Invasive Aspergillosis, Invasive Mucormycosis
Conditions
Keywords
ASP9766, Cresemba, BAL8557, isavuconazonium sulfate
Brief summary
The purpose of this study was to evaluate the safety, tolerability, and efficacy of isavuconazonium sulfate in pediatric participants.
Detailed description
Treatment began on Day 1 and then participants were followed for 60 days post-last dose for safety. Treatment was administered until the participant had a successful outcome or for a maximum duration of 84 days (IA) or 180 days (IM), whichever occured first. Participants received a loading regimen of isavuconazonium sulfate (via intravenous or oral administration at the investigator's discretion), which consisted of a dose every 8 hours (± 2 hours) on Days 1 and 2 (for a total of 6 doses), followed by once daily maintenance dosing for up to 84 days (IA) or 180 days (IM) of dosing. The first maintenance dose started 12 to 24 hours after the administration of the last loading dose. Subsequent maintenance doses were administered once daily (24 hours ± 2 hours from the previous maintenance dose). The oral formulation could only be given to participants 6 years to \< 18 years of age and with a body weight of at least 12 kg. Participants who were discharged from the hospital with oral capsules for at-home administration had to return weekly for study drug accountability and to receive new oral dosing supplies. Participants who began oral administration were to complete the oral dosing acceptability assessment after ingesting their first oral dose.
Interventions
Intravenous (IV) infusion
Sponsors
Study design
Eligibility
Inclusion criteria
* Subject diagnosed with IA or IM. A positive diagnosis is defined as follows: * Proven, probable or possible IFI per the European Organisation for Research and Treatment of Cancer/Mycoses Study Group \[EORTC/MSG\], 2008 criteria Note: Subjects with possible IFI will be eligible for enrollment; however, diagnostic tests to confirm the invasive fungal disease as probable or proven according to the EORTC/MSG criteria should be completed within 10 calendar days after the first dose of study drug * Note: In addition to the criteria set for mycological criteria by the EORTC/MSG in 2008, and only for subjects with an underlying hematologic malignancy or recipients of hematopoietic stem cell transplant (HSCT) who also have clinical and radiologic features consistent with invasive fungal infection, the following are acceptable: * Galactomannan (GM) levels (optical density index) meeting the below criteria are acceptable mycological evidence for enrollment or upgrading the diagnosis to probable IA: * 1\. A single value for serum or bronchoalveolar lavage (BAL) fluid of ≥ 1.0 or * 2\. Two serum GM values of ≥ 0.5 from two separate samples * Subject has sufficient venous access to permit intravenous administration of study drug or the ability to swallow oral capsules * A female subject is eligible to participate if not pregnant and at least one of the following conditions applies: * Not a subject who is of childbearing potential, OR * Subject who is of childbearing potential who agrees to follow a contraceptive guidance throughout the treatment period and for at least 30 days after the final study drug administration * Subject and subject's parent(s) or legal guardian agree that the subject will not participate in another interventional study while on treatment with the exception of oncology trials
Exclusion criteria
* Subject has familial short QT syndrome, is receiving medications that are known to shorten the QT interval, or has a clinically significant abnormal ECG * Subject has evidence of hepatic dysfunction defined as any of the following: * Total bilirubin (TBL) ≥ 3 times the upper limit of normal (ULN) * Alanine transaminase (ALT) or aspartate transaminase (AST) ≥ 5 times the ULN * Known cirrhosis or chronic hepatic failure * Subject has used strong cytochrome P450 (CYP3A4) inhibitors or inducers such as ketoconazole, high dose ritonavir, rifampin/rifampicin, long acting barbiturates (e.g., phenytoin), carbamazepine and St. John's Wort in the 5 days prior to the first dose of study drug * Subject has another IFI other than possible, probably or proven IA or IM * Subject has chronic aspergillosis, aspergilloma or allergic bronchopulmonary aspergillosis * Subject has received mould active systemic antifungal therapy, effective against the primary IMI, for more than four days during the seven days preceding the first dose * Note: Prior use of prophylactic antifungal therapy is acceptable. In case of breakthrough IA while on prophylactic mould-active azole class drugs, additional documentation will be required to be submitted to the sponsor medical monitor or designee to approve subject enrollment * Subject has known history of allergy, hypersensitivity or any serious reaction to any of the azole class antifungals, or any components of the study drug formulation * Subject has any condition which makes the subject unsuitable for study participation * Subject is unlikely to survive 30 days * Subject has received investigational drug, with the exception of oncology drug trials, or trials with investigational drugs treating graft versus host disease, within 28 days or five half-lives, whichever is longer, prior to screening
