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Safety, Efficacy, and Pharmacokinetics (PK) of Daptomycin (MK-3009) in Japanese Pediatric Subjects With Complicated Skin and Soft Tissue Infections (cSSTI) and Bacteremia (MK-3009-029)

Primary Purpose

Bacteremia, Soft Tissue Infections, Skin Diseases, Infectious

Status
Completed
Phase
Phase 2
Locations
Japan
Study Type
Interventional
Intervention
Daptomycin for Injection
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Bacteremia focused on measuring methicillin-resistant S. aureus (MRSA) infections, complicated skin and soft tissue infections (cSSTI)

Eligibility Criteria

1 Year - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Requires treatment for cSSTI or bacteremia.
  • Is male or female Japanese aged ≥ 1 to ≤ 17 years on the day of signing informed consent.
  • As a male participant, has agreed to use contraception during the treatment period and for at least 14 days after the last dose of study treatment and refrain from donating sperm during this period.
  • As a female participant, has agreed to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: not a woman of childbearing potential (WOCBP) or a WOCBP who agrees to follow the contraceptive guidance during the treatment period and for at least 14 days after the last dose of study treatment.
  • Has agreed to allow any bacterial isolates obtained from protocol-required specimens related to the current infection to be provided the Central Microbiology Reference Laboratory for study-related microbiological testing, long-term storage, and other future testing.

cSSTI Participants

  • Has cSSTI known or suspected to be caused by gram-positive cocci that requires intravenous antibiotic treatment and diagnosed with either Gram stain or culture.
  • Has at least 3 of the following clinical signs and symptoms associated with the cSSTI: pain, tenderness to palpation, temperature >37.0°C axillary or >37.5°C oral or >38.0° C rectal, forehead, or aural, white blood count (WBC) >12,000/mm^3 or ≥10% bands, swelling and/or induration, erythema (>1 cm beyond edge of wound or abscess), pus formation, CRP > upper limited of normal.

Bacteremia Participants

  • Have proven bacteremia with pathogen identification of gram-positive cocci at least one blood culture bottle by conventional culture methods or by a rapid diagnostic test in screening period.
  • Have probable bacteremia with a blood culture result demonstrating gram-positive cocci by Gram stain in screening period.

Exclusion Criteria:

  • Has received previous systemic antimicrobial therapy that is effective against gram-positive cocci and exceeding 72 hours duration administered at any time during the 96 hours prior to the first dose of study drug.
  • Has a known infection caused solely by gram-negative pathogen(s), fungus(i) or virus(es).
  • Has pneumonia (septic emboli in the lung is not an exclusion if clear evidence of source of infection is other than lungs), empyema, meningitis, endocarditis, or osteoarticular infection.
  • Has a history of or current rhabdomyolysis.
  • Is anticipated to require non-study systemic antibiotics that may be potentially effective against gram-positive pathogen(s).
  • Has shock or hypotension unresponsive to fluids or vasopressors for ≥ 4 hours.
  • Has significant allergy/hypersensitivity or intolerance to daptomycin.
  • Has renal insufficiency.
  • Has a history of clinically significant (as assessed by the Investigator) muscular disease, nervous system or seizure disorder, including unexplained muscular weakness, history of peripheral neuropathy, Guillain-Barre or spinal cord injury; previous uncomplicated febrile seizure allowed.
  • Has a history or current evidence of any condition, therapy, lab abnormality or other circumstance that might expose the participant to risk by participating in the trial, confound the results of the trial, or interfere with the participant's participation for the full duration of the trial.
  • Is a female who is pregnant or is expecting to conceive (or is a male partner of a female who is expecting to conceive), is breastfeeding, or plans to breastfeed prior to completion of the study.
  • Is currently participating in, or has participated in, any other clinical study involving the administration of investigational or experimental medication (not licensed by regulatory agencies) at the time of the presentation or during the previous 30 days prior to screening or is anticipated to participate in such a clinical study during the course of this trial.
  • Has previously participated in this study at any time.
  • Is or has an immediate family member (e.g., spouse, parent/legal guardian, sibling or child) who is investigational site or sponsor staff directly involved with this study.

Sites / Locations

  • Japan Community Health Care Organization Chukyo Hospital ( Site 0030)
  • Japan Community Health care Organization Kyushu Hospital ( Site 0016)
  • Maebashi Red Cross Hospital ( Site 0012)
  • Kobe University Hospital ( Site 0015)
  • Shikoku Medical Center for Children and Adults ( Site 0027)
  • Showa University Fujigaoka Hospital ( Site 0023)
  • Kanagawa Children's Medical Center ( Site 0025)
  • National Hospital Organization National Mie Hospital ( Site 0002)
  • National Hospital Organization Beppu Medical Center ( Site 0003)
  • Tokyo Metropolitan Children's Medical Center ( Site 0004)
  • Chiba University Hospital ( Site 0005)
  • Chiba Children's Hospital ( Site 0024)
  • National Hospital Organization Kumamoto Medical Center ( Site 0018)
  • Osaka City General Hospital ( Site 0020)
  • Saitama City Hospital ( Site 0008)
  • Nihon University Itabashi Hospital ( Site 0029)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Daptomycin

Arm Description

Participants aged 1 to 17 years old with cSSTI or bacteremia will receive daptomycin intravenously every 24 hours for either 5-14 days for cSSTI or for 5-42 days for bacteremia.

