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Late-onset Sepsis in Term and Pre-term Neonates and Infants up to 3 Months of Age

Primary Purpose

Neonatal Sepsis

Status
Recruiting
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Ceftobiprole medocaril
Sponsored by
Basilea Pharmaceutica
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neonatal Sepsis focused on measuring Late-onset sepsis, Neonates, Infants

Eligibility Criteria

3 Days - 3 Months (Child)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria: Informed consent from parent(s) or other legally acceptable representative (LAR) to participate in the study Male or female, with a gestational age of ≥ 24 weeks and a post-natal age ranging from ≥ 3 days to ≤ 3 months Diagnosis of documented or presumed bacterial LOS requiring administration of systemic antibiotic treatment Sufficient vascular access to receive study drug and to allow blood sampling at a site separate from the study drug infusion line Key Exclusion Criteria: Refractory septic shock not responding to 60 minutes of vasopressor treatment within 48 hours before enrollment Proven ventilator-associated pneumonia Proven central nervous system infection (e.g., meningitis, brain abscess) Proven osteomyelitis, infective endocarditis, or necrotising enterocolitis Impaired renal function or known significant renal disease, as evidenced by an estimated glomerular filtration rate (using the Schwartz formula or other applicable formula) calculated to be less than 2/3 of normal for the applicable age group, OR urinary output < 0.5 mL/kg/h (measured over at least 8 hours), OR requirement for dialysis Progressively fatal underlying disease, or life expectancy < 30 days Use of systemic antibacterial therapy for longer than 48 hours within 7 days before start of study medication Participation in another clinical study with an investigational product within 30 days of enrollment in the current study

Sites / Locations

  • NorthShore University HealthSystem-Evanston HospitalRecruiting
  • West Virginia UniversityRecruiting
  • MHAT Dr. Stamen Iliev AD Montana, Neonatology DepartmentRecruiting
  • UMHAT "Sveti Georgi" EAD, Pediatric surgery ClinicRecruiting
  • "Acibadem City Clinic University Hospital Tokuda" EAD, Neonatology DepartmentRecruiting
  • Tallinn Childrens' HospitalRecruiting
  • Klinikum der Universität München, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen KinderspitalRecruiting
  • Pauls Stradins Clinical University HospitalRecruiting
  • Children Clinical University Hospital - Neonatology ClinicRecruiting
  • Lithuanian Health Science University Hospital Kauno klinikos - Neonatology ClinicRecruiting
  • Vilnius University Hospital Santaros klinikos - Neonatology CenterRecruiting
  • Ginekologiczno-Położniczy Szpital Kliniczny im. MarcinkowskiegoRecruiting
  • Szpital Uniwersytecki - Klinika NeonatologiiRecruiting
  • Univerzitna nemocnica MartinRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment Arm: Ceftobiprole

Arm Description

Ceftobiprole medocaril: 7.5 mg/kg to 15 mg/kg

Outcomes

Primary Outcome Measures

Safety and tolerability by incidence of adverse events (AEs) and serious adverse events (SAEs)
Descriptive statistics of AEs, SAEs, deaths, and discontinuations due to AEs during treatment with ceftobiprole
Number of participants with clinically relevant findings in laboratory tests
Descriptive statistics of clinical laboratory tests (including hematology, blood chemistry, urinalysis) and the change from baseline to each post-baseline visit value will also be summarized
Number of participants with clinically relevant findings in vital signs
Descriptive statistics of vital signs findings including body temperature, respiratory rate, pulse rate, and systolic and diastolic blood pressures
Number of participants with clinically relevant findings in physical examination
Descriptive statistics of physical examination findings including examination of general appearance, skin, head, neck, eyes, ears, nose, throat, cardiovascular system, thorax/lungs, abdomen, lymph nodes, extremities, and nervous system

Secondary Outcome Measures

Observed plasma concentrations of ceftobiprole, ceftobiprole medocaril, and open-ring metabolite
Descriptive analyses of these concentrations will be summarised by timepoint for term and pre-term neonates with post-natal age up to 3 months.
Clinical response
Clinical cure rate at the end of treatment (EOT) at day 7-14 and test of cure (TOC) at 7-14 days after last ceftobiprole dose visits in the Intent-to-Treat (ITT) and Clinically Evaluable (CE) populations
All-cause mortality
All-cause mortality (ITT population)
Microbiological response
Microbiological eradication or presumed eradication rate at the EOT and TOC visits (in the Microbiological Intent-to-Treat [mITT] and Microbiologically Evaluable [ME] populations)
Number of participants with improved signs and symptoms of LOS
Improved signs and symptoms of LOS (including fever, hypothermia, abnormal heart rate, signs of impaired circulation, petechial rash or sclerema neonatorum, respiratory distress, gastrointestinal distress, irritability, lethargy and/or muscular or arterial hypotonia) will be assessed at Day 3, EOT, and TOC visits (ITT and CE populations)