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Treatment Emergent Adverse Events (TEAEs) | From first dose to 30 days after the last dose (maximum 210 Days) | An AE is any untoward medical occurrence in a participant administered a study drug, which does not have to have a causal relationship with this treatment. It can be any unfavorable sign, symptom, or disease temporally associated with the use of a medicinal product. TEAE is defined as an AE observed after starting administration of the study drug through 30 days after the last dose. |
| Percentage of Participants With All - Cause Mortality Through Day 42 | Baseline up to 42 days | All - Cause Mortality Through Day 42 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Clinical Response: AC Assessment | Baseline up to days 42, 84 and EOT (180 days) | AC Assessed Clinical response was defined as follows: * Success: Complete (if resolution of all attributable clinical symptoms and physical findings occurs); Partial (if resolution of at least some of the clinical symptoms and physical findings associated with IFD) * Failure: Stable (if minor of no change in clinical symptoms and physical findings associated with IFD); Progression (if worsening or new clinical symptoms and physical findings associated with IFD, or if alternative systemic antifungal treatment is required) * Not Evaluable: If not assessed or no clinical signs or symptoms at baseline * No assessment: Those participants that do not fall under any of the above criteria |
| Percentage of Participants With Clinical Response: Investigator Assessment | Baseline up to days 42, 84 and EOT (180 days) | Investigator-assessed Clinical Response was defined as follows: * Success: if resolution of all attributable signs and symptoms or resolution of attributable clinical symptoms and physical findings * Failure: if no resolution of any attributable signs and symptoms or no resolution of any attributable signs and symptoms (no change) or worsening of any attributable signs and symptoms * Not Evaluable: if results not available /participant unevaluable or if no attributable signs and symptoms * No assessment: Those participants that do not fall under any of the above criteria |
| Percentage of Participants With Radiological Response: AC Assessment | Baseline up to days 42, 84 and EOT (180 days) | AC-assessed Radiological Response was defined as follows: * Success: Complete (if ≥ 90% improvement); Partial (if at least \< 25% response at day 42 and at least 50% response by Day 84) * Failure: Stable (if minor or no change in radiographic abnormalities associated with IFD, but no signs of progression); Progression (if worsening or new radiological abnormalities associated with IRD) * Not Evaluable: if no post baseline radiology available with baseline evidence of radiolical disease Or Radiology not applicable at baseline * No assessment: Those participants that do not fall under any of the above criteria |
| Percentage of Participants With All - Cause Mortality | Baseline up to day 84 and end of treatment (EOT) (up to a maximum of 180 days) (Average duration of treatment: 57.7 days) | EOT was defined as anytime from day 1 to a maximum of day 180. Data reported in the table below for each category, i.e., Day 84 represented data between Day 1 and Day 84 and for EOT, data represented between Day 1 to the EOT day for each individual. Participants who died after EOT assessment but before reaching Day 84 were included in the data for Day 84 category. Only those deaths that occurred after Day 84 would be included in EOT category if the death occurred during the treatment period (i.e. prior to the EOT). |
| Percentage of Participants With Mycological Response: AC Assessment | Baseline up to days 42, 84 and EOT (180 days) | AC assessed mycological response was defined as follows: * Success: Eradicated (no growth of the original \[at baseline\] causative organism on culture or identified by histology/cytology on post baseline \[after day 7\] cultures and/or histology/cytology); Presumed Eradicated (missing post baseline documentation of eradication of the original causative organism at baseline PLUS resolution of all or some clinical symptoms/physical finding) * Failure: Persistence (persistence of the original causative organism cultured or identified by histological /cytology at baseline); Presumed Persistence (missing post baseline documentation of the persistence of the original causative organism at baseline PLUS no resolution or worsening of any clinical symptoms/physical findings) * Not Evaluable - no mycological evidence * No assessment: Those participants that do not fall under any of the above criteria |
