Platform Trial For Cryptococcal Meningitis

Status: Recruiting
Location: See all (2) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 2/Phase 3
SUMMARY

Cryptococcal meningitis is a fungal infection that causes a severe syndrome of meningitis that is 100% fatal without antifungal therapy. Even with antifungal therapy, mortality rates remain high, especially in low and middle income countries where the ongoing HIV/AIDS pandemic increases the risk of cryptococcosis among persons living with HIV infection. The combination of amphotericin and flucytosine (5-FC) has been the mainstay of therapy for the initial management of cryptococcal meningitis for 4 decades. Indeed, the effective delivery of these first line therapy in Africa can lower mortality to 25%. However, several challenges exist. First, even while 5-FC is included on the WHO list of essential medicines, the availability of 5-FC worldwide is limited. Second, liposomal amphotericin (Ambisome ®) is currently available from a single source supplier, creating risk. Third, current therapies have substantial toxicity. Lastly, with widespread agricultural fungicide use of azoles, the median fluconazole minimum inhibitory concentration (MIC50 ) for Cryptococcus has doubled since 2013. Globally, new or improved antifungals are needed for cryptococcal meningitis, particularly those which have less toxicity, greater efficacy, a prolonged half-life, and minimal drug-drug interactions. As multiple new antifungal medicines are on the horizon, this platform trial utilizes a master protocol to investigate, multiple regimens using standardized eligibility criteria, standardized study schedule of events, and standardized contemporary endpoints.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• CSF cryptococcal antigen (CrAg) positive meningitis

• HIV positive

• Ability and willingness to provide informed consent

• Willing to receive protocol-specified lumbar punctures

• Age \>= 18 years

• Female participants of childbearing potential who are participating in sexual activity that could lead to pregnancy must agree to use reliable forms of contraception (duration will be indicated in each Trial Appendix).

Locations
Other Locations
Uganda
Infectious Diseases Institute
RECRUITING
Kampala
Mbarara University of Science and Technology
RECRUITING
Mbarara
Contact Information
Primary
David Boulware, MD, MPH
boulw001@umn.edu
612-624-9996
Time Frame
Start Date: 2025-05-28
Estimated Completion Date: 2032-04-21
Participants
Target number of participants: 2000
Treatments
Active_comparator: Control group
randomized to standard of care
Experimental: Experimental group 1
randomized to experimental antifungal therapy #1
Experimental: Experimental group 2
randomized to experimental antifungal therapy #2
Experimental: Experimental group 3
randomized to experimental antifungal therapy #3
Experimental: Experimental group 4
randomized to experimental antifungal therapy #4
Sponsors
Leads: University of Minnesota

This content was sourced from clinicaltrials.gov

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