search
Back to results

A Study of LBP-EC01 in the Treatment of Acute Uncomplicated UTI Caused by Multi-drug Resistant E. Coli (ELIMINATE Trial) (ELIMINATE)

Primary Purpose

Urinary Tract Infections

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
LBP-EC01 0.1 x IV dose
LBP-EC01 0.01x IV Dose
LBP-EC01 IV Infusion Dose
Placebo
LBP-EC01
TMP/SMX
Sponsored by
Locus Biosciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Urinary Tract Infections focused on measuring LBP-EC01, Urinary tract infection, E. coli, Bacteriophage, Phage, crPhage, Recombinant bacteriophage

Eligibility Criteria

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

Inclusion Criteria:

  • History of recurrent UTI defined as ≥2 UTIs in the past 6 months or ≥ 3 UTIs in the past 12 months prior to Screening (Day 1/Visit 1) with at least one of these caused by E. coli (as single pathogen or part of polymicrobial infection where E. coli was the predominant pathogen at quantitation ≥ 1.0 × 10^5 colony forming units [CFU]/mL) based on culture results/documentation.
  • History of positive urine culture with presence of MDR OR extended spectrum beta-lactamases (ESBL) E. coli within the last 12 months.
  • Able to supply a mid-stream, clean catch urine sample for microbiological analysis.
  • Active acute uUTI infection defined by:

    a. Evidence of pyuria: i. >10 white blood cell (WBC)/mL3 on microscopic evaluation of spun, clean, mid-stream urine specimen or >3 WBC/high power field on unspun clean, mid-stream urine specimen, AND/OR ii. Dipstick analysis of a clean, mid-stream urine specimen positive for leukocytes, AND/OR iii. Positive catalase test of a clean, mid-stream urine specimen. AND b. At least 2 of the following signs or symptoms of UTI: dysuria, urinary frequency, urinary urgency, or suprapubic pain"

  • Willing to comply with all aspects of study design including study restrictions, blood, urine, and stool sampling, and scheduled study visits.
  • All sexually active female patients of childbearing potential must use highly effective contraception during the study and until 2 weeks after the last dose of study drug treatment.
  • Agrees to STOP the use of cranberry products, probiotics (Lactobacillus spp), D-mannose, OM-89 (various strains of E. coli), continuous low dose antimicrobial prophylaxis and/or post-coital antimicrobial prophylaxis to prevent UTI for the entire study duration (throughout the 6-month follow-up period or study discharge).
  • Agrees to not use any prescription or non-prescription medication for the microbiological or symptomatic treatment of the presenting acute uUTI for the first 10 days of the study.
  • Capable of providing their own signed informed consent form (ICF) prior to any study-related procedures being performed.
  • If participating in Part 1 of the study, agrees to fast for ≥2 h prior to first dose of study drug on Day 1/Visit 1 except for drinking 240 mL of water with study drug administration.

Exclusion Criteria:

  • Pregnant or nursing women.
  • Allergies to excipients of the study drug or antibiotics.
  • History of autonomic dysreflexia.
  • History of intravenous (IV) drug abuse or is currently using or has positive results for drugs of abuse at screening.
  • Signs or symptoms of systemic illness such as fever greater than 38° Centigrade/Celsius, shaking chills, or other clinical manifestations suggestive of complicated UTI.
  • Treatment with other antibacterial drugs including those that are effective for treatment of the acute uUTI or prevention of recurrent UTI in the 3 days prior to Screening unless the recovered pathogen demonstrates resistance to the initial antibiotic and clinical symptoms persist.
  • Clinical symptoms for more than 7 days before Screening.
  • Presence of indwelling urinary bladder catheters, urinary tract anatomical abnormalities, poorly-controlled diabetes mellitus, immunocompromising condition and/or treatment, or advanced renal disfunction.
  • Clinically significant serious unstable physical illness that in the investigator's opinion prevents patient from completing the study or prevents interpretation or resolution of clinical symptoms.
  • Exposure to any investigational drugs or other phage therapy 30 days prior to Screening (D1/V1) or prior to participation in this study. Patients who participate in Part 1 are not eligible for participation in Part 2.
  • Patients who reside in a long-term care facility.
  • Suspected or confirmed acute coronavirus disease 2019 (COVID-19) or recent COVID-19 infection with ongoing symptoms.

