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Efficacy and Safety Study of Eravacycline Compared With Meropenem in Complicated Intra-abdominal Infections (IGNITE4)

Primary Purpose

Complicated Intra-abdominal Infections, Complicated Appendicitis

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Eravacycline
Meropenem
Placebo
Sponsored by
Tetraphase Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Complicated Intra-abdominal Infections

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female participant hospitalized for cIAI
  • At least 18 years of age
  • Evidence of a systemic inflammatory response
  • Abdominal pain or flank pain (with or without rebound tenderness), or pain caused by cIAI that is referred to another anatomic area
  • Able to provide informed consent
  • If male: must agree to use an effective barrier method of contraception during the study and for 14 days following the last dose if sexually active with a female of childbearing potential
  • If female, not pregnant or nursing or, if of childbearing potential: either will commit to use at least two medically accepted, effective methods of birth control (for example, condom, oral contraceptive, indwelling intrauterine device, hormonal implant /patch, injections, approved cervical ring) during study drug dosing and for 14 days following last study drug dose or practicing sexual abstinence

Exclusion Criteria:

  • Unlikely to survive the 6-8 week study period
  • Creatinine clearance of ≤50 milliliter (mL)/minute
  • Presence or possible signs of significant hepatic disease
  • Immunocompromised condition, including known human immunodeficiency virus (HIV) positivity, transplant recipients, and hematological malignancy
  • History of moderate or severe hypersensitivity reactions to tetracyclines, carbapenems, β-lactam antibiotics, or to any of the excipients contained in the study drug formulations
  • Participation in any investigational drug or device study within 30 days prior to study entry
  • Known or suspected current central nervous system (CNS) disorder that may predispose to seizures or lower seizure threshold (for example, severe cerebral arteriosclerosis, epilepsy)
  • Antibiotic-related exclusions:

    1. Receipt of effective antibacterial drug therapy for cIAI for a continuous duration of >24-hours during the 72-hours preceding randomization [however, participants with documented cIAI (that is, known baseline pathogen) who have received at least 72-hours of antibiotic therapy and are considered treatment failures may be enrolled. Treatment failure is defined as persistent fever and/or clinical symptoms; or the development of a new intra-abdominal abscess after ≥72-hours of antibiotic therapy], or
    2. Receipt of meropenem or any other carbapenem, or tigecycline for the current infection, or
    3. Need for concomitant systemic antimicrobial agents effective in cIAI other than study drug
  • Refusal of mechanical ventilation, dialysis or hemofiltration, cardioversion, or any other resuscitative measures and drug/fluid therapy at time of consent
  • Known or suspected inflammatory bowel disease or associated visceral abscess
  • The anticipated need for systemic antibiotics for a duration of more than 14 days
  • Systemic malignancy that required chemotherapy, immunotherapy, radiation therapy, or antineoplastic therapy within the previous 3 months or that is anticipated to begin prior to the Test-of-Cure (TOC) visit
  • Known at study entry to have cIAI caused by a pathogen(s) resistant to one of the study drugs

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Eravacycline

Meropenem

Arm Description

Outcomes

Primary Outcome Measures

Number of Participants With a Favorable Clinical Response at the Test-of-Cure (TOC) Visit in the Microbiological Intent-to-treat (Micro-ITT) Population
Clinical cure was defined as complete resolution or significant improvement of signs and symptoms of the index infection such that no additional antibacterial therapy, surgical, or radiological intervention was required. Clinical failure was defined as death related to complicated intra-abdominal infection (cIAI), persistence of clinical symptoms of cIAI, unplanned surgical or percutaneous drainage procedures for complication or recurrence of cIAI, post-surgical wound infections requiring systemic antibiotics, or initiation of rescue antibacterial drug therapy for treatment of cIAI. Indeterminate/missing was defined as an outcome that was neither a clinical cure nor clinical failure, if the investigator did not complete an assessment, if a study visit was not conducted, or if the subject died for a cause unrelated to cIAI.

