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Study Comparing the Safety and Efficacy of Intravenous CXA-201 and Intravenous Meropenem in Complicated Intraabdominal Infections

Primary Purpose

Complicated Intra-abdominal Infection

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
CXA-201 and metronidazole
Meropenem
Sponsored by
Cubist Pharmaceuticals LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Complicated Intra-abdominal Infection focused on measuring cIAI

Eligibility Criteria

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

Inclusion Criteria:

  • Diagnoses of cIAI.
  • Subject requires surgical intervention (e.g., laparotomy, laparoscopic surgery, or percutaneous draining of an abscess) within 24 hours of (before or after) the first dose of study drug.

Exclusion Criteria:

  • Simple appendicitis; acute suppurative cholangitis; infected necrotizing pancreatitis; pancreatic abscess; or pelvic infections.
  • Complicated intraabdominal infection managed by staged abdominal repair (STAR), open abdomen technique including temporary closure of the abdomen, or any situation where infection source control is not likely to be achieved.
  • Use of systemic antibiotic therapy for IAI for more than 24 hours prior to the first dose of study drug, unless there is a documented treatment failure with such therapy.
  • Have a concomitant infection at the time of randomization, which requires non-study systemic antibacterial therapy in addition to IV study drug therapy. (Drugs with only gram-positive activity [e.g., daptomycin, vancomycin, linezolid] are allowed).
  • Severe impairment of renal function (estimated CrCl < 30 mL/min), or requirement for peritoneal dialysis, hemodialysis or hemofiltration, or oliguria (< 20 mL/h urine output over 24 hours).
  • The presence of hepatic disease at baseline.
  • Considered unlikely to survive the 4 to 5 week study period.
  • Any rapidly-progressing disease or immediately life-threatening illness (including respiratory failure and septic shock).
  • Have a documented history of any moderate or severe hypersensitivity or allergic reaction to any β-lactam antibacterial (a history of a mild rash followed by uneventful re-exposure is not a contraindication to enrollment), including cephalosporins, carbapenems, penicillins, or ß-lactamase inhibitors, or metronidazole, or nitroimidazole derivatives.
  • Women who are pregnant or nursing.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

CXA-201 and Metronidazole as treatment for cIAI

Meropenem as treatment for cIAI

Arm Description

Outcomes

Primary Outcome Measures

The Percentage of Subjects With Clinical Outcome of Cure at the Test of Cure (TOC) Visit in the Microbiological Intent to Treat (MITT) Population
Clinical cure is complete resolution or significant improvement in signs and symptoms of the index infection, such that no additional antibacterial therapy or surgical or drainage procedure was required for the index infection.

Secondary Outcome Measures

The Percentage of Subjects With Microbiological Outcome of Success at the TOC Visit in the Microbiologically Evaluable (ME) Population
Success is eradication (absence of the baseline pathogen in a specimen appropriately obtained from the original site of infection) or presumed eradication (absence of material to culture in a subject who was assessed as a clinical cure) for each baseline pathogen
The Percentage of Subjects With Clinical Response at End of Therapy (EOT) Visit in the MITT Population
Clinical response is complete resolution or significant improvement in signs and symptoms of the index infection, such that no additional antibacterial therapy or surgical or drainage procedure was required for the index infection.
The Percentage of Subjects With Clinical Response at End of Therapy in the ME Population
Clinical response is complete resolution or significant improvement in signs and symptoms of the index infection, such that no additional antibacterial therapy or surgical or drainage procedure was required for the index infection.
The Percentage of Subjects With Clinical Response at Long Term Follow-Up (LFU) in the MITT Population
Clinical response is clinical cure at TOC and no signs and symptoms recur or worsen since the TOC visit.
The Percentage of Subjects With Clinical Response at LFU Visit in the ME Population
Clinical response is clinical cure at TOC and no signs and symptoms recur or worsen since the TOC visit

Full Information

First Posted
September 26, 2011
Last Updated
October 18, 2018
Sponsor
Cubist Pharmaceuticals LLC
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1. Study Identification