| Percentage of Participats With Mycological Response: Investigator Assessment | Baseline up to days 42, 84 and EOT (180 days) | Investigator's assessed mycological response was defined as follows: * Success: Eradicated (no growth of the original \[at baseline\] causative organism on culture or identified by histology/cytology on post baseline \[after day 7\] cultures and/or histology/cytology); Presumed Eradicated (missing post baseline documentation of eradication of the original causative organism at baseline PLUS resolution of all or some clinical symptoms/physical finding) * Failure: Persistence (persistence of the original causative organism cultured or identified by histological /cytology at baseline); Presumed Persistence (missing post baseline documentation of the persistence of the original causative organism at baseline PLUS no resolution or worsening of any clinical symptoms/physical findings) * Not Evaluable: Indeterminate/no mycological follow-up or results available * No assessment: Those participants that do not fall under any of the above criteria |
| Pharmacokinetics of Isavuconazonium Sulphate in Plasma: Trough Concentration (Ctrough) | Predose on days 7, and 14 | Ctrough was defined as the predose concentration at the end of dosing interval. |
| Percentage of Participants With Radiological Response: Investigator Assessment | Baseline up to days 42, 84 and EOT (180 days) | Investigator's assessed radiological response was defined as follows: * Success: if ≥ 90% improvement, ≥ 50% to \< 90% improvement, ≥ 25% to 50% improvement (for Day 42 only) * Failure if \< 25% improvement at any time or no signs or radiological Images * Not Evaluable if results not evaluable or no radiological data available * No assessment: Those participants that do not fall under any of the above criteria |
| Percentage of Participants With Overall Response: Adjudication Committee (AC) Assessment | Baseline up to days 42, 84 and EOT (180 days) | Overall response was based on a composite of clinical, mycological, and radiological responses with success criteria assessed. Success criteria as assessed by AC in: Clinical response: * Complete: Resolution of all attributable clinical symptoms and physical findings * Partial: Resolution of at Least some of the clinical symptoms and physical findings associated with IFD Mycological response: * Eradication: No growth of the original (at baseline) causative organism on culture or identified by histology/cytology on post baseline (after day 7) cultures and/or histology/cytology * Presumed eradication: Missing post baseline documentation of eradication of the original causative organism at baseline PLUS resolution of all or some clinical symptoms/physical finding Radiological response: * Complete: ≥ 90% improvement * Partial: At least \< 25% response at day 42 and at least 50% by Day 84 |
Countries
Belgium, Spain, United States
Participant flow
Recruitment details
A total of 31 pediatric participants diagnosed with invasive aspergillosis (IA) or invasive mucormycosis (IM) were enrolled and received isavuconazonium sulfate.
Pre-assignment details
Male or female participant 1 year to \< 18 years of age diagnosed with IA or IM. A positive diagnosis was defined as proven, probable or possible invasive fungal infection (IFI) per the European Organisation for Research and Treatment of Cancer/Mycoses Study Group \[EORTC/MSG\], 2008 criteria.
Participants by arm
| Arm | Count |
|---|---|
| Isavuconazonium Sulfate Participants received 10 mg/kg dose of isavuconazonium sulfate every 8 hours (± 2 hours) on days 1 and 2 for a total of 6 doses (via intravenous or oral administration at the investigator's discretion)followed by once-daily maintenance dose of 10 mg/kg for up to 84 days for IA or 180 days for IM or until the participant had a successful outcome as judged by the investigator, whichever occured first. The route of administration could have been changed per the investigator's discretion. | 31 |
| Total | 31 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 3 |
| Overall Study | Lack of Efficacy | 4 |
| Overall Study | Miscellaneous | 5 |
Baseline characteristics
| Characteristic | Isavuconazonium Sulfate |
|---|---|
| Age, Continuous | 9.7 Years STANDARD_DEVIATION 5 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 10 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 19 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 2 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 5 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 6 Participants |
| Race (NIH/OMB) White | 19 Participants |
| Sex: Female, Male Female | 25 Participants |
| Sex: Female, Male Male | 6 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 3 / 31 |
| other Total, other adverse events | 28 / 31 |
| serious Total, serious adverse events | 18 / 31 |
Outcome results
Number of Participants With Treatment Emergent Adverse Events (TEAEs)
An AE is any untoward medical occurrence in a participant administered a study drug, which does not have to have a causal relationship with this treatment. It can be any unfavorable sign, symptom, or disease temporally associated with the use of a medicinal product. TEAE is defined as an AE observed after starting administration of the study drug through 30 days after the last dose.