Full Information

First Posted
April 17, 2023
Last Updated
September 11, 2023
Sponsor
Basilea Pharmaceutica
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1. Study Identification

Unique Protocol Identification Number
NCT05856227
Brief Title
Late-onset Sepsis in Term and Pre-term Neonates and Infants up to 3 Months of Age
Official Title
A Multicenter, Open-label, Single-arm, Multiple-dose Study to Evaluate the Safety, Pharmacokinetics, and Efficacy of Ceftobiprole Medocaril in Term and Pre-term Neonates and Infants up to 3 Months of Age With Late-onset Sepsis
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 6, 2023 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Basilea Pharmaceutica

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 study will evaluate the safety, pharmacokinetics and efficacy of ceftobiprole in term and pre-term newborn babies and infants up to 3 months of age with late-onset sepsis (LOS). Ceftobiprole is an antibiotic which belongs to a group of medicines called 'cephalosporin antibiotics'. It is approved for its use to treat adults and children with pneumonia in many European and non-European countries.
Detailed Description
This is a multicenter, open-label, single-arm, multiple-dose study of intravenous (IV) ceftobiprole medocaril (prodrug of the active moiety ceftobiprole). It may be combined with ampicillin and/or an aminoglycoside based on the Investigator's judgement according to manufacturer's instructions and/or local standard of care. Following screening, ceftobiprole will be administered as a 2-hour infusion at a dose of 7.5 mg/kg every 12 hours to 15 mg/kg every 8 hours, depending on age and weight. The target treatment duration is 7-10 days, which may be either extended to 14 days if considered clinically necessary by the Investigator or may be may be stopped after 5 days at the discretion of the Investigator based on resolution of signs and symptoms of sepsis and blood inflammation markers, in accordance with local standard of care.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neonatal Sepsis
Keywords
Late-onset sepsis, Neonates, Infants

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
15 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment Arm: Ceftobiprole
Arm Type
Experimental
Arm Description
Ceftobiprole medocaril: 7.5 mg/kg to 15 mg/kg
Intervention Type
Drug
Intervention Name(s)
Ceftobiprole medocaril
Intervention Description
Ceftobiprole medocaril: 7.5 mg/kg every 12 hours to 15 mg/kg every 8 hours, administered IV as a 2-hour infusion.
Primary Outcome Measure Information:
Title
Safety and tolerability by incidence of adverse events (AEs) and serious adverse events (SAEs)
Description
Descriptive statistics of AEs, SAEs, deaths, and discontinuations due to AEs during treatment with ceftobiprole
Time Frame
Up to 5-7 weeks
Title
Number of participants with clinically relevant findings in laboratory tests
Description
Descriptive statistics of clinical laboratory tests (including hematology, blood chemistry, urinalysis) and the change from baseline to each post-baseline visit value will also be summarized
Time Frame
Up to 5-7 weeks
Title
Number of participants with clinically relevant findings in vital signs
Description
Descriptive statistics of vital signs findings including body temperature, respiratory rate, pulse rate, and systolic and diastolic blood pressures
Time Frame
Up to 5-7 weeks
Title
Number of participants with clinically relevant findings in physical examination
Description
Descriptive statistics of physical examination findings including examination of general appearance, skin, head, neck, eyes, ears, nose, throat, cardiovascular system, thorax/lungs, abdomen, lymph nodes, extremities, and nervous system
Time Frame
Up to 5-7 weeks
Secondary Outcome Measure Information:
Title
Observed plasma concentrations of ceftobiprole, ceftobiprole medocaril, and open-ring metabolite
Description
Descriptive analyses of these concentrations will be summarised by timepoint for term and pre-term neonates with post-natal age up to 3 months.
Time Frame
At day 3
Title
Clinical response
Description
Clinical cure rate at the end of treatment (EOT) at day 7-14 and test of cure (TOC) at 7-14 days after last ceftobiprole dose visits in the Intent-to-Treat (ITT) and Clinically Evaluable (CE) populations
Time Frame
5-7 weeks
Title
All-cause mortality
Description
All-cause mortality (ITT population)
Time Frame
through Day 28
Title
Microbiological response
Description
Microbiological eradication or presumed eradication rate at the EOT and TOC visits (in the Microbiological Intent-to-Treat [mITT] and Microbiologically Evaluable [ME] populations)
Time Frame
5-7 weeks
Title
Number of participants with improved signs and symptoms of LOS
Description
Improved signs and symptoms of LOS (including fever, hypothermia, abnormal heart rate, signs of impaired circulation, petechial rash or sclerema neonatorum, respiratory distress, gastrointestinal distress, irritability, lethargy and/or muscular or arterial hypotonia) will be assessed at Day 3, EOT, and TOC visits (ITT and CE populations)
Time Frame
At the Day 3 and up to 5-7 weeks