Sites / Locations

  • Research Site 112
  • Research Site 102Recruiting
  • Research Site 107
  • Research Site 106
  • Research Site 103Recruiting
  • Research Site 100
  • Research Site 111
  • Research Site 113
  • Research Site 109
  • Research Site 110
  • Research Site 108

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

Part 1- Arm 4 (previously 1)

Part 1- Arm 5 (previously 2)

Part 1- Arm 6 (previously 3)

Part 2: LBP-EC01

Part 2: Placebo

Arm Description

Intraurethral (IU) LBP-EC01 on D1 and D2 with intravenous (IV) LBP-EC01 (1x10^11 PFU) and oral TMP/SMX on D1 through D3.

Intraurethral (IU) LBP-EC01 on D1 and D2 with intravenous (IV) LBP-EC01 (1x10^10 PFU) and oral TMP/SMX on D1 through D3.

Intraurethral (IU) LBP-EC01 on D1 and D2 with intravenous (IV) LBP-EC01 infusion (1x10^12 PFU) and oral TMP/SMX on D1 through D3.

LBP-EC01 given by dose regimen selected from Part 1 and oral TMP/SMX.

Placebo given by dose regimen selected from Part 1 and oral TMP/SMX.

Outcomes

Primary Outcome Measures

Part 1: Levels of LBP-EC01 in urine and blood measured by quantitative plaquing assay across the treatment period and over 48 h after the last dose
The regimen for LBP-EC01 when used concomitantly with TMP/SMX which optimizes pharmacokinetics (PK) for LBP-EC01 will be selected.
Part 2: Proportion of patients with resolution of clinical symptoms of a uncomplicated urinary tract infection (uUTI) and microbiologic response of uUTI caused by multidrug resistant or multidrug resistance (MDR) E. coli as defined at Day 10
The efficacy of LBP-EC01 when used concomitantly with TMP/SMX compared to placebo when used concomitantly with TMP/SMX on resolution of acute uUTI symptoms and demonstration of microbiologic response of acute uUTI caused by MDR E. coli will be assessed.

Secondary Outcome Measures

Part 1: Number of patients with Adverse Events (AEs) and Serious Adverse Events (SAEs)
The safety and tolerability of LBP-EC01 when given with TMP/SMX will be assessed.
Part 1: Number of patients with immunogenicity
The immunogenicity of LBP-EC01 by measuring neutralizing antibody (NAb) levels will be assessed.
Part 2: Proportion of patients with MDR E. coli achieving maintenance of clinical and microbiologic response at Day 21
The impact of LBP-EC01 when used concomitantly with TMP/SMX compared to placebo when used concomitantly with TMP/SMX on maintenance of clinical (symptom resolution) and microbiologic success in those randomized patients with MDR E. coli uUTI demonstrating an initial response will be assessed.
Part 2: Proportion of patients with resolution of clinical symptoms of an uncomplicated (uUTI) and microbiologic response of uUTI caused by E. coli at Day 10
The efficacy of LBP-EC01 when used concomitantly with TMP/SMX compared to placebo when used concomitantly with TMP/SMX, on resolution of uUTI symptoms and demonstration of microbiologic response of uUTIs caused by E. coli will be assessed.
Part 2: Proportion of patients with E. coli achieving maintenance of clinical and microbiologic response at Day 21
The impact of LBP-EC01 when used concomitantly with TMP/SMX compared to placebo when used concomitantly with TMP/SMX on maintenance of clinical (symptom resolution) and microbiologic success in those randomized patients with E. coli uUTI demonstrating an initial response will be assessed.
Part 2: Proportion of patients with recurrence of uUTI episodes caused by E. coli within a 6-month follow-up period
Patients will be monitored for 6 months for recurrence of uUTI in those with a documented history of prior E. coli infections of the urinary tract.

Full Information

First Posted
August 2, 2022
Last Updated
September 25, 2023
Sponsor
Locus Biosciences
Collaborators
Parexel
search

1. Study Identification

Unique Protocol Identification Number
NCT05488340
Brief Title
A Study of LBP-EC01 in the Treatment of Acute Uncomplicated UTI Caused by Multi-drug Resistant E. Coli (ELIMINATE Trial)
Acronym
ELIMINATE
Official Title
A Phase 2/3, Double-blind, Randomized, Active-controlled Evaluation of the Safety, Tolerability, Pharmacokinetics and Efficacy of LBP-EC01 in the Treatment of Acute Uncomplicated Urinary Tract Infection Caused by Multidrug Resistant E. Coli
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 13, 2022 (Actual)
Primary Completion Date
June 2025 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Locus Biosciences
Collaborators
Parexel

