A Phase 2a Study, Effect of Vancomycin With vs Without Delpazolid (LCB01-0371) in Patients With MRSA Bacteremia
A Multicenter, Double-blinded, Randomized, Parallel Design, Phase IIa Clinical Trial to Evaluate the Efficacy, Safety and PK of LCB01-0371 With Vancomycin Versus Vancomycin Monotherapy in Patients With MRSA Bacteremia
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The mortality from S aureus bacteremia is higher for MRSA than for methicillin-susceptible S aureus (MSSA), typically at 20% to 25%.
The current standard therapy for MRSA bacteremia is Vancomycin. Vancomycin has many shortcomings, including poor tissue penetration and slow killing time. Vancomycin has reduced efficacy against MRSA and tended to increase the MIC level (called MIC creep). Addition of Delpazolid to Vancomycin could improve the known drawbacks of Vancomycin alone.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: YunHee Lee
- Phone Number: +82 2 461 0716
- Email: yhlee@legochembio.com
Study Locations
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Gwangju, Korea, Republic of, 61469
- Chonnam National University Hospital
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Gwangju, Korea, Republic of, 61453
- Chosun University Hospital
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Gyeonggi-do, Korea, Republic of, 13620
- Seoul National University Bundang Hospital
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Gyeonggi-do, Korea, Republic of, 15355
- Korea University Ansan Hospital
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Seoul, Korea, Republic of, 03722
- Severance Hospital
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Seoul, Korea, Republic of, 05505
- Asan Medical Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male or female ≥19 years of age on the date of written consent
- Subject who has confirmed positive MRSA at least one set of blood cultures within 72 hours prior to randomization OR, Subject who has confirmed positive MRSA at least one set of blood culture whthin 96 hours prior to randomization and treated with vancomycin at least 72 hours prior to randomization
- Subject who has clinical symptoms or signs of MRSA bacteremia according to the judgment of the investigator
- Subject who voluntarily decides to participate in this clinical trial after being explained fully, and agrees in writing to implement the clinical trial compliance matters
Exclusion Criteria:
- Subject with polymicrobial bacteremia or infections including Gram-negative strain
- Subject undergoing or in need of treatment with antiviral or antifungal drugs
- Subject who has received treatment for MRSA bacteremia within 3 months of screening (Subjects who have "re-infection" by investigator's judgement may participant in the study.)
- Subject who has been administered effective antibiotics against MRSA (Vancomycin, etc.) for more than 96 hours prior to the first investigational product administration. (However, antibiotics effective for MRSA such as vancomycin are allowed to be administered for less than 72 hours.)
- Septic shock patients
- Subject who has hypersensitivity to vancomycin or linezolid
- Subject who has a history of hypersensitivity to peptide-based antibiotics and aminoglycoside-based antibiotics
- Subject who is receiving a MAO inhibitor(MAOI) or has received MAOI within 14 days of the first investigational drug administration
- Subject taking serotonin reuptake inhibitors, tricyclic antidepressants, serotonin 5-HT1 receptor agonists (triptan), meperidine, or buspirone
- Subject with severely decreased immunity (Severe neutropenia (ANC <0.5×10^9/L) etc.)
- Subject who is expected to die within 2 days due to serious complications of MRSA bacteremia based on the judgment of the investigator
- Body Mass Index (BMI) ≥35 kg/m2
- Subject who is unable to administer drugs orally
- Pregnant or lactating female, female or male with childbearing potential who disagrees with the use of appropriate contraceptive methods during the study and up to 14 days after the last dose of the investigator product
- Subject who has received other clinical trial drugs within 30 days of screening
- Subject who is not suitable for participation in this clinical trial according to the medical findings of investigators
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Combination therapy - Vancomycin (IV) plus Delpazolid (PO)
Vancomycin: IV infusion per 2020 IDSA guideline
Delpazolid: 800 mg, BID, PO |
BID, PO
Other Names:
IV infusion per 2020 IDSA guideline
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Placebo Comparator: Monotherapy - Vancomycin (IV) plus Placebo of Delpazolid (PO)
Vancomycin: IV infusion per 2020 IDSA guideline
Placebo of Delpazolid: BID, PO |
IV infusion per 2020 IDSA guideline
BID, PO
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall Cure Rate at Day 14 After the Start of Treatment (Composite Response Rate: Clinical Improvement Plus Clearance of Bacteremia)_FAS
Time Frame: at Day 14
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at Day 14
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Overall Cure Rate at Day 14 After the Start of Treatment (Composite Response Rate: Clinical Improvement Plus Clearance of Bacteremia)_PPS
Time Frame: at Day 14
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at Day 14
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Overall Cure Rate by End of Treatment (EOT)_FAS
Time Frame: Day 7 visit and EOT (up to 6 weeks) visit
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Day 7 visit and EOT (up to 6 weeks) visit
