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Oritavancin Versus IV Vancomycin for the Treatment of Participants With Acute Bacterial Skin and Skin Structure Infection (SOLO I) (SOLO I)

7 juli 2022 bijgewerkt door: Melinta Therapeutics, Inc.

A Multicenter, Double-Blind, Randomized Study to Evaluate the Efficacy and Safety of Single-Dose IV Oritavancin Versus IV Vancomycin for the Treatment of Patients With Acute Bacterial Skin and Skin Structure Infection (SOLO I)

The purpose of this Phase 3 trial was to evaluate the efficacy, safety, and tolerability of oritavancin in acute bacterial skin and skin structure infections (ABSSSIs), including those caused by methicillin-resistant staphylococcus aureus (MRSA), and to evaluate the potential economic benefit of oritavancin administered as a single 1200-milligram (mg) intravenous (IV) dose.

Studie Overzicht

Gedetailleerde beschrijving

This was a Phase 3, multicenter, randomized, double-blind, parallel, comparative efficacy and safety study of single-dose IV oritavancin/IV placebo versus IV vancomycin for 7 to 10 days in adults with ABSSSI suspected or proven to be caused by gram-positive pathogens. Approximately 960 participants were to be randomized at 100 centers globally.

In addition, this study characterized the pharmacokinetics (PK) and PK/pharmacodynamics (PD) properties of a single 1200-mg IV dose of oritavancin and evaluated the potential health economic benefits offered by this dosing strategy.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

968

Fase

  • Fase 3

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

    • California
      • Chula Vista, California, Verenigde Staten, 91911
        • Sharp Chula Vista Medical Center

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

Participants were included in the study if they met all of the following inclusion criteria:

  1. Males or females ≥18 years old
  2. Diagnosis of ABSSSI suspected or confirmed to be caused by a gram-positive pathogen requiring at least 7 days of IV therapy
  3. An ABSSSI included 1 of the following infections: wound infections, cellulitis/erysipelas, major cutaneous abscess
  4. ABSSSI must have presented with at least 2 local signs and symptoms and at least 1 sign of systemic inflammation (unless >70 years of age).
  5. Able to give informed consent and willing to comply with all required study procedures

Exclusion Criteria:

Participants were excluded from the study if any of the following exclusion criteria applied prior to randomization:

  1. Prior systemic or topical antibacterial therapy with activity against suspected or proven gram-positive pathogens within the preceding 14 days unless:

    • The causative gram-positive pathogen(s) isolated from the ABSSSI site was/were resistant in vitro to the antibacterial(s) that was/were administered with documented clinical progression.
    • Documented failure to previous ABSSSI antibiotic therapy was available. Documentation of treatment failure must have been recorded.
    • Participant received a single dose of a short-acting antibacterial therapy 3 or more days before randomization.
  2. Infections associated with, or in close proximity to, a prosthetic device
  3. Severe sepsis or refractory shock
  4. Known or suspected bacteremia at time of Screening
  5. ABSSSI due to or associated with any of the following:

    • Infections suspected or documented to be caused by gram-negative pathogens
    • Wound infections (surgical or traumatic) and abscesses with only gram-negative pathogens
    • Diabetic foot infections
    • Concomitant infection at another site not including a secondary ABSSSI lesion
    • Infected burns
    • A primary infection secondary to a pre-existing skin disease with associated inflammatory changes
    • Decubitus or chronic skin ulcer, or ischemic ulcer due to peripheral vascular disease
    • Any evolving necrotizing process gangrene or infection suspected or proven to be caused by Clostridium species
    • Infections known to be caused by a gram-positive organism with a vancomycin minimum inhibitory concentration >2 micrograms/milliliter or clinically failing prior therapy with glycopeptides
    • Catheter site infections
  6. Allergy or intolerance to aztreonam or metronidazole in a participant with suspected or proven polymicrobial wound infection involving gram-negative and/or anaerobic bacteria
  7. Was currently receiving chronic systemic immunosuppressive therapy
  8. Acquired immunodeficiency syndrome with cluster of differentiation 4 count <200 cells/cubic millimeter
  9. Neutropenia
  10. Significant or life-threatening condition that would confound or interfere with the assessment of the ABSSSI
  11. Women who were pregnant or nursing
  12. History of immune-related hypersensitivity reaction to glycopeptides
  13. Participants that required anticoagulant monitoring with an activated partial thromboplastin time
  14. Contraindication to vancomycin
  15. Participants unwilling to forego blood and/or blood product donation
  16. Treatment with investigational medicinal product within 30 days before enrollment and for the duration of the study
  17. Investigational device present, or removed <30 days before enrollment, or presence of device-related infection
  18. Participants unlikely to adhere to the protocol, comply with study drug administration, or complete the clinical study
  19. Severe hepatic disease
  20. Presence of hyperuricemia
  21. Unwilling to refrain from chronic use of any medication with antipyretic properties

