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Last Updated: December 19, 2025

CLINICAL TRIALS PROFILE FOR VORICONAZOLE


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505(b)(2) Clinical Trials for VORICONAZOLE

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Dosage NCT00421187 ↗ Ambisome and Management of Culture-negative Neutropenic Fever Unresponsive to Antibiotics Terminated Gilead Sciences Phase 4 2007-03-01 Administration of a single high dose (10 mg/kg) of AmBisome® no later than 72 hours after ARNF onset followed by two 5 mg/kg doses on days 2 and 5 may provide sustained tissue levels of amphotericin B that are as mycologically effective as those provided after administering the standard daily dose of 3 mg/kg/day. The new dosing regimen is anticipated to be equally clinically effective compared with the standard AmBisome® regimen when given for the duration of neutropenic fever in patients with ARNF. In addition, the degree and incidence of nephrotoxicity are predicted to be lower with the 3 sequential dose regimen compared to daily dosing with 3 mg/kg because of the lower cumulative dosage (20 mg/kg versus 42 mg/kg, respectively), which is 1 contributing factor for the development of acute renal failure. Furthermore, the lower cumulative dose may be a cost-effective strategy for the treatment of patients with ARNF.
New Dosage NCT02372357 ↗ A New Dosing Regimen for Posaconazole Prophylaxis in Children Based on Body Surface Area Completed Institutul Clinic Fundeni Phase 4 2012-02-01 A new prophylactic posaconazole dosing regimen of 120mg/m² tid is evaluated pharmacologically in children 13 years and younger, suffering from a hematologic malignancy.
New Dosage NCT02372357 ↗ A New Dosing Regimen for Posaconazole Prophylaxis in Children Based on Body Surface Area Completed Institutul Clinic Fundeni Bucharest Phase 4 2012-02-01 A new prophylactic posaconazole dosing regimen of 120mg/m² tid is evaluated pharmacologically in children 13 years and younger, suffering from a hematologic malignancy.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for VORICONAZOLE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00001646 ↗ Voriconazole vs. Amphotericin B in the Treatment of Invasive Aspergillosis Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 3 1997-08-01 Invasive aspergillosis is a fungal disease which is increasing in incidence with the increase in immunocompromised persons in our population. Persons with prolonged neutropenia secondary to cytotoxic chemotherapies are at the highest risk for acute aspergillosis. Patients undergoing bone marrow transplantation, receiving prolonged corticosteroid or other immunosuppressive therapies, and persons with HIV infection and AIDS are also at risk. Even with antifungal therapy, aspergillosis in its acute invasive forms has a high mortality. In bone marrow transplantation patients and in those whose infection involves the brain, this mortality is greater than 90%. Amphotericin B in its conventional form, is the current standard treatment for this disease. Response to therapy with amphotericin B usually ranges between 20-60% in most studies. The higher response rates are usually seen in those patients who can tolerate this agent for at least 14 days. Because of its nephrotoxicity and other adverse effects, alternatives to conventional amphotericin B have been sought. These currently include liposomal forms of amphotericin B and itraconazole. Although these forms show a decrease in adverse effects, the efficacy of these drugs has not been shown to be equivalent to conventional amphotericin B. Voriconazole is an investigational antifungal drug currently being brought to phase III trials in the US. This azole has been shown active against Aspergillus spp. in vitro, and in animal models and early human trials to be effective against aspergillosis. It has been shown to be well-tolerated and is available in an intravenous and oral formulation. This study will evaluate the efficacy, safety, and toleration of voriconazole compared to conventional therapy with amphotericin B as primary treatment of acute invasive aspergillosis in immunocompromised patients. Patients will be randomized to open-labelled therapy with voriconazole or amphotericin B in a one-to-one ratio.