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Overall Cure Rate by End of Treatment (EOT)_PPS
Time Frame: Day 7 visit and EOT (up to 6 weeks) visit
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Day 7 visit and EOT (up to 6 weeks) visit
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Mortality From MRSA Bacteremia by EOT_FAS
Time Frame: During the treatment period (from the first administration to EOT (up to 6 weeks))
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During the treatment period (from the first administration to EOT (up to 6 weeks))
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Mortality From MRSA Bacteremia by EOT_PPS
Time Frame: During the treatment period (from the first administration to EOT (up to 6 weeks))
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During the treatment period (from the first administration to EOT (up to 6 weeks))
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Relapse Rate of MRSA bacteremia_FAS
Time Frame: from the first administration to TOC (4 weeks after EOT)
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from the first administration to TOC (4 weeks after EOT)
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Relapse Rate of MRSA bacteremia_PPS
Time Frame: from the first administration to TOC (4 weeks after EOT)
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from the first administration to TOC (4 weeks after EOT)
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Clearance Rate of MRSA Bacteremia at Day 3, Day 5, Day 7, Day 14, EOT_FAS
Time Frame: Day 3, Day 5, Day 7, Day 14, EOT (up to 6 weeks)
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Day 3, Day 5, Day 7, Day 14, EOT (up to 6 weeks)
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Clearance Rate of MRSA Bacteremia at Day 3, Day 5, Day 7, Day 14, EOT_PPS
Time Frame: Day 3, Day 5, Day 7, Day 14, EOT (up to 6 weeks)
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Day 3, Day 5, Day 7, Day 14, EOT (up to 6 weeks)
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Persistent Rate of Bacteremia at Day 3, Day 5, Day 7, Day 14_FAS
Time Frame: Day 3, Day 5, Day 7, Day 14
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Day 3, Day 5, Day 7, Day 14
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Persistent Rate of Bacteremia at Day 3, Day 5, Day 7, Day 14_PPS
Time Frame: Day 3, Day 5, Day 7, Day 14
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Day 3, Day 5, Day 7, Day 14
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Time to Clearance of MRSA bacteremia_FAS
Time Frame: by EOT (up to 6 weeks)
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If negative in the blood culture test is confirmed for the first time, additional test will be performed the next day, and if it results negative for a total of two times in a row, it is judged as clearance of bacteremia.
The period until the clearance of bacteremia is defined as the period (day) from the date of the first blood culture test within 72 hours prior to randomization with MRSA positive (index blood culture) to the date of the blood culture test with the first negative result confirmed.
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by EOT (up to 6 weeks)
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Time to Clearance of MRSA bacteremia_PPS
Time Frame: by EOT (up to 6 weeks)
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If negative in the blood culture test is confirmed for the first time, additional test will be performed the next day, and if it results negative for a total of two times in a row, it is judged as clearance of bacteremia.
The period until the clearance of bacteremia is defined as the period (day) from the date of the first blood culture test within 72 hours prior to randomization with MRSA positive (index blood culture) to the date of the blood culture test with the first negative result confirmed.
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by EOT (up to 6 weeks)
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Vancomycin MIC Level
Time Frame: at Screening visit (baseline)
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Vancomycin minimum inhibitory concentration (MIC) levels
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at Screening visit (baseline)
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Delpazolid MIC Levels
Time Frame: Screening (Baseline), Day 14, EOT
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Delpazolid minimum inhibitory concentration (MIC) level by broth microdilution (BMD)
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Screening (Baseline), Day 14, EOT
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Pharmacokinetics (PK) parameters_AUC,ss
Time Frame: Plasma samples for pharmacokinetic evaluation were collected once at each timepoint on Day 1 and between Day 3 and end of treatment (EOT), specifically at 30 minutes to 1 hour and 2 to 8 hours after administration of the investigational product.
|
Plasma LCB01-0371 concentration data in MRSA bacteremia patients were used to establish a pharmacokinetic model using NONMEM®. A two-compartment model, in which the Hemodialysis (HD) status and albumin as a covariate, was selected as the final model. (AUC,ss: Area under the concentration-time curve at steady state) |
Plasma samples for pharmacokinetic evaluation were collected once at each timepoint on Day 1 and between Day 3 and end of treatment (EOT), specifically at 30 minutes to 1 hour and 2 to 8 hours after administration of the investigational product.
