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    Clinical Trial Results:
    A PROSPECTIVE, OPEN-LABEL, NON-RANDOMIZED, MULTI-CENTER STUDY TO INVESTIGATE THE SAFETY AND TOLERABILITY OF VORICONAZOLE AS PRIMARY THERAPY FOR TREATMENT OF INVASIVE ASPERGILLOSIS AND MOLDS SUCH AS SCEDOSPORIUM OR FUSARIUM SPECIES IN PEDIATRIC PATIENTS

    Summary
    EudraCT number
    2008-005275-10
    Trial protocol
    NL   HU   CZ   ES   DE   BG   Outside EU/EEA  
    Global end of trial date
    15 May 2013

    Results information
    Results version number
    v2(current)
    This version publication date
    18 Jun 2016
    First version publication date
    25 Jul 2015
    Other versions
    v1
    Version creation reason
    • Correction of full data set
    Reporting periods and duplicate Adverse Events in their data.

    Trial information

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    Trial identification
    Sponsor protocol code
    A1501080
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00836875
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Pfizer Inc.
    Sponsor organisation address
    235 E 42nd Street, New York, United States, NY 10017
    Public contact
    Pfizer ClinicalTrials.gov Call Center, Pfizer Inc, 001 800-718-1021, ClinicalTrials.gov_Inquiries@pfizer.com
    Scientific contact
    Pfizer ClinicalTrials.gov Call Center, Pfizer Inc, 001 800-718-1021, ClinicalTrials.gov_Inquiries@pfizer.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-000191-PIP01-08
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    14 Apr 2014
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    15 May 2013
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To evaluate the safety and tolerability of voriconazole as primary treatment of invasive aspergillosis (IA) and rare molds such as Scedosporium or Fusarium species in immunocompromised pediatric subjects from 2 to less than (<) 18 years of age.
    Protection of trial subjects
    The study was in compliance with with the ethical principles derived from the Declaration of Helsinki and in compliance with all International Conference on Harmonisation (ICH) Good Clinical Practice (GCP) Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were followed.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    26 May 2009
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety
    Long term follow-up duration
    1 Months
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Poland: 1
    Country: Number of subjects enrolled
    Netherlands: 4
    Country: Number of subjects enrolled
    Spain: 2
    Country: Number of subjects enrolled
    Czech Republic: 1
    Country: Number of subjects enrolled
    Thailand: 11
    Country: Number of subjects enrolled
    Singapore: 5
    Country: Number of subjects enrolled
    United States: 7
    Worldwide total number of subjects
    31
    EEA total number of subjects
    8
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    11
    Adolescents (12-17 years)
    20
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Study was started on 26 May 2009 and ended on 15 May 2013. Overall, 31 subjects were enrolled into the study across 7 countries.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Voriconazole: 2 to <12 Years
    Arm description
    Subjects aged 2 to <12 years with possible, probable or proven IA.
    Arm type
    Experimental

    Investigational medicinal product name
    Voriconazole
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for infusion, Powder for oral suspension, Tablet
    Routes of administration
    Intravenous use, Oral use
    Dosage and administration details
    For subjects aged 2 to <12 years, voriconazole was administered at a loading dose of 9 milligrams per kg (mg/kg), intravenously (IV) every 12 hours (q12h) for the first 24 hours,  followed by maintenance IV dosing regimen of 8 mg/kg IV q12h for a minimum of 7 days. Once significant clinical improvement was observed, subjects could be switched to oral (PO) dosing regimen of 9 mg/kg (a maximum dose of 350 mg) PO q12h. Investigators used subject, tolerability and voriconazole trough plasma levels to facilitate dose adjustments. All subjects received voriconazole therapy for at least 6 weeks, up to a maximum of 12 weeks.

