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caspofungin

Phase 3

Fungal Infection | Small molecule | Infectious Disease |Merck & Company, Inc.|Last Updated: Aug 27, 2018

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindCONTROLLED
Total Trials4
Total Enrollment250

FDA Designations

No designations recorded

Clinical trial landscape

caspofungin · 9 trials · 8 indications

Phase 3 4Phase 2 5
NCT00717860A Clinical Study of MK0991 (Caspofungin) in Japanese Patients With Deep-seated Candida or Aspergillus Infections (0991-062)(COMPLETED)Fungal Infection
COMPLETED121 Analytics
NCT00635648A Study of Caspofungin Acetate (MK0991) for the Treatment of Esophageal Candidiasis or Invasive Candidiasis in Chinese Adults (MK-0991-066)Fungal Infection
COMPLETED63 Analytics
NCT00250432A Multicenter, Randomized, Double-Blind, Comparative Study to Evaluate the Safety, Tolerability, and Efficacy of 2 Dosing Regimens of an Antifungal Drug in the Treatment of Fungal Infections in Adults (0991-801)(COMPLETED)Invasive Candidiasis
COMPLETED204 Analytics
NCT00379964A 28 - 90 Days Study to Evaluate the Safety, Tolerability, and Efficacy of Caspofungin Injection as Empirical Therapy in Indian Adults With Persistent Fever and Neutropenia (0991-053)(COMPLETED)Fungal Infection
COMPLETED50 Analytics
PHASE3COMPLETED
A Clinical Study of MK0991 (Caspofungin) in Japanese Patients With Deep-seated Candida or Aspergillus Infections (0991-062)(COMPLETED)
Fungal InfectionUnlock trial analytics
PHASE3COMPLETED
A Study of Caspofungin Acetate (MK0991) for the Treatment of Esophageal Candidiasis or Invasive Candidiasis in Chinese Adults (MK-0991-066)
Fungal InfectionUnlock trial analytics
PHASE3COMPLETED
A Multicenter, Randomized, Double-Blind, Comparative Study to Evaluate the Safety, Tolerability, and Efficacy of 2 Dosing Regimens of an Antifungal Drug in the Treatment of Fungal Infections in Adults (0991-801)(COMPLETED)
Invasive CandidiasisUnlock trial analytics
PHASE3COMPLETED
A 28 - 90 Days Study to Evaluate the Safety, Tolerability, and Efficacy of Caspofungin Injection as Empirical Therapy in Indian Adults With Persistent Fever and Neutropenia (0991-053)(COMPLETED)
Fungal InfectionUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With a Significant Drug-related Adverse Experience
1-4 weeks for esophageal candidiasis, 2-8 weeks for invasive candidiasis, 2-12 weeks for aspergillosis

A significant drug-related adverse experience was defined as a serious drug-related adverse experience or a drug-related adverse experience leading to study therapy discontinuation.

Number of Participants With One or More Drug-related Serious Adverse Events
First dose of study drug through 14 days post therapy (maximum 28 days of study drug for esophageal candidiasis, 60 days for invasive candidiasis; mean treatment duration of 14 days)

A serious adverse event is one that results in death, disability/incapacity, or hospitalization or is life threatening, a congenital anomaly or birth defect, cancer, an overdose, or otherwise jeopardizes the patient and may require medical intervention. A drug-related adverse event is a determination by the investigator physician that the study drug caused the event based on exposure, time course, likely cause, dechallenge (event resolved/improved when drug was discontinued), rechallenge (event resolved/improved when drug was re-introduced), and consistency with the drug profile.

Number of Patients Who Develop Significant Drug-related Adverse Events.
90 Days

Number of patients with at least 1 significant drug-related adverse event (serious drug-related or drug-related adverse events leading to caspofungin discontinuation) while on caspofungin study therapy or during the immediate 14-day post-caspofungin therapy period.