Time frame: From first dose to 30 days after the last dose (maximum 210 Days)
Population: The safety analysis set (SAF) consisted of all participant who were enrolled and received at least one dose of study drug.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Isavuconazonium Sulfate | Number of Participants With Treatment Emergent Adverse Events (TEAEs) | 29 Participants |
Percentage of Participants With All - Cause Mortality Through Day 42
All - Cause Mortality Through Day 42
Time frame: Baseline up to 42 days
Population: FAS population
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Isavuconazonium Sulfate | Percentage of Participants With All - Cause Mortality Through Day 42 | 6.5 Percentage of participants |
Percentage of Participants With All - Cause Mortality
EOT was defined as anytime from day 1 to a maximum of day 180. Data reported in the table below for each category, i.e., Day 84 represented data between Day 1 and Day 84 and for EOT, data represented between Day 1 to the EOT day for each individual. Participants who died after EOT assessment but before reaching Day 84 were included in the data for Day 84 category. Only those deaths that occurred after Day 84 would be included in EOT category if the death occurred during the treatment period (i.e. prior to the EOT).
Time frame: Baseline up to day 84 and end of treatment (EOT) (up to a maximum of 180 days) (Average duration of treatment: 57.7 days)
Population: FAS population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Isavuconazonium Sulfate | Percentage of Participants With All - Cause Mortality | Day 84 | 9.7 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With All - Cause Mortality | EOT | 0.00 Percentage of participants |
Percentage of Participants With Clinical Response: AC Assessment
AC Assessed Clinical response was defined as follows: * Success: Complete (if resolution of all attributable clinical symptoms and physical findings occurs); Partial (if resolution of at least some of the clinical symptoms and physical findings associated with IFD) * Failure: Stable (if minor of no change in clinical symptoms and physical findings associated with IFD); Progression (if worsening or new clinical symptoms and physical findings associated with IFD, or if alternative systemic antifungal treatment is required) * Not Evaluable: If not assessed or no clinical signs or symptoms at baseline * No assessment: Those participants that do not fall under any of the above criteria
Time frame: Baseline up to days 42, 84 and EOT (180 days)
Population: FAS population. If participant did not reach Day 42 or Day 84 of therapy then the AC did not perform these assessments.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: AC Assessment | EOT Not Evaluable | 83.87 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: AC Assessment | EOT No Assessment | 0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: AC Assessment | Day 42 Success | 0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: AC Assessment | Day 42 Failure | 0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: AC Assessment | Day 42 Not Evaluable | 58.06 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: AC Assessment | Day 42 No Assessment | 41.94 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: AC Assessment | Day 84 Success | 0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: AC Assessment | Day 84 Failure | 0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: AC Assessment | Day 84 Not Evaluable | 35.48 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: AC Assessment | Day 84 No Assessment | 64.52 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: AC Assessment | EOT Success | 6.45 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: AC Assessment | EOT Failure | 9.68 Percentage of participants |
Percentage of Participants With Clinical Response: Investigator Assessment
Investigator-assessed Clinical Response was defined as follows: * Success: if resolution of all attributable signs and symptoms or resolution of attributable clinical symptoms and physical findings * Failure: if no resolution of any attributable signs and symptoms or no resolution of any attributable signs and symptoms (no change) or worsening of any attributable signs and symptoms * Not Evaluable: if results not available /participant unevaluable or if no attributable signs and symptoms * No assessment: Those participants that do not fall under any of the above criteria
Time frame: Baseline up to days 42, 84 and EOT (180 days)
