A Study to Evaluate Efficacy and Safety of Four Posaconazole Regimens With Placebo and Terbinafine in the Treatment of Toenail Onychomycosis (Study P05082AM2)(COMPLETED)
Condition: Onychomycosis
MeSH terms: Onychomycosis
Intervention: SCH 56592; SCH 56592; SCH 56592; SCH 56592; Terbinafine; Placebo
Intervention description: Posaconazole oral suspension (40 mg/mL) 100 mg QD for 24 weeks.; Posaconazole oral suspension (40 mg/mL) 200 mg QD for 24 weeks.; Posaconazole oral suspension (40 mg/mL) 400 mg QD for 24 weeks.; Posaconazole oral suspension (40 mg/mL) 400 mg QD for 12 weeks.; Terbinafine 250 mg QD for 12 weeks.; Placebo for 24 weeks.
Intervention MeSH terms: Posaconazole; Terbinafine
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Enrollment: 218.0
Sex: All
Minimum age: 18 Years
Maximum age: 75 Years
Healthy volunteers: No

Summary:

      The purpose of this study is to evaluate the efficacy, safety, and tolerability of oral
      administration of four dosing regimens of posaconazole relative to placebo and terbinafine,
      in the treatment of toenail onychomycosis.
    

Eligibility criteria:

        Inclusion Criteria:

          -  The subject must meet ALL the criteria listed below for entry:

               -  Subject must be between 18 and 75 years of age inclusive, of either sex, and of
                  any race;

               -  Subject must have distal subungual infection that affects approximately 25% to
                  75% of at least one great toenail, both clinically and mycologically diagnosed;

               -  Subject must have at least 2 mm of the proximal end of the target toenail free of
                  infection;

               -  Subject must have a target toenail that is assessed as capable of growing
                  approximately 1 mm/month, (eg, the subject needs to report cutting his or her
                  toenails at least once per month);

               -  Subject must have liver function tests within 1.5 x the upper limit of normal
                  (bilirubin and transaminases);

               -  Subject must have normal serum creatinine levels;

               -  Subject must be able to take study medication orally;

               -  Subject must have no history of current narcotic or alcohol addiction;

               -  Subject must be willing to give written informed consent and able to adhere to
                  dose, procedures, and visit schedules;

               -  Woman of childbearing potential who is currently sexually active must agree to
                  use a medically accepted method of contraception while receiving
                  protocol-specified medication and for 30 days after stopping the medication.
                  Methods include condoms (male or female) with or without a spermicidal agent,
                  diaphragm or cervical cap with spermicide, medically prescribed intrauterine
                  device, oral or systemic hormonal contraceptive (plus an additional reliable
                  barrier method), and surgical sterilization (eg, hysterectomy or tubal ligation).

        Woman of child-bearing potential who is not currently sexually active must agree to use a
        medically accepted method of contraception should she become sexually active while
        participating in the study.

          -  Woman of childbearing potential must have a negative serum pregnancy test within 72
             hours prior to start of study drug.

        Exclusion Criteria:

          -  The subject will be excluded from entry if ANY of the criteria listed below are met:

               -  Subject with one or more of the following conditions on the target toenail:

                    -  proximal subungual onychomycosis,

                    -  white superficial onychomycosis,

                    -  dermatophytoma or "yellow spike/streak",

                    -  exclusively lateral disease,

                    -  inability to become normal in the opinion of the investigator.

               -  Subject with psoriasis, severe moccasin-type tinea pedis requiring treatment,
                  symptomatic interdigital tinea pedis, lichen planus, or other abnormalities that
                  could result in a clinically abnormal nail;

               -  Subject with peripheral vascular disease or peripheral circulatory impairment;

               -  Subject with history of uncontrolled diabetes mellitus;

               -  Subject with known chronic or active liver disease;

               -  Subject with any known immunodeficiency;

               -  Subject with a family history of long QT syndrome;

               -  Subject with an electrocardiogram with QTc interval prolongation greater than 450
                  msec for males and 470 msec for females;

               -  Subject with potassium or magnesium lower than the lower limit of normal;

               -  Subject with any clinically significant condition or situation, other than the
                  condition being studied that, in the opinion of the investigator, would interfere
                  with study evaluations or optimal participation in the study;

               -  Subject who has received systemic antifungal therapy within 3 months or topical
                  antifungal therapy applied to the foot or toenails within 1 month of study entry;

               -  Subject who has received radiation therapy, chemotherapy, and/or
                  immunosuppressive drugs within 6 months of Randomization, and/or oral
                  corticosteroids for >1 month within the 6 months of Randomization (exception:
                  inhaled steroids);

               -  Subject using medications known to interact with azoles such as terfenadine,
                  pimozide, quinidine, halofantrine, astemizole, alfentanil, cisapride, HMG-Co A
                  (3-hydroxy-3-methylglutaryl coenzyme A) reductase inhibitors that are metabolized
                  by CYP3A4, and ebastine, within 7 days prior to Randomization; and pravastatin
                  within 14 days prior to Randomization;

               -  Subject using medications known to lower the serum concentration/efficacy of
                  azoles including rifampin, rifabutin, cimetidine, carbamazepine, phenytoin,
                  barbiturates, and isoniazid, 3 doses or more within 7 days prior to
                  Randomization;

               -  Subject with a known sensitivity to azoles, POS and/or its excipients,
                  terbinafine and/or its excipients;

               -  Subject who has been previously enrolled in this study or any other POS
                  investigational trial;

               -  Subject known to have received treatment with investigational drugs within 30
                  days prior to enrollment into this study;

               -  Woman who is breastfeeding, pregnant, or intends to become pregnant;

               -  Subject who is part of the staff personnel directly involved with this study;

               -  Subject who is a family member of the investigational study staff.