Unique Protocol Identification Number
NCT01445678
Brief Title
Study Comparing the Safety and Efficacy of Intravenous CXA-201 and Intravenous Meropenem in Complicated Intraabdominal Infections
Official Title
A Multicenter, Double-Blind, Randomized, Phase 3 Study to Compare the Efficacy and Safety of Intravenous CXA-201 With That of Meropenem in Complicated Intraabdominal Infections
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Completed
Study Start Date
December 23, 2011 (Actual)
Primary Completion Date
October 3, 2013 (Actual)
Study Completion Date
October 15, 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cubist Pharmaceuticals LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase 3, multicenter, prospective, randomized, double-blind, double dummy study of CXA-201 Intravenous (IV) infusions (1500mg q8h) and metronidazole (500mg q8h) versus meropenem (1000mg q8h)for the treatment of adults with Complicated Intraabdominal Infections (cIAI).
Detailed Description
Approximately, 500 subjects will be enrolled into this study, randomized 1:1 to receive CXA-201 and metronidazole or comparator (meropenem). Subject participation will require a minimum commitment of 38 days and a maximum of 45 days. An End of Treatment (EOT) visit will occur within 24 hours following the last dose of study drug administration/drug discontinuation. A Test of Cure (TOC)/Safety visit will be conducted 26 to 30 days following the first dose of study drug administration. A Last Follow-up (LFU) visit will be conducted 38 to 45 days after the first dose of study drug.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Complicated Intra-abdominal Infection
Keywords
cIAI

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
494 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CXA-201 and Metronidazole as treatment for cIAI
Arm Type
Experimental
Arm Title
Meropenem as treatment for cIAI
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
CXA-201 and metronidazole
Intervention Description
CXA-201 IV infusion (1500mg q8h) and metronidazole IV infusion (500mg q 8h) for 4-14 days
Intervention Type
Drug
Intervention Name(s)
Meropenem
Intervention Description
Meropenem IV infusion (1000mg q8h) for 4-14 days
Primary Outcome Measure Information:
Title
The Percentage of Subjects With Clinical Outcome of Cure at the Test of Cure (TOC) Visit in the Microbiological Intent to Treat (MITT) Population
Description
Clinical cure is complete resolution or significant improvement in signs and symptoms of the index infection, such that no additional antibacterial therapy or surgical or drainage procedure was required for the index infection.
Time Frame
TOC; 26-30 days after start of study drug administration
Secondary Outcome Measure Information:
Title
The Percentage of Subjects With Microbiological Outcome of Success at the TOC Visit in the Microbiologically Evaluable (ME) Population
Description
Success is eradication (absence of the baseline pathogen in a specimen appropriately obtained from the original site of infection) or presumed eradication (absence of material to culture in a subject who was assessed as a clinical cure) for each baseline pathogen
Time Frame
TOC; 26-30 days after start of study drug administration
Title
The Percentage of Subjects With Clinical Response at End of Therapy (EOT) Visit in the MITT Population
Description
Clinical response is complete resolution or significant improvement in signs and symptoms of the index infection, such that no additional antibacterial therapy or surgical or drainage procedure was required for the index infection.
Time Frame
EOT; Within 24 hours of last study drug administration
Title
The Percentage of Subjects With Clinical Response at End of Therapy in the ME Population
Description
Clinical response is complete resolution or significant improvement in signs and symptoms of the index infection, such that no additional antibacterial therapy or surgical or drainage procedure was required for the index infection.
Time Frame
EOT; Within 24 hours of last study drug administration
Title
The Percentage of Subjects With Clinical Response at Long Term Follow-Up (LFU) in the MITT Population
Description
Clinical response is clinical cure at TOC and no signs and symptoms recur or worsen since the TOC visit.
Time Frame
LFU; 38 to 45 days after first study drug administration
Title
The Percentage of Subjects With Clinical Response at LFU Visit in the ME Population
Description
Clinical response is clinical cure at TOC and no signs and symptoms recur or worsen since the TOC visit
Time Frame
LFU; 38 to 45 days after first study drug administration

