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Safety, Tolerability, and Pharmacokinetics of Sulopenem in Adolescents

Primary Purpose

Urinary Tract Infections, Pyelonephritis Acute, Intraabdominal Infections

Status
Withdrawn
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Sulopenem
Sponsored by
Iterum Therapeutics, International Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Urinary Tract Infections

Eligibility Criteria

12 Years - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient's parent/both parents or guardian must provide written informed consent and a statement of assent from the adolescent patient (if required by Institutional Review Board [IRB] according to local regulations and guidelines) must be obtained prior to any study-related procedures.
  2. Patient is male or female adolescent who are ≥12 and <18 years of age.
  3. Patient has a diagnosis of uUTI, cUTI, AP, or cIAI as documented by the treating physician
  4. Patient will be hospitalized for urinary tract infection, acute pyelonephritis, or complicated intraabdominal infection for at least 48 hours and be receiving appropriate anti-infective treatment.
  5. Patient must have sufficient venous access to permit administration of study drug, collection of PK samples, and monitoring of laboratory safety variables.
  6. Female patients who are post-menarche must not be pregnant or breast feeding and must have a documented negative serum pregnancy test at Screening.
  7. Post-menarchal females and post-pubertal males must agree to use a highly effective method of birth control with partners of childbearing potential throughout the duration of the study and for 1 month following the last dose of study drug.
  8. Patient must be willing to follow all study procedures.

Exclusion Criteria:

  1. Patient has creatinine clearance <90 mL/min using the Cockcroft-Gault formula.
  2. Patient is unable to tolerate oral medications.
  3. Patient has presence of Endocarditis, Meningitis, Necrotizing fasciitis, or Gas gangrene
  4. Patient has signs of severe sepsis
  5. Patient has evidence of active liver disease or hepatic dysfunction
  6. Patient has neutropenia with absolute neutrophil count <500 cells/mm3.
  7. Patient has history of solid organ transplantation reported at any time.
  8. Patient has any finding that, in the view of the Investigator, would compromise the patient's safety requirements.
  9. Patient has known allergies to penicillin, carbapenems, and/or cephalosporins, known allergy to probenecid, or severe allergic reactions to any drug in the past.
  10. Patient has history of intolerance to β-lactam antibiotics, including but not limited to a history of clinically significant diarrhea/loose stools.
  11. Patient has a history of hypersensitivity to the study drug or any of the excipients or to medicinal products with similar chemical structures.
  12. Patient has involvement in the planning and/or conduct of this study
  13. Patient has participated in any other clinical study where an investigational product was ingested within 30 days or 5 half-lives of the drug (whichever is longer) prior to the current study.
  14. Patient has definite or suspected personal history or family history of clinically significant adverse drug reactions.
  15. Patient has history or presence of GI, hepatic, or renal disease, or other conditions known to interfere with absorption, distribution, metabolism, or excretion of drugs.
  16. Patient had treatment in the previous 3 months with any drug known to have a well-defined potential for hepatotoxicity (eg, halothane).
  17. Patient weighs <35 kg.
  18. Patient is pregnant or lactating.

Sites / Locations

  • Medical Facility

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Sulopenem

Arm Description

Sulopenem intravenous 1000 mg (single dose) on Day 1 followed by oral sulopenem etzadroxil/probenecid 500 mg/500 mg (single dose) on Day 2.

Outcomes

Primary Outcome Measures

Maximum plasma concentration
Maximum plasma concentration (Cmax) of sulopenem at multiple timepoints after dose