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
This is a Phase 2/3 superiority study of LBP-EC01, a recombinant bacteriophage cocktail, with an initial 3-arm pharmacokinetic (PK) lead-in portion of 30 patients to evaluate the optimal dosing regimen to be used in the subsequent 550 patient portion of the study which will be randomized 1:1 comparing LBP-EC01 + antibiotic versus placebo + antibiotic in patients with a history of prior urinary tract infection (UTI) cased by E. coli. All patients will be required to have an active acute uncomplicated UTI at baseline.
Detailed Description
This study will consist of two parts. Part 1 - Dose regimen selection: An open-label, 30 patient, 3-arm PK assessment of: Arm 4 (previously 1): LBP-EC01 (approximately 2×10^12 PFU) given by IU administration on D1 and D2 and LBP-EC01 (approximately 1×10^11 PFU) IV given as a 1 milliliter (mL) bolus QD from D1 through D3 concomitantly with oral trimethoprim/sulfamethoxazole (TMP 160mg/SMX 800mg) BID from D1 through D3 (6 doses); Arm 5 (previously 2): LBP-EC01 (approximately 2×10^12 PFU) given by IU administration on D1 and D2 and LBP-EC01 (approximately 1×10^10 PFU) IV given as a 1 mL bolus QD from D1 through D3 concomitantly with oral TMP/SMX BID from D1 through D3 (6 doses); Arm 6 (previously 3): LBP-EC01 (2×10^12 PFU) given by IU administration on D1 and D2 and LBP-EC01 (approximately 1×10^12 PFU) IV given as a 100 mL IV infusion over 2 h on D1 through D3 concomitantly with oral TMP/SMX BID from D1 through D3 (6 doses). Part 2 - Efficacy, Safety, Tolerability and Pharmacokinetics: A blinded, 550 patient, 1:1 randomized evaluation of the dose regimen selected from Part 1 versus placebo + antibiotic (TMP/SMX -160 mg TMP and 800 mg SMX) given orally BID on Days 1 through 3.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Urinary Tract Infections
Keywords
LBP-EC01, Urinary tract infection, E. coli, Bacteriophage, Phage, crPhage, Recombinant bacteriophage

