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A Study of Safety, Tolerability, and Efficacy of AFN-12520000 in the Treatment of Acute Bacterial Skin and Skin Structure Infections Due to Staphylococci

Primary Purpose

Skin and Subcutaneous Tissue Bacterial Infections, Wound Infection, Cutaneous Abscess

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
AFN-12520000
Sponsored by
Affinium Pharmaceuticals, Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Skin and Subcutaneous Tissue Bacterial Infections focused on measuring Skin and Subcutaneous Tissue Bacterial Infections

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Provide written informed consent and to understand the demands of the protocol;
  • Ages of 18 and 70 years, inclusive;
  • Have clinically documented ABSSSI suspected or documented to be caused by staphylococci accompanied by redness, edema, and/or induration of a minimum surface area of 75 cm2 and can be categorized as one or more of the following: Wound infection; Cutaneous abscess Burn infection (≤20% of total body surface area) or Cellulitis
  • Have a primary infected lesion with at least three of the following: Significant pain or tenderness to palpation; Purulent or seropurulent drainage or discharge; Erythema; Fluctuance; Induration; Edema; Heat or localized warmth;
  • Have at least two of the following signs and symptoms of systemic inflammation or complicating factors: Documented or reported fever >38.0°C; WBC count of >10,000 cells/mm3; Greater than 15% immature neutrophils irrespective of total WBC; Elevated CRP or ESR; or Local/regional lymphadenopathy;
  • Have a Gram stain with Gram-positive cocci in clusters or PCR result indicating an infection with Staphylococci.
  • Have clearly failed as defined in the protocol previous treatment after a minimum of 48 hours
  • Women of childbearing potential must have a negative pregnancy test at screening before enrollment
  • Male and Female patients must utilize a highly effective method of contraception
  • In the judgment of the Investigator have an expectation of survival and prompt improvement with effective oral antibiotic therapy and appropriate supportive care for the anticipated duration of the study
  • Willing and able to comply with all the study activities and procedures in the hospital or clinic.

Exclusion Criteria:

  • Have any one of the following conditions:

    • Chronically infected "diabetic foot ulcers" or infections of chronic non-healing wounds of peripheral sites in a patient with advanced peripheral vascular disease;
    • A wound infection involving foreign body or prosthetic material that will not be removed within 48 hours of initiation of treatment;
    • Infected abdominal wounds unable to be surgically closed;
    • Necrotizing fasciitis, rapidly necrotizing infections, or gangrenous processes;
    • Infected burn involving >20% of the total body surface area;
    • Infected bite from human or animal origin.
    • Erysipelas or a primary infection suspected or documented to be due to streptococci or infection with a Gram-negative pathogen without evidence of a concomitant staphylococcal infection
    • Evidence of either a Gram-negative or Gram-positive pathogen not susceptible to treatment with protocol-specified antibiotics and AFN-12520000; or
    • An existing abscess that cannot be drained within 48 hours of initiation of treatment;
  • Unable to tolerate an oral formulation of antibiotic, have an underlying gastrointestinal disease (would be poorly absorbed or tolerated), have a medical condition or post-operative condition leading to significant gastrointestinal malabsorption, and/or are unable to tolerate a normal diet;
  • Have a known or suspected non-skin source of infection such as endocarditis, osteomyelitis, retroperitoneal abscess, septic arthritis, meningitis, or pneumonia;
  • Exhibit signs of severe sepsis:
  • Plans to have surgery utilizing general anesthetic during the study period (except surgery to remove a prosthetic device complicating the infection site or surgery to drain the abscess/wound within 48 hours);
  • Pregnant or breastfeeding women;
  • History of epilepsy, known seizure disorder, or history of severe and frequent migraine headaches;
  • Taken an investigational medication during the month prior to enrollment;
  • Prior exposure to the AFN investigational product;
  • Known hypersensitivity to the protocol specified antibiotic necessary for the treatment of Staphylococcus or the protocol-specified concomitant antibiotic for the treatment of bacterial co-pathogens present in the wound;
  • Treatment with any systemic antibiotic (excluding topical antibiotics), which is potentially effective against prevalent community or hospital isolates of Staphylococcus causing ABSSSI within 72 hours prior to enrollment and treatment with study medication unless the patient has clearly failed treatment;
  • Not expected to survive for at least 60 days after enrollment;
  • Anticipated amputation during the study of the limb involving the primary site of infection;
  • History of human immunodeficiency virus infection with a current or previous CD4 count <200/mm3;
  • Presence of immunodeficiency or an immunocompromised condition including hematologic malignancy, bone marrow transplant, or receiving immunosuppressive therapy such as cancer chemotherapy, medications for the rejection of transplantation, and long-term (≥2 weeks) use of systemic corticosteroids;
  • Neutropenia
  • End-stage renal disease or significant hepatic insufficiency
  • Need for protocol defined prohibited concomitant treatments
  • Unable or unwilling, in the judgment of the Investigator, to comply with the protocol
  • An employee of the Investigator or study center with direct involvement in the proposed study or other studies under the direction of that Investigator or study center, as well as a family member of the employee or the Investigator

