search
Back to results

A Study to Evaluate the Safety and Efficacy of 3% LTX-109 for Nasal Decolonisation of Staphylococcus

Primary Purpose

Nasal Decolonization of Staphylococcus Aureus

Status
Completed
Phase
Phase 1
Locations
Sweden
Study Type
Interventional
Intervention
LTX-109 gel, 3% w/w
Placebo
Sponsored by
Pharma Holdings AS
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nasal Decolonization of Staphylococcus Aureus

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Willing and able to give written informed consent for participation in the study.
  2. Male or female subject aged 18 to 65 years inclusive at Visit 2.
  3. Persistent nasal carrier of Staphylococcus aureus (MSSA and/or MRSA), confirmed by two positive bacterial cultures from the nose during the screening period.
  4. Clinically normal medical history, physical findings, vital signs and laboratory values at the time of screening Visit 2, as judged by the Investigator.
  5. Women of child bearing potential (WOCBP) must practice abstinence (only allowed when this is the preferred and usual lifestyle of the subject) or must agree to use a highly effective method of contraception with a failure rate of < 1% to prevent pregnancy (combined [oestrogen and progestogen containing] hormonal contraception associated with inhibition of ovulation [oral, intravaginal, transdermal], progestogen-only hormonal contraception associated with inhibition of ovulation [oral, injectable, implantable], intrauterine device [IUD]or intrauterine hormone-releasing system [IUS]) from at least 2 weeks prior to dose to 2 weeks after last dose. Female subjects must refrain from donating eggs from the date of dosing until 3 months after dosing with the IMP. Their male partner must agree to use a condom during the same time frame if he has not undergone vasectomy.

Women of non-childbearing potential are defined as pre-menopausal females who are sterilised (tubal ligation or permanent bilateral occlusion of fallopian tubes); or females who have undergone hysterectomy or bilateral oophorectomy; or post-menopausal defined as 12 months of amenorrhea (in questionable cases a blood sample with simultaneous detection of follicle stimulating hormone [FSH] 25-140 IE/L is confirmatory).

Male subjects must be willing to use condom or be vasectomised or practice sexual abstinence to prevent pregnancy and drug exposure of a partner and refrain from donating sperm from the date of dosing until 3 months after dosing with the IMP. Their female partner of child-bearing potential must use contraceptive methods with a failure rate of < 1% to prevent pregnancy (see above).

Exclusion Criteria:

  1. History of any clinically significant disease or disorder which, in the opinion of the Investigator, may either put the subject at risk because of participation in the study, or influence the results or the subject's ability to participate in the study.
  2. Any clinically significant illness, medical/surgical procedure or trauma within 4 weeks of the first administration of IMP.
  3. Severe eczema or skin wounds, dry or sensitive skin assessed as clinically significant by the Investigator.
  4. Malignancy within the past 5 years with the exception of in situ removal of basal cell carcinoma.
  5. Any positive result at screening for serum hepatitis B surface antigen, hepatitis C antibody and Human Immunodeficiency Virus (HIV).
  6. History of severe allergy/hypersensitivity or ongoing allergy/hypersensitivity, as judged by the Investigator, or history of hypersensitivity to drugs with a similar chemical structure or class to LTX-109 or chlorhexidine.
  7. S. aureus (MSSA and/or MRSA) decolonisation attempt in the 6 months prior to screening Visit 2.
  8. Inability to take medications nasally.
  9. Nasal polyps or significant anatomical nasal abnormality, as judged by the Investigator.
  10. Evidence of open wound, lesion, inflammation, erythema or infection (including active rhinitis, sinusitis or upper respiratory infection) affecting the nostril area, lip and skin close to the nose.
  11. History of multiple episodes (>3) of epistaxis within 12 months prior to screening Visit 2.
  12. Disease in the region of the application sites, significant history of trauma or skin disease in the region of the application sites, current nasal skin or nasal septum condition requiring treatment or nasal surgery in the 6 months prior to screening Visit 2.
  13. In situ nasal jewellery or open nasal piercings.
  14. Previous or concurrent treatment with antimicrobials for an infection within the last 30 days prior to the first administration of IMP.
  15. Regular use of cortisone or anticoagulation medication within 14 days prior to the first administration of IMP and regular use of nasal decongestants within 30 days prior to the first IMP administration, at the discretion of the Investigator.
  16. Planned treatment or treatment with another investigational drug within 30 days prior to Day 1. Subjects consented and screened but not dosed in previous Phase I studies are not excluded.
  17. Positive screen for drugs of abuse or alcohol at screening Visit 2 or on admission to the unit prior to administration of the IMP.
  18. History of alcohol abuse or excessive intake of alcohol, as judged by the Investigator.
  19. Presence or history of drug abuse, as judged by the Investigator.
  20. History of, or current use of, anabolic steroids.
  21. Plasma donation within 2 weeks of screening Visit 2 or blood donation (or corresponding blood loss) during the three months prior to screening.
  22. Investigator considers the subject unlikely to comply with study procedures, restrictions and requirements.
  23. Female subjects who are pregnant or who are currently breast feeding.