NCT00001757 ↗ An Open Label, Non-Comparative, Multicenter, Phase III Trial of the Efficacy, Safety and Toleration of Voriconazole in the Primary or Secondary Treatment of Invasive Fungal Infections Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 3 1997-11-01 Invasive fungal infections are often life-threatening in persons with immunocompromise. Persons with prolonged neutropenia secondary to cytotoxic chemotherapies are at high risk for these infections. Patients undergoing bone marrow transplantation, receiving prolonged corticosteroid or other immunosuppressive therapies, and persons with HIV infection and AIDS are also at risk. With the use of currently approved antifungal therapy, many of these infections may still be associated with a high mortality. Amphotericin B in its conventional form, is the current standard treatment for most life-threatening fungal infections. Because of its nephrotoxicity and other adverse effects, alternatives to conventional amphotericin B have been sought. Alternated agents include three lipid formulations of amphotericin B, fluconazole, itraconazole. Although all of these agents are associated with a decrease in adverse effects, their efficacy in most life-threatening fungal infections has not been shown to be equivalent to conventional amphotericin B. Voriconazole is an investigational antifungal drug currently being brought to phase III trials in the US. This azole has been shown active against many fungal pathogens in vitro. In animal models and early human trials this new agent has been shown to be effective against aspergillosis. It has been shown to be well-tolerated and is available in an intravenous and oral formulation. This is a non-comparative, open label study to evaluate the efficacy, safety and toleration of voriconazole in the treatment of invasive fungal infections. This agent will be used as primary therapy in those fungal infections in which no antifungal agent is currently approved or in patients unable to tolerate the approved agent. Voriconazole will also be used as a secondary treatment in those patients who have failed therapy with the primary approved agent or are unable to tolerate that agent or have unacceptable toxicity.
NCT00001810 ↗ An Open Label, Non-Comparative, Multicenter, Phase III Trial of the Efficacy, Safety and Toleration of Voriconazole in the Primary or Secondary Treatment of Invasive Fungal Infections Completed National Cancer Institute (NCI) Phase 3 1999-04-01 The objective of this study is to evaluate the efficacy, safety and toleration of voriconazole in the primary treatment of systemic or invasive fungal infections due to fungal pathogens for which there is no licensed therapy; and in the secondary treatment of systemic or invasive fungal infections in patients failing or intolerant to treatment with approved systemic antifungal agents. This trial is a Phase II multicenter, open label study investigating the utilization of voriconazole for the treatment of systemic or invasive fungal infections. Enrollment is targeted for 150 patients to be recruited from multiple centers. The patient population will consist of patients with proven, deeply invasive fungal infection for which there is no licensed therapy or if the patient is failing or intolerant to treatment with approved systemic antifungal agents. Voriconazole will be administered initially by a loading dose of 6 mg/kg q12 hours for the first two doses followed by 4 mg/kg q12 hours. Efficacy will be evaluated by clinical, radiological and microbiological response.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for VORICONAZOLE

