A Study to Evaluate the Efficacy and Safety of Sitafloxacin in Adult Subjects With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Primary Purpose
COPD Exacerbation Acute
Status
Recruiting
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
Sitafloxacin
Moxifloxacin Hydrochloride
Sponsored by
About this trial
This is an interventional treatment trial for COPD Exacerbation Acute focused on measuring Chronic obstructive pulmonary disease, Exacerbation, Sitafloxacin
Eligibility Criteria
Inclusion Criteria:
- Age β₯ 40;
- History of moderate to very severe COPD with a post-bronchodilator Forced Expiratory Volume in One Second/Forced Vital Capacity (FEV1/FVC) < 70% and a post-bronchodilator Forced Expiratory Volume in One Second (FEV1) < 80% of predicted normal value within one year prior to enrollment;
- History of one or more acute exacerbations within one year prior to enrollment;
- At least 6 weeks of stable disease prior to enrollment;
- The acute exacerbation is classified as Anthonisen I (with 3 main symptoms of worsening dyspnea, increased sputum volume and sputum purulence) or II (with sputum purulence and another main symptom);
- Participants can be treated on an outpatient basis after clinical assessment.
Exclusion Criteria:
- Anthonisen III acute exacerbation (Have two major symptoms of worsening dyspnea and increased sputum volume or one of the two major symptoms)
- Hospitalization or intensive care unit (ICU) treatment is required
- Sputum culture within the previous year indicated the presence of pathogenic microorganisms resistant to quinolones
- Quinolone allergy
- History of QTc prolongation, or need for medications to treat QTc prolongation (e.g., Class Ia or Class III antiarrhythmics);
- Definite pulmonary disease other than COPD (asthma, bronchiectasis, active pulmonary tuberculosis, pulmonary embolism, pulmonary fibrosis, lung cancer)
- History of severe cardiovascular disease (e.g., congestive heart failure, clinically significant coronary heart disease, stroke, myocardial infarction and/or stroke within 6 months, clinically significant arrhythmia, previous history of aortic aneurysm or aortic dissection, positive family history, or risk factors (e.g., Marfan syndrome), poorly controlled hypertension (systolic blood pressure > 160 mmHg or diastolic blood pressure > 100 mmHg on 2 or more consecutive measurements)
- Severe systemic diseases, such as severe dizziness, headache and other nervous system diseases
- Malignant tumor
- Concomitant or history of tendon disease or myasthenia gravis or Parkinson's disease
- Abnormal liver function, aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) level > 3 times the upper limit of normal, and/or total bilirubin level >2 times the upper limit of normal
- With moderate or severe decline of renal function, endogenous creatinine clearance rate (Ccr) < 50ml/min
- History of seizure, or psychiatric condition that could affect compliance with the protocol, or risk for suicide, or history of alcohol or illicit drug abuse
- Immunocompromised participants using glucocorticoids (total dose equivalent to prednisone 20 mg daily for more than 2 weeks) or immunosuppressive agents or HIV infected participants
- Gastrointestinal disorders that may affect drug absorption (e.g., active Crohn's disease, active ulcerative colitis)
- Pregnant or lactating women or women of childbearing potential who are planning to become pregnant
- Participation in other clinical trials within 3 months prior to screening
- Used antibiotics (including systemic and inhalation) 30 days before enrollment
- Serum potassium < 3.5mmol/L at screening, or repeated hypokalemia that was difficult to correct in the past
- Other reasons that the investigator considered inappropriate to participate in the study.
