Information:
paper  This link exits the ClinicalTrials.gov site

Publications of Results:
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Responsible Party: Radboud University
ClinicalTrials.gov Identifier: NCT03102658    
Other Study ID Numbers: UMCN-AKF 16.02
First Posted: April 6, 2017    Key Record Dates
Last Update Posted: October 19, 2020
Last Verified: September 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Additional relevant MeSH terms:
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Obesity, Morbid
Obesity
Overnutrition
Nutrition Disorders
Overweight
Body Weight
Micafungin
Antifungal Agents
Anti-Infective Agents