Secondary Outcome Measures

Time to maximum plasma concentration
Time to maximum plasma concentration (Tmax) of sulopenem at multiple timepoints after dose
Time above minimum inhibitory concentration
Time above minimum inhibitory concentration (MIC) at multiple timepoints after dose
Area under the plasma concentration-time curve from time zero to time of last quantifiable plasma concentration
Area under the plasma concentration-time curve (AUC) from time zero to time of last quantifiable plasma concentration at multiple timepoints after dose
Area under the plasma concentration-time curve from time zero extrapolated to infinity
Area under the plasma concentration-time curve (AUC) from time zero extrapolated to infinity at multiple timepoints after dose
Percentage of area under the concentration-time curve extrapolated
Percentage of area under the concentration-time curve (AUC) extrapolated at multiple timepoints after dose
Terminal elimination half-life
Terminal elimination half-life at multiple timepoints after dose
Total body clearance for intravenous administration
Total body clearance for intravenous administration at multiple timepoints after intravenous dose
Apparent total body clearance for oral administration
Apparent total body clearance for oral administration at multiple timepoints after oral dose
Volume of distribution for intravenous administration
Volume of distribution for intravenous administration at multiple timepoints after intravenous dose
Apparent volume of distribution for oral administration
Apparent volume of distribution for oral administration at multiple timepoints after oral dose

Full Information

First Posted
January 6, 2021
Last Updated
June 9, 2022
Sponsor
Iterum Therapeutics, International Limited
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1. Study Identification

Unique Protocol Identification Number
NCT04700787
Brief Title
Safety, Tolerability, and Pharmacokinetics of Sulopenem in Adolescents
Official Title
A Phase 1, Multi-Center, Open-Label Study to Evaluate Safety, Tolerability, and Pharmacokinetics of Sulopenem and Sulopenem Etzadroxil + Probenecid in Adolescent Patients With Bacterial Infection
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Withdrawn
Why Stopped
Enrollment challenges and change in development plan necessitating a change in study design
Study Start Date
April 30, 2021 (Actual)
Primary Completion Date
March 25, 2022 (Actual)
Study Completion Date
April 4, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Iterum Therapeutics, International Limited

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
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 evaluate the safety, tolerability, and pharmacokinetics of intravenous sulopenem and oral sulopenem etzadroxil/probenecid in adolescent patients.
Detailed Description
After being informed about the study and potential risks, all patients giving written informed consent will be screened for eligibility. Hospitalized patients who are 12-18 years of age and who are receiving background antibiotic treatment for uncomplicated urinary tract infection, complicated urinary tract infection, acute pyelonephritis, or complicated intraabdominal infection, and who meet eligibility requirements will receive a single 1000 mg IV dose of sulopenem on Day 1. The following day, patients will receive a single dose of 500 mg of sulopenem etzadroxil and 500 mg of probenecid given orally as a bilayer tablet. During treatment, pharmacokinetic samples will be collected and patients will be monitored for safety and tolerability.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Urinary Tract Infections, Pyelonephritis Acute, Intraabdominal Infections