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnoses of cIAI. Subject requires surgical intervention (e.g., laparotomy, laparoscopic surgery, or percutaneous draining of an abscess) within 24 hours of (before or after) the first dose of study drug. Exclusion Criteria: Simple appendicitis; acute suppurative cholangitis; infected necrotizing pancreatitis; pancreatic abscess; or pelvic infections. Complicated intraabdominal infection managed by staged abdominal repair (STAR), open abdomen technique including temporary closure of the abdomen, or any situation where infection source control is not likely to be achieved. Use of systemic antibiotic therapy for IAI for more than 24 hours prior to the first dose of study drug, unless there is a documented treatment failure with such therapy. Have a concomitant infection at the time of randomization, which requires non-study systemic antibacterial therapy in addition to IV study drug therapy. (Drugs with only gram-positive activity [e.g., daptomycin, vancomycin, linezolid] are allowed). Severe impairment of renal function (estimated CrCl < 30 mL/min), or requirement for peritoneal dialysis, hemodialysis or hemofiltration, or oliguria (< 20 mL/h urine output over 24 hours). The presence of hepatic disease at baseline. Considered unlikely to survive the 4 to 5 week study period. Any rapidly-progressing disease or immediately life-threatening illness (including respiratory failure and septic shock). Have a documented history of any moderate or severe hypersensitivity or allergic reaction to any β-lactam antibacterial (a history of a mild rash followed by uneventful re-exposure is not a contraindication to enrollment), including cephalosporins, carbapenems, penicillins, or ß-lactamase inhibitors, or metronidazole, or nitroimidazole derivatives. Women who are pregnant or nursing.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ellie Hershberger, Pharm.D
Organizational Affiliation
Cubist Pharmaceuticals LLC
Official's Role
Study Director
Facility Information:
City
Springfield
State/Province
Illinois
Country
United States
City
Boston
State/Province
Massachusetts
Country
United States
City
Robbinsdale
State/Province
Minnesota
Country
United States
City
Columbus
State/Province
Ohio
Country
United States
City
Ciudadelo-Buenos Aires
State/Province
Buenos Aires
Country
Argentina
City
General Rodriguez
State/Province
Buenos Aires
Country
Argentina
City
La Plata
State/Province
Buenos Aires
Country
Argentina
City
Loma Hermosa
State/Province
Buenos Aires
Country
Argentina
City
Lujan
State/Province
Buenos Aires
Country
Argentina
City
Merlo
State/Province
Buenos Aires
Country
Argentina
City
Tandil
State/Province
Buenos Aires
Country
Argentina
City
Vicente Lopez
State/Province
Buenos Aires
Country
Argentina
City
Parana
State/Province
Entre Rios
Country
Argentina
City
Cordoba
Country
Argentina
City
Corrientes
Country
Argentina
City
Santa Fe
Country
Argentina
City
Pleven
Country
Bulgaria
City
Sofia
Country
Bulgaria
City
Varna
Country
Bulgaria
City
Temuco
State/Province
Cautin
Country
Chile
City
Santiago
Country
Chile
City
Split
State/Province
Dalmatia
Country
Croatia
City
Zagreb
Country
Croatia
City
Kohtla-Jarve
Country
Estonia
City
Tallinn
Country
Estonia
City
Tartu
Country
Estonia
City
Freiburg
State/Province
Baden-Weurttemberg
Country
Germany
City
Heidelberg
State/Province
Baden-Wuerttemberg
Country
Germany
City
Gyula
State/Province
Bekes
Country
Hungary
City
Szeged
State/Province
Csongrad
Country
Hungary
City
Szentes
State/Province
Csongrad
Country
Hungary
City
Gyor
State/Province
Gyor-Moson-Sopron
Country
Hungary
City
Zalaegerszerg
State/Province
Zala
Country
Hungary
City
Budapest
Country
Hungary
City
Kaposvar
Country
Hungary
City
Kecskemet
Country
Hungary
City
Vac
Country
Hungary
City
Kfar Saba
State/Province
Sharon
Country
Israel
City
Tel Hashomer
State/Province
Tel Aviv
Country
Israel
City
Beer Yahkov
Country
Israel
City
Haifa
Country
Israel
City
Wonju
State/Province
Gangwon-Do
Country
Korea, Republic of
City
Incheon
State/Province
Gyeonggi-Do
Country
Korea, Republic of
City
Suwon-si
State/Province
Gyeonggi-Do
Country
Korea, Republic of
City
Seoul
Country
Korea, Republic of
City
Liepaja
Country
Latvia
City
Riga
Country
Latvia
City
Kaunas
Country
Lithuania
City
Klaipeda
Country
Lithuania
City
Siauliai
Country
Lithuania
City
Vilnius
Country
Lithuania
City
Chisinau
Country
Moldova, Republic of
City
Lodz
State/Province
Lodzkie
Country
Poland
City
Lubin
State/Province
Lubelskie
Country
Poland
City
Krakow
State/Province
Malopolskie
Country
Poland
City
Wolomin
State/Province
Mazowieckie
Country
Poland
City
Szczecin
State/Province
Zachodniopomorskie
Country
Poland
City
Belgrade
Country
Serbia
City
Krafujevac
Country
Serbia
City
Nis
Country
Serbia
City
Novi Sad
Country
Serbia