Sites / Locations
- The Third Xiangya Hospital of Central South UniversityRecruiting
- West China Hospital Sichuan UniversityRecruiting
- The First Affiliated Hospital of Dalian Medical UniversityRecruiting
- Nanfang Hospital Southern Medical UniversityRecruiting
- Qilu Hospital of Shandong UniversityRecruiting
- Peking University Shougang HospitalRecruiting
- Huadong Hospital Affiliated To Fudan UniversityRecruiting
- Shenzhen People's HospitalRecruiting
- Tianjin Medical University General HospitalRecruiting
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyRecruiting
- The Affiliated Hospital of Xuzhou Medical UniversityRecruiting
- Affiliated Hospital of Guangdong Medical UniversityRecruiting
- Henan Provincial People's HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Sitafloxacin
Moxifloxacin
Arm Description
Adult participants who will be randomized to receive 100 mg sitafloxacin (2 tablets) orally once a day.
Adult participants who will be randomized to receive 400 mg moxifloxacin (1 tablet) orally every 24 hours.
Outcomes
Primary Outcome Measures
Number of Participants Achieving Clinical Efficacy in Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Clinical efficacy is divided into clinical cure and clinical ineffective. Clinical cure is defined as the three main symptoms of AECOPD (worsening dyspnea, increased sputum volume and sputum purulence) that disappear or return to the baseline level of stable phase at the end of treatment/discontinuation and no additional systemic antibacterial therapy is required for the target indication.
Clinical ineffective is defined as the three main symptoms of AECOPD (worsening dyspnea, increased sputum volume and sputum purulence) that persist or incompletely disappear (do not return to the baseline level of stable phase).
Secondary Outcome Measures
Number of Participants Achieving Clinical Efficacy in Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Clinical efficacy is divided into clinical cure and clinical ineffective. Clinical cure is defined as the three main symptoms of AECOPD (worsening dyspnea, increased sputum volume and sputum purulence) that disappear or return to the baseline level of stable phase at the end of treatment/discontinuation and no additional systemic antibacterial therapy is required for the target indication.
Clinical ineffective is defined as the three main symptoms of AECOPD (worsening dyspnea, increased sputum volume and sputum purulence) that persist or incompletely disappear (do not return to the baseline level of stable phase).
Number of Participants Achieving Microbiological Efficacy in Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Microbiological efficacy is determined by bacterial clearance:
Clearance is defined as specimens from the original infection site after treatment do not culture pathogenic bacteria from the original infection.
Number of Days With Symptom Relief in Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
The number of days with symptom relief of the three main symptoms of AECOPD (worsening dyspnea, increased sputum volume and sputum purulence) will be assessed.
Change from Baseline in Each Chronic Obstructive Pulmonary Disease Symptom Score in Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease symptom scores include dyspnea (ranging from 0 [Dyspnea only with strenuous activity] to 4 [Unable to leave home due to severe respiratory distress, or dyspnea when wearing and undressing]), sputum volume (ranging from 0 [no sputum] to 3 [severe]), sputum purulence (ranging from 0 [myxoid sample] to 3 [severe purulent]), cough score (ranging from 0 [no cough] to 3 [severe cough]), fever (ranging from 0 [β€37.0Β°C] to 3 [>38.0Β°C], and COPD Assessment Test (CAT) (where questions 1-8, range from a score of 0 [no impact] to 5 [severely impacted]. For all assessments, higher scores indicate worse outcome.
Change from Baseline in Inflammatory Biomarker C-reactive Protein in Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Recurrence Rate of Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Recurrence rate is defined as when the clinical outcome of the participant at the end/discontinuation of treatment is determined to be clinically cured, but AECOPD occurs again within 20 days after drug withdrawal due to incomplete anti-infective treatment, the participant develops one or more of the three main symptoms of worsening dyspnea, increased phlegm production, and sputum production, and also has relevant signs of AECOPD, with repeated blood routine, C-reactive protein and other inflammatory indicators, and needs to receive systemic antibacterial drug treatment again, and the pathogenic bacteria belonged to the same strain and serotype as the bacteria originally infected.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05400369
Brief Title
A Study to Evaluate the Efficacy and Safety of Sitafloxacin in Adult Subjects With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Official Title
A Multicenter, Randomized, Open-Label, Parallel-Controlled Clinical Study to Evaluate the Efficacy and Safety of Sitafloxacin in Adult Subjects With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Study Type
Interventional
2. Study Status
Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 10, 2022 (Actual)
Primary Completion Date
February 28, 2024 (Anticipated)
Study Completion Date
March 30, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Daiichi Sankyo, Inc.
