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Antifungal

Posaconazole for Crohn's Disease

Phase 4
Recruiting
Led By Gil Y Melmed, MD
Research Sponsored by Cedars-Sinai Medical Center
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial
Must have
Have an endoscopically-confirmed active Crohn's disease with active disease defined by SES-CD > 6 (>4 if ileal only), AND active symptoms of Crohn's disease (CDAI score >220)
Homozygous for CARD9 S12N risk allele, without the protective exon 11 polymorphism
Must not have
Moderate or severe renal impairment (Cr Clearance <50)
Proarrhythmic conditions
Timeline
Screening 3 weeks
Treatment Varies
Follow Up week 12
Awards & highlights
Drug Has Already Been Approved
Pivotal Trial

Summary

This trial is testing an oral antifungal medication to help Crohn's disease patients with a specific genetic marker. The medication aims to reduce a type of fungus in the body, which may calm the immune system and improve symptoms.

Who is the study for?
Adults aged 18-60 with Crohn's Disease affecting the ileum/colon, carrying a specific genetic risk (CARD9 S12N allele), can join this trial. They must have stable disease treatments and agree to contraception if applicable. Excluded are those allergic to azoles, with severe colitis or organ issues, recent drug/alcohol abuse, or on certain medications.
What is being tested?
The study tests Posaconazole against a placebo in Crohn's patients with a genetic predisposition. It aims to see if the antifungal treatment reduces disease activity and immune responses by altering gut microbes associated with Malassezia spp.
What are the potential side effects?
Posaconazole may cause headaches, nausea, stomach pain, diarrhea, fever; it might also affect liver enzymes and interact with other drugs. The exact side effects will be monitored throughout the trial.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below
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I have active Crohn's disease confirmed by a scope test and symptoms.
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I have a specific genetic variation linked to increased disease risk.
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I have Crohn's disease affecting my ileum or colon for at least 6 months.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:
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My kidney function is reduced with a creatinine clearance below 50.
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I do not have a heart condition that can cause irregular heartbeats.
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I have severe colon issues, including toxic megacolon or need for a stoma.
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I have been diagnosed with a type of colitis.
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I am not taking drugs that are mainly processed by the liver enzyme CY3PA4.

Timeline

Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~week 12
This trial's timeline: 3 weeks for screening, Varies for treatment, and week 12 for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.
Primary study objectives
Endoscopic Response
Secondary study objectives
Induction of Clinical Remission
Proportion of subjects in endoscopic remission

Awards & Highlights

Drug Has Already Been Approved
The FDA has already approved this drug, and is just seeking more data.
Pivotal Trial
The final step before approval, pivotal trials feature drugs that have already shown basic safety & efficacy.

Trial Design

2Treatment groups
Experimental Treatment
Placebo Group
Group I: PosaconazoleExperimental Treatment1 Intervention
Subjects administered posaconazole (Noxafil®, Merck) 300mg twice daily for 1 day followed by 300mg daily for 12 weeks
Group II: PlaceboPlacebo Group1 Intervention
Subjects administered three matching placebo tablets twice daily for 1 day followed by three tablets daily for 12 weeks

Research Highlights

Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.
Mechanism Of Action
Side Effect Profile
Prior Approvals
Other Research
Common treatments for Crohn's Disease include biological agents and antifungal treatments. Biological agents, such as anti-TNF agents (e.g., infliximab, adalimumab), work by inhibiting tumor necrosis factor-alpha (TNF-α), a key cytokine in inflammation. Other agents like ustekinumab target interleukins (IL-12 and IL-23) to reduce inflammatory responses. The antifungal treatment with Posaconazole aims to reduce the burden of Malassezia spp., potentially dampening immune responses in genetically predisposed individuals. These treatments are crucial as they target specific inflammatory pathways and microbial factors, offering tailored approaches to reduce inflammation and manage Crohn's Disease activity.
Review article: biological agents in the treatment of Crohn's disease.

Find a Location

Who is running the clinical trial?

Cedars-Sinai Medical CenterLead Sponsor
512 Previous Clinical Trials
163,340 Total Patients Enrolled
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)NIH
2,456 Previous Clinical Trials
4,335,107 Total Patients Enrolled
Gil Y Melmed, MDPrincipal InvestigatorCedars-Sinai Medical Center

Media Library

Posaconazole (Antifungal) Clinical Trial Eligibility Overview. Trial Name: NCT04966585 — Phase 4
Crohn's Disease Research Study Groups: Posaconazole, Placebo
Crohn's Disease Clinical Trial 2023: Posaconazole Highlights & Side Effects. Trial Name: NCT04966585 — Phase 4
Posaconazole (Antifungal) 2023 Treatment Timeline for Medical Study. Trial Name: NCT04966585 — Phase 4
~0 spots leftby Dec 2024