Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: A Multicentre Randomised Controlled Trial Comparing the Current Standard Diagnostic Strategy for Invasive Aspergillosis to the New Diagnostic Strategy for Invasive Aspergillosis in High-Risk Haematology Patients in Order to Determine Which Strategy Results in the Lower Rates of Use of Empiric Antifungal Therapy
Brief Summary: Aspergillus is a fungus found in soil, on farms and on construction sites. In those whose immune system is impaired it causes severe infection. The people who are particularly at high-risk of infection with Aspergillus (which is called Invasive Aspergillosis)are those with acute leukaemia who are having chemotherapy and those post bone marrow transplantation. Currently 15% of those at high-risk develop Invasive Aspergillosis and 60-90% of those with Invasive Aspergillosis die.

The main reason for this high death rate is that our current diagnostic tests are not good at detecting infection or often only detect the infection at advanced stages when treatment is ineffective. Because of the limitations of current diagnostic tests the current practice is to give empiric antifungal therapy (EAFT) early to treat suspected Invasive Aspergillosis. However studies have demonstrated that this therapy has only resulted in a minor reduction in the mortality rates and it also causes significant drug toxicity. It is a suboptimal treatment modality.

New tests have recently been developed to diagnose Invasive Aspergillosis. These tests are for the detection of an Aspergillus protein in blood and for the detection of Aspergillus DNA in blood. Available data suggests that these new tests make an early diagnosis and seem to be able to monitor responses to treatment. However no study has been reported to date which demonstrates that the use of these tests can impact on important patient outcomes. This trial is being performed to determine whether the use of the new diagnostic tests to guide antifungal therapy will help improve treatment of Invasive Aspergillosis, reduce drug toxicity and reduce the death rate in the high-risk patients as compared with the current standard method of diagnosis and treatment with EAFT.


Options:
A: Arm Label: Standard diagnostic strategy of culture and histology; Type: ACTIVE_COMPARATOR; Interventions: Other: Culture and histology | Arm Label: Aspergillus galactomannan and PCR directed; Type: EXPERIMENTAL; Interventions: Other: Aspergillus galactomannan and PCR | Intervention Type: OTHER; Name: Culture and histology; Assigned to Arm(s): Standard diagnostic strategy of culture and histology | Intervention Type: OTHER; Name: Aspergillus galactomannan and PCR; Assigned to Arm(s): Aspergillus galactomannan and PCR directed
B: Arm Label: Proven/Probable IA Patients; Type: N/A; Interventions: N/A | Arm Label: possible/No IA Patients; Type: N/A; Interventions: N/A
C: Arm Label: 1; Type: ACTIVE_COMPARATOR; Interventions: Drug: ORAL VORICONAZOLE and IV Amphotericin B | Arm Label: 2; Type: ACTIVE_COMPARATOR; Interventions: Drug: ORAL VORICONAZOLE and IV Amphotericin B | Intervention Type: DRUG; Name: ORAL VORICONAZOLE and IV Amphotericin B; Assigned to Arm(s): 1, 2
D: Arm Label: High Risk Oncohematological Patients; Type: N/A; Interventions: Procedure: Aspergillus PCR technique, Procedure: Aspergillus AGA technique | Intervention Type: PROCEDURE; Name: Aspergillus PCR technique; Assigned to Arm(s): High Risk Oncohematological Patients | Intervention Type: PROCEDURE; Name: Aspergillus AGA technique; Assigned to Arm(s): High Risk Oncohematological Patients

Answer: A