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
Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease, that causes obstructed airflow from the lungs that causes persistent obstructive airflow limitation.
Acute exacerbation, especially frequent exacerbation, is associated with an increased risk of death in COPD patients. The most common causes of acute attacks are viral and bacterial infections.
This study will assess the efficacy and safety of sitafloxacin, a quinolone antibacterial drug, in participants with AECOPD.
Detailed Description
Clinical evidence suggests that AECOPD may be an important factor in the cause of death in patients with COPD. AECOPD typically presents with increased dyspnea, cough, and sputum volume, or purulent changes in sputum. The most common factors of AECOPD are viral and bacterial infections. Anti-infection agents have shown to be effective in patients with infectious AECOPD.
This study will assess the anti-bacterial drug sitafloxacin in participants with AECOPD. Clinical efficacy is the primary objective of the study. Microbiological validity, symptom relief, magnitude of change in symptom score and inflammatory biomarker, and recurrence rate and safety will also be assessed.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COPD Exacerbation Acute
Keywords
Chronic obstructive pulmonary disease, Exacerbation, Sitafloxacin
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
268 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Sitafloxacin
Arm Type
Experimental
Arm Description
Adult participants who will be randomized to receive 100 mg sitafloxacin (2 tablets) orally once a day.
Arm Title
Moxifloxacin
Arm Type
Active Comparator
Arm Description
Adult participants who will be randomized to receive 400 mg moxifloxacin (1 tablet) orally every 24 hours.
Intervention Type
Drug
Intervention Name(s)
Sitafloxacin
Other Intervention Name(s)
Gracevit
Intervention Description
Oral administration, 50 mg tablets
Intervention Type
Drug
Intervention Name(s)
Moxifloxacin Hydrochloride
Other Intervention Name(s)
Avelox
Intervention Description
Oral administration, 400 mg tablets
Primary Outcome Measure Information:
Title
Number of Participants Achieving Clinical Efficacy in Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Description
Clinical efficacy is divided into clinical cure and clinical ineffective. Clinical cure is defined as the three main symptoms of AECOPD (worsening dyspnea, increased sputum volume and sputum purulence) that disappear or return to the baseline level of stable phase at the end of treatment/discontinuation and no additional systemic antibacterial therapy is required for the target indication.
Clinical ineffective is defined as the three main symptoms of AECOPD (worsening dyspnea, increased sputum volume and sputum purulence) that persist or incompletely disappear (do not return to the baseline level of stable phase).
Time Frame
End of treatment (approximately Day 10 post-dose)
Secondary Outcome Measure Information:
Title
Number of Participants Achieving Clinical Efficacy in Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Description
Clinical efficacy is divided into clinical cure and clinical ineffective. Clinical cure is defined as the three main symptoms of AECOPD (worsening dyspnea, increased sputum volume and sputum purulence) that disappear or return to the baseline level of stable phase at the end of treatment/discontinuation and no additional systemic antibacterial therapy is required for the target indication.
Clinical ineffective is defined as the three main symptoms of AECOPD (worsening dyspnea, increased sputum volume and sputum purulence) that persist or incompletely disappear (do not return to the baseline level of stable phase).
Time Frame
1 month post-dose
Title
Number of Participants Achieving Microbiological Efficacy in Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Description
Microbiological efficacy is determined by bacterial clearance:
Clearance is defined as specimens from the original infection site after treatment do not culture pathogenic bacteria from the original infection.
Time Frame
End of treatment (approximately Day 10 post-dose)
Title
Number of Days With Symptom Relief in Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Description
The number of days with symptom relief of the three main symptoms of AECOPD (worsening dyspnea, increased sputum volume and sputum purulence) will be assessed.