    Arm title
    Voriconazole: 12 to <18 Years
    Arm description
    Subjects aged 12 to <18 years with possible, probable or proven IA.
    Arm type
    Experimental

    Investigational medicinal product name
    Voriconazole
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for infusion, Powder for oral suspension, Tablet
    Routes of administration
    Intravenous use, Oral use
    Dosage and administration details
    For subjects aged 12 to <18 years (excluding those aged 12-­14 years weighing <50 kg), voriconazole was administered at loading doses of 6 mg/kg, IV, q12h for the first 24 hours, followed by maintenance IV dosing regimen of 4 mg/kg IV q12h for a minimum of 7 days. Once significant clinical improvement was observed, subjects could be switched to oral dosing regimen of 200-300 mg PO q12h. Investigators used subject, tolerability and voriconazole trough plasma levels to facilitate dose adjustments. All subjects received voriconazole therapy for at least 6 weeks, up to a maximum of 12 weeks.

    Number of subjects in period 1
    Voriconazole: 2 to <12 Years Voriconazole: 12 to <18 Years
    Started
    11
    20
    Completed
    8
    17
    Not completed
    3
    3
         Consent withdrawn by subject
    -
    1
         Death
    3
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Voriconazole: 2 to <12 Years
    Reporting group description
    Subjects aged 2 to <12 years with possible, probable or proven IA.

    Reporting group title
    Voriconazole: 12 to <18 Years
    Reporting group description
    Subjects aged 12 to <18 years with possible, probable or proven IA.

    Reporting group values
    Voriconazole: 2 to <12 Years Voriconazole: 12 to <18 Years Total
    Number of subjects
    11 20 31
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    7.9 ± 2.3 14.1 ± 1.7 -
    Gender categorical
    Units: Subjects
        Female
    4 11 15
        Male
    7 9 16

    End points

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    End points reporting groups
    Reporting group title
    Voriconazole: 2 to <12 Years
    Reporting group description
    Subjects aged 2 to <12 years with possible, probable or proven IA.

    Reporting group title
    Voriconazole: 12 to <18 Years
    Reporting group description
    Subjects aged 12 to <18 years with possible, probable or proven IA.

    Primary: Number of Subjects With Adverse Events (AEs)

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    End point title
    Number of Subjects With Adverse Events (AEs) [1]
    End point description
    Safety population: included all subjects who received at least 1 dose of study medication.
    End point type
    Primary
    End point timeframe
    Baseline, daily while hospitalized, Days 7, 14, 28, 42, 84, 114, at end of treatment, up to 1 month post treatment
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only descriptive data was planned to be analyzed for the endpoint.
    End point values
    Voriconazole: 2 to <12 Years Voriconazole: 12 to <18 Years
    Number of subjects analysed
    11
    20
    Units: Subjects
        With AEs
    11
    19
        With serious AEs
    6
    9
        With severe AEs
    5
    8
        Discontinued treatment due to AEs
    1
    0
        Dose reduced or temporarily discontinued due to AE
    0
    4
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With a Global Response of Success

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    End point title
    Percentage of Subjects With a Global Response of Success
    End point description
    Percentage of subjects with global response of success at Weeks 6 and at end of treatment (EOT) (up to Week 12). Global response of success was defined as a subject who achieved a complete or partial global response per the investigator. Complete response was defined as resolution of all clinical signs and symptoms PLUS resolution of 90 percent (%) or more of the lesions visible on radiological studies and attributed to invasive aspergillosis (IA) at Baseline. Partial response was defined as clinical improvement PLUS 50% to <90 % resolution of the radiological lesions attributed to IA at Baseline. Modified intent to treat (MITT) population: all subjects receiving at least 1 dose of study drug and diagnosed with proven or probable aspergillosis (defined by modified European Organization for Research and Treatment of Cancer Mycoses Study Group [EORTC/MSC] criteria) or microbiologically confirmed scedosporium or fusarium infection.
    End point type
    Secondary
    End point timeframe
    Weeks 6, EOT (up to Week 12)
    End point values
    Voriconazole: 2 to <12 Years Voriconazole: 12 to <18 Years
    Number of subjects analysed
    5
    9
    Units: percentage of subjects
    number (confidence interval 95%)
        Week 6
    40 (5.3 to 85.3)
    77.8 (40 to 97.2)
        EOT
    40 (5.3 to 85.3)
    77.8 (40 to 97.2)
    No statistical analyses for this end point

