Ganciclovir to Prevent Reactivation of Cytomegalovirus in Patients With Acute Respiratory Failure and Sepsis

Stopped early · Phase 3 · Has a placebo group

Conditions studied: Acute Respiratory Failure

In brief

This is a phase 3 study designed to evaluate whether the administration of ganciclovir increases ventilator-free days in immunocompetent patients with sepsis associated acute respiratory failure. Our hypothesis is that IV ganciclovir administered early in critical illness will effectively suppress CMV reactivation in CMV seropositive adults with sepsis-associated acute respiratory failure thereby leading to improved clinical outcomes

Key facts

Study ID

NCT04706507

Run by

Fred Hutchinson Cancer Center

People needed

205

Starts

2021-06-29

Expected to finish

2025-04-08

Last updated by the study team

2025-12-12

Who can join

Age: 18 and older, up to 85. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Subject/next of kin informed consent
• Age > 18 years
• CMV IgG seropositive by lateral flow assay (LFA) or standard serologic methods
• Receiving care in an ICU
• Acute respiratory failure as defined in Section 4.1.1.
• Expected to require respiratory support for at least 2 more days after randomization
• Infection confirmed or suspected by the treating clinician and felt to be the source of acute respiratory failure (Respiratory failure associated with infection confers at least 2 SOFA points above assumed baseline SOFA score of 0, thereby meeting Sepsis-3 definition).

You may not qualify if…

• Known or suspected immunosuppression, including:
• HIV+ (i.e. prior positive test or clinical signs of suspicion of HIV/AIDS; a negative HIV test is not required for enrollment)
• stem cell transplantation:
• within 6 months after autologous transplantation or
• within 1 years after allogeneic transplantation (regardless of immunosuppression)
• greater than 1 year of allogeneic transplantation if still taking systemic immunosuppression or prophylactic antibiotics (e.g. for chronic graft versus host disease) Note: if details of stem cell transplantation are unknown, patients who do not take systemic immunosuppression and do not take anti-infective prophylaxis are acceptable for enrollment and randomization.
• solid organ transplantation with receipt of systemic immunosuppression (any time)
• cytotoxic anti-cancer chemotherapy within the past three months (Note: next-of-kin estimate is acceptable)
• congenital immunodeficiency requiring antimicrobial prophylaxis (e.g. TMP-SMX, dapsone, antifungal drugs, intravenous immunoglobulin)
• receipt of one or more of the following in the indicated time period (see Appendix C):
• within 6 months: alemtuzumab, antithymocyte/antilymphocyte antibodies, or other immunosuppressive drugs associated with CMV reactivation Note: if no information on these agents is available in the history and no direct or indirect evidence exists from the history that any condition exists that requires treatment with these agents (based on the investigator's assessment), the subject may be enrolled. For all drug information, next-of-kin estimates are acceptable. See Appendix C for commonly prescribed immunosuppressive agents. Information on the use of biologics with moderate immunosuppressive effect but no known effect on CMV are permitted and will be recorded in the CRFs.
• Expected to survive < 72 hours (in the opinion of the investigator)
• Has been hospitalized for > 120 hours (subjects who are transferred from a chronic care ward, such as a rehabilitation unit, with an acute event are acceptable).
• Pregnant or breastfeeding (either currently or expected within one month). Note: for women of childbearing age (18-60 years, unless documentation of surgical sterilization [hysterectomy, tubal ligation, oophorectomy]), if a pregnancy test has not been done as part of initial ICU admission work-up, it will be ordered stat and documented to be negative before randomization. Both urine and blood tests are acceptable.
• Absolute neutrophil count < 1,000/mm3 (if no ANC value is available, the WBC must be > 2500/mm3)
• Use of anti-CMV drugs (cidofovir, letermovir, foscarnet, valganciclovir, ganciclovir) within seven (7) days of patient randomization.
• Currently enrolled in an interventional trial of an investigational therapeutic agent known or suspected to have anti-CMV activity or to be associated with significant known hematologic toxicity (prior approval required).
• At baseline patients who have both a tracheostomy, and have been on continuous 24-hour chronic mechanical ventilation.
• Patients with Child Class C Cirrhosis.
• Patients with severe (requiring home oxygen) pre-existing interstitial lung disease.
• Allergy to ganciclovir
• Incarcerated

Where it is running

• University of Colorado Denver — Denver, Colorado, United States
• Johns Hopkins University — Baltimore, Maryland, United States
• Brigham & Women's Hospital — Boston, Massachusetts, United States
• University of Michigan — Ann Arbor, Michigan, United States
• Henry Ford Hospital — Detroit, Michigan, United States
• Washington University — St Louis, Missouri, United States
• Montefioure Medical Center — The Bronx, New York, United States
• Duke University — Durham, North Carolina, United States
• Wakeforest University, School of Medicine — Winston-Salem, North Carolina, United States
• University of Cincinnati — Cincinnati, Ohio, United States
• The Cleveland Clinic Foundation — Cleveland, Ohio, United States
• Ohio State University Medical Center — Columbus, Ohio, United States
• University of Pittsburgh Medical Center — Pittsburgh, Pennsylvania, United States
• Medical College of South Carolina — Charleston, South Carolina, United States
• Vanderbilt University — Nashville, Tennessee, United States
• Intermountain Medical Center — Murray, Utah, United States
• University of Vermont College of Medicine — Burlington, Vermont, United States
• Harborview Medical Center — Seattle, Washington, United States
• University of Washington Medical Center — Seattle, Washington, United States
• University of Wisconsin School of Medicine & Public Health — Madison, Wisconsin, United States

Full record on ClinicalTrials.gov

Trial information comes from ClinicalTrials.gov and is refreshed daily. TrialsForMe does not provide medical care and does not run the studies it lists.