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
https://www.merck.com/clinical-trials/pdf/ProcedureAccessClinicalTrialData.pdf
IPD Sharing URL
http://engagezone.msd.com/ds_documentation.php
Citations:
PubMed Identifier
28464828
Citation
Popejoy MW, Long J, Huntington JA. Analysis of patients with diabetes and complicated intra-abdominal infection or complicated urinary tract infection in phase 3 trials of ceftolozane/tazobactam. BMC Infect Dis. 2017 May 2;17(1):316. doi: 10.1186/s12879-017-2414-9.
Results Reference
derived
PubMed Identifier
28446129
Citation
Xiao Y, Tong ML, Liu LL, Lin LR, Chen MJ, Zhang HL, Zheng WH, Li SL, Lin HL, Lin ZF, Xing HQ, Niu JJ, Yang TC. Novel predictors of neurosyphilis among HIV-negative syphilis patients with neurological symptoms: an observational study. BMC Infect Dis. 2017 Apr 26;17(1):310. doi: 10.1186/s12879-017-2339-3. Erratum In: BMC Infect Dis. 2017 May 22;17 (1):357.
Results Reference
derived
PubMed Identifier
27999024
Citation
Kullar R, Wagenlehner FM, Popejoy MW, Long J, Yu B, Goldstein EJ. Does moderate renal impairment affect clinical outcomes in complicated intra-abdominal and complicated urinary tract infections? Analysis of two randomized controlled trials with ceftolozane/tazobactam. J Antimicrob Chemother. 2017 Mar 1;72(3):900-905. doi: 10.1093/jac/dkw486.
Results Reference
derived
PubMed Identifier
27139477
Citation
Miller B, Popejoy MW, Hershberger E, Steenbergen JN, Alverdy J. Characteristics and Outcomes of Complicated Intra-abdominal Infections Involving Pseudomonas aeruginosa from a Randomized, Double-Blind, Phase 3 Ceftolozane-Tazobactam Study. Antimicrob Agents Chemother. 2016 Jun 20;60(7):4387-90. doi: 10.1128/AAC.03074-15. Print 2016 Jul.
Results Reference
derived
PubMed Identifier
25670823
Citation
Solomkin J, Hershberger E, Miller B, Popejoy M, Friedland I, Steenbergen J, Yoon M, Collins S, Yuan G, Barie PS, Eckmann C. Ceftolozane/Tazobactam Plus Metronidazole for Complicated Intra-abdominal Infections in an Era of Multidrug Resistance: Results From a Randomized, Double-Blind, Phase 3 Trial (ASPECT-cIAI). Clin Infect Dis. 2015 May 15;60(10):1462-71. doi: 10.1093/cid/civ097. Epub 2015 Feb 10.
Results Reference
derived

Learn more about this trial

Study Comparing the Safety and Efficacy of Intravenous CXA-201 and Intravenous Meropenem in Complicated Intraabdominal Infections

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