Sites / Locations

  • SITE 018
  • SITE 005
  • SITE 001
  • SITE 016
  • SITE 017
  • SITE 002
  • SITE 004
  • SITE 006
  • SITE 003
  • SITE 007
  • SITE 011
  • SITE 008
  • SITE 014
  • SITE 015

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

AFN-12520000

Arm Description

100 mg tablet

Outcomes

Primary Outcome Measures

Safety
To assess the safety, tolerability, and efficacy of AFN-12520000 in patients with staphylococcal ABSSSI by exploring a variety of endpoints of clinical response and the rate and type of adverse events from baseline to the long term follow-up.

Secondary Outcome Measures

Pharmacokinetics
To assess the population pharmacokinetics (PK) of AFN 12520000 in patients with staphylococcal ABSSSI. PK measures will include Area Under the Curve (AUC), Maximum concentration (Cmax) and Half-life.

Full Information

First Posted
January 17, 2012
Last Updated
August 3, 2012
Sponsor
Affinium Pharmaceuticals, Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT01519492
Brief Title
A Study of Safety, Tolerability, and Efficacy of AFN-12520000 in the Treatment of Acute Bacterial Skin and Skin Structure Infections Due to Staphylococci
Official Title
A Phase 2, Open-Label, Multi-Center Study of Safety, Tolerability, and Efficacy of AFN-12520000 in the Treatment of Acute Bacterial Skin and Skin Structure Infections (ABSSSI) Due to Staphylococci
Study Type
Interventional

2. Study Status

Record Verification Date
August 2012
Overall Recruitment Status
Completed
Study Start Date
February 2012 (undefined)
Primary Completion Date
August 2012 (Actual)
Study Completion Date
August 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Affinium Pharmaceuticals, Ltd

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the study is to determine the safety, tolerability and effectiveness of AFN-12520000 for in the treatment of Staphylococcal infections of the skin.
Detailed Description
This open-label Phase 2 study is designed as a proof-of-concept study to evaluate the efficacy of a total daily dose of 400 mg of AFN-12520000 using a number of newly defined early endpoints, conventional endpoints, and composite endpoints to determine clinical response. Safety and tolerability will also be evaluated by conventional endpoints. The study will enroll up to 100 patients with a clinically documented diagnosis of Acute Bacterial Skin and Skin Structure Infections (ABSSSI) due to staphylococci. Patients meeting eligibility criteria will be identified and evaluated in a hospital or specialized clinic. After consent is obtained, the first dose of study medication will be administered. Daily clinical assessments will be conducted at the hospital and/or outpatient clinic during the first 5 days of treatment. Adverse events (AEs) and response to therapy will also be assessed. The study will consist of a screening period, which includes the baseline visit; a treatment period, and an end-of-treatment (EOT) visit; and a follow-up period, which includes a short-term (Test-of-Cure [TOC]) follow-up (STFU/TOC) visit and a long-term follow-up (LTFU) visit. Treatment regimens as short as 5 days (10 doses) and as long as 14 days (28 doses) will be permitted depending on individual response to treatment. The anticipated time commitment for patient participation in the study will be approximately 20 to 42 days from screening/baseline to the LTFU visit. The total duration of the study will be < 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Skin and Subcutaneous Tissue Bacterial Infections, Wound Infection, Cutaneous Abscess, Burn Infection, Cellulitis
Keywords
Skin and Subcutaneous Tissue Bacterial Infections