Outcomes

Primary Outcome Measures

Percentage of Participants With an Adverse Event
An adverse event (AE) is any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an adverse event.
Percentage of Participants That Discontinued Study Treatment Due to an Adverse Event (AE)
An AE is any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an adverse event.

Secondary Outcome Measures

Percentage of Participants With Methicillin-Resistant Staphylococcus Aureus (MRSA) Infections Who Experienced Clinical Success
Clinical success in participants with MRSA infections was defined as either "Cure" - Resolution of clinically significant signs and symptoms associated with admission infection and no further antibiotic therapy required, OR "Improved"- partial resolution of clinical signs or symptoms of infection with no further antibiotic therapy required.
Percentage of Participants With MRSA Infections Who Experienced a Microbiological Response
Participant-level microbiological response in participants with MRSA infections at baseline is defined as absence or presumed absence of all baseline infecting pathogens AND no gram-positive superinfection or gram-positive new infection, as assessed by infection site specimen culture or blood culture.
Area Under the Concentration Time Curve From 0 to 24 Hours (AUC0-24hr) of Daptomycin
Blood samples were collected at pre-specified time points to determine the AUC0-24 of daptomycin.
Maximum Plasma Concentration (Cmax) of Daptomycin
Blood samples were collected at pre-specified timepoints to determine Cmax of daptomycin.
Time to Maximum Plasma Concentration (Tmax) of Daptomycin
Blood samples were collected at pre-specified time points to determine Tmax of daptomycin
Body Weight Adjusted Clearance (CLss/wt) of Daptomycin
Blood samples were collected at pre-specified time points to determine CLss/wt of daptomycin at steady state.
Volume of Distribution at Steady State (Vss) of Daptomycin
Blood samples were collected at pre-specified time points to determine Vss (mL) of daptomycin.
Apparent Terminal Half-Life (t½) of Daptomycin
Blood samples were collected at pre-specified time points to determine the t½ of daptomycin.

Full Information

First Posted
August 21, 2018
Last Updated
April 19, 2022
Sponsor
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT03643952
Brief Title
Safety, Efficacy, and Pharmacokinetics (PK) of Daptomycin (MK-3009) in Japanese Pediatric Subjects With Complicated Skin and Soft Tissue Infections (cSSTI) and Bacteremia (MK-3009-029)
Official Title
A Phase II Open-Label, Single-arm Clinical Trial to Study the Safety, Efficacy and Pharmacokinetics of MK-3009 (Daptomycin) in Japanese Pediatric Participants Aged 1 to 17 Years With Complicated Skin and Soft Tissue Infections or Bacteremia Caused by Gram-positive Cocci
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
December 6, 2018 (Actual)
Primary Completion Date
April 7, 2020 (Actual)
Study Completion Date
April 7, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Merck Sharp & Dohme LLC