    Secondary: All-Cause Mortality - Number of Subjects Deaths

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    End point title
    All-Cause Mortality - Number of Subjects Deaths
    End point description
    Number of subject deaths reported at Week 6 and at EOT (up to Week 12). Safety population.
    End point type
    Secondary
    End point timeframe
    Week 6, EOT (up to Week 12)
    End point values
    Voriconazole: 2 to <12 Years Voriconazole: 12 to <18 Years
    Number of subjects analysed
    11
    20
    Units: Subjects
        Week 6
    3
    1
        EOT
    0
    1
    No statistical analyses for this end point

    Secondary: Attributable Mortality - Number of Subject Deaths

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    End point title
    Attributable Mortality - Number of Subject Deaths
    End point description
    Number of subject deaths attributable to study drug reported at Week 6 and at EOT (up to Week 12). Safety population.
    End point type
    Secondary
    End point timeframe
    Weeks 6 and EOT (up to Week 12)
    End point values
    Voriconazole: 2 to <12 Years Voriconazole: 12 to <18 Years
    Number of subjects analysed
    11
    20
    Units: Subjects
    0
    0
    No statistical analyses for this end point

    Secondary: Time to Death

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    End point title
    Time to Death
    End point description
    Safety population; only subjects who died were included in the analysis.
    End point type
    Secondary
    End point timeframe
    Baseline up to 1 month post treatment
    End point values
    Voriconazole: 2 to <12 Years Voriconazole: 12 to <18 Years
    Number of subjects analysed
    3
    2
    Units: days
        median (full range (min-max))
    30 (18 to 38)
    47.5 (20 to 75)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline up to 7 days after last dose of study treatment
    Adverse event reporting additional description
    The same event may appear as both an AE and a Serious AE (SAE). However, what is presented are distinct events. An event may be categorized as serious in one subject and as non serious in another subject, or one subject may have experienced both a serious and non serious event during the study.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16.0
    Reporting groups
    Reporting group title
    Voriconazole: 2 to <12 Years
    Reporting group description
    Subjects aged 2 to <12 years with possible, probable or proven IA.

    Reporting group title
    Voriconazole: 12 to <18 Years
    Reporting group description
    Subjects aged 12 to <18 years with possible, probable or proven IA.