10. Eligibility

Sex
All
Gender Based
Yes
Gender Eligibility Description
Male or female
Minimum Age & Unit of Time
3 Days
Maximum Age & Unit of Time
3 Months
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Informed consent from parent(s) or other legally acceptable representative (LAR) to participate in the study Male or female, with a gestational age of ≥ 24 weeks and a post-natal age ranging from ≥ 3 days to ≤ 3 months Diagnosis of documented or presumed bacterial LOS requiring administration of systemic antibiotic treatment Sufficient vascular access to receive study drug and to allow blood sampling at a site separate from the study drug infusion line Key Exclusion Criteria: Refractory septic shock not responding to 60 minutes of vasopressor treatment within 48 hours before enrollment Proven ventilator-associated pneumonia Proven central nervous system infection (e.g., meningitis, brain abscess) Proven osteomyelitis, infective endocarditis, or necrotising enterocolitis Impaired renal function or known significant renal disease, as evidenced by an estimated glomerular filtration rate (using the Schwartz formula or other applicable formula) calculated to be less than 2/3 of normal for the applicable age group, OR urinary output < 0.5 mL/kg/h (measured over at least 8 hours), OR requirement for dialysis Progressively fatal underlying disease, or life expectancy < 30 days Use of systemic antibacterial therapy for longer than 48 hours within 7 days before start of study medication Participation in another clinical study with an investigational product within 30 days of enrollment in the current study
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Marc Engelhardt, MD
Phone
+41 79 701 0551
Email
marc.engelhardt@basilea.com
First Name & Middle Initial & Last Name or Official Title & Degree
Manuel Häckl, MD
Phone
+41 615671533
Email
manuel.haeckl@basilea.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marc Engelhardt, MD
Organizational Affiliation
Basilea Pharmaceutica International Ltd, Allschwil
Official's Role
Study Director
Facility Information:
Facility Name
NorthShore University HealthSystem-Evanston Hospital
City
Evanston
State/Province
Illinois
ZIP/Postal Code
60201
Country
United States
Individual Site Status
Recruiting
Facility Name
West Virginia University
City
Morgantown
State/Province
West Virginia
ZIP/Postal Code
26506
Country
United States
Individual Site Status
Recruiting
Facility Name
MHAT Dr. Stamen Iliev AD Montana, Neonatology Department
City
Montana
ZIP/Postal Code
3400
Country
Bulgaria
Individual Site Status
Recruiting
Facility Name
UMHAT "Sveti Georgi" EAD, Pediatric surgery Clinic
City
Plovdiv
ZIP/Postal Code
4000
Country
Bulgaria
Individual Site Status
Recruiting
Facility Name
"Acibadem City Clinic University Hospital Tokuda" EAD, Neonatology Department
City
Sofia
ZIP/Postal Code
1407
Country
Bulgaria
Individual Site Status
Recruiting
Facility Name
Tallinn Childrens' Hospital
City
Tallinn
ZIP/Postal Code
13419
Country
Estonia
Individual Site Status
Recruiting
Facility Name
Klinikum der Universität München, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital
City
Munich
State/Province
Bavaria
ZIP/Postal Code
80337
Country
Germany
Individual Site Status
Recruiting
Facility Name
Pauls Stradins Clinical University Hospital
City
Riga
ZIP/Postal Code
1002
Country
Latvia
Individual Site Status
Recruiting
Facility Name
Children Clinical University Hospital - Neonatology Clinic
City
Riga
ZIP/Postal Code
1004
Country
Latvia
Individual Site Status
Recruiting
Facility Name
Lithuanian Health Science University Hospital Kauno klinikos - Neonatology Clinic
City
Kaunas
ZIP/Postal Code
50161
Country
Lithuania
Individual Site Status
Recruiting
Facility Name
Vilnius University Hospital Santaros klinikos - Neonatology Center
City
Vilnius
ZIP/Postal Code
08410
Country
Lithuania
Individual Site Status
Recruiting
Facility Name
Ginekologiczno-Położniczy Szpital Kliniczny im. Marcinkowskiego
City
Poznan
ZIP/Postal Code
60-535
Country
Poland
Individual Site Status
Recruiting
Facility Name
Szpital Uniwersytecki - Klinika Neonatologii
City
Wroclaw
ZIP/Postal Code
50-556
Country
Poland
Individual Site Status
Recruiting
Facility Name
Univerzitna nemocnica Martin
City
Martin
ZIP/Postal Code
03659
Country
Slovakia
Individual Site Status
Recruiting

12. IPD Sharing Statement

Learn more about this trial

Late-onset Sepsis in Term and Pre-term Neonates and Infants up to 3 Months of Age

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