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
The purpose of this study is to assess the safety, efficacy and pharmacokinetic (PK) parameters of daptomycin for injection in Japanese pediatric participants aged 1 to 17 years with complicated skin and soft tissue infection (cSSTI) or bacteremia caused by gram-positive cocci.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Bacteremia, Soft Tissue Infections, Skin Diseases, Infectious
Keywords
methicillin-resistant S. aureus (MRSA) infections, complicated skin and soft tissue infections (cSSTI)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Daptomycin
Arm Type
Experimental
Arm Description
Participants aged 1 to 17 years old with cSSTI or bacteremia will receive daptomycin intravenously every 24 hours for either 5-14 days for cSSTI or for 5-42 days for bacteremia.
Intervention Type
Drug
Intervention Name(s)
Daptomycin for Injection
Other Intervention Name(s)
MK-3009
Intervention Description
Once daily administration of 5, 7, 9, 10, or 12 mg/kg intravenous (IV) daptomycin infused with 25-50 mL saline over 30-60 minutes depending upon infection type and age level.
Primary Outcome Measure Information:
Title
Percentage of Participants With an Adverse Event
Description
An adverse event (AE) is any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an adverse event.
Time Frame
Up to 56 days
Title
Percentage of Participants That Discontinued Study Treatment Due to an Adverse Event (AE)
Description
An AE is any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an adverse event.
Time Frame
Up to 42 days
Secondary Outcome Measure Information:
Title
Percentage of Participants With Methicillin-Resistant Staphylococcus Aureus (MRSA) Infections Who Experienced Clinical Success
Description
Clinical success in participants with MRSA infections was defined as either "Cure" - Resolution of clinically significant signs and symptoms associated with admission infection and no further antibiotic therapy required, OR "Improved"- partial resolution of clinical signs or symptoms of infection with no further antibiotic therapy required.
Time Frame
Up to 7 days following end of treatment (up to 49 days)
Title
Percentage of Participants With MRSA Infections Who Experienced a Microbiological Response
Description
Participant-level microbiological response in participants with MRSA infections at baseline is defined as absence or presumed absence of all baseline infecting pathogens AND no gram-positive superinfection or gram-positive new infection, as assessed by infection site specimen culture or blood culture.
Time Frame
Up to 7 days following end of treatment (up to 49 days)
Title
Area Under the Concentration Time Curve From 0 to 24 Hours (AUC0-24hr) of Daptomycin
Description
Blood samples were collected at pre-specified time points to determine the AUC0-24 of daptomycin.
Time Frame
Pre-dose and at 15 minutes, 1 hour, 4 hours, and 12 hours post-dose on Day 3 of daptomycin treatment
Title
Maximum Plasma Concentration (Cmax) of Daptomycin
Description
Blood samples were collected at pre-specified timepoints to determine Cmax of daptomycin.
Time Frame
Pre-dose and at 15 minutes, 1 hour, 4 hours, and 12 hours post-dose on Day 3 of daptomycin treatment
Title
Time to Maximum Plasma Concentration (Tmax) of Daptomycin
Description
Blood samples were collected at pre-specified time points to determine Tmax of daptomycin
Time Frame
Pre-dose and at 15 minutes, 1 hour, 4 hours, and 12 hours post-dose on Day 3 of daptomycin treatment
Title
Body Weight Adjusted Clearance (CLss/wt) of Daptomycin
Description
Blood samples were collected at pre-specified time points to determine CLss/wt of daptomycin at steady state.
Time Frame
Pre-dose and at 15 minutes, 1 hour, 4 hours, and 12 hours post-dose on Day 3 of daptomycin treatment
Title
Volume of Distribution at Steady State (Vss) of Daptomycin
Description
Blood samples were collected at pre-specified time points to determine Vss (mL) of daptomycin.
Time Frame
Pre-dose and at 15 minutes, 1 hour, 4 hours, and 12 hours post-dose on Day 3 of daptomycin treatment
Title
Apparent Terminal Half-Life (t½) of Daptomycin
Description
Blood samples were collected at pre-specified time points to determine the t½ of daptomycin.
Time Frame
Pre-dose and at 15 minutes, 1 hour, 4 hours, and 12 hours post-dose on Day 3 of daptomycin treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Requires treatment for cSSTI or bacteremia. Is male or female Japanese aged ≥ 1 to ≤ 17 years on the day of signing informed consent. As a male participant, has agreed to use contraception during the treatment period and for at least 14 days after the last dose of study treatment and refrain from donating sperm during this period. As a female participant, has agreed to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: not a woman of childbearing potential (WOCBP) or a WOCBP who agrees to follow the contraceptive guidance during the treatment period and for at least 14 days after the last dose of study treatment. Has agreed to allow any bacterial isolates obtained from protocol-required specimens related to the current infection to be provided the Central Microbiology Reference Laboratory for study-related microbiological testing, long-term storage, and other future testing. cSSTI Participants Has cSSTI known or suspected to be caused by gram-positive cocci that requires intravenous antibiotic treatment and diagnosed with either Gram stain or culture. Has at least 3 of the following clinical signs and symptoms associated with the cSSTI: pain, tenderness to palpation, temperature >37.0°C axillary or >37.5°C oral or >38.0° C rectal, forehead, or aural, white blood