Population: FAS population. If participant did not reach Day 42 or Day 84 of therapy then the investigator did not perform these assessments.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: Investigator Assessment | Day 42 Success | 41.9 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: Investigator Assessment | Day 42 Failure | 9.7 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: Investigator Assessment | Day 42 Not Evaluable | 0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: Investigator Assessment | Day 42 No Assessment | 48.4 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: Investigator Assessment | Day 84 Success | 32.3 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: Investigator Assessment | Day 84 Failure | 0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: Investigator Assessment | Day 84 Not Evaluable | 0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: Investigator Assessment | Day 84 No Assessment | 67.7 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: Investigator Assessment | EOT Success | 61.3 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: Investigator Assessment | EOT Failure | 29.0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: Investigator Assessment | EOT Not Evaluable | 3.2 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Clinical Response: Investigator Assessment | EOT No Assessment | 6.5 Percentage of participants |
Percentage of Participants With Mycological Response: AC Assessment
AC assessed mycological response was defined as follows: * Success: Eradicated (no growth of the original \[at baseline\] causative organism on culture or identified by histology/cytology on post baseline \[after day 7\] cultures and/or histology/cytology); Presumed Eradicated (missing post baseline documentation of eradication of the original causative organism at baseline PLUS resolution of all or some clinical symptoms/physical finding) * Failure: Persistence (persistence of the original causative organism cultured or identified by histological /cytology at baseline); Presumed Persistence (missing post baseline documentation of the persistence of the original causative organism at baseline PLUS no resolution or worsening of any clinical symptoms/physical findings) * Not Evaluable - no mycological evidence * No assessment: Those participants that do not fall under any of the above criteria
Time frame: Baseline up to days 42, 84 and EOT (180 days)
Population: FAS population. If participant did not reach Day 42 or Day 84 of therapy then the AC did not perform these assessments.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Isavuconazonium Sulfate | Percentage of Participants With Mycological Response: AC Assessment | Day 84 No Assessment | 64.52 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Mycological Response: AC Assessment | EOT Failure | 12.90 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Mycological Response: AC Assessment | EOT Not Evaluable | 51.61 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Mycological Response: AC Assessment | EOT No Assessment | 0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Mycological Response: AC Assessment | Day 42 Success | 19.35 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Mycological Response: AC Assessment | Day 42 Failure | 3.23 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Mycological Response: AC Assessment | Day 42 Not Evaluable | 35.48 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Mycological Response: AC Assessment | Day 42 No Assessment | 41.94 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Mycological Response: AC Assessment | Day 84 Success | 19.35 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Mycological Response: AC Assessment | Day 84 Failure | 0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Mycological Response: AC Assessment | Day 84 Not Evaluable | 16.13 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Mycological Response: AC Assessment | EOT Success | 35.48 Percentage of participants |
Percentage of Participants With Overall Response: Adjudication Committee (AC) Assessment
Overall response was based on a composite of clinical, mycological, and radiological responses with success criteria assessed. Success criteria as assessed by AC in: Clinical response: * Complete: Resolution of all attributable clinical symptoms and physical findings * Partial: Resolution of at Least some of the clinical symptoms and physical findings associated with IFD Mycological response: * Eradication: No growth of the original (at baseline) causative organism on culture or identified by histology/cytology on post baseline (after day 7) cultures and/or histology/cytology * Presumed eradication: Missing post baseline documentation of eradication of the original causative organism at baseline PLUS resolution of all or some clinical symptoms/physical finding Radiological response: * Complete: ≥ 90% improvement * Partial: At least \< 25% response at day 42 and at least 50% by Day 84