Any clinical or laboratory serious drug-related adverse experience during the study drug therapy period plus 14 days posttherapy.
during the study drug therapy period plus 14 days posttherapy
Percentage of Participants With an Overall Favorable Response to Therapy
Invasive candidiasis: up to 56 days; aspergillosis: up to 84 days

Invasive candidiasis: favorable overall response required resolved clinical findings and negative culture test for Candida species on follow-up. If Candida species were not observed in the baseline blood culture, favorable overall response required resolved clinical findings and resolved or improved radiographic findings. Aspergillosis: favorable overall response required resolved, improved, or unchanged clinical findings and resolved or improved radiographic findings, or resolved or improved clinical findings and resolved, improved, or stable radiographic findings.

Percentage of Participants With One or More Drug-Related Adverse Experiences
Invasive candidiasis: up to 70 days; aspergillosis: up to 98 days

An adverse experience (AE) is defined as any unfavorable or unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study drug. Any worsening of a preexisting condition which is temporally associated with the use of the study drug is also an AE. A drug-related AE is one judged to be definitely, probably, or possibly related to the study drug.

Pharmacokinetic parameters of drug exposure
Plasma drug-level observed in children 3 to 24 months of age is similar to the levels observed in adults.
28 Days
The proportion of patients with one or more drug-related clinical or laboratory adverse experience(s)
To estimate the proportion of patients treated with caspofungin reporting one or more clinical and/or laboratory drug-related adverse experience(s) during the study drug therapy period plus 14 days posttherapy

Secondary Endpoints

Number of Participants With a Specific Safety Finding
1-4 weeks for esophageal candidiasis, 2-8 weeks for invasive candidiasis, 2-12 weeks for aspergillosis
Number of Participants With Favorable Overall Response at the End of Study Therapy
1-4 weeks for esophageal candidiasis, 2-8 weeks for invasive candidiasis, 2-12 weeks for aspergillosis
Number of Participants With One or More Drug-related Adverse Events
First dose of study drug through 14 days post therapy (maximum 28 days of study drug for esophageal candidiasis, 60 days for invasive candidiasis; mean treatment duration of 14 days)
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
CaspofunginEXPERIMENTALcaspofungin acetate (MK0991)
MicafunginACTIVE_COMPARATORMicafungin sodium
Caspofungin 50 mg Intravenous (IV)EXPERIMENTAL -
1ACTIVE_COMPARATOR50 mg intravenous (IV) infusion (diluted with 9% saline) administered daily (following a 70-mg IV loading dose on Day 1), over the course of \~2 hrs. all patients should be treated with antifungal therapy for at least 14 days following both the improvement in clinical and radiographic signs of disease and the eradication of Candida from culture samples obtained from the invasive site of infection.
2EXPERIMENTAL150 mg intravenous (IV) infusion (diluted with 9% saline) administered daily, over the course of \~2 hrs. all patients should be treated with antifungal therapy for at least 14 days following both the improvement in clinical and radiographic signs of disease and the eradication of Candida from culture samples obtained from the invasive site of infection.
Participants with Esophageal CandidiasisEXPERIMENTALCandida infection is strongly suspected based on clinical symptoms and the participant's clinical course, white moss (plaque) is observed on the esophageal mucosa, and therapy via intravenous infusion is judged to be suitable for the present episode of esophageal candidiasis. MK-0991 therapy as a single loading dose of 70 mg/m\^2 intravenously on Day 1 (maximum not to exceed 70 mg), followed by 50 mg/m\^2 as a single once-daily dose on all subsequent days (maximum of 70 mg daily). The minimum and maximum treatment duration was 7 and 28 days, respectively.
Participants with Invasive CandidiasisEXPERIMENTALCandida infection is strongly suspected based on the presence of refractory fever not responding to an antibiotic agent, or clinical symptoms at the site of disease, or the participant's clinical course. In addition, at least 1 of the following criteria must be met: 1) Candida infection is strongly suspected based on radiographic imaging findings and positive serological test for fungus, 2) yeast is observed by direct microscopy or histopathological test of tissue biopsied from the site of disease, or 3) Candida species are observed by culture test of specimens sampled from the site of disease. MK-0991 therapy as a single loading dose of 70 mg/m\^2 intravenously on Day 1 (maximum not to exceed 70 mg), followed by 50 mg/m\^2 as a single once-daily dose on all subsequent days (maximum of 70 mg daily). The minimum and maximum treatment duration was 14 and 56 days, respectively.
Participants with AspergillosisEXPERIMENTALAspergillus infection is strongly suspected based on clinical symptoms and the participant's clinical course, and characteristic radiographic imaging findings are observed. In addition, at least 1 of the following criteria must be met: 1) risk factors predisposing to an Aspergillus infection, 2) positive serological test for Aspergillus, 3) acute-branching mold with separated hyphae are observed by direct microscopy or histopathological test, or 4) Aspergillus species are observed by culture test. MK-0991 therapy as a single loading dose of 70 mg/m\^2 intravenously on Day 1 (maximum not to exceed 70 mg), followed by 50 mg/m\^2 as a single once-daily dose on all subsequent days (maximum of 70 mg daily). The minimum and maximum treatment duration was 14 and 84 days, respectively.