count (WBC) >12,000/mm^3 or ≥10% bands, swelling and/or induration, erythema (>1 cm beyond edge of wound or abscess), pus formation, CRP > upper limited of normal. Bacteremia Participants Have proven bacteremia with pathogen identification of gram-positive cocci at least one blood culture bottle by conventional culture methods or by a rapid diagnostic test in screening period. Have probable bacteremia with a blood culture result demonstrating gram-positive cocci by Gram stain in screening period. Exclusion Criteria: Has received previous systemic antimicrobial therapy that is effective against gram-positive cocci and exceeding 72 hours duration administered at any time during the 96 hours prior to the first dose of study drug. Has a known infection caused solely by gram-negative pathogen(s), fungus(i) or virus(es). Has pneumonia (septic emboli in the lung is not an exclusion if clear evidence of source of infection is other than lungs), empyema, meningitis, endocarditis, or osteoarticular infection. Has a history of or current rhabdomyolysis. Is anticipated to require non-study systemic antibiotics that may be potentially effective against gram-positive pathogen(s). Has shock or hypotension unresponsive to fluids or vasopressors for ≥ 4 hours. Has significant allergy/hypersensitivity or intolerance to daptomycin. Has renal insufficiency. Has a history of clinically significant (as assessed by the Investigator) muscular disease, nervous system or seizure disorder, including unexplained muscular weakness, history of peripheral neuropathy, Guillain-Barre or spinal cord injury; previous uncomplicated febrile seizure allowed. Has a history or current evidence of any condition, therapy, lab abnormality or other circumstance that might expose the participant to risk by participating in the trial, confound the results of the trial, or interfere with the participant's participation for the full duration of the trial. Is a female who is pregnant or is expecting to conceive (or is a male partner of a female who is expecting to conceive), is breastfeeding, or plans to breastfeed prior to completion of the study. Is currently participating in, or has participated in, any other clinical study involving the administration of investigational or experimental medication (not licensed by regulatory agencies) at the time of the presentation or during the previous 30 days prior to screening or is anticipated to participate in such a clinical study during the course of this trial. Has previously participated in this study at any time. Is or has an immediate family member (e.g., spouse, parent/legal guardian, sibling or child) who is investigational site or sponsor staff directly involved with this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Merck Sharp & Dohme LLC
Official's Role
Study Director
Facility Information:
Facility Name
Japan Community Health Care Organization Chukyo Hospital ( Site 0030)
City
Nagoya
State/Province
Aichi
ZIP/Postal Code
457-8510
Country
Japan
Facility Name
Japan Community Health care Organization Kyushu Hospital ( Site 0016)
City
Kitakyushu
State/Province
Fukuoka
ZIP/Postal Code
806-8501
Country
Japan
Facility Name
Maebashi Red Cross Hospital ( Site 0012)
City
Maebashi
State/Province
Gunma
ZIP/Postal Code
371-0811
Country
Japan
Facility Name
Kobe University Hospital ( Site 0015)
City
Kobe
State/Province
Hyogo
ZIP/Postal Code
650-0017
Country
Japan
Facility Name
Shikoku Medical Center for Children and Adults ( Site 0027)
City
Zentsuji
State/Province
Kagawa
ZIP/Postal Code
765-8507
Country
Japan
Facility Name
Showa University Fujigaoka Hospital ( Site 0023)
City
Yokohama
State/Province
Kanagawa
ZIP/Postal Code
227-8501
Country
Japan
Facility Name
Kanagawa Children's Medical Center ( Site 0025)
City
Yokohama
State/Province
Kanagawa
ZIP/Postal Code
232-8555
Country
Japan
Facility Name
National Hospital Organization National Mie Hospital ( Site 0002)
City
Tsu
State/Province
Mie
ZIP/Postal Code
514-0125
Country
Japan
Facility Name
National Hospital Organization Beppu Medical Center ( Site 0003)
City
Beppu
State/Province
Oita
ZIP/Postal Code
874-0011
Country
Japan
Facility Name
Tokyo Metropolitan Children's Medical Center ( Site 0004)
City
Fuchu
State/Province
Tokyo
ZIP/Postal Code
183-8561
Country
Japan
Facility Name
Chiba University Hospital ( Site 0005)
City
Chiba
ZIP/Postal Code
260-8677
Country
Japan
Facility Name
Chiba Children's Hospital ( Site 0024)
City
Chiba
ZIP/Postal Code
266-0007
Country
Japan
Facility Name
National Hospital Organization Kumamoto Medical Center ( Site 0018)
City
Kumamoto
ZIP/Postal Code
860-0008
Country
Japan
Facility Name
Osaka City General Hospital ( Site 0020)
City
Osaka
ZIP/Postal Code
534-0021
Country
Japan
Facility Name
Saitama City Hospital ( Site 0008)
City
Saitama
ZIP/Postal Code
336-8522
Country
Japan
Facility Name
Nihon University Itabashi Hospital ( Site 0029)
City
Tokyo
ZIP/Postal Code
173-8610
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
IPD Sharing URL
http://engagezone.msd.com/ds_documentation.php
Citations:
PubMed Identifier
34920946
Citation
Iwata S, Koyama H, Murata Y. Efficacy and safety of daptomycin in Japanese pediatric participants with complicated skin and soft tissue infections or bacteremia caused by gram-positive cocci. J Infect Chemother. 2022 Mar;28(3):406-412. doi: 10.1016/j.jiac.2021.11.019. Epub 2021 Dec 15.
Results Reference
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Safety, Efficacy, and Pharmacokinetics (PK) of Daptomycin (MK-3009) in Japanese Pediatric Subjects With Complicated Skin and Soft Tissue Infections (cSSTI) and Bacteremia (MK-3009-029)

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