Sites / Locations

  • ClinSmart Sweden AB

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

LTX-109 treatment

Placebo

Arm Description

Nasal application of LTX-109 gel 3% (w/w), 250 mikroliters in each nostril, 4 times in one day, every two hours.

Nasal application of placebo, 250 mikroliters in each nostril, 4 times in one day, every two hours.

Outcomes

Primary Outcome Measures

Assessment of safety by occurence and frequency of Adverse Events
Occurrence and frequency of Adverse Events
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point graded scale.
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point graded scale.
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale.
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale.
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale.
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale.
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale.
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Local tolerability assessed by the subject by Visual Analog Scale.
Assessment of Local tolerability on Visual Analog Scale
Local tolerability assessed by the subject by Visual Analog Scale.
Assessment of Local tolerability on Visual Analog Scale

Secondary Outcome Measures

Number of subjects on LTX-109 versus placebo with bacterial eradication at Test of Cure
Assessment of eradication of bacteria defined as non-presence of Staphylococcus aureus (MSSA and/or MRSA) in quantitative cultures
Number of subjects on LTX-109 versus placebo with bacterial eradication at other specified time points than Time of Cure.
Assessment of bacterial count at specified points in time to explore effect of the intervention
Number of colony forming units (CFUs) in subjects on LTX-109 versus placebo at specified points in time.
Assessment of bacterial count at specified points in time to explore effect of the intervention
Number of subjects on LTX-109 vs placebo with bacterial recolonisation defined as the timepoint of recurrence of colonisation after confirmed eradication.
Assessment of recurrence
Plasma concentrations of LTX-109
Assessment of plasma concentratin by analysis of blood samples

Full Information

First Posted
February 12, 2021
Last Updated
August 27, 2021
Sponsor
Pharma Holdings AS
Collaborators
CTC Clinical Trial Consultants AB
search

1. Study Identification

Unique Protocol Identification Number
NCT04767321
Brief Title
A Study to Evaluate the Safety and Efficacy of 3% LTX-109 for Nasal Decolonisation of Staphylococcus
Official Title
A Phase I/IIa, Randomised, Double-blind, Placebo-controlled Study to Evaluate the Safety and Exploratory Efficacy of 3% LTX-109 Compared to Placebo for Nasal Decolonisation of Staphylococcus Aureus
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Completed
Study Start Date
February 22, 2021 (Actual)
Primary Completion Date
March 23, 2021 (Actual)
Study Completion Date
June 1, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pharma Holdings AS
Collaborators
CTC Clinical Trial Consultants AB

4. Oversight

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

5. Study Description

Brief Summary
A Phase I/IIa, double-blind, placebo-controlled, randomised study designed to evaluate the safety, tolerability, exploratory efficacy and exposure of LTX-109 administered topically to the anterior nares in subjects with persistent carriage of S. aureus (methicillin-susceptible S. aureus [MSSA] and/or methicillin-resistant S. aureus [MRSA]).
Detailed Description
Approximately 60 subjects will be screened to achieve 24 persistent MSSA and/or MRSA carriers and 16 randomised and dosed subjects randomized 3:1, active to placebo. Eligible subjects will be admitted to the clinic on Day 1 for randomisation and dosing and will remain at the clinic until Day 2. Following nasal and perineum swabs and a chlorhexidine (Hibiscrub®) shower, the investigational medicinal product (IMP) will be applied topically to both nostrils by a qualified health professional 4 times during a six hour period (every two hours at 0, 2, 4 and 6 hours) on Day 1. Subjects will come back to the research clinic on Day 3, Day 4, Day 8 and Day 15 (Visits 4 to 7) for safety, tolerability and efficacy assessments and for blood sampling for bioanalysis. On Day 5 and Day 6, subjects will take a chlorhexidine shower at home. A final end-of-study visit (Visit 8) will take place on Day 22 (±3 days) or after early withdrawal. All subjects will be instructed to wash the body and hair with chlorhexidine body wash and shampoo at the clinic on Day 1 (prior to the first dose) and on Day 2. Prior to leaving the clinic on Day 2, subjects will be provided with chlorhexidine body wash and shampoo for body and hair wash at home on Day 3 (prior to Visit 4), on Day 4 (prior to Visit 5) and on Day 5 and Day 6. Each subject is expected to participate in the study for approximately 50 days including a 28 day screening period