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Part 1 - open label, Part 2 - blinded.
Allocation
Randomized
Enrollment
580 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Part 1- Arm 4 (previously 1)
Arm Type
Experimental
Arm Description
Intraurethral (IU) LBP-EC01 on D1 and D2 with intravenous (IV) LBP-EC01 (1x10^11 PFU) and oral TMP/SMX on D1 through D3.
Arm Title
Part 1- Arm 5 (previously 2)
Arm Type
Experimental
Arm Description
Intraurethral (IU) LBP-EC01 on D1 and D2 with intravenous (IV) LBP-EC01 (1x10^10 PFU) and oral TMP/SMX on D1 through D3.
Arm Title
Part 1- Arm 6 (previously 3)
Arm Type
Experimental
Arm Description
Intraurethral (IU) LBP-EC01 on D1 and D2 with intravenous (IV) LBP-EC01 infusion (1x10^12 PFU) and oral TMP/SMX on D1 through D3.
Arm Title
Part 2: LBP-EC01
Arm Type
Experimental
Arm Description
LBP-EC01 given by dose regimen selected from Part 1 and oral TMP/SMX.
Arm Title
Part 2: Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo given by dose regimen selected from Part 1 and oral TMP/SMX.
Intervention Type
Drug
Intervention Name(s)
LBP-EC01 0.1 x IV dose
Other Intervention Name(s)
1x10^11 PFU IV dose
Intervention Description
Intraurethral (IU) dose of two (2) x 6mL vials of LBP-EC01 (approximately 2x10^12 PFU) diluted in 188 mL of Lactated Ringer's solution on Day 1 and Day 2. Intravenous (IV) dose of 0.6mL of LBP-EC01 (approximately 1x10^11 PFU) diluted in 0.4mL of Lactated Ringer's solution given on Days 1 through Day 3.
Intervention Type
Drug
Intervention Name(s)
LBP-EC01 0.01x IV Dose
Other Intervention Name(s)
1x10^10 PFU IV Dose
Intervention Description
Intraurethral (IU) dose of two (2) x 6mL vials of LBP-EC01 (approximately 2x10^12 PFU) diluted in 188 mL of Lactated Ringer's solution on Day 1 and Day 2. Intravenous (IV) dose of 0.06 mL of LBP-EC01 (approximately 1x10^10 PFU) diluted in 0.94 mL of Lactated Ringer's solution given on Days 1 through Day 3.
Intervention Type
Drug
Intervention Name(s)
LBP-EC01 IV Infusion Dose
Other Intervention Name(s)
1x10^12 PFU IV Infusion Dose
Intervention Description
Intraurethral (IU) dose of two (2) x 6mL vials of LBP-EC01 (approximately 2x10^12 PFU) diluted in 188 mL of Lactated Ringer's solution on Day 1 and Day 2. Intravenous infusion dose of 6mL of LBP-EC01 (approximately 1x10^12 PFU) diluted in 94 mL of Lactated Ringer's solution given over 2 hours on Days 1 through Day 3.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Dose regimen selected from Part 1 of placebo (Tris buffer).
Intervention Type
Drug
Intervention Name(s)
LBP-EC01
Intervention Description
Dose regimen selected from Part 1 of LBP-EC01 (1x10^10 - 1x10^13 PFU) per dose.
Intervention Type
Drug
Intervention Name(s)
TMP/SMX
Intervention Description
TMP/SMX (160 mg trimethoprim and 800 mg sulfamethoxazole) given orally BID on Days 1 through 3.
Primary Outcome Measure Information:
Title
Part 1: Levels of LBP-EC01 in urine and blood measured by quantitative plaquing assay across the treatment period and over 48 h after the last dose
Description
The regimen for LBP-EC01 when used concomitantly with TMP/SMX which optimizes pharmacokinetics (PK) for LBP-EC01 will be selected.
Time Frame
Day 1 to Day 5
Title
Part 2: Proportion of patients with resolution of clinical symptoms of a uncomplicated urinary tract infection (uUTI) and microbiologic response of uUTI caused by multidrug resistant or multidrug resistance (MDR) E. coli as defined at Day 10
Description
The efficacy of LBP-EC01 when used concomitantly with TMP/SMX compared to placebo when used concomitantly with TMP/SMX on resolution of acute uUTI symptoms and demonstration of microbiologic response of acute uUTI caused by MDR E. coli will be assessed.
Time Frame
Day 10
Secondary Outcome Measure Information:
Title
Part 1: Number of patients with Adverse Events (AEs) and Serious Adverse Events (SAEs)
Description
The safety and tolerability of LBP-EC01 when given with TMP/SMX will be assessed.
Time Frame
Day 1 to Day 34
Title
Part 1: Number of patients with immunogenicity
Description
The immunogenicity of LBP-EC01 by measuring neutralizing antibody (NAb) levels will be assessed.
Time Frame
Baseline Day 1 to Day 2, Day 5, Day 10, Day 34/Early Termination [ET]) post-hoc
Title
Part 2: Proportion of patients with MDR E. coli achieving maintenance of clinical and microbiologic response at Day 21
Description
The impact of LBP-EC01 when used concomitantly with TMP/SMX compared to placebo when used concomitantly with TMP/SMX on maintenance of clinical (symptom resolution) and microbiologic success in those randomized patients with MDR E. coli uUTI demonstrating an initial response will be assessed.
Time Frame
Day 21
Title
Part 2: Proportion of patients with resolution of clinical symptoms of an uncomplicated (uUTI) and microbiologic response of uUTI caused by E. coli at Day 10
Description
The efficacy of LBP-EC01 when used concomitantly with TMP/SMX compared to placebo when used concomitantly with TMP/SMX, on resolution of uUTI symptoms and demonstration of microbiologic response of uUTIs caused by E. coli will be assessed.
Time Frame
Day 10
Title
Part 2: Proportion of patients with E. coli achieving maintenance of clinical and microbiologic response at Day 21
Description
The impact of LBP-EC01 when used concomitantly with TMP/SMX compared to placebo when used concomitantly with TMP/SMX on maintenance of clinical (symptom resolution) and microbiologic success in those randomized patients with E. coli uUTI demonstrating an initial response will be assessed.
Time Frame
Day 21
Title
Part 2: Proportion of patients with recurrence of uUTI episodes caused by E. coli within a 6-month follow-up period
Description
Patients will be monitored for 6 months for recurrence of uUTI in those with a documented history of prior E. coli infections of the urinary tract.
Time Frame
Within the 6-month follow-up period

