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Tolerability, Safety, and Efficacy of Tedizolid as Oral Treatment for Bone and Joint Infections

Primary Purpose

Bone and Joint Infection

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Tedizolid
Sponsored by
Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Bone and Joint Infection focused on measuring bone and joint infection, osteomyelitis, tedizolid

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Treatment of bone and joint infection in which therapy for Gram positive organisms is documented or suspected, as determined by the treating physician and treatment of at least 4 weeks is planned. Bone and joint infection and trauma-associated bone and joint infection will defined clinically using radiologic (e.g., MRI) and/or surgical (e.g., intra-operative findings)
  • Aged between 18 years and 85 years.
  • Plans to treat bone and joint infection in outpatient setting.
  • No limited planned course of antibiotics (i.e., no indefinite treatment plans for chronic suppression). Co-administration of other antibiotics that target other causative or potentially causative organisms (e.g., fluoroquinolones) is acceptable.
  • Able to come to the research clinic for study follow-up visits for the study period.

Exclusion Criteria:

  • Planned prolonged hospitalization (> 1 week).
  • Pregnancy (all female subjects of childbearing age will be given a pregnancy test prior to enrollment) or breast feeding. If a women is of childbearing potential, she must consistently use an acceptable method of contraception (IUD, injectable contraceptive, birth control patch, OCP, barrier method, abstinence) from baseline through the course of antibiotics (4-12 weeks). If a male patient's sexual partner is of childbearing potential, the male patient must acknowledge that they will consistently use an acceptable method of contraception as defined above from baseline through the course of antibiotics (4-12 weeks).
  • Comorbidities that, in the opinion of the investigator, are uncontrolled (e.g., diabetes, hypertension, psychiatric disease).
  • Peripheral or optic neuropathy.
  • Underlying hematologic cytopenias (e.g., baseline thrombocytopenia, or severe anemia, or leukopenia) as determined by the following limits from a baseline CBC/CMP obtained within the past 14 days. Note that if a CBC has not been performed within the past 14 days, a CBC will be performed on the day of enrollment prior to any study drug being administered to ensure the patient does not meet exclusion criteria. Cytopenias are defined as:

    1. Hemoglobin (Hgb) < 8.0g/dL
    2. WBC < 4,000 k/cumm
    3. Platelets < 150,000 k/cumm
  • Severe hepatic dysfunction as defined by liver function tests (ALT, ALP, AST, total bilirubin) > 3.0 times the upper limit of normal. as determined by the following limits from a baseline CMP obtained within the past 7 days. If a CMP has not been performed within the past 7 days, baseline levels may be used from a CMP performed within the past 2 months as long as another CMP is performed on the day of enrollment and the subject's levels are within the following limits.
  • Hypersensitivity to tedizolid or other oxazolidinone-class antibiotics or similar compounds.
  • Ongoing antibiotic-associated colitis.
  • A diet high in tyramine-containing foods such as pickled or fermented meats and cheeses, wine, or avocados per investigator discretion.
  • Concurrent use of sodium picosulfate (brand names: Sodipic Picofast, Laxoberal, Laxoberon, Purg-Odan, Picolax, Guttalax, Namilax, Pico-Salax and Prepopik).
  • Previous participation in the study.
  • Use of tedizolid for any condition in the past 3 months.
  • Any other medical, psychological, or social condition that, in the opinion of the Investigator, would prevent the patient from fully participating in the study or would represent a concern for study compliance or constitute a safety concern to the patient.

Sites / Locations

  • Harbor-UCLA Medical Center
  • Los Angeles BioMedical Research Institute (LA BioMed)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Drug: 200mg oral Tedizolid

Arm Description

200mg oral tablet of tedizolid to be taken once daily

Outcomes

Primary Outcome Measures

Number of "moderate" or "serious" adverse events as assessed by MedDRA v18.1
Study Hypothesis: Tedizolid is well tolerated for prolonged (4-12 weeks)courses of antibiotic therapy for patients with bone and joint infection. Comprehensive Chemistry Panels including liver function tests (CMP) and Complete Blood Count (CBC) Panels will be collected at regular intervals along with standardized surveys to measure adverse events as defined by the Medical Dictionary for Regulatory Activities Terminology (MedDRA) Version 18.1
Number of participants with an outcome of "cure" as defined as no need for further antibiotics beyond the originally planned duration determined by the participant's primary/treating physician.
Study Hypothesis: Tedizolid is effective for the treatment of bone and joint infection. Specifically, cure will be defined as no need for further antibiotics beyond the originally planned duration (i.e., 6 weeks for non-device associated bone and joint infection or until hardware removal for subjects with implants). Unplanned surgical procedures prompted by inadequate infection control will be categorized as treatment failure. We will also measure long-term efficacy by performing a phone survey 3 months after completion of antibiotics. Recurrence of signs or symptoms of bone and joint infection will be considered a long-term treatment failure.