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nasal Decolonization of Staphylococcus Aureus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Randomised, Double-blind, Placebo-controlled Randomization 3:1, active to placebo
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
15 (Actual)

8. Arms, Groups, and Interventions

Arm Title
LTX-109 treatment
Arm Type
Experimental
Arm Description
Nasal application of LTX-109 gel 3% (w/w), 250 mikroliters in each nostril, 4 times in one day, every two hours.
Arm Title
Placebo
Arm Type
Experimental
Arm Description
Nasal application of placebo, 250 mikroliters in each nostril, 4 times in one day, every two hours.
Intervention Type
Drug
Intervention Name(s)
LTX-109 gel, 3% w/w
Intervention Description
LTX-109 gel will be applied topically to both nostrils by a qualified health professional. On each dosing occasion, a large drop of IMP will be applied into each nostril and distributed to cover the whole area of the nostril.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo gel will be applied topically to both nostrils by a qualified health professional. On each dosing occasion, a large drop of IMP will be applied into each nostril and distributed to cover the whole area of the nostril.
Primary Outcome Measure Information:
Title
Assessment of safety by occurence and frequency of Adverse Events
Description
Occurrence and frequency of Adverse Events
Time Frame
Through treatment and followup of 22 days
Title
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point graded scale.
Description
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Time Frame
Day 1
Title
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point graded scale.
Description
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Time Frame
Day 2
Title
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale.
Description
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Time Frame
Day 3
Title
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale.
Description
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Time Frame
Day 4
Title
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale.
Description
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Time Frame
Day 8
Title
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale.
Description
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Time Frame
Day 15
Title
Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale.
Description
Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)
Time Frame
Day 22
Title
Local tolerability assessed by the subject by Visual Analog Scale.
Description
Assessment of Local tolerability on Visual Analog Scale
Time Frame
Day 1
Title
Local tolerability assessed by the subject by Visual Analog Scale.
Description
Assessment of Local tolerability on Visual Analog Scale
Time Frame
Day 2
Secondary Outcome Measure Information:
Title
Number of subjects on LTX-109 versus placebo with bacterial eradication at Test of Cure
Description
Assessment of eradication of bacteria defined as non-presence of Staphylococcus aureus (MSSA and/or MRSA) in quantitative cultures
Time Frame
54 hours (+ 2 hours)
Title
Number of subjects on LTX-109 versus placebo with bacterial eradication at other specified time points than Time of Cure.
Description
Assessment of bacterial count at specified points in time to explore effect of the intervention
Time Frame
4, 6, 12, 24, 78 hours and Days 8, 15 and 22
Title
Number of colony forming units (CFUs) in subjects on LTX-109 versus placebo at specified points in time.
Description
Assessment of bacterial count at specified points in time to explore effect of the intervention
Time Frame
4, 6, 12, 24, 78 hours and Days 8, 15 and 22
Title
Number of subjects on LTX-109 vs placebo with bacterial recolonisation defined as the timepoint of recurrence of colonisation after confirmed eradication.
Description
Assessment of recurrence
Time Frame
Days 4, 8, 15 and 22
Title
Plasma concentrations of LTX-109
Description
Assessment of plasma concentratin by analysis of blood samples
Time Frame
6, 24, 54 and 78 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Willing and able to give written informed consent for participation in the study. Male or female subject aged 18 to 65 years inclusive at Visit 2. Persistent nasal carrier of Staphylococcus aureus (MSSA and/or MRSA), confirmed by two positive bacterial cultures from the nose during the screening period. Clinically normal medical history, physical findings, vital signs and laboratory values at the time of screening Visit 2, as judged by the Investigator. Women of child bearing potential (WOCBP) must practice abstinence (only allowed when this is the preferred and usual lifestyle of the subject) or must agree to use a highly effective method of contraception with a failure rate of < 1% to prevent pregnancy (combined [oestrogen and