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A Study to Evaluate the Efficacy and Safety of Intravenous Ceftaroline Versus Intravenous Ceftriaxone in the Treatment of Adult Hospitalised Patients With Community-Acquired Bacterial Pneumonia in Asia

Primary Purpose

Community-Acquired Bacterial Pneumonia, Lung Infection of Individual Not Recently Hospitalized

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Ceftaroline
Ceftriaxone
Sponsored by
Pfizer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Community-Acquired Bacterial Pneumonia focused on measuring Community-Acquired Bacterial Pneumonia

Eligibility Criteria

18 Years - 150 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Males and females 18 or more years of age
  • Lung Infection of Individual not Recently Hospitalized meeting the following criteria: Radiographically-confirmed pneumonia (new or progressive infection site of the lungs) consistent with bacterial pneumonia), AND Acute illness (≤ 7 days duration) with at least three of the following clinical signs or symptoms consistent with lung infection: New or increased cough, Purulent sputum or change in sputum character, Auscultatory findings consistent with pneumonia, Difficulty in breathing, short breath, or decreased partial pressure of oxygen in blood, Fever greater than 38ºC oral or body temperature lower than that required for normal body function(< 35ºC), White blood cell count greater than or less than the normal, Greater than 15% immature neutrophils (bands) irrespective of white blood cell count, AND Moderate lung infection
  • The subject must require initial hospitalization, or treatment in an emergency room or urgent care setting, by the standard of care
  • The subject's infection would require initial treatment with intravenous antimicrobials
  • Female subjects of child-bearing potential, and those who are fewer than 2 years post-menopausal, must agree to, and comply with, using highly effective methods of birth control while participating in this study

Exclusion Criteria:

  • Lung Infection of Individual not Recently Hospitalized suitable for outpatient therapy with an oral antimicrobial agent
  • Confirmed or suspected respiratory tract infections attributable to sources other than bacteria from the individuals not recently hospitalized(e.g., ventilator-associated pneumonia, hospital-acquired pneumonia, visible/gross aspiration pneumonia, suspected viral, fungal, or mycobacterial infection of the lung)
  • Non-infectious causes of lung lesion (e.g., pulmonary embolism, chemical pneumonitis from aspiration, hypersensitivity pneumonia, congestive heart failure)
  • Accumulation of pus in the pleural cavity
  • Microbiologically-documented infection with a pathogen known to be resistant to ceftriaxone, or epidemiological or clinical context suggesting high likelihood of a ceftriaxone-resistant "typical" bacterial pathogen.

Sites / Locations

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Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Ceftaroline

Ceftriaxone plus placebo

Arm Description

Outcomes

Primary Outcome Measures

Clinical Cure Rate for Ceftaroline Compared to That for Ceftriaxone at Test of Cure (TOC) in CE Population
Cure:Total resolution of all signs and symptoms of pneumonia (ie,CABP), or improvement to such an extent that further antimicrobial therapy was not necessary Failure: Any of the following: •Persistence, incomplete clinical resolution, or worsening in signs and symptoms of CABP that required alternative antimicrobial therapy •Treatment-limiting AE leading to discontinuation of study drug therapy, when subject required alternative antimicrobial therapy to treat the pneumonia •Death wherein pneumonia (ie,CABP) was considered causative Indeterminate: Inability to determine an outcome