Secondary Outcome Measures

Number of participants with treatment-related adverse events as assessed by MedDRA v18.1
Study Hypothesis: Tedizolid is safe for prolonged (4-12 weeks) courses of antibiotic therapy for patients with bone and joint infection. Comprehensive Chemistry Panels including liver function tests (CMP) and Complete Blood Count (CBC) Panels will be collected at regular intervals along with standardized surveys to measure adverse events as defined by the Medical Dictionary for Regulatory Activities Terminology (MedDRA) Version 18.1

Full Information

First Posted
December 21, 2016
Last Updated
February 22, 2021
Sponsor
Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT03009045
Brief Title
Tolerability, Safety, and Efficacy of Tedizolid as Oral Treatment for Bone and Joint Infections
Official Title
Tolerability, Safety, and Efficacy of Tedizolid as Oral Treatment for Bone and Joint Infections
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Active, not recruiting
Study Start Date
February 6, 2017 (Actual)
Primary Completion Date
July 2021 (Anticipated)
Study Completion Date
January 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The problem of interest is that doctors are looking for new antibiotic treatments for bone and joint infections. Treatment for bone and joint infection is not standardized, which allows a wide range of antibiotic therapy to potentially be given. A type of bacteria called S. aureus is the most common cause of bone and joint infection. Methicillin resistant S. aureus (MRSA) is a type of bacteria that is not killed by some antibiotics, and it is increasingly common in U.S. and non-U.S. medical centers. This problem will be studied by investigating whether an antibiotic called tedizolid is tolerable, safe and effective to treat bone and joint infections.
Detailed Description
The problem of interest is that doctors are looking for new antibiotic treatments for bone and joint infections. Treatment for bone and joint infection is not standardized, which allows a wide range of antibiotic therapy to potentially be given. A type of bacteria called S. aureus is the most common cause of bone and joint infection. Methicillin resistant S. aureus (MRSA) is a type of bacteria that is not killed by some antibiotics, and it is increasingly common in U.S. and non-U.S. medical centers. Trauma-associated bone and joint infection is also a common problem. Victims of major trauma often suffer bone fractures, which require temporary or permanent use of metal or other synthetic devices such as external-fixation pins, plates, and screws. These synthetic devices can also get infected and cause bone and joint infections. This problem will be studied by investigating whether an antibiotic called tedizolid is tolerable, safe and effective to treat bone and joint infections. Tedizolid is a new FDA-approved antibiotic, and can be given through the bloodstream via an IV or orally in the form of a pill. Tedizolid has less side effects compared to linezolid and is effective against types of bacteria like S. aureus. Other research also suggests that the side effects associated with long-term therapy of older types of antibiotics may not be found with tedizolid. This study will advance scientific knowledge of antibiotic treatments for bone and joint infections. Given the large and increasing burden of disease of bone and joint infection and the increasing acceptability of oral antibiotics for its management, tedizolid holds promise as a good option for patients with bone and joint infection. Harbor-UCLA Medical Center is a large medical center in the County of Los Angeles, the most populous County in the United States. The Infectious Disease consult service sees many bone and joint infections. Use of prolonged antibiotics is common in this setting. The investigators believe tedizolid addresses the unmet need for an oral antibiotic that is well-tolerated and efficacious for use as a prolonged therapy for bone and joint infection.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Bone and Joint Infection
Keywords
bone and joint infection, osteomyelitis, tedizolid