Time frame: Baseline up to days 42, 84 and EOT (180 days)
Population: FAS population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Isavuconazonium Sulfate | Percentage of Participants With Overall Response: Adjudication Committee (AC) Assessment | Day 42 | 29.0 Percentage of partticipants |
| Isavuconazonium Sulfate | Percentage of Participants With Overall Response: Adjudication Committee (AC) Assessment | Day 84 | 25.8 Percentage of partticipants |
| Isavuconazonium Sulfate | Percentage of Participants With Overall Response: Adjudication Committee (AC) Assessment | EOT | 54.8 Percentage of partticipants |
Percentage of Participants With Radiological Response: AC Assessment
AC-assessed Radiological Response was defined as follows: * Success: Complete (if ≥ 90% improvement); Partial (if at least \< 25% response at day 42 and at least 50% response by Day 84) * Failure: Stable (if minor or no change in radiographic abnormalities associated with IFD, but no signs of progression); Progression (if worsening or new radiological abnormalities associated with IRD) * Not Evaluable: if no post baseline radiology available with baseline evidence of radiolical disease Or Radiology not applicable at baseline * No assessment: Those participants that do not fall under any of the above criteria
Time frame: Baseline up to days 42, 84 and EOT (180 days)
Population: FAS population. If participant did not reach Day 42 or Day 84 of therapy then the AC did not perform these assessments.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: AC Assessment | Day 42 Success | 29.03 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: AC Assessment | Day 42 Failure | 6.45 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: AC Assessment | Day 42 Not Evaluable | 22.58 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: AC Assessment | Day 42 No Assessment | 41.94 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: AC Assessment | Day 84 Success | 25.81 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: AC Assessment | Day 84 Failure | 0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: AC Assessment | Day 84 Not Evaluable | 9.68 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: AC Assessment | Day 84 No Assessment | 64.52 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: AC Assessment | EOT Success | 51.61 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: AC Assessment | EOT Failure | 16.13 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: AC Assessment | EOT Not Evaluable | 32.26 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: AC Assessment | EOT No Assessment | 0 Percentage of participants |
Percentage of Participants With Radiological Response: Investigator Assessment
Investigator's assessed radiological response was defined as follows: * Success: if ≥ 90% improvement, ≥ 50% to \< 90% improvement, ≥ 25% to 50% improvement (for Day 42 only) * Failure if \< 25% improvement at any time or no signs or radiological Images * Not Evaluable if results not evaluable or no radiological data available * No assessment: Those participants that do not fall under any of the above criteria
Time frame: Baseline up to days 42, 84 and EOT (180 days)
Population: FAS population. If participant did not reach Day 42 or Day 84 of therapy then the investigator did not perform these assessments.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: Investigator Assessment | Day 42 No Assessment | 58.1 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: Investigator Assessment | Day 42 Success | 25.8 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: Investigator Assessment | Day 42 Failure | 3.2 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: Investigator Assessment | Day 42 Not Evaluable | 12.9 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: Investigator Assessment | Day 84 Success | 19.4 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: Investigator Assessment | Day 84 Failure | 0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: Investigator Assessment | Day 84 Not Evaluable | 9.7 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: Investigator Assessment | Day 84 No Assessment | 71.0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: Investigator Assessment | EOT Success | 48.4 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: Investigator Assessment | EOT Failure | 16.1 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: Investigator Assessment | EOT Not Evaluable | 29.0 Percentage of participants |
| Isavuconazonium Sulfate | Percentage of Participants With Radiological Response: Investigator Assessment | EOT No Assessment | 6.5 Percentage of participants |
Percentage of Participats With Mycological Response: Investigator Assessment