Secondary Outcome Measures

Clinical Response at End of Treatment (EOT) Visit in MITT Population
Clinical Response at End of Treatment (EOT) Visit in CE Population
Clinical Response at the Test of Cure (TOC) Visit in MITT Population
Clinical Response at the Test of Cure (TOC) Visit in mMITT Population
Clinical Response at the Test of Cure (TOC) Visit in ME Population
Clinical Response at Test of Cure (TOC) Visit by Pathogen in ME Population
Per-Pathogen Microbiological Response at Test of Cure (TOC) Visit by Pathogen in ME Population
Per-Patient Microbiological Response at Test of Cure (TOC) Visit in mMITT Population
An outcome is considered as favourable if the per-pathogen response for that subject is either Eradication (An adequate source specimen demonstrates absence of the original baseline pathogen) or presumed eradication (An adequate source specimen was not available to culture and the patient was assessed as a clinical cure). Here, an adequate source specimen is defined as any sample that may yield the growth of a CABP pathogen eg, blood, respiratory specimens, or pleural fluid.
Per-Patient Microbiological Response at Test of Cure (TOC) Visit in ME Population
An outcome is considered as favourable if the per-pathogen response for that subject is either Eradication (An adequate source specimen demonstrates absence of the original baseline pathogen) or presumed eradication (An adequate source specimen was not available to culture and the patient was assessed as a clinical cure). Here, an adequate source specimen is defined as any sample that may yield the growth of a CABP pathogen eg, blood, respiratory specimens, or pleural fluid.
Overall (Clinical and Radiographic) Success Rate at Test of Cure (TOC) Visit in MITT Population
Overall (Clinical and Radiographic) Success Rate at Test of Cure (TOC) Visit in CE Population
Clinical Relapse at the LFU Visit for Clinical Cure Patients at Test of Cure (TOC) Visit in MITT Population
Clinical Relapse at the LFU Visit for Clinical Cure Patients at Test of Cure (TOC) Visit in CE Population
Microbiological Re-infection/Recurrence at LFU Visit in mMITT Population
Microbiological Re-infection/Recurrence at LFU Visit in ME Population

Full Information

First Posted
April 27, 2011
Last Updated
September 1, 2017
Sponsor
Pfizer
Collaborators
Forest Laboratories
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1. Study Identification

Unique Protocol Identification Number
NCT01371838
Brief Title
A Study to Evaluate the Efficacy and Safety of Intravenous Ceftaroline Versus Intravenous Ceftriaxone in the Treatment of Adult Hospitalised Patients With Community-Acquired Bacterial Pneumonia in Asia
Official Title
A Phase III, Multicentre, Randomised, Double-Blind, Comparative Study to Evaluate the Efficacy and Safety of Intravenous Ceftaroline Versus Intravenous Ceftriaxone in the Treatment of Adult Hospitalised Patients With Community-Acquired Bacterial Pneumonia in Asia
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
December 2011 (undefined)
Primary Completion Date
May 2013 (Actual)
Study Completion Date
May 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pfizer
Collaborators
Forest Laboratories