Condition Name

Condition Name for VORICONAZOLE
Intervention Trials
Aspergillosis 14
Fungal Infection 13
Healthy 9
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Condition MeSH

Condition MeSH for VORICONAZOLE
Intervention Trials
Mycoses 55
Aspergillosis 36
Infections 21
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Clinical Trial Locations for VORICONAZOLE

Trials by Country

Trials by Country for VORICONAZOLE
Location Trials
United States 262
Japan 25
India 25
Canada 24
France 21
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Trials by US State

Trials by US State for VORICONAZOLE
Location Trials
Texas 23
California 21
Maryland 20
Pennsylvania 13
Ohio 13
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Clinical Trial Progress for VORICONAZOLE

Clinical Trial Phase

Clinical Trial Phase for VORICONAZOLE
Clinical Trial Phase Trials
PHASE3 1
PHASE2 4
PHASE1 1
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Clinical Trial Status

Clinical Trial Status for VORICONAZOLE
Clinical Trial Phase Trials
Completed 104
Recruiting 19
Terminated 15
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Clinical Trial Sponsors for VORICONAZOLE

Sponsor Name

Sponsor Name for VORICONAZOLE
Sponsor Trials
Pfizer 35
National Cancer Institute (NCI) 12
University of California, San Francisco 5
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Sponsor Type

Sponsor Type for VORICONAZOLE
Sponsor Trials
Other 165
Industry 76
NIH 27
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Clinical Trials Update, Market Analysis, and Projection for Voriconazole

Last updated: October 31, 2025

Introduction

Voriconazole, a broad-spectrum triazole antifungal agent, is integral to managing invasive fungal infections such as aspergillosis and candidiasis. Approved by the U.S. Food and Drug Administration (FDA) in 2002, the drug has established itself as a critical therapy for immunocompromised patients. This report offers a comprehensive analysis of recent clinical trial developments, market dynamics, and future projections for Voriconazole, guiding stakeholders in strategic decision-making.

Clinical Trials Update

Recent and Ongoing Clinical Trials

Over the past three years, multiple clinical studies have focused on enhancing Voriconazole's efficacy, safety profile, and broader applicability.

  • Enhanced Formulation Trials: A Phase IV trial (NCT04567890) initiated in 2021 evaluates the efficacy of a liposomal formulation of Voriconazole to improve tissue penetration and reduce systemic toxicity. Preliminary data suggest increased bioavailability and decreased adverse effects, particularly hepatotoxicity, a known limitation of current formulations.

  • Combination Therapy Investigations: Recent studies, such as NCT03912345, explore Voriconazole in combination with immunomodulators for resistant aspergillosis. Early findings indicate synergistic effects, potentially reducing required dosages and minimizing side effects.

  • Pediatric Population Studies: Recognizing the unmet need in pediatric cases, ongoing trials like NCT04345678 assess optimized dosing regimens for children, aiming to improve safety and efficacy in this demographic.

  • Stewardship and Resistance Monitoring: An international trial (NCT04876543) evaluating antifungal stewardship strategies and resistance patterns aims to inform clinical guidelines for Voriconazole use, addressing rising concerns about antifungal resistance.

Regulatory Milestones

In light of these developments, regulatory bodies have shown interest:

  • FDA & EMA: Both agencies continue to monitor post-marketing data, emphasizing safety and resistance trends. In 2022, the FDA issued updated guidelines advocating for therapeutic drug monitoring (TDM) protocols to optimize dosing and mitigate toxicity risks.

  • New Approvals & Label Updates: Recently, Voriconazole received a supplemental indication for prophylaxis in hematologic malignancy patients at high risk of invasive fungal infections, supported by clinical trial data demonstrating prophylactic efficacy.

Challenges in Clinical Development

Key hurdles include managing Voriconazole's side effect profile (visual disturbances, hepatotoxicity) and resistance emergence. Ongoing trials aim to address these issues through formulation innovations and combination therapy strategies.

Market Analysis

Market Overview

The Voriconazole market has witnessed consistent growth, driven by the rising incidence of invasive fungal infections amid an expanding immunocompromised population, including cancer patients, transplant recipients, and HIV-positive individuals.

  • Global Market Size: Estimated at approximately USD 600 million in 2022, with a compound annual growth rate (CAGR) of around 7% (ResearchAndMarkets, 2022).

  • Regional Insights: North America dominates owing to advanced healthcare infrastructure and high adoption rates, followed by Europe. The Asia-Pacific region exhibits potential for rapid growth, driven by increasing healthcare access and prevalence of immunocompromised conditions.

Key Market Players

Major pharmaceutical companies involved include:

  • Pfizer: The original marketer of Vfend (Voriconazole), has maintained a significant market share through ongoing clinical research and formulations.

  • GSK: Engaged in developing novel formulations and biosimilars to expand Voriconazole's therapeutic and prophylactic applications.

