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Study of Two Treatment Regimens for Candidemia and/or Invasive Candidiasis: Intravenous Echinocandin followed by Oral Ibrexafungerp versus Intravenous Echinocandin followed by Oral Fluconazole

A Phase 3, Multicenter, Prospective, Randomized, Double-blind Study of Two Treatment Regimens for Candidemia and/or Invasive Candidiasis: Intravenous Echinocandin followed by Oral Ibrexafungerp versus Intravenous Echinocandin followed by Oral Fluconazole (MARIO) - MARIO

Status
Active, not recruiting
Phases
Phase 3
Study type
Interventional
Source
EU CTR
Registry ID
EUCTR2022-000648-32-FR
Enrollment
240
Registered
2022-08-01
Start date
2022-10-24
Completion date
Unknown
Last updated
2024-08-12

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Invasive Candidiasis/ Candidemia MedDRA version: 20.0 Level: LLT Classification code 10060573 Term: Candidemia System Organ Class: 100000004862 MedDRA version: 20.0 Level: LLT Classification code 10064954 Term: Invasive candidiasis System Organ Class: 100000004862

Interventions

Product Name: Ibrexafungerp Pharmaceutical Form: Tablet INN or Proposed INN: IBREXAFUNGERP CAS Number: 1965291-08-0 Concentration unit: mg milligram(s) Concentration type: equal Concentration number:

Sponsors

SCYNEXIS, Inc.
Lead Sponsor

Eligibility

Sex/Gender
All

Inclusion criteria

Inclusion criteria: KEY INCLUSION CRITERIA Subjects must fulfill all of the following KEY criteria at Screening to be eligible for participating in the study: 1. Subject is a male or female adult = 18 years of age on the day the study informed consent is signed. 2. Subject has a diagnosis of candidemia and/or invasive candidiasis, defined as evidence of Candida spp. in either a bloodstream or tissue culture from a normally sterile site (excluding eye, cardiac tissue, bone tissue, central nervous system or prosthetic device) collected = 4 days (within 96 hours) prior to initiation of IV echinocandin accompanied by any related clinical sign and/or symptom (e.g., fever [on one occasion > 38°C], hypotension, or local signs of inflammation). Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range 192 F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range 48

Exclusion criteria

Exclusion criteria: KEY EXCLUSION CRITERIA A subject will be excluded from participation in the study if he or she meets any of the following KEY exclusion criteria: 1. Subject has any of the following forms of invasive candidiasis at Screening: a. Septic arthritis in a prosthetic joint (septic arthritis in a native joint is allowed), b. Osteomyelitis, c. Endocarditis or myocarditis, d. Meningitis, endophthalmitis, or any central nervous system infection, e. Chronic disseminated candidiasis, f. Urinary tract candidiasis due to ascending Candida infection secondary to unresolved obstruction or non-removeable device in the urinary tract, g. Patients with a sole diagnosis of mucocutaneous candidiasis, i.e., oropharyngeal, esophageal, or genital candidiasis; or Candida lower urinary tract infection or Candida isolated solely from respiratory tract specimens, h. Patients with concurrent invasive fungal infection other than Candida spp., e.g., cryptococcosis, mold infection or endemic fungal infection, i. Patients who failed a previous antifungal therapy for the same infection, j. Subject has an inappropriately controlled fungal disease source (e.g., indwelling vascular catheter or device that cannot be removed or an abscess that cannot be drained) that is likely to be the source of the candidemia or invasive candidiasis. 2. Subject has abnormal liver test parameters: alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels > 10-fold the upper limit of normal (ULN). 3. Subject has severe hepatic impairment and a history of chronic cirrhosis (Child-Pugh score > 9). 4. Subject has received more than 48 hours of non-echinocandin antifungal therapy for the treatment of invasive candidiasis (including candidemia) within 96 hours preceding initiation of IV echinocandin. a. Exception: Receipt of antifungal therapy to which any Candida spp. isolated in qualifying culture is not susceptible. 5. Baseline QTcF = 500 msec.

Design outcomes

Primary

MeasureTime frame
Main Objective: • To demonstrate that treatment of Invasive Candidiasis/ Candidemia with intravenous (IV) echinocandin followed by oral ibrexafungerp is non inferior to IV echinocandin followed by oral fluconazole based on 30-day all-cause mortality (ACM).;Secondary Objective: Key Secondary Objective: • To demonstrate that treatment of Invasive Candidiasis/ Candidemia with IV echinocandin followed by oral ibrexafungerp is non inferior to IV echinocandin followed by oral fluconazole based on Global Response (clinical, radiological, and mycological response, as confirmed by the Data Review Committee [DRC]) at Day 14. Other Secondary Objectives: • To compare the efficacy of the treatment regimens, based on: o Global Response at Day 30 and End of Therapy (EOT) as determined by the PI and DRC, o Clinical Response as determined by the PI and DRC, o Mycological Response as determined by the DRC, o no recurrence as determined by the DRC, and o fungal-free survival as determined by the DRC. • To evaluate the safety of the regimens. • To evaluate the pharmacokinetics (PK) of ibrexafungerp. ;Primary end point(s): The primary endpoint of the study is ACM at Day 30 in the ITT population.;Timepoint(s) of evaluation of this end point: At Day 30

Secondary

MeasureTime frame
Secondary end point(s): Key Secondary Endpoint: The percentage of subjects with Successful Global Response, as determined by the DRC at Day 14. Secondary Endpoints: Efficacy Endpoints • The percentage of subjects with Successful Global Response at Day 30 and EOT as determined by the PI and the DRC. • The percentage of subjects with Successful Clinical Response at Day 14 and EOT as determined by the PI and the DRC. • The percentage of subjects with Successful Mycological Response at Day 14 and EOT as determined by the DRC. • The percentage of subjects with no recurrence before EOT and at 2 weeks and 6 weeks after EOT as determined by the DRC. • The percentage of subjects alive with Successful Global Response and no recurrence at 6 weeks after EOT as determined by the DRC. Safety Endpoints • Frequency of treatment-emergent adverse events (TEAEs), drug-related adverse events (AEs), discontinuations due to AEs, serious adverse events (SAEs), and safety laboratory assessments. PK Endpoint • Ibrexafungerp plasma concentrations. ;Timepoint(s) of evaluation of this end point: Key secondary endpoint at Day 14 Efficacy endpoint: • At Day 30 and EOT • Day 14 and EOT • Day 14 and EOT • At 2 weeks and 6 weeks after EOT • At 6 weeks after EOT

Countries

Belgium, Bulgaria, Czechia, France, Germany, Greece, Israel, Italy, Korea, Republic of, South Africa, Spain, United States

Contacts

Public ContactClinical Operations

SCYNEXIS, Inc.

clinicaltrials@scynexis.com+1201-884-5485

Outcome results

None listed

Source: EU CTR (via WHO ICTRP) · Data processed: Feb 4, 2026