    Serious adverse events
    Voriconazole: 2 to <12 Years Voriconazole: 12 to <18 Years
    Total subjects affected by serious adverse events
         subjects affected / exposed
    6 / 11 (54.55%)
    9 / 20 (45.00%)
         number of deaths (all causes)
    3
    2
         number of deaths resulting from adverse events
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Acute lymphocytic leukaemia
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Vascular disorders
    Aneurysm ruptured
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Surgical and medical procedures
    Endotracheal intubation
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pleural effusion
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary oedema
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Respiratory failure
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Cardiac arrest
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Loss of consciousness
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Coagulopathy
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 11 (9.09%)
    2 / 20 (10.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Visual impairment
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Gingival bleeding
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small intestinal haemorrhage
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Drug-induced liver injury
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Renal failure acute
         subjects affected / exposed
    1 / 11 (9.09%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Muscular weakness
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Aspergillosis
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 11 (9.09%)
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    2 / 11 (18.18%)
    2 / 20 (10.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    0 / 1
    Metabolism and nutrition disorders
    Hypoglycaemia
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 2%
    Non-serious adverse events
    Voriconazole: 2 to <12 Years Voriconazole: 12 to <18 Years
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    10 / 11 (90.91%)
    19 / 20 (95.00%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Leukaemia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Vascular disorders
    Flushing
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Haematoma
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Haemorrhage
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Hypertension
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Hypotension
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Phlebitis
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    General disorders and administration site conditions
    Catheter site discharge
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Catheter site pain
         subjects affected / exposed
    1 / 11 (9.09%)
    2 / 20 (10.00%)
         occurrences all number
    3
    2
    Fatigue
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Infusion site pain
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Local swelling
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Mucosal inflammation
         subjects affected / exposed
    0 / 11 (0.00%)
    3 / 20 (15.00%)
         occurrences all number
    0
    5
    Oedema peripheral
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Pain
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    5
    Pyrexia
         subjects affected / exposed
    0 / 11 (0.00%)
    7 / 20 (35.00%)
         occurrences all number
    0
    9
    Reproductive system and breast disorders
    Genital swelling
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Vulvar erosion
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Respiratory, thoracic and mediastinal disorders
    Bronchospasm
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Cough
         subjects affected / exposed
    2 / 11 (18.18%)
    2 / 20 (10.00%)
         occurrences all number
    2
    2
    Dyspnoea
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Epistaxis
         subjects affected / exposed
    2 / 11 (18.18%)
    4 / 20 (20.00%)
         occurrences all number
    2
    8
    Haemoptysis
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Hypoxia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Nasal congestion
         subjects affected / exposed
    1 / 11 (9.09%)
    2 / 20 (10.00%)
         occurrences all number
    1
    2
    Oropharyngeal pain
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Pharyngeal inflammation
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Rales
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Tachypnoea
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Psychiatric disorders
    Affect lability
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Depression
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Insomnia
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Investigations
    Activated partial thromboplastin time prolonged
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Alanine aminotransferase increased
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Aspartate aminotransferase increased
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Blood bilirubin increased
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Blood creatinine increased
         subjects affected / exposed
    1 / 11 (9.09%)
    1 / 20 (5.00%)
         occurrences all number
    1
    1
    Blood phosphorus decreased
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Blood potassium increased
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Blood pressure increased
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    2
    Blood uric acid increased
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Cardiac murmur
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Liver function test abnormal
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Oxygen saturation decreased
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Prothrombin time prolonged
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Respirovirus test positive
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Transaminases increased
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    4
    Weight decreased
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Injury, poisoning and procedural complications
    Allergic transfusion reaction
         subjects affected / exposed
    1 / 11 (9.09%)
    1 / 20 (5.00%)
         occurrences all number
    1
    1
    Contusion
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Excoriation