4. Oversight

5. Study Description

Brief Summary
This purpose of this study is to Evaluate the Efficacy and Safety of Intravenous Ceftaroline Versus Intravenous Ceftriaxone in the Treatment of Adult Hospitalised Patients With Community-Acquired Bacterial Pneumonia in Asia.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Community-Acquired Bacterial Pneumonia, Lung Infection of Individual Not Recently Hospitalized
Keywords
Community-Acquired Bacterial Pneumonia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
848 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ceftaroline
Arm Type
Experimental
Arm Title
Ceftriaxone plus placebo
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Ceftaroline
Intervention Description
Two consecutive infusions q12h for 5 to 7 days
Intervention Type
Drug
Intervention Name(s)
Ceftriaxone
Intervention Description
One dose infusion followed by IV saline placebo infused q24h for 5 to 7 days plus two consecutive saline placebo infusion q24h.
Primary Outcome Measure Information:
Title
Clinical Cure Rate for Ceftaroline Compared to That for Ceftriaxone at Test of Cure (TOC) in CE Population
Description
Cure:Total resolution of all signs and symptoms of pneumonia (ie,CABP), or improvement to such an extent that further antimicrobial therapy was not necessary Failure: Any of the following: •Persistence, incomplete clinical resolution, or worsening in signs and symptoms of CABP that required alternative antimicrobial therapy •Treatment-limiting AE leading to discontinuation of study drug therapy, when subject required alternative antimicrobial therapy to treat the pneumonia •Death wherein pneumonia (ie,CABP) was considered causative Indeterminate: Inability to determine an outcome
Time Frame
7-20 days after last dose of study drug
Secondary Outcome Measure Information:
Title
Clinical Response at End of Treatment (EOT) Visit in MITT Population
Time Frame
Last day of study drug administration
Title
Clinical Response at End of Treatment (EOT) Visit in CE Population
Time Frame
Last day of study drug administration
Title
Clinical Response at the Test of Cure (TOC) Visit in MITT Population
Time Frame
7-20 days after last day of study drug administration
Title
Clinical Response at the Test of Cure (TOC) Visit in mMITT Population
Time Frame
7-20 days after last day of study drug administration
Title
Clinical Response at the Test of Cure (TOC) Visit in ME Population
Time Frame
7-20 days after last day of study drug administration
Title
Clinical Response at Test of Cure (TOC) Visit by Pathogen in ME Population
Time Frame
7-20 days after last dose of study drug
Title
Per-Pathogen Microbiological Response at Test of Cure (TOC) Visit by Pathogen in ME Population
Time Frame
7-20 days after last dose of study drug
Title
Per-Patient Microbiological Response at Test of Cure (TOC) Visit in mMITT Population
Description
An outcome is considered as favourable if the per-pathogen response for that subject is either Eradication (An adequate source specimen demonstrates absence of the original baseline pathogen) or presumed eradication (An adequate source specimen was not available to culture and the patient was assessed as a clinical cure). Here, an adequate source specimen is defined as any sample that may yield the growth of a CABP pathogen eg, blood, respiratory specimens, or pleural fluid.
Time Frame
7-20 days after last day of study drug administration
Title
Per-Patient Microbiological Response at Test of Cure (TOC) Visit in ME Population
Description
An outcome is considered as favourable if the per-pathogen response for that subject is either Eradication (An adequate source specimen demonstrates absence of the original baseline pathogen) or presumed eradication (An adequate source specimen was not available to culture and the patient was assessed as a clinical cure). Here, an adequate source specimen is defined as any sample that may yield the growth of a CABP pathogen eg, blood, respiratory specimens, or pleural fluid.
Time Frame
7-20 days after last day of study drug administration
Title
Overall (Clinical and Radiographic) Success Rate at Test of Cure (TOC) Visit in MITT Population
Time Frame
7-20 days after last day of study drug administration
Title
Overall (Clinical and Radiographic) Success Rate at Test of Cure (TOC) Visit in CE Population
Time Frame
7-20 days after last dose of study drug
Title
Clinical Relapse at the LFU Visit for Clinical Cure Patients at Test of Cure (TOC) Visit in MITT Population
Time Frame
21-42 days after last day of study drug administration
Title
Clinical Relapse at the LFU Visit for Clinical Cure Patients at Test of Cure (TOC) Visit in CE Population
Time Frame
21-42 days after last day of study drug administration
Title
Microbiological Re-infection/Recurrence at LFU Visit in mMITT Population
Time Frame
21-42 days after last dose of study drug
Title
Microbiological Re-infection/Recurrence at LFU Visit in ME Population
Time Frame
21-42 days after last dose of study drug