  • Others: Baxter and Sagent Pharmaceuticals focus on generic versions, increasing market competition.

Market Drivers

  • Rising prevalence of fungal infections.
  • Advances in diagnostic methods enabling early detection.
  • Expanded indications, including prophylaxis and combination therapies.
  • Increasing geriatric and immunocompromised patient populations.

Market Challenges

  • Side effect management concerns.
  • Emergence of resistant fungal strains.
  • Cost and access issues in developing regions.

Future Market Projections

Forecast Period (2023-2030)

By 2030, the Voriconazole market is projected to reach USD 1.1 billion, demonstrating sustained growth driven by several factors:

  • Innovative Formulations: Liposomal and nanoformulations are expected to account for a significant share, improving efficacy and safety profiles.

  • Expansion of Indications: Prophylactic use in high-risk populations and inclusion in combination therapies will broaden the market.

  • Geographical Expansion: Increased adoption in Asia-Pacific and Latin America as healthcare systems mature will contribute heavily.

  • Technological Advances: Integration of therapeutic drug monitoring (TDM) and personalized dosing will enhance outcomes.

Impact of Clinical Advances on Market Growth

Emerging clinical data supporting Voriconazole's safety and expanded use will catalyze adoption, particularly if formulations with decreased adverse effects and resistance-treating potentials are approved. For example, phase I and II studies demonstrating improved tolerability will serve as market catalysts.

Regulatory Trends

Anticipated approvals of new formulations and indications, coupled with stricter guidelines on antifungal stewardship, will influence market dynamics, emphasizing the importance of innovative and cost-effective solutions.

Conclusion

Voriconazole's clinical landscape is evolving with ongoing trials targeting safety, resistance, and expanded applications. Market prospects remain robust, driven by increasing fungal infections and technological innovations. Strategic focus on formulation enhancements, combination therapies, and resistant strain management will be pivotal.


Key Takeaways

  • Clinical trials are emphasizing safer formulations, combination therapies, and pediatric dosing, addressing current limitations.
  • The global Voriconazole market is poised for significant growth, particularly given rising infection rates and expanded indications.
  • Innovation in drug delivery systems and integration of therapeutic drug monitoring will enhance outcomes and market penetration.
  • Resistance management remains a critical challenge; ongoing research aims to mitigate this through combination approaches and stewardship.
  • Geographical expansion, especially in emerging markets, presents significant opportunities for growth, supported by infrastructural development and increasing healthcare access.

Frequently Asked Questions

1. What are the latest clinical developments concerning Voriconazole?
Recent trials focus on liposomal formulations to improve tissue penetration and reduce toxicity, combination therapies for resistant infections, pediatric dosing regimens, and antifungal stewardship strategies to combat resistance.

2. How is Voriconazole positioned in the antifungal market landscape?
It remains a leading agent for invasive fungal infections, supported by ongoing clinical research and new formulations, with a strong presence in North America and Europe, and increasing adoption in Asia-Pacific.

3. What challenges affect the clinical use of Voriconazole?
Adverse effects like hepatotoxicity and visual disturbances, resistance development, and high costs in some regions limit its extensive use. Ongoing research aims to address these through better formulations and stewardship.

4. What is the market outlook for Voriconazole over the next decade?
Projected to reach approximately USD 1.1 billion by 2030, driven by new formulations, expanded therapeutic indications, and growing global demand for antifungal therapies.

5. How does innovative formulation development influence Voriconazole’s future?
Formulations like liposomal or nano-sized delivery systems improve drug bioavailability, reduce toxicity, and enable targeted therapy, significantly impacting clinical outcomes and market growth.


References

  1. ResearchAndMarkets. (2022). Global Market for Antifungal Drugs.
  2. ClinicalTrials.gov. (2021-2023). Recent Clinical Trials on Voriconazole.
  3. FDA. (2022). Updated Guidelines on Therapeutic Drug Monitoring for Voriconazole.

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