Secondary Outcome Measures

Number of Participants With a Favorable Clinical Response at the Test-of-Cure (TOC) Visit in the All-Treated (MITT) Population
Clinical cure was defined as complete resolution or significant improvement of signs and symptoms of the index infection such that no additional antibacterial therapy, surgical, or radiological intervention was required. Clinical failure was defined as death related to complicated intra-abdominal infection (cIAI), persistence of clinical symptoms of cIAI, unplanned surgical or percutaneous drainage procedures for complication or recurrence of cIAI, post-surgical wound infections requiring systemic antibiotics, or initiation of rescue antibacterial drug therapy for treatment of cIAI. Indeterminate/missing was defined as an outcome that was neither a clinical cure nor clinical failure, if the investigator did not complete an assessment, if a study visit was not conducted, or if the subject died for a cause unrelated to cIAI.
Number of Participants With a Favorable Clinical Response at the Test-of-Cure (TOC) Visit in the Clinically Evaluable (CE) Population
Clinical cure was defined as complete resolution or significant improvement of signs and symptoms of the index infection such that no additional antibacterial therapy, surgical, or radiological intervention was required. Clinical failure was defined as death related to complicated intra-abdominal infection (cIAI), persistence of clinical symptoms of cIAI, unplanned surgical or percutaneous drainage procedures for complication or recurrence of cIAI, post-surgical wound infections requiring systemic antibiotics, or initiation of rescue antibacterial drug therapy for treatment of cIAI.

Full Information

First Posted
May 23, 2016
Last Updated
December 16, 2021
Sponsor
Tetraphase Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02784704
Brief Title
Efficacy and Safety Study of Eravacycline Compared With Meropenem in Complicated Intra-abdominal Infections
Acronym
IGNITE4
Official Title
A Phase 3, Randomized, Double-Blind, Double-Dummy, Multicenter, Prospective Study to Assess the Efficacy and Safety of Eravacycline Compared With Meropenem in Complicated Intra-abdominal Infections
Study Type
Interventional

2. Study Status

Record Verification Date
December 2021
Overall Recruitment Status
Completed
Study Start Date
October 13, 2016 (Actual)
Primary Completion Date
May 8, 2017 (Actual)
Study Completion Date
May 19, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tetraphase Pharmaceuticals, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase 3, randomized, double-blind, double-dummy, multicenter, prospective study to assess the efficacy, safety, and pharmacokinetics (PK) of eravacycline compared with meropenem in the treatment of complicated intra-abdominal infections (cIAIs).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Complicated Intra-abdominal Infections, Complicated Appendicitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
500 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Eravacycline
Arm Type
Experimental
Arm Title
Meropenem
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Eravacycline
Other Intervention Name(s)
TP-434
Intervention Type
Drug
Intervention Name(s)
Meropenem
Other Intervention Name(s)
Merrem
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Number of Participants With a Favorable Clinical Response at the Test-of-Cure (TOC) Visit in the Microbiological Intent-to-treat (Micro-ITT) Population
Description
Clinical cure was defined as complete resolution or significant improvement of signs and symptoms of the index infection such that no additional antibacterial therapy, surgical, or radiological intervention was required. Clinical failure was defined as death related to complicated intra-abdominal infection (cIAI), persistence of clinical symptoms of cIAI, unplanned surgical or percutaneous drainage procedures for complication or recurrence of cIAI, post-surgical wound infections requiring systemic antibiotics, or initiation of rescue antibacterial drug therapy for treatment of cIAI. Indeterminate/missing was defined as an outcome that was neither a clinical cure nor clinical failure, if the investigator did not complete an assessment, if a study visit was not conducted, or if the subject died for a cause unrelated to cIAI.
Time Frame
TOC visit: 25-31 days after first dose of study drug
Secondary Outcome Measure Information:
Title
Number of Participants With a Favorable Clinical Response at the Test-of-Cure (TOC) Visit in the All-Treated (MITT) Population
Description
Clinical cure was defined as complete resolution or significant improvement of signs and symptoms of the index infection such that no additional antibacterial therapy, surgical, or radiological intervention was required. Clinical failure was defined as death related to complicated intra-abdominal infection (cIAI), persistence of clinical symptoms of cIAI, unplanned surgical or percutaneous drainage procedures for complication or recurrence of cIAI, post-surgical wound infections requiring systemic antibiotics, or initiation of rescue antibacterial drug therapy for treatment of cIAI. Indeterminate/missing was defined as an outcome that was neither a clinical cure nor clinical failure, if the investigator did not complete an assessment, if a study visit was not conducted, or if the subject died for a cause unrelated to cIAI.
Time Frame
TOC visit: 25-31 days after first dose of study drug
Title
Number of Participants With a Favorable Clinical Response at the Test-of-Cure (TOC) Visit in the Clinically Evaluable (CE) Population
Description
Clinical cure was defined as complete resolution or significant improvement of signs and symptoms of the index infection such that no additional antibacterial therapy, surgical, or radiological intervention was required. Clinical failure was defined as death related to complicated intra-abdominal infection (cIAI), persistence of clinical symptoms of cIAI, unplanned surgical or percutaneous drainage procedures for complication or recurrence of cIAI, post-surgical wound infections requiring systemic antibiotics, or initiation of rescue antibacterial drug therapy for treatment of cIAI.
Time Frame
TOC visit: 25-31 days after first dose of study drug