Time Frame
From the start of treatment up to relief of three main symptoms of AECOPD (worsening dyspnea, increased sputum volume and sputum purulence), up to 1 month post-dose
Title
Change from Baseline in Each Chronic Obstructive Pulmonary Disease Symptom Score in Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Description
Chronic obstructive pulmonary disease symptom scores include dyspnea (ranging from 0 [Dyspnea only with strenuous activity] to 4 [Unable to leave home due to severe respiratory distress, or dyspnea when wearing and undressing]), sputum volume (ranging from 0 [no sputum] to 3 [severe]), sputum purulence (ranging from 0 [myxoid sample] to 3 [severe purulent]), cough score (ranging from 0 [no cough] to 3 [severe cough]), fever (ranging from 0 [β€37.0Β°C] to 3 [>38.0Β°C], and COPD Assessment Test (CAT) (where questions 1-8, range from a score of 0 [no impact] to 5 [severely impacted]. For all assessments, higher scores indicate worse outcome.
Time Frame
End of treatment (approximately Day 10 post-dose)
Title
Change from Baseline in Inflammatory Biomarker C-reactive Protein in Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Time Frame
End of treatment (approximately Day 10 post-dose)
Title
Recurrence Rate of Participants With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Description
Recurrence rate is defined as when the clinical outcome of the participant at the end/discontinuation of treatment is determined to be clinically cured, but AECOPD occurs again within 20 days after drug withdrawal due to incomplete anti-infective treatment, the participant develops one or more of the three main symptoms of worsening dyspnea, increased phlegm production, and sputum production, and also has relevant signs of AECOPD, with repeated blood routine, C-reactive protein and other inflammatory indicators, and needs to receive systemic antibacterial drug treatment again, and the pathogenic bacteria belonged to the same strain and serotype as the bacteria originally infected.
Time Frame
End of treatment (approximately Day 10 post-dose) up to 1 month post-dose
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age β₯ 40;
History of moderate to very severe COPD with a post-bronchodilator Forced Expiratory Volume in One Second/Forced Vital Capacity (FEV1/FVC) < 70% and a post-bronchodilator Forced Expiratory Volume in One Second (FEV1) < 80% of predicted normal value within one year prior to enrollment;
History of one or more acute exacerbations within one year prior to enrollment;
At least 6 weeks of stable disease prior to enrollment;
The acute exacerbation is classified as Anthonisen I (with 3 main symptoms of worsening dyspnea, increased sputum volume and sputum purulence) or II (with sputum purulence and another main symptom);
Participants can be treated on an outpatient basis after clinical assessment.
Exclusion Criteria:
Anthonisen III acute exacerbation (Have two major symptoms of worsening dyspnea and increased sputum volume or one of the two major symptoms)
Hospitalization or intensive care unit (ICU) treatment is required
Sputum culture within the previous year indicated the presence of pathogenic microorganisms resistant to quinolones
Quinolone allergy
History of QTc prolongation, or need for medications to treat QTc prolongation (e.g., Class Ia or Class III antiarrhythmics);
Definite pulmonary disease other than COPD (asthma, bronchiectasis, active pulmonary tuberculosis, pulmonary embolism, pulmonary fibrosis, lung cancer)
History of severe cardiovascular disease (e.g., congestive heart failure, clinically significant coronary heart disease, stroke, myocardial infarction and/or stroke within 6 months, clinically significant arrhythmia, previous history of aortic aneurysm or aortic dissection, positive family history, or risk factors (e.g., Marfan syndrome), poorly controlled hypertension (systolic blood pressure > 160 mmHg or diastolic blood pressure > 100 mmHg on 2 or more consecutive measurements)
Severe systemic diseases, such as severe dizziness, headache and other nervous system diseases
Malignant tumor
Concomitant or history of tendon disease or myasthenia gravis or Parkinson's disease
Abnormal liver function, aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) level > 3 times the upper limit of normal, and/or total bilirubin level >2 times the upper limit of normal
With moderate or severe decline of renal function, endogenous creatinine clearance rate (Ccr) < 50ml/min
History of seizure, or psychiatric condition that could affect compliance with the protocol, or risk for suicide, or history of alcohol or illicit drug abuse
