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The Safety and Pharmacokinetics of Carbavance™ (RPX2014/RPX7009) in Subjects With Renal Insufficiency

Primary Purpose

Subjects With Varying Degrees of Renal Insufficiency and, Subjects With Normal Renal Function

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
RPX7009 and RPX2014
Sponsored by
Rempex Pharmaceuticals (a wholly owned subsidiary of The Medicines Company)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Subjects With Varying Degrees of Renal Insufficiency and

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Males and females aged 18 through 80 years of age
  2. Willing to abstain from alcohol for 48 hours prior to dosing through discharge
  3. Normal volunteer first matched by age (± 10 years), BMI (± 20%), and gender to the mean values of the moderate renal insufficiency group.
  4. Have negative test results for HBsAg, anti-HCV antibody and anti-HIV antibody.
  5. Voluntarily consent to participate in the study
  6. Sexually abstinent or agree to use two approved methods of contraception.
  7. Assessment of renal insufficiency for assignment to study groups will be based on measurements of eGFR calculated by the MDRD equation at the Screening Visit to determine eligibility.

Exclusion Criteria:

  1. Unstable or new medical conditions (e.g., cardiovascular, respiratory, hepatic, renal, gastrointestinal, autoimmune, endocrine, or neurological disorders)
  2. Hypersensitivity or idiosyncratic reaction to β-lactam antibiotics (e.g. penicillins, cephalosporins, or carbapenems)
  3. History of clinically significant seizures, head injury, or meningitis.
  4. Current evidence or history of malignancy, excluding basal cell carcinoma, in the 2 years prior to Day -1 with no evidence of recurrence.
  5. Females who are pregnant, lactating, or have a positive pregnancy test
  6. Previously received any dose of Carbavance (RPX2014/RPX7009).
  7. Current participation in another investigational study or participation in another investigational clinical study within 30 days prior to the Screening Visit.
  8. Blood donation or significant blood loss (i.e., > 500 mL) within 56 days prior to Day 1.
  9. Plasma or platelet donation within 14 days prior to Day -1.
  10. Any acute illness requiring antibiotic drug therapy within 30 days prior to Day 1 or a febrile illness within 7 days prior to Day 1.
  11. Vigorous exercise from 48 hours prior to Day -1 until the day of discharge from the study.
  12. Positive urine drug/alcohol test at the Screening Visit or Day -1
  13. Concurrent use of medications known to affect the elimination of serum creatinine (e.g., trimethoprim/sulfamethoxazole [Bactrim®] or cimetidine [Tagamet®]) and competitors of renal tubular secretion (e.g., probenecid) within 30 days prior to the first dose of study drug
  14. Abnormal and clinically significant findings on physical examination, medical history, serum chemistry, hematology, or urinalysis
  15. Use of any other prescription or nonprescription drugs, vitamins, grapefruit/grapefruit juice or dietary or herbal supplements within 14 days prior to Day -1.

    1. Oral contraceptives are permitted for birth control.
    2. Acetaminophen (≤ 1 g/day) and low-dose ASA (i.e., ≤ 325 mg per day) are permitted.
  16. Currently receives hemodialysis or peritoneal dialysis.

Sites / Locations

  • DaVita Clinical Research
  • DaVita Clinical Research

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single dose of RPX7009 and RPX2014

Arm Description

Single dose of combination RPX7009 and RPX2014

Outcomes

Primary Outcome Measures

Safety from baseline through the end of the study
Number of patients with adverse events; assessed by patient reporting, collection of vital signs, ECGs and absolute values and changes over time of hematology, chemistry and urinalysis

Secondary Outcome Measures

Full Information

First Posted
December 10, 2013
Last Updated
March 1, 2018
Sponsor
Rempex Pharmaceuticals (a wholly owned subsidiary of The Medicines Company)
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1. Study Identification

Unique Protocol Identification Number
NCT02020434
Brief Title
The Safety and Pharmacokinetics of Carbavance™ (RPX2014/RPX7009) in Subjects With Renal Insufficiency
Official Title
A Phase 1, Open-label, Single-dose Study to Determine the Safety and Pharmacokinetics of Carbavance™ (RPX2014/RPX7009) in Subjects With Renal Insufficiency
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
January 2014 (undefined)
Primary Completion Date
September 2014 (Actual)
Study Completion Date
October 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Rempex Pharmaceuticals (a wholly owned subsidiary of The Medicines Company)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
RPX7009(beta-lactamase inhibitor) is being studied in combination with carbapenem (RPX2014)to treat bacterial infections, including those due to multi-drug resistant bacteria.
Detailed Description
The worldwide spread of resistance to antibiotics among Gram-negative bacteria, particularly members of the ESKAPE group of pathogens, has resulted in a crisis in the treatment of hospital acquired infections. In particular, the recent dissemination of a serine carbapenemase (e.g., KPC) in Enterobacteriaceae in US hospitals now poses a considerable threat to the carbapenems and other members of the beta-lactam class of antimicrobial agents. Rempex is developing a fixed combination antibiotic of a carbapenem (RPX2014) plus a new beta-lactamase inhibitor (RPX7009) which has activity against serine beta-lactamases, including KPC. This Phase 1 study will assess the safety, tolerability and pharmacokinetics of intravenous RPX2014 and RPX7009, administered in combination in subjects with varying degrees of renal insufficiency.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Subjects With Varying Degrees of Renal Insufficiency and, Subjects With Normal Renal Function

