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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 de julho de 2022 atualizado por: 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.

Visão geral do estudo

Descrição detalhada

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.

Tipo de estudo

Intervencional

Inscrição (Real)

968

Estágio

  • Fase 3

Contactos e Locais

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Locais de estudo

    • California
      • Chula Vista, California, Estados Unidos, 91911
        • Sharp Chula Vista Medical Center

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

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

Plano de estudo

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Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Quadruplicar

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Difosfato de Oritavancina IV de Dose Única
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).
Comparador Ativo: IV Vancomicina
Intravenous vancomycin was administered for a minimum of 7 days and up to a maximum of 10 days.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
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)
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
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)
Prazo: 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
Prazo: 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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Investigadores

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

Publicações e links úteis

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Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

1 de dezembro de 2010

Conclusão Primária (Real)

1 de outubro de 2012

Conclusão do estudo (Real)

30 de novembro de 2012

Datas de inscrição no estudo

Enviado pela primeira vez

1 de dezembro de 2010

Enviado pela primeira vez que atendeu aos critérios de CQ

1 de dezembro de 2010

Primeira postagem (Estimativa)

3 de dezembro de 2010

Atualizações de registro de estudo

Última Atualização Postada (Real)

1 de agosto de 2022

Última atualização enviada que atendeu aos critérios de controle de qualidade

7 de julho de 2022

Última verificação

1 de julho de 2022

Mais Informações

Termos relacionados a este estudo

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Sim

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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