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Pharmacokinetics (PK) parameters_Cmax,ss
Time Frame: Plasma samples for pharmacokinetic evaluation were collected once at each timepoint on Day 1 and between Day 3 and end of treatment (EOT), specifically at 30 minutes to 1 hour and 2 to 8 hours after administration of the investigational product.
|
Plasma LCB01-0371 concentration data in MRSA bacteremia patients were used to establish a pharmacokinetic model using NONMEM®. A two-compartment model, in which the Hemodialysis (HD) status and albumin as a covariate, was selected as the final model. (Cmax,ss: Maximum concentration of drug at steady state) |
Plasma samples for pharmacokinetic evaluation were collected once at each timepoint on Day 1 and between Day 3 and end of treatment (EOT), specifically at 30 minutes to 1 hour and 2 to 8 hours after administration of the investigational product.
|
|
Pharmacokinetics (PK) parameters_Cmin,ss
Time Frame: Plasma samples for pharmacokinetic evaluation were collected once at each timepoint on Day 1 and between Day 3 and end of treatment (EOT), specifically at 30 minutes to 1 hour and 2 to 8 hours after administration of the investigational product.
|
Plasma LCB01-0371 concentration data in MRSA bacteremia patients were used to establish a pharmacokinetic model using NONMEM®. A two-compartment model, in which the Hemodialysis (HD) status and albumin as a covariate, was selected as the final model. (Cmin,ss: Minimum concentration of drug at steady state) |
Plasma samples for pharmacokinetic evaluation were collected once at each timepoint on Day 1 and between Day 3 and end of treatment (EOT), specifically at 30 minutes to 1 hour and 2 to 8 hours after administration of the investigational product.
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Pharmacokinetics (PK) parameters_Tmax,ss
Time Frame: Plasma samples for pharmacokinetic evaluation were collected once at each timepoint on Day 1 and between Day 3 and end of treatment (EOT), specifically at 30 minutes to 1 hour and 2 to 8 hours after administration of the investigational product.
|
Plasma LCB01-0371 concentration data in MRSA bacteremia patients were used to establish a pharmacokinetic model using NONMEM®. A two-compartment model, in which the Hemodialysis (HD) status and albumin as a covariate, was selected as the final model. (Tmax,ss: Time to reach Cmax at steady state) |
Plasma samples for pharmacokinetic evaluation were collected once at each timepoint on Day 1 and between Day 3 and end of treatment (EOT), specifically at 30 minutes to 1 hour and 2 to 8 hours after administration of the investigational product.
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Pharmacokinetics (PK) parameters_t1/2β
Time Frame: Plasma samples for pharmacokinetic evaluation were collected once at each timepoint on Day 1 and between Day 3 and end of treatment (EOT), specifically at 30 minutes to 1 hour and 2 to 8 hours after administration of the investigational product.
|
Plasma LCB01-0371 concentration data in MRSA bacteremia patients were used to establish a pharmacokinetic model using NONMEM®. A two-compartment model, in which the Hemodialysis (HD) status and albumin as a covariate, was selected as the final model. (t1/2β : Terminal elimination half-life) |
Plasma samples for pharmacokinetic evaluation were collected once at each timepoint on Day 1 and between Day 3 and end of treatment (EOT), specifically at 30 minutes to 1 hour and 2 to 8 hours after administration of the investigational product.
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|
Pharmacokinetics (PK) parameters_MRT,ss
Time Frame: Plasma samples for pharmacokinetic evaluation were collected once at each timepoint on Day 1 and between Day 3 and end of treatment (EOT), specifically at 30 minutes to 1 hour and 2 to 8 hours after administration of the investigational product.
|
Plasma LCB01-0371 concentration data in MRSA bacteremia patients were used to establish a pharmacokinetic model using NONMEM®. A two-compartment model, in which the Hemodialysis (HD) status and albumin as a covariate, was selected as the final model. (MRT,ss: Mean residence time at steady state) |
Plasma samples for pharmacokinetic evaluation were collected once at each timepoint on Day 1 and between Day 3 and end of treatment (EOT), specifically at 30 minutes to 1 hour and 2 to 8 hours after administration of the investigational product.
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Hongbin Kim, Seoul National University Bundang Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Infections
- Sepsis
- Systemic Inflammatory Response Syndrome
- Inflammation
- Bacterial Infections
- Bacterial Infections and Mycoses
- Bacteremia
- Anti-Bacterial Agents
- Anti-Infective Agents
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Protein Synthesis Inhibitors
- Delpazolid
- Vancomycin
- Oxazolidinones
Other Study ID Numbers
Other Study ID Numbers
- LCB35-0371-21-2-01
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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