progestogen containing] hormonal contraception associated with inhibition of ovulation [oral, intravaginal, transdermal], progestogen-only hormonal contraception associated with inhibition of ovulation [oral, injectable, implantable], intrauterine device [IUD]or intrauterine hormone-releasing system [IUS]) from at least 2 weeks prior to dose to 2 weeks after last dose. Female subjects must refrain from donating eggs from the date of dosing until 3 months after dosing with the IMP. Their male partner must agree to use a condom during the same time frame if he has not undergone vasectomy. Women of non-childbearing potential are defined as pre-menopausal females who are sterilised (tubal ligation or permanent bilateral occlusion of fallopian tubes); or females who have undergone hysterectomy or bilateral oophorectomy; or post-menopausal defined as 12 months of amenorrhea (in questionable cases a blood sample with simultaneous detection of follicle stimulating hormone [FSH] 25-140 IE/L is confirmatory). Male subjects must be willing to use condom or be vasectomised or practice sexual abstinence to prevent pregnancy and drug exposure of a partner and refrain from donating sperm from the date of dosing until 3 months after dosing with the IMP. Their female partner of child-bearing potential must use contraceptive methods with a failure rate of < 1% to prevent pregnancy (see above). Exclusion Criteria: History of any clinically significant disease or disorder which, in the opinion of the Investigator, may either put the subject at risk because of participation in the study, or influence the results or the subject's ability to participate in the study. Any clinically significant illness, medical/surgical procedure or trauma within 4 weeks of the first administration of IMP. Severe eczema or skin wounds, dry or sensitive skin assessed as clinically significant by the Investigator. Malignancy within the past 5 years with the exception of in situ removal of basal cell carcinoma. Any positive result at screening for serum hepatitis B surface antigen, hepatitis C antibody and Human Immunodeficiency Virus (HIV). History of severe allergy/hypersensitivity or ongoing allergy/hypersensitivity, as judged by the Investigator, or history of hypersensitivity to drugs with a similar chemical structure or class to LTX-109 or chlorhexidine. S. aureus (MSSA and/or MRSA) decolonisation attempt in the 6 months prior to screening Visit 2. Inability to take medications nasally. Nasal polyps or significant anatomical nasal abnormality, as judged by the Investigator. Evidence of open wound, lesion, inflammation, erythema or infection (including active rhinitis, sinusitis or upper respiratory infection) affecting the nostril area, lip and skin close to the nose. History of multiple episodes (>3) of epistaxis within 12 months prior to screening Visit 2. Disease in the region of the application sites, significant history of trauma or skin disease in the region of the application sites, current nasal skin or nasal septum condition requiring treatment or nasal surgery in the 6 months prior to screening Visit 2. In situ nasal jewellery or open nasal piercings. Previous or concurrent treatment with antimicrobials for an infection within the last 30 days prior to the first administration of IMP. Regular use of cortisone or anticoagulation medication within 14 days prior to the first administration of IMP and regular use of nasal decongestants within 30 days prior to the first IMP administration, at the discretion of the Investigator. Planned treatment or treatment with another investigational drug within 30 days prior to Day 1. Subjects consented and screened but not dosed in previous Phase I studies are not excluded. Positive screen for drugs of abuse or alcohol at screening Visit 2 or on admission to the unit prior to administration of the IMP. History of alcohol abuse or excessive intake of alcohol, as judged by the Investigator. Presence or history of drug abuse, as judged by the Investigator. History of, or current use of, anabolic steroids. Plasma donation within 2 weeks of screening Visit 2 or blood donation (or corresponding blood loss) during the three months prior to screening. Investigator considers the subject unlikely to comply with study procedures, restrictions and requirements. Female subjects who are pregnant or who are currently breast feeding.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Johan Nilsson, MD
Organizational Affiliation
CTC Clinical Trial Consultants AB
Official's Role
Principal Investigator
Facility Information:
Facility Name
ClinSmart Sweden AB
City
Uppsala
ZIP/Postal Code
SE-752 37
Country
Sweden

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study to Evaluate the Safety and Efficacy of 3% LTX-109 for Nasal Decolonisation of Staphylococcus

We'll reach out to this number within 24 hrs