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
150 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females 18 or more years of age Lung Infection of Individual not Recently Hospitalized meeting the following criteria: Radiographically-confirmed pneumonia (new or progressive infection site of the lungs) consistent with bacterial pneumonia), AND Acute illness (≤ 7 days duration) with at least three of the following clinical signs or symptoms consistent with lung infection: New or increased cough, Purulent sputum or change in sputum character, Auscultatory findings consistent with pneumonia, Difficulty in breathing, short breath, or decreased partial pressure of oxygen in blood, Fever greater than 38ºC oral or body temperature lower than that required for normal body function(< 35ºC), White blood cell count greater than or less than the normal, Greater than 15% immature neutrophils (bands) irrespective of white blood cell count, AND Moderate lung infection The subject must require initial hospitalization, or treatment in an emergency room or urgent care setting, by the standard of care The subject's infection would require initial treatment with intravenous antimicrobials Female subjects of child-bearing potential, and those who are fewer than 2 years post-menopausal, must agree to, and comply with, using highly effective methods of birth control while participating in this study Exclusion Criteria: Lung Infection of Individual not Recently Hospitalized suitable for outpatient therapy with an oral antimicrobial agent Confirmed or suspected respiratory tract infections attributable to sources other than bacteria from the individuals not recently hospitalized(e.g., ventilator-associated pneumonia, hospital-acquired pneumonia, visible/gross aspiration pneumonia, suspected viral, fungal, or mycobacterial infection of the lung) Non-infectious causes of lung lesion (e.g., pulmonary embolism, chemical pneumonitis from aspiration, hypersensitivity pneumonia, congestive heart failure) Accumulation of pus in the pleural cavity Microbiologically-documented infection with a pathogen known to be resistant to ceftriaxone, or epidemiological or clinical context suggesting high likelihood of a ceftriaxone-resistant "typical" bacterial pathogen.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Melnick
Organizational Affiliation
AstraZeneca
Official's Role
Study Director
Facility Information:
Facility Name
Research Site
City
Beijing
Country
China
Facility Name
Research Site
City
Chengdu
Country
China
Facility Name
Research Site
City
Guang Zhou
Country
China
Facility Name
Research Site
City
Haikou
Country
China
Facility Name
Research Site
City
Hangzhou
Country
China
Facility Name
Research Site
City
Hefei
Country
China
Facility Name
Research Site
City
Jiangyin
Country
China
Facility Name
Research Site
City
Nanchang
Country
China
Facility Name
Research Site
City
Shanghai
Country
China
Facility Name
Research Site
City
Shenyang
Country
China
Facility Name
Research Site
City
Shenzhen
Country
China
Facility Name
Research Site
City
Shijiazhuang
Country
China
Facility Name
Research Site
City
Wuxi
Country
China
Facility Name
Research Site
City
Bangalore
Country
India
Facility Name
Research Site
City
Calicut
Country
India
Facility Name
Research Site
City
Goa
Country
India
Facility Name
Research Site
City
Hyderabad
Country
India
Facility Name
Research Site
City
Jaipur
Country
India
Facility Name
Research Site
City
Lucknow
Country
India
Facility Name
Research Site
City
Ludhiana
Country
India
Facility Name
Research Site
City
Mysore
Country
India
Facility Name
Research Site
City
New Delhi
Country
India
Facility Name
Research Site
City
Trivandrum
Country
India
Facility Name
Research Site
City
Varanasi
Country
India
Facility Name
Research Site
City
Vellore
Country
India
Facility Name
Research Site
City
Anyang-si
Country
Korea, Republic of
Facility Name
Research Site
City
Bucheon-si
Country
Korea, Republic of
Facility Name
Research Site
City
Cheonan-si
Country
Korea, Republic of
Facility Name
Research Site
City
Chuncheon-si
Country
Korea, Republic of
Facility Name
Research Site
City
Daegu
Country
Korea, Republic of
Facility Name
Research Site
City
Daejeon
Country
Korea, Republic of
Facility Name
Research Site
City
Incheon
Country
Korea, Republic of
Facility Name
Research Site
City
Seoul
Country
Korea, Republic of
Facility Name
Research Site
City
Suwon-si
Country
Korea, Republic of
Facility Name
Research Site
City
Wonju-si
Country
Korea, Republic of
Facility Name
Research Site
City
Kaohsiung
Country
Taiwan
Facility Name
Research Site
City
Keelung
Country
Taiwan
Facility Name
Research Site
City
Taichung
Country
Taiwan
Facility Name
Research Site
City
Taipei
Country
Taiwan
Facility Name
Research Site
City
Can Tho
Country
Vietnam
Facility Name
Research Site
City
Hanoi
Country
Vietnam
Facility Name
Research Site
City
Ho Chi Minh
Country
Vietnam
Facility Name
Research Site
City
Hochiminh
Country
Vietnam