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Incorrect drug administration rate
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Procedural pain
         subjects affected / exposed
    2 / 11 (18.18%)
    2 / 20 (10.00%)
         occurrences all number
    2
    2
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Nervous system disorders
    Central nervous system lesion
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    2
    Dizziness
         subjects affected / exposed
    0 / 11 (0.00%)
    3 / 20 (15.00%)
         occurrences all number
    0
    4
    Headache
         subjects affected / exposed
    1 / 11 (9.09%)
    2 / 20 (10.00%)
         occurrences all number
    2
    2
    Lethargy
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Paraesthesia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Somnolence
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Blood and lymphatic system disorders
    Disseminated intravascular coagulation
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Febrile neutropenia
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Lymphadenitis
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Lymphopenia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Neutropenia
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Neutrophilia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Pancytopenia
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Thrombocytopenia
         subjects affected / exposed
    1 / 11 (9.09%)
    2 / 20 (10.00%)
         occurrences all number
    1
    2
    Ear and labyrinth disorders
    Ear haemorrhage
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Tinnitus
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Eye disorders
    Abnormal sensation in eye
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Asthenopia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    2
    Cataract
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Chromatopsia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Conjunctival haemorrhage
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Conjunctivitis
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    3
    Diplopia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Dry eye
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Eye discharge
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Eye irritation
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Eye pain
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Photophobia
         subjects affected / exposed
    1 / 11 (9.09%)
    1 / 20 (5.00%)
         occurrences all number
    1
    2
    Vision blurred
         subjects affected / exposed
    0 / 11 (0.00%)
    3 / 20 (15.00%)
         occurrences all number
    0
    3
    Visual impairment
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    2
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Abdominal pain
         subjects affected / exposed
    0 / 11 (0.00%)
    3 / 20 (15.00%)
         occurrences all number
    0
    4
    Abdominal pain upper
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Anal fissure
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Constipation
         subjects affected / exposed
    1 / 11 (9.09%)
    1 / 20 (5.00%)
         occurrences all number
    1
    1
    Diarrhoea
         subjects affected / exposed
    3 / 11 (27.27%)
    1 / 20 (5.00%)
         occurrences all number
    3
    1
    Dysphagia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Flatulence
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Gastritis
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Gastrooesophageal reflux disease
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Haematemesis
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Lip dry
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Mouth haemorrhage
         subjects affected / exposed
    1 / 11 (9.09%)
    1 / 20 (5.00%)
         occurrences all number
    1
    1
    Mouth ulceration
         subjects affected / exposed
    1 / 11 (9.09%)
    2 / 20 (10.00%)
         occurrences all number
    1
    2
    Nausea
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Painful defaecation
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Proctalgia
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Rectal haemorrhage
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Vomiting
         subjects affected / exposed
    1 / 11 (9.09%)
    1 / 20 (5.00%)
         occurrences all number
    1
    2
    Hepatobiliary disorders
    Jaundice cholestatic
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Skin and subcutaneous tissue disorders
    Decubitus ulcer
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Dermatitis allergic
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Dermatitis contact
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Dermatitis exfoliative
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    2
    Dry skin
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Ecchymosis
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Erythema
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Heat rash
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Hyperhidrosis
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Ingrowing nail
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Petechiae
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Pigmentation disorder
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Post inflammatory pigmentation change
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Pruritus
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Rash
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Rash macular
         subjects affected / exposed
    1 / 11 (9.09%)
    1 / 20 (5.00%)
         occurrences all number
    1
    1
    Rash maculo-papular
         subjects affected / exposed
    2 / 11 (18.18%)
    1 / 20 (5.00%)
         occurrences all number
    2
    1
    Red man syndrome
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Scab
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Skin burning sensation
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Skin lesion
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    3
    0
    Toxic skin eruption
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Urticaria
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Pollakiuria
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Renal failure
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Urinary retention
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Back pain
         subjects affected / exposed
    0 / 11 (0.00%)
    3 / 20 (15.00%)
         occurrences all number
