600 Participants Needed

Rezafungin for Prevention of Fungal Infections

(ReSPECT Trial)

Recruiting at 42 trial locations
Ho
Overseen ByHead of Clinical Operations
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial
Approved in 2 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial is testing if Rezafungin, given through an IV, is safe and effective in preventing serious fungal infections. It focuses on patients who have had blood and marrow transplants, as they are more likely to get these infections. Rezafungin works by stopping the growth of harmful fungi. It is designed for the treatment and prevention of invasive fungal infections with unique chemical stability.

Will I have to stop taking my current medications?

The trial protocol does not specify if you need to stop taking your current medications. However, if you are taking medications that severely interact with the standard antimicrobial regimen, you may need to adjust them. It's best to discuss your current medications with the trial team.

Is Rezafungin safe for humans?

Rezafungin has been tested in clinical trials and generally showed a good safety profile, with no serious adverse events reported in a study with healthy adults. Some mild to moderate side effects like increased liver enzymes and slow heart rate were noted, but they were not directly linked to the drug. Injection site reactions were observed, leading to a re-evaluation of the formulation.12345

How is the drug Rezafungin unique for preventing fungal infections?

Rezafungin is unique because it is a next-generation echinocandin that can be administered once a week due to its long half-life, making it more convenient than other treatments that require more frequent dosing. It also has strong activity against a wide range of fungal pathogens, including those resistant to other antifungal drugs.46789

What data supports the effectiveness of the drug Rezafungin for preventing fungal infections?

Rezafungin has been shown to be effective in treating candidaemia and invasive candidiasis, and it is being developed for preventing fungal infections in transplant patients. It has broad activity against many Candida species and some drug-resistant strains, making it a promising option for preventing fungal infections.14101112

Who Is on the Research Team?

LC

Laura Cox, PhD

Principal Investigator

Mundipharma Research Limited

Are You a Good Fit for This Trial?

Adults over 18 with certain blood diseases like leukemia or lymphoma, undergoing bone marrow transplants, can join this trial. They must have good kidney and liver function, agree to birth control measures if applicable, and not have had recent fungal infections or other specific health issues.

Inclusion Criteria

Willing and able to provide written informed consent
I have been diagnosed with a specific blood-related disease.
I agree to use birth control as required by the study.
See 5 more

Exclusion Criteria

Pregnant or lactating females
My lymphoma has not responded to chemotherapy.
I have been diagnosed with heart failure that causes symptoms.
See 20 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive Rezafungin or standard antimicrobial regimen for prevention of invasive fungal diseases

13 weeks
Weekly visits for dosing and monitoring

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks
Once weekly for outpatient, or twice weekly for inpatient

What Are the Treatments Tested in This Trial?

Interventions

  • Rezafungin for Injection
Trial Overview The study is testing Rezafungin's effectiveness in preventing invasive fungal diseases during bone marrow transplantation compared to standard antifungal drugs like Posaconazole and Fluconazole.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Group 1: Rezafungin for InjectionExperimental Treatment3 Interventions
Subjects in Rezafungin treatment group will receive a 400 mg loading dose in Week 1, followed by 200 mg once weekly, for a total of 13 weeks. Subjects will receive oral placebo for standard antimicrobial regimen (SAR) azole prophylaxis and oral placebo for SAR anti-Pneumocystis pneumonia (PCP) prophylaxis in accordance with the respective SAR dosing regimens for each. For subjects who are switched to a SAR IV regimen, oral placebo for SAR azole prophylaxis will be changed to IV placebo. There is no IV option for SAR anti-PCP prophylaxis.
Group II: Group 2: Oral AntifungalActive Control3 Interventions
Subjects randomized to the SAR will receive either fluconazole or posaconazole as the first-line SAR as per site's standard practice. Fluconazole will be administered orally at once daily doses of 400 mg for 13 weeks. Posaconazole will be administered orally as 300 mg twice daily on the first day and 300 mg once daily thereafter for 13 weeks. Azole-based antifungal therapy (fluconazole or posaconazole) can be switched from oral therapy to IV therapy if there is oral intolerance, at the discretion of the Investigator. Subjects who started on fluconazole SAR may be switched to posaconazole at the discretion of the Investigator if they develop acute clinically significant GVHD; In addition, subjects in the SAR group will receive anti PCP prophylaxis with oral TMP/SMX (80 mg TMP/ 400 mg SMX) once daily. There is no IV option for SAR anti-PCP prophylaxis.