12. IPD Sharing Statement

Citations:
PubMed Identifier
35237053
Citation
Zhuo C, Huang Y, Liu W, Xu JF, Zhu WY, Stone GG, Yan JL, Mohamed N. Efficacy and Safety of Ceftaroline Fosamil in Hospitalized Patients with Community-Acquired Pneumonia in China: Subset Analysis of an International Phase 3 Randomized Controlled Trial. Infect Drug Resist. 2022 Feb 23;15:605-617. doi: 10.2147/IDR.S342558. eCollection 2022.
Results Reference
derived
PubMed Identifier
34922058
Citation
Dryden M, Kantecki M, Yan JL, Stone GG, Leister-Tebbe H, Wilcox M. Treatment outcomes of secondary bacteraemia in patients treated with ceftaroline fosamil: pooled results from six phase III clinical trials. J Glob Antimicrob Resist. 2022 Mar;28:108-114. doi: 10.1016/j.jgar.2021.10.027. Epub 2021 Dec 16.
Results Reference
derived
PubMed Identifier
31044546
Citation
Li J, Das S, Zhou D, Al-Huniti N. Population Pharmacokinetic Modeling and Probability of Target Attainment Analyses in Asian Patients With Community-Acquired Pneumonia Treated With Ceftaroline Fosamil. Clin Pharmacol Drug Dev. 2019 Jul;8(5):682-694. doi: 10.1002/cpdd.673. Epub 2019 May 1.
Results Reference
derived
PubMed Identifier
30597021
Citation
Cheng K, Pypstra R, Yan JL, Hammond J. Summary of the safety and tolerability of two treatment regimens of ceftaroline fosamil: 600 mg every 8 h versus 600 mg every 12 h. J Antimicrob Chemother. 2019 Apr 1;74(4):1086-1091. doi: 10.1093/jac/dky519.
Results Reference
derived
PubMed Identifier
30380060
Citation
Das S, Li J, Iaconis J, Zhou D, Stone GG, Yan JL, Melnick D. Ceftaroline fosamil doses and breakpoints for Staphylococcus aureus in complicated skin and soft tissue infections. J Antimicrob Chemother. 2019 Feb 1;74(2):425-431. doi: 10.1093/jac/dky439.
Results Reference
derived
PubMed Identifier
26702925
Citation
Taboada M, Melnick D, Iaconis JP, Sun F, Zhong NS, File TM, Llorens L, Friedland HD, Wilson D. Ceftaroline fosamil versus ceftriaxone for the treatment of community-acquired pneumonia: individual patient data meta-analysis of randomized controlled trials. J Antimicrob Chemother. 2016 Apr;71(4):862-70. doi: 10.1093/jac/dkv415. Epub 2015 Dec 24. Erratum In: J Antimicrob Chemother. 2016 Jun;71(6):1748-9.
Results Reference
derived
PubMed Identifier
25539586
Citation
Zhong NS, Sun T, Zhuo C, D'Souza G, Lee SH, Lan NH, Chiang CH, Wilson D, Sun F, Iaconis J, Melnick D. Ceftaroline fosamil versus ceftriaxone for the treatment of Asian patients with community-acquired pneumonia: a randomised, controlled, double-blind, phase 3, non-inferiority with nested superiority trial. Lancet Infect Dis. 2015 Feb;15(2):161-71. doi: 10.1016/S1473-3099(14)71018-7. Epub 2014 Dec 22.
Results Reference
derived
Links:
URL
http://filehosting.pharmacm.com/DownloadService.ashx?client=CTR_MED_7111&studyid=1374&filename=D3720C00002_Synopsis.pdf
Description
D3720C00002 CSR Synopsis
URL
http://filehosting.pharmacm.com/DownloadService.ashx?client=CTR_MED_7111&studyid=1374&filename=D3720C00002_Revised_CSP_1_(redacted).pdf
Description
Revised CSP

Learn more about this trial

A Study to Evaluate the Efficacy and Safety of Intravenous Ceftaroline Versus Intravenous Ceftriaxone in the Treatment of Adult Hospitalised Patients With Community-Acquired Bacterial Pneumonia in Asia

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