    0
    4
    Muscle spasms
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    2
    Myalgia
         subjects affected / exposed
    1 / 11 (9.09%)
    1 / 20 (5.00%)
         occurrences all number
    1
    1
    Neck pain
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Pain in extremity
         subjects affected / exposed
    1 / 11 (9.09%)
    2 / 20 (10.00%)
         occurrences all number
    1
    2
    Pain in jaw
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Infections and infestations
    Anal abscess
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Bacteraemia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Bronchitis
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Cytomegalovirus infection
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Device related infection
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Implant site pustules
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Paronychia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Postoperative wound infection
         subjects affected / exposed
    1 / 11 (9.09%)
    0 / 20 (0.00%)
         occurrences all number
    1
    0
    Sinusitis
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Staphylococcal bacteraemia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Staphylococcal infection
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Systemic candida
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Upper respiratory tract infection
         subjects affected / exposed
    3 / 11 (27.27%)
    1 / 20 (5.00%)
         occurrences all number
    3
    1
    Viral upper respiratory tract infection
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Metabolism and nutrition disorders
    Fluid overload
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Fluid retention
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Hypercalcaemia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Hyperkalaemia
         subjects affected / exposed
    0 / 11 (0.00%)
    2 / 20 (10.00%)
         occurrences all number
    0
    2
    Hyperuricaemia
         subjects affected / exposed
    0 / 11 (0.00%)
    1 / 20 (5.00%)
         occurrences all number
    0
    1
    Hypoalbuminaemia
         subjects affected / exposed
    1 / 11 (9.09%)
    1 / 20 (5.00%)
         occurrences all number
    1
    1
    Hypocalcaemia
         subjects affected / exposed
    3 / 11 (27.27%)
    0 / 20 (0.00%)
         occurrences all number
    3
    0
    Hypokalaemia
         subjects affected / exposed
    1 / 11 (9.09%)
    3 / 20 (15.00%)
         occurrences all number
    2
    3
    Hypomagnesaemia
         subjects affected / exposed
    2 / 11 (18.18%)
    1 / 20 (5.00%)
         occurrences all number
    2
    1
    Hyponatraemia
         subjects affected / exposed
    2 / 11 (18.18%)
    0 / 20 (0.00%)
         occurrences all number
    2
    0
    Hypophosphataemia
         subjects affected / exposed
    3 / 11 (27.27%)
    0 / 20 (0.00%)
         occurrences all number
    5
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    04 Dec 2008
    1. Added attributable mortality as a study endpoint. 2. Added Electrocardiography (ECGs) and vital signs to the primary analysis of AEs, tests and added significant ECG and vital signs changes to safety data summaries. 3. Added requirement for formal ophthalmologic exam(including fundoscopic exam) if a treatment-emergent visual AE was noted and added follow-up procedures for subjects with treatment-emergent visual AEs persisting at 1-month follow-up (FU) visit. 4. Expanded eligible diagnoses to include infection due to rare molds such as Scedosporium or Fusarium species and specified that mycology, histology,and cytology assessments were to be done at local site. 5. Clarified definition of discontinuation and required that discontinuations due to AEs be documented, reported immediately to the sponsor, and followed or referred for follow-up. 6. Added EOT as an analysis timepoint and the 6-week timepoint to global response assessment. 7. Changed primary analysis definition to include treatment-emergent AEs,ECGs, vital signs and not include physical examinations. 8. Added ECGs and vital signs to primary analysis of AEs, tests and added significant ECG and vital signs changes to safety data summaries. 9. Added text describing the option of an earlier switch to oral dosing. 10. Revised and clarified exclusion criteria. 11. Added a Week 6 treatment visit and defined the associated assessments and procedures. 12. Changed the time period for monitoring AEs to conclude with the 1-month FU visit. 13. Revised dosing recommendations for subjects with elevated voriconazole levels and clarified collection of plasma peak and trough samples. 14. Included male subjects in contraceptive guidelines and clarified the acceptability of complete abstinence. 15. Added Sections describing dose reductions and describing dose escalations. 16. Revised procedures for subjects discontinued for rescue therapy. 17. Reduced the samples for galactomannan assay at EOT from 2 to 1.
    14 Jul 2010
    1. Specified the approximate total blood sampling volume for a subject during the study and restricted the total volume to 150 milliliter (mL) or less. 2. Required that of the 15 subjects with proven or probable IA, a minimum of 10 subjects evaluable for safety were enrolled from the 2 to <12 years age-group and stated that subjects would receive a total of 6 to 12 weeks of therapy. 3. Added the correlation between CYP2C19 genotype status and voriconazole exposure as an exploratory endpoint and added a requirement for the collection of 2 buccal swab samples at baseline or during the study. 4. Clarified the conditions for switching to oral voriconazole therapy and modified the dosing scheme and infusion rates. 5. Revised the requirements and recommendations for voriconazole level plasma sample collection on Day 3 and after dose adjustments. 6. Updated the dosing scheme for children (2 to <12 years of age) and adolescents 12 to 14 years of age weighing less than 50 kg based on the results of 2 recently completed PK studies (A1501081 and A1501088) to allow enrollment in the younger age-group (children). 7. Added the requirement for assent from children who, per the investigator's judgment, were able to comprehend and as required by local regulations.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    The study was prematurely terminated due to slow enrollment. The study was not terminated due to any safety issues or concerns. Interpretation of the data are limited due to the small sample size and descriptive design.
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