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Single dose of RPX7009 and RPX2014
Arm Type
Experimental
Arm Description
Single dose of combination RPX7009 and RPX2014
Intervention Type
Drug
Intervention Name(s)
RPX7009 and RPX2014
Intervention Description
The study is designed to enroll approximately 32 subjects. There will be approximately 24 subjects with varying degrees of renal insufficiency and approximately 8 subjects with normal renal function.
Primary Outcome Measure Information:
Title
Safety from baseline through the end of the study
Description
Number of patients with adverse events; assessed by patient reporting, collection of vital signs, ECGs and absolute values and changes over time of hematology, chemistry and urinalysis
Time Frame
7days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Males and females aged 18 through 80 years of age Willing to abstain from alcohol for 48 hours prior to dosing through discharge Normal volunteer first matched by age (± 10 years), BMI (± 20%), and gender to the mean values of the moderate renal insufficiency group. Have negative test results for HBsAg, anti-HCV antibody and anti-HIV antibody. Voluntarily consent to participate in the study Sexually abstinent or agree to use two approved methods of contraception. Assessment of renal insufficiency for assignment to study groups will be based on measurements of eGFR calculated by the MDRD equation at the Screening Visit to determine eligibility. Exclusion Criteria: Unstable or new medical conditions (e.g., cardiovascular, respiratory, hepatic, renal, gastrointestinal, autoimmune, endocrine, or neurological disorders) Hypersensitivity or idiosyncratic reaction to β-lactam antibiotics (e.g. penicillins, cephalosporins, or carbapenems) History of clinically significant seizures, head injury, or meningitis. Current evidence or history of malignancy, excluding basal cell carcinoma, in the 2 years prior to Day -1 with no evidence of recurrence. Females who are pregnant, lactating, or have a positive pregnancy test Previously received any dose of Carbavance (RPX2014/RPX7009). Current participation in another investigational study or participation in another investigational clinical study within 30 days prior to the Screening Visit. Blood donation or significant blood loss (i.e., > 500 mL) within 56 days prior to Day 1. Plasma or platelet donation within 14 days prior to Day -1. Any acute illness requiring antibiotic drug therapy within 30 days prior to Day 1 or a febrile illness within 7 days prior to Day 1. Vigorous exercise from 48 hours prior to Day -1 until the day of discharge from the study. Positive urine drug/alcohol test at the Screening Visit or Day -1 Concurrent use of medications known to affect the elimination of serum creatinine (e.g., trimethoprim/sulfamethoxazole [Bactrim®] or cimetidine [Tagamet®]) and competitors of renal tubular secretion (e.g., probenecid) within 30 days prior to the first dose of study drug Abnormal and clinically significant findings on physical examination, medical history, serum chemistry, hematology, or urinalysis Use of any other prescription or nonprescription drugs, vitamins, grapefruit/grapefruit juice or dietary or herbal supplements within 14 days prior to Day -1. Oral contraceptives are permitted for birth control. Acetaminophen (≤ 1 g/day) and low-dose ASA (i.e., ≤ 325 mg per day) are permitted. Currently receives hemodialysis or peritoneal dialysis.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chris Galloway, MD
Organizational Affiliation
Da Vita Clinical Research
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jolene K Berg, MD
Organizational Affiliation
Da Vita Clinical Research
Official's Role
Principal Investigator
Facility Information:
Facility Name
DaVita Clinical Research
City
Lakewood
State/Province
Colorado
ZIP/Postal Code
80228
Country
United States
Facility Name
DaVita Clinical Research
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55404
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29311069
Citation
Rubino CM, Bhavnani SM, Loutit JS, Lohse B, Dudley MN, Griffith DC. Single-Dose Pharmacokinetics and Safety of Meropenem-Vaborbactam in Subjects with Chronic Renal Impairment. Antimicrob Agents Chemother. 2018 Feb 23;62(3):e02103-17. doi: 10.1128/AAC.02103-17. Print 2018 Mar.
Results Reference
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The Safety and Pharmacokinetics of Carbavance™ (RPX2014/RPX7009) in Subjects With Renal Insufficiency

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