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sulopenem
Arm Type
Experimental
Arm Description
Sulopenem intravenous 1000 mg (single dose) on Day 1 followed by oral sulopenem etzadroxil/probenecid 500 mg/500 mg (single dose) on Day 2.
Intervention Type
Drug
Intervention Name(s)
Sulopenem
Intervention Description
sulopenem intravenous 1000 mg on Day 1 and then sulopenem etzadroxil/probenecid oral 500 mg/500 mg on Day 2
Primary Outcome Measure Information:
Title
Maximum plasma concentration
Description
Maximum plasma concentration (Cmax) of sulopenem at multiple timepoints after dose
Time Frame
To be measured at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 9.0, 10.0, and 12.0 hours post dose
Secondary Outcome Measure Information:
Title
Time to maximum plasma concentration
Description
Time to maximum plasma concentration (Tmax) of sulopenem at multiple timepoints after dose
Time Frame
To be measured at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 9.0, 10.0, and 12.0 hours post dose
Title
Time above minimum inhibitory concentration
Description
Time above minimum inhibitory concentration (MIC) at multiple timepoints after dose
Time Frame
To be measured at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 9.0, 10.0, and 12.0 hours post dose
Title
Area under the plasma concentration-time curve from time zero to time of last quantifiable plasma concentration
Description
Area under the plasma concentration-time curve (AUC) from time zero to time of last quantifiable plasma concentration at multiple timepoints after dose
Time Frame
To be measured at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 9.0, 10.0, and 12.0 hours post dose
Title
Area under the plasma concentration-time curve from time zero extrapolated to infinity
Description
Area under the plasma concentration-time curve (AUC) from time zero extrapolated to infinity at multiple timepoints after dose
Time Frame
To be measured at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 9.0, 10.0, and 12.0 hours post dose
Title
Percentage of area under the concentration-time curve extrapolated
Description
Percentage of area under the concentration-time curve (AUC) extrapolated at multiple timepoints after dose
Time Frame
To be measured at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 9.0, 10.0, and 12.0 hours post dose
Title
Terminal elimination half-life
Description
Terminal elimination half-life at multiple timepoints after dose
Time Frame
To be measured at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 9.0, 10.0, and 12.0 hours post dose
Title
Total body clearance for intravenous administration
Description
Total body clearance for intravenous administration at multiple timepoints after intravenous dose
Time Frame
To be measured at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 9.0, 10.0, and 12.0 hours post dose
Title
Apparent total body clearance for oral administration
Description
Apparent total body clearance for oral administration at multiple timepoints after oral dose
Time Frame
To be measured at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 9.0, 10.0, and 12.0 hours post dose
Title
Volume of distribution for intravenous administration
Description
Volume of distribution for intravenous administration at multiple timepoints after intravenous dose
Time Frame
To be measured at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 9.0, 10.0, and 12.0 hours post dose
Title
Apparent volume of distribution for oral administration
Description
Apparent volume of distribution for oral administration at multiple timepoints after oral dose
Time Frame
To be measured at 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 9.0, 10.0, and 12.0 hours post dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient's parent/both parents or guardian must provide written informed consent and a statement of assent from the adolescent patient (if required by Institutional Review Board [IRB] according to local regulations and guidelines) must be obtained prior to any study-related procedures. Patient is male or female adolescent who are ≥12 and <18 years of age. Patient has a diagnosis of uUTI, cUTI, AP, or cIAI as documented by the treating physician Patient will be hospitalized for urinary tract infection, acute pyelonephritis, or complicated intraabdominal infection for at least 48 hours and be receiving appropriate anti-infective treatment. Patient must have sufficient venous access to permit administration of study drug, collection of PK samples, and monitoring of laboratory safety variables. Female patients who are post-menarche must not be pregnant or breast feeding and must have a documented negative serum pregnancy test at Screening. Post-menarchal females and post-pubertal males must agree to use a highly effective method of birth control with partners of childbearing potential throughout the duration of the study and for 1 month following the last dose of study drug. Patient must be willing to follow all study procedures. Exclusion Criteria: Patient has creatinine clearance <90 mL/min using the Cockcroft-Gault formula. Patient is unable to tolerate oral medications. Patient has presence of Endocarditis, Meningitis, Necrotizing fasciitis, or Gas gangrene Patient has signs of severe sepsis Patient has evidence of active liver disease or hepatic dysfunction Patient has neutropenia with absolute neutrophil count <500 cells/mm3. Patient has history of solid organ transplantation reported at any time. Patient has any finding that, in the view of the Investigator, would compromise the patient's safety requirements. Patient has known allergies to penicillin, carbapenems, and/or cephalosporins, known allergy to probenecid, or severe allergic reactions to any drug in the past. Patient has history of intolerance to β-lactam antibiotics, including but not limited to a history of clinically significant diarrhea/loose stools. Patient has a history of hypersensitivity to the study drug or any of the excipients or to medicinal products with similar chemical structures. Patient has involvement in the planning and/or conduct of this study Patient has participated in any other clinical study where an investigational product was ingested within 30 days or 5 half-lives of the drug (whichever is longer) prior to the current study. Patient has definite or suspected personal history or family history of clinically significant adverse drug reactions. Patient has history or presence of GI, hepatic, or renal disease, or other conditions known to interfere with absorption, distribution, metabolism, or excretion of drugs. Patient had treatment in the previous 3 months with any drug known to have a well-defined potential for hepatotoxicity (eg, halothane). Patient weighs <35 kg. Patient is pregnant or lactating.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Steven I Aronin, MD
Organizational Affiliation
Employee
Official's Role
Study Director
Facility Information:
Facility Name
Medical Facility
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety, Tolerability, and Pharmacokinetics of Sulopenem in Adolescents

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