Interventions

NameTypeDescription
caspofungin acetateDRUGCaspofungin acetate (50 mg/day for participants with esophageal candidiasis and 50 mg/day for participants with invasive candidiasis or aspergillosis after a 70 mg loading dose on Day 1), once daily intravenously (IV) for 1-4 weeks for esophageal candidiasis, 2-8 weeks for invasive candidiasis, 2-12 weeks for aspergillosis.
Comparator: Micafungin sodiumDRUGMicafungin sodium 150 mg/day, once daily IV, for 1-4 weeks for esophageal candidiasis, 2-8 weeks for invasive candidiasis, 2-12 weeks for aspergillosis.
CaspofunginDRUG -
Comparator: AmBisomeDRUGDuration of Treatment: 28-90 days
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Eligibility Criteria

Age Range20 Years to N/A
SexALL
Healthy VolunteersNo

Inclusion Criteria: * Japanese Patients In Whom A Causative Fungus Is Detected Before Treatment With The Study Drug Or Patients With Strongly Suspected Deep-Seated Fungal Infection Due To Candida species (Spp.) Or Aspergillus Spp. Exclusion Criteria: * Patients With Mycoses Other Than Ones Due To...

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Competitive Landscape -Fungal Infections 10 trials (matched to "Fungal Infection")

Frequently asked questions about caspofungin

What is Caspofungin used for?

Caspofungin is an investigational small molecule being studied for the treatment of fungal infections, including invasive candidiasis, candidiasis, esophageal candidiasis, aspergillosis, and infections in neutropenic patients. It is being evaluated in pediatric and adult populations with documented Candida or Aspergillus infections.

Who makes Caspofungin?

Caspofungin is being developed by Merck & Company, Inc., which trades under the ticker symbol MRK on the New York Stock Exchange. The company is conducting clinical trials to evaluate the drug's safety and efficacy in treating fungal infections.

What phase is Caspofungin in?

Caspofungin is in Phase 2 clinical development. It is an investigational drug and has not been approved by regulatory authorities. All four clinical trials listed for Caspofungin are Phase 2 studies that have been completed.

What clinical trials is Caspofungin in?

Caspofungin has completed four Phase 2 clinical trials: NCT00082524 in pediatric patients with Candida or Aspergillus infections, NCT00082537 comparing it to amphotericin B in febrile neutropenic patients, NCT00330395 a pharmacokinetic study in neonates and infants, and NCT01165320 in Japanese children and adolescents.

How does Caspofungin work?

Caspofungin is a small molecule antifungal agent. It works by inhibiting the synthesis of beta-glucan, a key component of fungal cell walls, which leads to fungal cell death. This mechanism targets the fungal cell wall specifically, making it effective against Candida and Aspergillus species.

Is Caspofungin the same as MK-0991?

Yes, Caspofungin is also known as MK-0991. Clinical trial records reference the drug under both names, with studies such as NCT01165320 titled 'A Study of Caspofungin (MK-0991) in Japanese Children and Adolescents.'