Rezafungin for Injection is already approved in United States, European Union for the following indications:

🇺🇸
Approved in United States as Rezzayo for:
  • Candidemia and invasive candidiasis in adults with limited or no alternative treatment options
🇪🇺
Approved in European Union as Rezzayo for:
  • Treatment of invasive candidiasis in adults

Find a Clinic Near You

Who Is Running the Clinical Trial?

Cidara Therapeutics Inc.

Lead Sponsor

Trials
12
Recruited
7,400+

Mundipharma Research Limited

Lead Sponsor

Trials
40
Recruited
830,000+

Published Research Related to This Trial

Rezafungin, an intravenous echinocandin, has been approved in the USA for treating candidaemia and invasive candidiasis in adults who have limited treatment options, highlighting its efficacy in addressing serious fungal infections.
In addition to its approved use, rezafungin is being developed for preventing invasive fungal diseases in patients undergoing blood and marrow transplants, indicating its potential broader application in immunocompromised populations.
Rezafungin: First Approval.Syed, YY.[2023]
Rezafungin shows broad in vitro activity against various Candida species, including C. auris, and has similar species-specific effectiveness compared to other echinocandins like anidulafungin and micafungin.
However, rezafungin was found to be less active overall than anidulafungin and micafungin on a milligram-per-liter basis, and a notable proportion of C. auris isolates exhibited mutations that conferred cross-resistance to echinocandins, indicating potential challenges in treatment efficacy.
Rezafungin In Vitro Activity against Contemporary Nordic Clinical Candida Isolates and Candida auris Determined by the EUCAST Reference Method.Helleberg, M., Jørgensen, KM., Hare, RK., et al.[2021]
Rezafungin (CD101) demonstrated effective in vitro activity against various Candida species, with the lowest minimum inhibitory concentrations (MICs) observed for C. albicans, indicating its potential as a treatment for invasive candidiasis.
Significant interlaboratory variation was noted in the susceptibility results for C. albicans, suggesting the need for further investigation to standardize testing methods and ensure consistent results across different laboratories.
Multicentre determination of rezafungin (CD101) susceptibility of Candida species by the EUCAST method.Arendrup, MC., Meletiadis, J., Zaragoza, O., et al.[2019]

Citations

Rezafungin: First Approval. [2023]
Rezafungin In Vitro Activity against Contemporary Nordic Clinical Candida Isolates and Candida auris Determined by the EUCAST Reference Method. [2021]
Multicentre determination of rezafungin (CD101) susceptibility of Candida species by the EUCAST method. [2019]
Expanded Access Use of Rezafungin for Salvage Therapy of Invasive Candida glabrata Infection: A Case Report. [2023]
Rezafungin versus caspofungin for treatment of candidaemia and invasive candidiasis (ReSTORE): a multicentre, double-blind, double-dummy, randomised phase 3 trial. [2023]
A phase I randomized, double-blind, single subcutaneous dose escalation study to determine the safety, tolerability, and pharmacokinetics of rezafungin in healthy adult subjects. [2022]
Efficacy and safety of rezafungin and caspofungin in candidaemia and invasive candidiasis: pooled data from two prospective randomised controlled trials. [2023]
Rezafungin-Mechanisms of Action, Susceptibility and Resistance: Similarities and Differences with the Other Echinocandins. [2020]
Rezafungin (CD101) demonstrates potent in vitro activity against Aspergillus, including azole-resistant Aspergillus fumigatus isolates and cryptic species. [2019]
10.United Statespubmed.ncbi.nlm.nih.gov
Rezafungin treatment in mouse models of invasive candidiasis and aspergillosis: Insights on the PK/PD pharmacometrics of rezafungin efficacy. [2023]
In vitro activity of rezafungin against common and rare Candida species and Saccharomyces cerevisiae. [2020]
Review of the Novel Echinocandin Antifungal Rezafungin: Animal Studies and Clinical Data. [2020]
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