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Impact of Rifampicin in Treatment Outcome of Cutibacterium Acnes Prosthetic Joint Infections (RIFACute)

Primary Purpose

Infections Joint Prosthetic

Status
Not yet recruiting
Phase
Phase 3
Locations
France
Study Type
Interventional
Intervention
amoxicillin or moxifloxacin
amoxicillin or moxifloxacin + rifampicin
Sponsored by
Centre Hospitalier Universitaire de Nice
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Infections Joint Prosthetic

Eligibility Criteria

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

Inclusion Criteria: Age: > or =18 years old; Monomicrobial, rifampicin susceptible Cutibacterium acnes late total knee arthroplasty (TKA) or hip arthroplasty (total, THA or hemiarthroplasty, HH) or shoulder arthroplasty (total, TSA or hemiarthroplasty, SH) infection treated surgically with single-stage or two-stage revision; Isolation of C. acnes on two distinct per-operative samples collected during the single-stage or the two-stage revision Based on the antimicrobial susceptibility test of the C. acnes and the medical history of the patient, the PJI can be treated with amoxicillin or moxifloxacin; Women considered of childbearing potential (WOCBP) requires use of a highly effective contraceptive measure as intrauterine device (IUD), intrauterine hormone-releasing system (IUS), documented bilateral tubal occlusion, documented vasectomised partner, sexual abstinence. Contraception should be maintained during treatment and until the end of relevant systemic exposure. Exclusion Criteria: Contraindication to Rifampicin (included ongoing treatment contraindicated with rifampicin) Contraindication to Amoxicillin AND moxifloxacin (included ongoing treatment contraindicated with these medicines) Empirical antibiotic treatment not administered during the 24 hours following revision surgery; Inactive empirical antibiotic treatment following surgery according to the AST of the bacteria; disease-modifying treatment incompatible with the inducer effect of rifampicin Liver cirrhosis; Pregnancy: a pregnancy blood test will be performed on all women of childbearing age. The results will be sent to the patient by the doctor of their choice; Porphyria; Renal insufficiency with GFR < 30ml/min/1.73 m2 (CKD-EPI);

Sites / Locations

  • CH Annecy Genevois
  • CHU de BORDEAUX
  • HCL
  • AP-HM
  • CHU de MONTPELLIER
  • CHU de Nantes
  • CHU de NICE
  • Dianonesses croix saint simon
  • CHU de Rennes
  • CHU Toulouse
  • Ch Tourcoing
  • CHRU Tours

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Antibiotic treatment backbone alone

Antibiotic treatment backbone + rifampicin

Arm Description

Amoxicillin or moxifloxacin to the investigator's discretion

Amoxicillin or moxifloxacin to the investigator's discretion + RIMACTAN

Outcomes

Primary Outcome Measures

Rate of C. acnes prosthetic joint infections management failure
Defined by Relapse, New infection, early failure
Rate of adverse event linked to rifampicin
adverse events will be described by frequency and grade, throughout the treatment (classified according to the CTCAE 5.0.)

Secondary Outcome Measures

Rate of C. acnes prosthetic joint infections probable failure
prosthetic joint infections probable failure suspected in case of specific clinical signs (fistula) and/or inflammatory synovial fluid without microbiological positive results and/or histopathological results after revision without microbiological positive results
Rate of C. acnes prosthetic joint infections management failure
Defined by Relapse, New infection, early failure
Rate of C. acnes prosthetic joint infections management failure
Defined by Relapse, New infection, early failure

Full Information

First Posted
June 5, 2023
Last Updated
June 5, 2023
Sponsor
Centre Hospitalier Universitaire de Nice
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1. Study Identification

Unique Protocol Identification Number
NCT05902221
Brief Title
Impact of Rifampicin in Treatment Outcome of Cutibacterium Acnes Prosthetic Joint Infections
Acronym
RIFACute
Official Title
Impact of Rifampicin in Treatment Outcome of Cutibacterium Acnes Prosthetic Joint Infections
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
July 1, 2023 (Anticipated)
Primary Completion Date
July 1, 2027 (Anticipated)
Study Completion Date
July 1, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Centre Hospitalier Universitaire de Nice