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Verviervoudigen

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Eenmalige dosis IV Oritavancinedifosfaat
Oritavancin was administered as a single IV dose.
Intravenous placebo was administered thereafter, for a minimum of 7 days and up to a maximum of 10 days (oritavancin and placebo).
Actieve vergelijker: IV Vancomycine
Intravenous vancomycin was administered for a minimum of 7 days and up to a maximum of 10 days.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Cessation Of Spread Or Reduction In Size Of Baseline Lesion, Absence Of Fever, And No Rescue Antibiotic Medication At Early Clinical Evaluation (ECE) (48 To 72 Hours)
Tijdsspanne: 48-72 hours after the initiation of study therapy

Clinical response at the ECE visit (48-72 hours following initiation of study drug administration). Early clinical response was defined as a composite outcome based on cessation of spreading or reduction in the size of baseline lesion, absence of fever and no rescue antibiotic medication.

A participant was classified as "success" if all of the following were met: cessation of spread or reduction of the lesion (defined as cessation of spread of the redness, edema, and/or induration or reduction in size [length, width, and area] of the redness, edema, and/or induration such that the size of the lesion was less than or equal to the size at baseline); resolution (absence) of fever (temperature <37.7°Celsius at the last 3 consecutive recordings by the same route of administration taken 4 times per day, for example every 6 hours between 48 and 72 hours); no rescue antibiotic medication.

48-72 hours after the initiation of study therapy

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Investigator Assessed Clinical Cure Of Treatment With Single-dose IV Oritavancin Compared With IV Vancomycin For 7 To 10 Days At Post-therapy Evaluation (Key Secondary Endpoint)
Tijdsspanne: 7-14 days after end of therapy
Compared the clinical efficacy at the post therapy evaluation of oritavancin and vancomycin based on the Investigator examination of the signs and symptoms of the primary acute bacterial skin and skin structure infection (ABSSSI). Investigator assessment of clinical cure was complete or nearly complete resolution of baseline signs and symptoms of the primary infection such that no further treatment with antibiotics was needed.
7-14 days after end of therapy
Number Of Participants With A Lesion Size Reduction ≥20% From Baseline At ECE
Tijdsspanne: 48-72 hours after the initiation of study therapy
Clinical response at the ECE visit (48-72 hours following initiation of study drug administration) based on changes in ABSSSI lesion size measurements from baseline. Participants with a ≥20% reduction in size of baseline lesion were classified a 'success', while those with missing data or those without a reduction in size of baseline lesion ≥20% were classified a 'failure'.
48-72 hours after the initiation of study therapy

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Onderzoekers

  • Hoofdonderzoeker: G. Ralph Corey, MD, Duke Clinical Research Institute

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

1 december 2010

Primaire voltooiing (Werkelijk)

1 oktober 2012

Studie voltooiing (Werkelijk)

30 november 2012

Studieregistratiedata

Eerst ingediend

1 december 2010

Eerst ingediend dat voldeed aan de QC-criteria

1 december 2010

Eerst geplaatst (Schatting)

3 december 2010

Updates van studierecords

Laatste update geplaatst (Werkelijk)

1 augustus 2022

Laatste update ingediend die voldeed aan QC-criteria

7 juli 2022

Laatst geverifieerd

1 juli 2022

Meer informatie

Termen gerelateerd aan deze studie

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Ja

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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