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female participant hospitalized for cIAI At least 18 years of age Evidence of a systemic inflammatory response Abdominal pain or flank pain (with or without rebound tenderness), or pain caused by cIAI that is referred to another anatomic area Able to provide informed consent If male: must agree to use an effective barrier method of contraception during the study and for 14 days following the last dose if sexually active with a female of childbearing potential If female, not pregnant or nursing or, if of childbearing potential: either will commit to use at least two medically accepted, effective methods of birth control (for example, condom, oral contraceptive, indwelling intrauterine device, hormonal implant /patch, injections, approved cervical ring) during study drug dosing and for 14 days following last study drug dose or practicing sexual abstinence Exclusion Criteria: Unlikely to survive the 6-8 week study period Creatinine clearance of ≤50 milliliter (mL)/minute Presence or possible signs of significant hepatic disease Immunocompromised condition, including known human immunodeficiency virus (HIV) positivity, transplant recipients, and hematological malignancy History of moderate or severe hypersensitivity reactions to tetracyclines, carbapenems, β-lactam antibiotics, or to any of the excipients contained in the study drug formulations Participation in any investigational drug or device study within 30 days prior to study entry Known or suspected current central nervous system (CNS) disorder that may predispose to seizures or lower seizure threshold (for example, severe cerebral arteriosclerosis, epilepsy) Antibiotic-related exclusions: Receipt of effective antibacterial drug therapy for cIAI for a continuous duration of >24-hours during the 72-hours preceding randomization [however, participants with documented cIAI (that is, known baseline pathogen) who have received at least 72-hours of antibiotic therapy and are considered treatment failures may be enrolled. Treatment failure is defined as persistent fever and/or clinical symptoms; or the development of a new intra-abdominal abscess after ≥72-hours of antibiotic therapy], or Receipt of meropenem or any other carbapenem, or tigecycline for the current infection, or Need for concomitant systemic antimicrobial agents effective in cIAI other than study drug Refusal of mechanical ventilation, dialysis or hemofiltration, cardioversion, or any other resuscitative measures and drug/fluid therapy at time of consent Known or suspected inflammatory bowel disease or associated visceral abscess The anticipated need for systemic antibiotics for a duration of more than 14 days Systemic malignancy that required chemotherapy, immunotherapy, radiation therapy, or antineoplastic therapy within the previous 3 months or that is anticipated to begin prior to the Test-of-Cure (TOC) visit Known at study entry to have cIAI caused by a pathogen(s) resistant to one of the study drugs
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chief Medical Officer
Organizational Affiliation