10. Eligibility

Sex
Female
Gender Based
Yes
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: History of recurrent UTI defined as ≥2 UTIs in the past 6 months or ≥ 3 UTIs in the past 12 months prior to Screening (Day 1/Visit 1) with at least one of these caused by E. coli (as single pathogen or part of polymicrobial infection where E. coli was the predominant pathogen at quantitation ≥ 1.0 × 10^5 colony forming units [CFU]/mL) based on culture results/documentation. History of positive urine culture with presence of AMR E. coli within the last 12 months. Able to supply a mid-stream, clean catch urine sample for microbiological analysis. Active acute uUTI infection defined by: a. Evidence of pyuria: i. >10 white blood cell (WBC)/mL3 on microscopic evaluation of spun, clean, mid-stream urine specimen or >3 WBC/high power field on unspun clean, mid-stream urine specimen, AND/OR ii. Dipstick analysis of a clean, mid-stream urine specimen positive for leukocytes, AND/OR iii. Positive catalase test of a clean, mid-stream urine specimen. AND b. At least 2 of the following signs or symptoms of UTI: dysuria, urinary frequency, urinary urgency, or suprapubic pain" Willing to comply with all aspects of study design including study restrictions, blood, urine, and stool sampling, and scheduled study visits. All sexually active female patients of childbearing potential must use highly effective contraception during the study and until 2 weeks after the last dose of study drug treatment. Agrees to STOP the use of cranberry products, probiotics (Lactobacillus spp), D-mannose, OM-89 (various strains of E. coli), continuous low dose antimicrobial prophylaxis and/or post-coital antimicrobial prophylaxis to prevent UTI for the entire study duration (throughout the 6-month follow-up period or study discharge). Agrees to not use any prescription or non-prescription medication for the microbiological or symptomatic treatment of the presenting acute uUTI for the first 10 days of the study. Capable of providing their own signed informed consent form (ICF) prior to any study-related procedures being performed. If participating in Part 1 of the study, agrees to fast for ≥2 h prior to first dose of study drug on Day 1/Visit 1 except for drinking 240 mL of water with study drug administration. Exclusion Criteria: Pregnant or nursing women. Allergies to excipients of the study drug or antibiotics. History of autonomic dysreflexia. History of intravenous (IV) drug abuse or is currently using or has positive results for drugs of abuse at screening. Signs or symptoms of systemic illness such as fever greater than 38° Centigrade/Celsius, shaking chills, or other clinical manifestations suggestive of complicated UTI. Treatment with other antibacterial drugs including those that are effective for treatment of the acute uUTI or prevention of recurrent UTI in the 3 days prior to Screening unless the recovered pathogen demonstrates resistance to the initial antibiotic and clinical symptoms persist. Clinical symptoms for more than 7 days before Screening. Presence of indwelling urinary bladder catheters, urinary tract anatomical abnormalities, poorly-controlled diabetes mellitus, immunocompromising condition and/or treatment, or advanced renal disfunction. Clinically significant serious unstable physical illness that in the investigator's opinion prevents patient from completing the study or prevents interpretation or resolution of clinical symptoms. Exposure to any investigational drugs or other phage therapy 30 days prior to Screening (D1/V1) or prior to participation in this study. Patients who participate in Part 1 are not eligible for participation in Part 2. Patients who reside in a long-term care facility. Suspected or confirmed acute coronavirus disease 2019 (COVID-19) or recent COVID-19 infection with ongoing symptoms.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Locus Clinical Operations
Phone
(919) 495-4510
Email
clinicaloperations@locus-bio.com
First Name & Middle Initial & Last Name or Official Title & Degree
Paul Kim
Phone
(919) 495-4510
Email
Paul.kim@locus-bio.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul Kim
Organizational Affiliation
Locus Biosciences
Official's Role
Study Director
Facility Information:
Facility Name
Research Site 112
City
Tempe
State/Province
Arizona
ZIP/Postal Code
85282
Country
United States
Individual Site Status
Withdrawn
Facility Name
Research Site 102
City
Doral
State/Province
Florida
ZIP/Postal Code
33166
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
B. Penafiel
Facility Name
Research Site 107
City
Miami
State/Province
Florida
ZIP/Postal Code
33165
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Research Site 106
City
Miami
State/Province
Florida
ZIP/Postal Code
33173
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Research Site 103
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Y. Rodriguez
Facility Name
Research Site 100
City
Palmetto Bay
State/Province
Florida
ZIP/Postal Code
33157
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Research Site 111
City
Sandy Springs
State/Province
Georgia
ZIP/Postal Code
30328
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Research Site 113
City
Canton
State/Province
Michigan
ZIP/Postal Code
48188
Country
United States
Individual Site Status
Withdrawn
Facility Name
Research Site 109
City
Fayetteville
State/Province
North Carolina
ZIP/Postal Code
28303
Country
United States
Individual Site Status
Withdrawn
Facility Name
Research Site 110
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27612
Country
United States
Individual Site Status
Withdrawn
Facility Name
Research Site 108
City
Forney
State/Province
Texas
ZIP/Postal Code
75126
Country
United States
Individual Site Status
Active, not recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of LBP-EC01 in the Treatment of Acute Uncomplicated UTI Caused by Multi-drug Resistant E. Coli (ELIMINATE Trial)

We'll reach out to this number within 24 hrs