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Drug: 200mg oral Tedizolid
Arm Type
Experimental
Arm Description
200mg oral tablet of tedizolid to be taken once daily
Intervention Type
Drug
Intervention Name(s)
Tedizolid
Other Intervention Name(s)
tedizolid phosphate, Sivextro
Intervention Description
200mg oral tedizolid one pill per day
Primary Outcome Measure Information:
Title
Number of "moderate" or "serious" adverse events as assessed by MedDRA v18.1
Description
Study Hypothesis: Tedizolid is well tolerated for prolonged (4-12 weeks)courses of antibiotic therapy for patients with bone and joint infection. Comprehensive Chemistry Panels including liver function tests (CMP) and Complete Blood Count (CBC) Panels will be collected at regular intervals along with standardized surveys to measure adverse events as defined by the Medical Dictionary for Regulatory Activities Terminology (MedDRA) Version 18.1
Time Frame
4-12 Weeks
Title
Number of participants with an outcome of "cure" as defined as no need for further antibiotics beyond the originally planned duration determined by the participant's primary/treating physician.
Description
Study Hypothesis: Tedizolid is effective for the treatment of bone and joint infection. Specifically, cure will be defined as no need for further antibiotics beyond the originally planned duration (i.e., 6 weeks for non-device associated bone and joint infection or until hardware removal for subjects with implants). Unplanned surgical procedures prompted by inadequate infection control will be categorized as treatment failure. We will also measure long-term efficacy by performing a phone survey 3 months after completion of antibiotics. Recurrence of signs or symptoms of bone and joint infection will be considered a long-term treatment failure.
Time Frame
4-12 Weeks
Secondary Outcome Measure Information:
Title
Number of participants with treatment-related adverse events as assessed by MedDRA v18.1
Description
Study Hypothesis: Tedizolid is safe for prolonged (4-12 weeks) courses of antibiotic therapy for patients with bone and joint infection. Comprehensive Chemistry Panels including liver function tests (CMP) and Complete Blood Count (CBC) Panels will be collected at regular intervals along with standardized surveys to measure adverse events as defined by the Medical Dictionary for Regulatory Activities Terminology (MedDRA) Version 18.1
Time Frame
4-12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Treatment of bone and joint infection in which therapy for Gram positive organisms is documented or suspected, as determined by the treating physician and treatment of at least 4 weeks is planned. Bone and joint infection and trauma-associated bone and joint infection will defined clinically using radiologic (e.g., MRI) and/or surgical (e.g., intra-operative findings) Aged between 18 years and 85 years. Plans to treat bone and joint infection in outpatient setting. No limited planned course of antibiotics (i.e., no indefinite treatment plans for chronic suppression). Co-administration of other antibiotics that target other causative or potentially causative organisms (e.g., fluoroquinolones) is acceptable. Able to come to the research clinic for study follow-up visits for the study period. Exclusion Criteria: Planned prolonged hospitalization (> 1 week). Pregnancy (all female subjects of childbearing age will be given a pregnancy test prior to enrollment) or breast feeding. If a women is of childbearing potential, she must consistently use an acceptable method of contraception (IUD, injectable contraceptive, birth control patch, OCP, barrier method, abstinence) from baseline through the course of antibiotics (4-12 weeks). If a male patient's sexual partner is of childbearing potential, the male patient must acknowledge that they will consistently use an acceptable method of contraception as defined above from baseline through the course of antibiotics (4-12 weeks). Comorbidities that, in the opinion of the investigator, are uncontrolled (e.g., diabetes, hypertension, psychiatric disease). Peripheral or optic neuropathy. Underlying hematologic cytopenias (e.g., baseline thrombocytopenia, or severe anemia, or leukopenia) as determined by the following limits from a baseline CBC/CMP obtained within the past 14 days. Note that if a CBC has not been performed within the past 14 days, a CBC will be performed on the day of enrollment prior to any study drug being administered to ensure the patient does not meet exclusion criteria. Cytopenias are defined as: Hemoglobin (Hgb) < 8.0g/dL WBC < 4,000 k/cumm Platelets < 150,000 k/cumm Severe hepatic dysfunction as defined by liver function tests (ALT, ALP, AST, total bilirubin) > 3.0 times the upper limit of normal. as determined by the following limits from a baseline CMP obtained within the past 7 days. If a CMP has not been performed within the past 7 days, baseline levels may be used from a CMP performed within the past 2 months as long as another CMP is performed on the day of enrollment and the subject's levels are within the following limits. Hypersensitivity to tedizolid or other oxazolidinone-class antibiotics or similar compounds. Ongoing antibiotic-associated colitis. A diet high in tyramine-containing foods such as pickled or fermented meats and cheeses, wine, or avocados per investigator discretion. Concurrent use of sodium picosulfate (brand names: Sodipic Picofast, Laxoberal, Laxoberon, Purg-Odan, Picolax, Guttalax, Namilax, Pico-Salax and Prepopik). Previous participation in the study. Use of tedizolid for any condition in the past 3 months. Any other medical, psychological, or social condition that, in the opinion of the Investigator, would prevent the patient from fully participating in the study or would represent a concern for study compliance or constitute a safety concern to the patient.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Loren G Miller, MD MPH
Organizational Affiliation
Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Harbor-UCLA Medical Center
City
Torrance
State/Province
California
ZIP/Postal Code
90502
Country
United States
Facility Name
Los Angeles BioMedical Research Institute (LA BioMed)
City
Torrance
State/Province
California
ZIP/Postal Code
90502
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
After publication of trial results, data will be shared with investigators upon request to the Principal Investigator and after signing a Data Use Agreement.

Learn more about this trial

Tolerability, Safety, and Efficacy of Tedizolid as Oral Treatment for Bone and Joint Infections

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