Investigator's assessed mycological response was defined as follows: * Success: Eradicated (no growth of the original \[at baseline\] causative organism on culture or identified by histology/cytology on post baseline \[after day 7\] cultures and/or histology/cytology); Presumed Eradicated (missing post baseline documentation of eradication of the original causative organism at baseline PLUS resolution of all or some clinical symptoms/physical finding) * Failure: Persistence (persistence of the original causative organism cultured or identified by histological /cytology at baseline); Presumed Persistence (missing post baseline documentation of the persistence of the original causative organism at baseline PLUS no resolution or worsening of any clinical symptoms/physical findings) * Not Evaluable: Indeterminate/no mycological follow-up or results available * No assessment: Those participants that do not fall under any of the above criteria
Time frame: Baseline up to days 42, 84 and EOT (180 days)
Population: FAS population. If participant did not reach Day 42 or Day 84 of therapy then the investigator did not perform these assessments.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Isavuconazonium Sulfate | Percentage of Participats With Mycological Response: Investigator Assessment | EOT No Assessment | 6.5 Percentage of Participants |
| Isavuconazonium Sulfate | Percentage of Participats With Mycological Response: Investigator Assessment | Day 42 Success | 22.6 Percentage of Participants |
| Isavuconazonium Sulfate | Percentage of Participats With Mycological Response: Investigator Assessment | Day 42 Failure | 6.5 Percentage of Participants |
| Isavuconazonium Sulfate | Percentage of Participats With Mycological Response: Investigator Assessment | Day 42 Not Evaluable | 22.6 Percentage of Participants |
| Isavuconazonium Sulfate | Percentage of Participats With Mycological Response: Investigator Assessment | Day 42 No Assessment | 48.4 Percentage of Participants |
| Isavuconazonium Sulfate | Percentage of Participats With Mycological Response: Investigator Assessment | Day 84 Success | 25.8 Percentage of Participants |
| Isavuconazonium Sulfate | Percentage of Participats With Mycological Response: Investigator Assessment | Day 84 Failure | 0 Percentage of Participants |
| Isavuconazonium Sulfate | Percentage of Participats With Mycological Response: Investigator Assessment | Day 84 Not Evaluable | 3.2 Percentage of Participants |
| Isavuconazonium Sulfate | Percentage of Participats With Mycological Response: Investigator Assessment | Day 84 No Assessment | 71.0 Percentage of Participants |
| Isavuconazonium Sulfate | Percentage of Participats With Mycological Response: Investigator Assessment | EOT Success | 45.2 Percentage of Participants |
| Isavuconazonium Sulfate | Percentage of Participats With Mycological Response: Investigator Assessment | EOT Failure | 12.9 Percentage of Participants |
| Isavuconazonium Sulfate | Percentage of Participats With Mycological Response: Investigator Assessment | EOT Not Evaluable | 35.5 Percentage of Participants |
Pharmacokinetics of Isavuconazonium Sulphate in Plasma: Trough Concentration (Ctrough)
Ctrough was defined as the predose concentration at the end of dosing interval.
Time frame: Predose on days 7, and 14
Population: The pharmacokinetic analysis set (PKAS) consisted of all participants who took at least one dose of study drug and who had at least one plasma concentration.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Isavuconazonium Sulfate | Pharmacokinetics of Isavuconazonium Sulphate in Plasma: Trough Concentration (Ctrough) | Age group 1 to <6 Day 7 | 2965.0 Nanograms/milliter (ng/mL) | Standard Deviation 1770.5 |
| Isavuconazonium Sulfate | Pharmacokinetics of Isavuconazonium Sulphate in Plasma: Trough Concentration (Ctrough) | Age group 1 to <6 Day 14 | 2286.7 Nanograms/milliter (ng/mL) | Standard Deviation 1991.3 |
| Isavuconazonium Sulfate | Pharmacokinetics of Isavuconazonium Sulphate in Plasma: Trough Concentration (Ctrough) | Age group 6 to <12 Day 7 | 3732.7 Nanograms/milliter (ng/mL) | Standard Deviation 1855 |
| Isavuconazonium Sulfate | Pharmacokinetics of Isavuconazonium Sulphate in Plasma: Trough Concentration (Ctrough) | Age group 6 to <12 Day 14 | 3623.3 Nanograms/milliter (ng/mL) | Standard Deviation 1878 |
| Isavuconazonium Sulfate | Pharmacokinetics of Isavuconazonium Sulphate in Plasma: Trough Concentration (Ctrough) | Age group 12 to <18 Day 7 | 3862.2 Nanograms/milliter (ng/mL) | Standard Deviation 1427.1 |
| Isavuconazonium Sulfate | Pharmacokinetics of Isavuconazonium Sulphate in Plasma: Trough Concentration (Ctrough) | Age group 12 to <18 Day 14 | 4380.0 Nanograms/milliter (ng/mL) | Standard Deviation 2022.4 |