Immunocompromised participants using glucocorticoids (total dose equivalent to prednisone 20 mg daily for more than 2 weeks) or immunosuppressive agents or HIV infected participants
Gastrointestinal disorders that may affect drug absorption (e.g., active Crohn's disease, active ulcerative colitis)
Pregnant or lactating women or women of childbearing potential who are planning to become pregnant
Participation in other clinical trials within 3 months prior to screening
Used antibiotics (including systemic and inhalation) 30 days before enrollment
Serum potassium < 3.5mmol/L at screening, or repeated hypokalemia that was difficult to correct in the past
Other reasons that the investigator considered inappropriate to participate in the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Contact for Clinical Trial Information
Phone
908-992-6400
Email
CTRinfo@dsi.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Global Clinical Director
Organizational Affiliation
Daiichi Sankyo, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
The Third Xiangya Hospital of Central South University
City
Changsha
ZIP/Postal Code
410013
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
Facility Name
West China Hospital Sichuan University
City
Chengdu
ZIP/Postal Code
610041
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
Facility Name
The First Affiliated Hospital of Dalian Medical University
City
Dalian
ZIP/Postal Code
116011
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
Facility Name
Nanfang Hospital Southern Medical University
City
Guangzhou
ZIP/Postal Code
510510
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
Facility Name
Qilu Hospital of Shandong University
City
Jinan
ZIP/Postal Code
250012
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
Facility Name
Peking University Shougang Hospital
City
Peking
ZIP/Postal Code
100144
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
Facility Name
Huadong Hospital Affiliated To Fudan University
City
Shanghai
ZIP/Postal Code
200433
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
Facility Name
Shenzhen People's Hospital
City
Shenzhen
ZIP/Postal Code
518140
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
Facility Name
Tianjin Medical University General Hospital
City
Tianjin
ZIP/Postal Code
300070
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
Facility Name
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
City
Wuhan
ZIP/Postal Code
430030
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
Facility Name
The Affiliated Hospital of Xuzhou Medical University
City
Xuzhou
ZIP/Postal Code
221004
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
Facility Name
Affiliated Hospital of Guangdong Medical University
City
Zhanjiang
ZIP/Postal Code
523710
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
Facility Name
Henan Provincial People's Hospital
City
Zhengzhou
ZIP/Postal Code
450003
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
De-identified individual participant data (IPD) on completed studies and applicable supporting clinical trial documents may be available upon request at https://vivli.org/. In cases where clinical trial data and supporting documents are provided pursuant to our company policies and procedures, Daiichi Sankyo will continue to protect the privacy of our clinical trial participants. Details on data sharing criteria and the procedure for requesting access can be found at this web address: https://vivli.org/ourmember/daiichi-sankyo/
IPD Sharing Time Frame
Completed studies that has reached a global end or completion with all data set collected and analyzed, and for which the medicine and indication have received European Union (EU) and United States (US), and/or Japan (JP) marketing approval on or after 01 January 2014 or by the US or EU or JP Health Authorities when regulatory submissions in all regions are not planned and after the primary study results have been accepted for publication.
IPD Sharing Access Criteria
Formal request from qualified scientific and medical researchers on IPD and clinical study documents on completed clinical trials supporting products submitted and licensed in the United States, the European Union and/or Japan from 01 January 2014 and beyond for the purpose of conducting legitimate research. This must be consistent with the principle of safeguarding study participants' privacy and consistent with provision of informed consent.
IPD Sharing URL
https://vivli.org/ourmember/daiichi-sankyo/
Learn more about this trial
A Study to Evaluate the Efficacy and Safety of Sitafloxacin in Adult Subjects With Acute Exacerbation of Chronic Obstructive Pulmonary Disease
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