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Study to Evaluate the Safety and Tolerability of Single-Dose Intravenous (IV) Oritavancin

Primary Purpose

Acute Bacterial Skin and Skin Structure Infection

Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Oritavancin
Sponsored by
Melinta Therapeutics, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Bacterial Skin and Skin Structure Infection

Eligibility Criteria

3 Months - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Male or female, 3 months to <18 years of age at randomization Diagnosis of at least one of the following ABSSSI infections (known or suspected to be caused by a gram-positive pathogen): Wound infection: that is either traumatic or surgical in origin, defined as an infection characterized by purulent drainage from a wound with surrounding erythema, edema, and/or induration Cellulitis/erysipelas: a diffuse skin infection characterized by spreading areas of erythema, edema, and/or induration Major cutaneous abscess: an infection characterized by a collection of pus within the dermis or subcutaneous tissue that is accompanied by surrounding erythema, edema, and/or induration ABSSSI must present with at least two of the following signs and symptoms: Purulent drainage or discharge Erythema (>1 cm beyond edge of wound or abscess) Fluctuance Heat or localized warmth Edema/induration Pain or tenderness to palpation AND at least one of the following signs of systemic inflammation: Proximal lymph node swelling and tenderness Increased temperature (>38.0°C [>100.4°F]) Decreased temperature (<36.0°C [<96.8°F]) Decreased white blood count (WBC) (<4000/mm3) or increased WBC (>12,000mm3) Bandemia >10% C-reactive protein (CRP) >upper limit of normal (ULN) Written informed consent obtained from parent(s) or legal guardian(s), with written or documented verbal assent of the child obtained, when appropriate, before initiation of any assessments conducted solely for study purposes. