A Bioequivalence Study of Two Ciprofloxacin/Dexamethasone Formulations in Patients With Otitis Externa

A Randomized, Double-Blind, Placebo-Controlled, Parallel Design, Multiple-Site Study to Evaluate the Clinical Equivalence of Ciprofloxacin 0.3%/Dexamethasone 0.1% Sterile Otic Suspension (Par) Compared to CIPRODEX® (Ciprofloxacin 0.3%/Dexamethasone 0.1%) Sterile Otic Suspension (Alcon) in the Treatment of Adults With Acute Bacterial Otitis Externa

The objective of this study is to compare the relative efficacy and safety of the test formulation of ciprofloxacin 0.3%/dexamethasone 0.1% sterile otic suspension (Par Pharmaceutical Companies, Inc.) to the already-marketed formulation CIPRODEX® (ciprofloxacin 0.3%/dexamethasone 0.1%) sterile otic suspension (Alcon) in the treatment of acute bacterial otitis externa.

Study Overview

• Status: Terminated
• Conditions: Otitis Externa
• Intervention / Treatment: Drug: Placebo; Drug: Ciprofloxacin/Dexamethasone; Drug: Ciprodex (R)

• Study Type: Interventional
• Enrollment (Actual): 455
• Phase: Phase 3

Contacts and Locations

Study Locations

• Puerto Rico
  • Canovanas, Puerto Rico, 00729
    • SMO The Clinical Research Group
  • Levittown, Puerto Rico, 00949
    • Clinical Research Puerto Rico Guayama
  • Naranjito, Puerto Rico, 00719
    • SMO The Clinical Research Group
  • San Juan, Puerto Rico, 00917
    • SMO The Clinical Research Group
  • Santa Isabel, Puerto Rico, 00757
    • SMO The Clinical Resarch Group
• United States
  • Arizona
    • Tucson, Arizona, United States, 85745
      • James Donivan Gordon, MD
  • Arkansas
    • Jonesboro, Arkansas, United States, 72401
      • NEA Baptist Clinic
    • Little Rock, Arkansas, United States, 72212
      • Applied Reserch Center
  • California
    • Carmichael, California, United States, 95608
      • John Champlin, MD
    • Long Beach, California, United States, 90813
      • Aliance Research
  • Florida
    • Boyton Beach, Florida, United States, 33426
      • ENT of South Florida
    • Ft. Myers, Florida, United States, 33919
      • Moore Clinical Research Inc
    • Hialeah, Florida, United States, 33016
      • Jorge Diaz, MD
    • Miami, Florida, United States, 33015
      • San Marcus Research Clinic
    • Miami, Florida, United States, 33125
      • The Medical Consulting Center
    • Ormond Beach, Florida, United States, 32174
      • Ormond Medical Arts Pharmaceutical Research Center
    • Winter Park, Florida, United States, 32792
      • Winter Park Clinical Research
  • Kentucky
    • Owensboro, Kentucky, United States, 42303
      • Research Integrity, LLC
  • Nebraska
    • Bellevue, Nebraska, United States, 68005
      • Pioneer Clinical Research
  • North Carolina
    • Raleigh, North Carolina, United States, 27609
      • PMG Research of Raleigh
    • Salisbury, North Carolina, United States, 28144
      • PMG Research of Salisbury
  • Ohio
    • Cincinnati, Ohio, United States, 45246
      • Julia Mullen, MD
  • Oregon
    • Ashland, Oregon, United States, 97520
      • Integrated Medical Research PC
    • Gresham, Oregon, United States, 97030
      • Cyn3rgy
  • Pennsylvania
    • Upper St. Clair, Pennsylvania, United States, 15241
      • Peak Research LLC
  • South Carolina
    • Orangeburgh, South Carolina, United States, 29118
      • John Ansley, MD
    • Spartanburg, South Carolina, United States, 29303
      • Spartanburg and Geer ENT
  • Tennessee
    • Brentwood, Tennessee, United States, 37027
      • Monica Davis, MD
  • Texas
    • Arlington, Texas, United States, 76012
      • Gilbert Ledesma, MD
    • Houston, Texas, United States, 77055
      • West Houston Clinical Research Service
    • Lake Jackson, Texas, United States, 77566
      • R-D Clinical Research
  • Virginia
    • Lynchburg, Virginia, United States, 24501
      • The Education and Research Foundation Inc.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Male or non-pregnant, non lactating females 18-65 years of age inclusive.
2. Signed informed consent form, which meets all of the criteria of current FDA regulations.
3. If female and of child bearing potential, have a negative urine pregnancy test at the baseline visit and prepare to abstain from sexual intercourse or use a reliable method of contraception during the study (e.g., condom, IUD, oral, injected, transdermal or implanted hormonal contraceptives). Patients on hormonal contraceptives must have been on the same method/type for at least 28 days prior to the start of the study and remain on the same throughout the study.
4. The presence of infection confirmed by a positive bacterial culture for the presence of Pseudomonas aeruginosa or Staphylococcus aureus. As the results of the bacterial culture will not be immediately known, patients who meet all the other inclusion/exclusion criteria may be enrolled in the study pending the results of the bacterial culture.
5. Clinical signs and symptoms consistent with bacterial otitis externa as defined by a combined Total Symptom Score (TSS) of at least 6 with a score of least 2 for otalgia using the following scale 0=none, 1=mild, 2=moderate, 3=severe.

Exclusion Criteria:

1. Females who are pregnant, breast feeding, or anticipate becoming pregnant during the study.
2. Signs and symptoms of otitis externa for longer than 21 days prior to being screened for inclusion in the study.
3. Previous episode of otitis externa within the previous 6 months or more than 2 episodes within the previous 12 months.
4. Been provided any therapeutic drug treatment for current episode of otitis externa.
5. Known history of, or ear exam reveals tympanic membrane perforation or damage for any reason.
6. Current or previous history of any otologic surgery including insertion/removal of tympanostomy tubes in infected ear(s).
7. Clinical diagnosis that suggests current signs or symptoms are not caused by acute bacterial otitis externa e.g. chronic suppurative otitis externa, acute otitis media
8. Clinical diagnosis of malignant otitis externa
9. Mastoid cavities, stenosis, exostosis or tumors of either ear or other noninfectious diseases of either ear.
10. Suspected concurrent fungal or viral infection (e.g. herpes simplex) of either ear.
11. Dermatitis of the infected ear such as psoriasis or seborrhea that would complicate evaluations.
12. Significant underlying disease such as diabetes, HIV or other immunocompromised conditions or receiving therapy that may cause patient to be immunocompromised.
13. Significant history or current evidence of chronic infectious disease, system disorder, organ disorder or other medical condition that in the Investigator's opinion would place the study patient at undue risk by participation or could jeopardize the integrity of the study evaluations.
14. Investigator believes that severity of infection is such that systemic antibiotics would be the preferred treatment option.
15. Use of any systemic antibacterial products or topical antibacterial products in the ear(s) within 28 days of screening for the study.
16. Use of any systemic anti-inflammatory products or topical anti-inflammatory products in the ear(s) (such as corticosteroids and NSAIDs) within 7 days of screening for the study.
17. Use of any topical or otic medication in the affected ear within 2 weeks prior to screening.
18. Use of any astringents such as vinegar, alcohol or medicated cleansing or swabbing of the ear within 48 hours of the baseline bacterial culture swab.
19. Any known hypersensitivity to ciprofloxacin or other carboxyquinolone derivatives, dexamethasone or corticosteroids or other ingredients of the formulation.
20. Receipt of any drug or device as part of a research study within 30 days prior to dosing.
21. Previous participation in this study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo	Drug: Placebo
Experimental: Test; Ciprofloxacin/Dexamethasone	Drug: Ciprofloxacin/Dexamethasone
Active Comparator: Reference; Ciprodex (R)	Drug: Ciprodex (R)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical Success	Evaluation of the difference between the proportions of patients considered a clinical success at the End of Study visit	Day 14-21

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Resolution of Symptoms	The time to complete resolution of disease specific clinically meaningful signs and symptoms at enrollment and the absence of new symptoms	Day 14-21

Collaborators and Investigators

• Sponsor: Par Pharmaceutical, Inc.
• Collaborators: Novum Pharmaceutical Research Services
• Investigators: Study Director: Chandra S Vattikonda, Ph.D., Par Pharamceutical, Inc.

Study record dates

Study Major Dates

• Study Start: July 1, 2013
• Primary Completion (Actual): February 1, 2015
• Study Completion (Actual): March 1, 2015

Study Registration Dates

• First Submitted: July 25, 2013
• First Submitted That Met QC Criteria: July 25, 2013
• First Posted (Estimate): July 29, 2013

Study Record Updates

• Last Update Posted (Estimate): October 18, 2016
• Last Update Submitted That Met QC Criteria: October 14, 2016
• Last Verified: October 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Otorhinolaryngologic Diseases; Ear Diseases; Otitis Externa; Otitis; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Anti-Infective Agents; Autonomic Agents; Peripheral Nervous System Agents; Enzyme Inhibitors; Anti-Inflammatory Agents; Antineoplastic Agents; Antiemetics; Gastrointestinal Agents; Glucocorticoids; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Antineoplastic Agents, Hormonal; Topoisomerase II Inhibitors; Topoisomerase Inhibitors; Anti-Bacterial Agents; Cytochrome P-450 Enzyme Inhibitors; Cytochrome P-450 CYP1A2 Inhibitors; Dexamethasone; Ciprofloxacin
• Other Study ID Numbers: 71205502