Tetraphase Pharmaceuticals
Official's Role
Study Director
Facility Information:
City
Los Angeles
State/Province
California
Country
United States
City
Indianapolis
State/Province
Indiana
Country
United States
City
Las Vegas
State/Province
Nevada
Country
United States
City
Somers Point
State/Province
New Jersey
Country
United States
City
Cleveland
State/Province
Ohio
Country
United States
City
Columbus
State/Province
Ohio
Country
United States
City
Pleven
Country
Bulgaria
City
Plovdiv
Country
Bulgaria
City
Ruse
Country
Bulgaria
City
Sofia
Country
Bulgaria
City
Varna
Country
Bulgaria
City
Jihlava
Country
Czechia
City
Kladno
Country
Czechia
City
Kolin
Country
Czechia
City
Prague
Country
Czechia
City
Tallinn
Country
Estonia
City
Tartu
Country
Estonia
City
Viljandi
Country
Estonia
City
Voru
Country
Estonia
City
Batumi
Country
Georgia
City
Kutaisi
Country
Georgia
City
Tbilisi
Country
Georgia
City
Zugdidi
Country
Georgia
City
Gyor
Country
Hungary
City
Kaposvar
Country
Hungary
City
Pecs
Country
Hungary
City
Veszprem
Country
Hungary
City
Daugavpils
Country
Latvia
City
Liepaja
Country
Latvia
City
Rezekne
Country
Latvia
City
Riga
Country
Latvia
City
Kaunas
Country
Lithuania
City
Klaipeda
Country
Lithuania
City
Vilnius
Country
Lithuania
City
Bucharest
Country
Romania
City
Cluj-Napoca
Country
Romania
City
Craiova
Country
Romania
City
Targu Mures
Country
Romania
City
Timisoara
Country
Romania
City
Arkhangelsk
Country
Russian Federation
City
Kaluga
Country
Russian Federation
City
Krasnodar
Country
Russian Federation
City
Nizhny Novgorod
Country
Russian Federation
City
St. Petersburg
Country
Russian Federation
City
Volgograd
Country
Russian Federation
City
Vsevolozhsk
Country
Russian Federation
City
Dnipro
Country
Ukraine
City
Ivano-Frankivsk
Country
Ukraine
City
Kharkiv
Country
Ukraine
City
Kyiv
Country
Ukraine
City
Lviv
Country
Ukraine
City
Odesa
Country
Ukraine
City
Uzhhorod
Country
Ukraine
City
Vinnytsia
Country
Ukraine

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
30561562
Citation
Solomkin JS, Gardovskis J, Lawrence K, Montravers P, Sway A, Evans D, Tsai L. IGNITE4: Results of a Phase 3, Randomized, Multicenter, Prospective Trial of Eravacycline vs Meropenem in the Treatment of Complicated Intraabdominal Infections. Clin Infect Dis. 2019 Aug 30;69(6):921-929. doi: 10.1093/cid/ciy1029.
Results Reference
result
PubMed Identifier
31570004
Citation
Solomkin JS, Sway A, Lawrence K, Olesky M, Izmailyan S, Tsai L. Eravacycline: a new treatment option for complicated intra-abdominal infections in the age of multidrug resistance. Future Microbiol. 2019 Oct;14:1293-1308. doi: 10.2217/fmb-2019-0135. Epub 2019 Oct 1.
Results Reference
derived
Links:
URL
https://www.ncbi.nlm.nih.gov/pubmed/?term=30561562
Description
IGNITE4: Results of a Phase 3, Randomized, Multicenter, Prospective Trial of Eravacycline vs. Meropenem in the Treatment of Complicated Intra-Abdominal Infections

Learn more about this trial

Efficacy and Safety Study of Eravacycline Compared With Meropenem in Complicated Intra-abdominal Infections

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