4. Oversight

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

5. Study Description

Brief Summary
Cutibacterium acnes is involved in nearly 40% of shoulder prosthetic joint infections (PJI). After shoulder prothesis, C. acnes mainly affects hip prosthesis. One recent work from the Lyon (France) bone and joint infections reference center with data focusing mainly on hip and knee PJI has reported that C. acnes is the leading cause of late-onset PJI after coagulase negative staphylococci (CNS) (late acute PJI not considered). In such late-onset device-related infection, biofilm, as produced by C. acnes during PJI represents a major hurdle on the path to patient's cure. Because biofilm-associated bacteria have a slower metabolism and a lower multiplication rate than planktonic bacteria, antibiotic susceptibility can be hampered. Rifampicin is an antibiotic with low minimal bactericidal concentration against S. aureus and CNS biofilm-associated bacteria8 which significantly influence patient's outcome during staphylococci PJI.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Infections Joint Prosthetic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Multicenter, randomized two-arm (parallel) comparative open-label cohort clinical trial.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
235 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Antibiotic treatment backbone alone
Arm Type
Active Comparator
Arm Description
Amoxicillin or moxifloxacin to the investigator's discretion
Arm Title
Antibiotic treatment backbone + rifampicin
Arm Type
Experimental
Arm Description
Amoxicillin or moxifloxacin to the investigator's discretion + RIMACTAN
Intervention Type
Drug
Intervention Name(s)
amoxicillin or moxifloxacin
Intervention Description
Antibiotic treatment back bone during 12 weeks
Intervention Type
Drug
Intervention Name(s)
amoxicillin or moxifloxacin + rifampicin
Intervention Description
Antibiotic treatment back bone during 12 weeks + rifampicin
Primary Outcome Measure Information:
Title
Rate of C. acnes prosthetic joint infections management failure
Description
Defined by Relapse, New infection, early failure
Time Frame
24 months after the end of antibiotic treatment
Title
Rate of adverse event linked to rifampicin
Description
adverse events will be described by frequency and grade, throughout the treatment (classified according to the CTCAE 5.0.)
Time Frame
during rifampicin treatment
Secondary Outcome Measure Information:
Title
Rate of C. acnes prosthetic joint infections probable failure
Description
prosthetic joint infections probable failure suspected in case of specific clinical signs (fistula) and/or inflammatory synovial fluid without microbiological positive results and/or histopathological results after revision without microbiological positive results
Time Frame
24 months after the end of antibiotic treatment
Title
Rate of C. acnes prosthetic joint infections management failure
Description
Defined by Relapse, New infection, early failure
Time Frame
24 months after the end of antibiotic treatment
Title
Rate of C. acnes prosthetic joint infections management failure
Description
Defined by Relapse, New infection, early failure
Time Frame
12 months after the end of antibiotic treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age: > or =18 years old; Monomicrobial, rifampicin susceptible Cutibacterium acnes late total knee arthroplasty (TKA) or hip arthroplasty (total, THA or hemiarthroplasty, HH) or shoulder arthroplasty (total, TSA or hemiarthroplasty, SH) infection treated surgically with single-stage or two-stage revision; Isolation of C. acnes on two distinct per-operative samples collected during the single-stage or the two-stage revision Based on the antimicrobial susceptibility test of the C. acnes and the medical history of the patient, the PJI can be treated with amoxicillin or moxifloxacin; Women considered of childbearing potential (WOCBP) requires use of a highly effective contraceptive measure as intrauterine device (IUD), intrauterine hormone-releasing system (IUS), documented bilateral tubal occlusion, documented vasectomised partner, sexual abstinence. Contraception should be maintained during treatment and until the end of relevant systemic exposure. Exclusion Criteria: Contraindication to Rifampicin (included ongoing treatment contraindicated with rifampicin) Contraindication to Amoxicillin AND moxifloxacin (included ongoing treatment contraindicated with these medicines) Empirical antibiotic treatment not administered during the 24 hours following revision surgery; Inactive empirical antibiotic treatment following surgery according to the AST of the bacteria; disease-modifying treatment incompatible with the inducer effect of rifampicin Liver cirrhosis; Pregnancy: a pregnancy blood test will be performed on all women of childbearing age. The results will be sent to the patient by the doctor of their choice; Porphyria; Renal insufficiency with GFR < 30ml/min/1.73 m2 (CKD-EPI);
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Johan COURJON, MD
Phone
+33(0)492034562
Email
courjon.j@chu-nice.fr
Facility Information:
Facility Name
CH Annecy Genevois
City
Annecy
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gabriel MACHEDA
Email
gmacheda@ch-annecygenevois.fr
Facility Name
CHU de BORDEAUX
City
Bordeaux
Country
France
Facility Name
HCL
City
Lyon
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tristan FERRY
Email
tristan.ferry@chu-lyon.fr
First Name & Middle Initial & Last Name & Degree
Florent VALOUR
Email
florent.valour@chu-lyon.fr
Facility Name
AP-HM
City
Marseille
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Carole ELDIN
Email
carole.eldin@ap-hm.fr
Facility Name
CHU de MONTPELLIER
City
Montpellier
Country
France
Facility Name
CHU de Nantes
City
Nantes
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Raphaël LECOMTE
Email
raphael.lecomte@chu-nantes.fr
Facility Name
CHU de NICE
City
Nice
ZIP/Postal Code
06200
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Johan COURJON
Phone
+33492034562
Email
courjon.j@chu-nice.fr
First Name & Middle Initial & Last Name & Degree
Irit TOUITOU
Phone
+3349203847
Email
touitou.i@chu-nice.fr
Facility Name
Dianonesses croix saint simon
City
Paris
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Valérie ZELLER
Email
vzeller@hopital-dcss.org
Facility Name
CHU de Rennes
City
Rennes
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Cédric ARVIEUX
Email
cedric.arvieux@chu-rennes.fr
Facility Name
CHU Toulouse
City
Toulouse
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Philippe DELOBEL
Email
delobel.p@chu-toulouse.fr
Facility Name
Ch Tourcoing
City
Tourcoing
Country
France
Facility Name
CHRU Tours
City
Tours
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marion LACASSE
Email
M.LACASSE@chu-tours.fr

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Not planned

Learn more about this trial

Impact of Rifampicin in Treatment Outcome of Cutibacterium Acnes Prosthetic Joint Infections

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