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
103 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AFN-12520000
Arm Type
Experimental
Arm Description
100 mg tablet
Intervention Type
Drug
Intervention Name(s)
AFN-12520000
Other Intervention Name(s)
AFN-1252, API-1252
Intervention Description
Two tablets taken in both the morning and evening on an empty stomach for a total daily dose 400 mg
Primary Outcome Measure Information:
Title
Safety
Description
To assess the safety, tolerability, and efficacy of AFN-12520000 in patients with staphylococcal ABSSSI by exploring a variety of endpoints of clinical response and the rate and type of adverse events from baseline to the long term follow-up.
Time Frame
From time of consent to long term follow-up (max of 42 days)
Secondary Outcome Measure Information:
Title
Pharmacokinetics
Description
To assess the population pharmacokinetics (PK) of AFN 12520000 in patients with staphylococcal ABSSSI. PK measures will include Area Under the Curve (AUC), Maximum concentration (Cmax) and Half-life.
Time Frame
Day 3, Day 5 and at EOT

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provide written informed consent and to understand the demands of the protocol; Ages of 18 and 70 years, inclusive; Have clinically documented ABSSSI suspected or documented to be caused by staphylococci accompanied by redness, edema, and/or induration of a minimum surface area of 75 cm2 and can be categorized as one or more of the following: Wound infection; Cutaneous abscess Burn infection (≤20% of total body surface area) or Cellulitis Have a primary infected lesion with at least three of the following: Significant pain or tenderness to palpation; Purulent or seropurulent drainage or discharge; Erythema; Fluctuance; Induration; Edema; Heat or localized warmth; Have at least two of the following signs and symptoms of systemic inflammation or complicating factors: Documented or reported fever >38.0°C; WBC count of >10,000 cells/mm3; Greater than 15% immature neutrophils irrespective of total WBC; Elevated CRP or ESR; or Local/regional lymphadenopathy; Have a Gram stain with Gram-positive cocci in clusters or PCR result indicating an infection with Staphylococci. Have clearly failed as defined in the protocol previous treatment after a minimum of 48 hours Women of childbearing potential must have a negative pregnancy test at screening before enrollment Male and Female patients must utilize a highly effective method of contraception In the judgment of the Investigator have an expectation of survival and prompt improvement with effective oral antibiotic therapy and appropriate supportive care for the anticipated duration of the study Willing and able to comply with all the study activities and procedures in the hospital or clinic. Exclusion Criteria: Have any one of the following conditions: Chronically infected "diabetic foot ulcers" or infections of chronic non-healing wounds of peripheral sites in a patient with advanced peripheral vascular disease; A wound infection involving foreign body or prosthetic material that will not be removed within 48 hours of initiation of treatment; Infected abdominal wounds unable to be surgically closed; Necrotizing fasciitis, rapidly necrotizing infections, or gangrenous processes; Infected burn involving >20% of the total body surface area; Infected bite from human or animal origin. Erysipelas or a primary infection suspected or documented to be due to streptococci or infection with a Gram-negative pathogen without evidence of a concomitant staphylococcal infection Evidence of either a Gram-negative or Gram-positive pathogen not susceptible to treatment with protocol-specified antibiotics and AFN-12520000; or An existing abscess that cannot be drained within 48 hours of initiation of treatment; Unable to tolerate an oral formulation of antibiotic, have an underlying gastrointestinal disease (would be poorly absorbed or tolerated), have a medical condition or post-operative condition leading to significant gastrointestinal malabsorption, and/or are unable to tolerate a normal diet; Have a known or suspected non-skin source of infection such as endocarditis, osteomyelitis, retroperitoneal abscess, septic arthritis, meningitis, or pneumonia; Exhibit signs of severe sepsis: Plans to have surgery utilizing general anesthetic during the study period (except surgery to remove a prosthetic device complicating the infection site or surgery to drain the abscess/wound within 48 hours); Pregnant or breastfeeding women; History of epilepsy, known seizure disorder, or history of severe and frequent migraine headaches; Taken an investigational medication during the month prior to enrollment; Prior exposure to the AFN investigational product; Known hypersensitivity to the protocol specified antibiotic necessary for the treatment of Staphylococcus or the protocol-specified concomitant antibiotic for the treatment of bacterial co-pathogens present in the wound; Treatment with any systemic antibiotic (excluding topical antibiotics), which is potentially effective against prevalent community or hospital isolates of Staphylococcus causing ABSSSI within 72 hours prior to enrollment and treatment with study medication unless the patient has clearly failed treatment; Not expected to survive for at least 60 days after enrollment; Anticipated amputation during the study of the limb involving the primary site of infection; History of human immunodeficiency virus infection with a current or previous CD4 count <200/mm3; Presence of immunodeficiency or an immunocompromised condition including hematologic malignancy, bone marrow transplant, or receiving immunosuppressive therapy such as cancer chemotherapy, medications for the rejection of transplantation, and long-term (≥2 weeks) use of systemic corticosteroids; Neutropenia End-stage renal disease or significant hepatic insufficiency Need for protocol defined prohibited concomitant treatments Unable or unwilling, in the judgment of the Investigator, to comply with the protocol An employee of the Investigator or study center with direct involvement in the proposed study or other studies under the direction of that Investigator or study center, as well as a family member of the employee or the Investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Barry Hafkin, MD
Organizational Affiliation
Affinium Pharmaceuticals, Ltd
Official's Role
Study Director
Facility Information:
Facility Name
SITE 018
City
Buena Park
State/Province
California
ZIP/Postal Code
90620
Country
United States
Facility Name
SITE 005
City
Chula Vista
State/Province
California
ZIP/Postal Code
91911
Country
United States
Facility Name
SITE 001
City
La Mesa
State/Province
California
ZIP/Postal Code
91942
Country
United States
Facility Name
SITE 016
City
Oceanside
State/Province
California
ZIP/Postal Code
92056
Country
United States
Facility Name
SITE 017
City
Augusta
State/Province
Georgia
ZIP/Postal Code
30909
Country
United States
Facility Name
SITE 002
City
Columbus
State/Province
Georgia
ZIP/Postal Code
31904
Country
United States
Facility Name
SITE 004
City
Savannah
State/Province
Georgia
ZIP/Postal Code
31406
Country
United States
Facility Name
SITE 006
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89109
Country
United States
Facility Name
SITE 003
City
Somers Point
State/Province
New Jersey
ZIP/Postal Code
08244
Country
United States
Facility Name
SITE 007
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45267
Country
United States
Facility Name
SITE 011
City
Toledo
State/Province
Ohio
ZIP/Postal Code
43608
Country
United States
Facility Name
SITE 008
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
SITE 014
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G 2B7
Country
Canada
Facility Name
SITE 015
City
Kingston
State/Province
Ontario
ZIP/Postal Code
K7L 2V7
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
26711777
Citation
Hafkin B, Kaplan N, Murphy B. Efficacy and Safety of AFN-1252, the First Staphylococcus-Specific Antibacterial Agent, in the Treatment of Acute Bacterial Skin and Skin Structure Infections, Including Those in Patients with Significant Comorbidities. Antimicrob Agents Chemother. 2015 Dec 28;60(3):1695-701. doi: 10.1128/AAC.01741-15.
Results Reference
derived

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A Study of Safety, Tolerability, and Efficacy of AFN-12520000 in the Treatment of Acute Bacterial Skin and Skin Structure Infections Due to Staphylococci

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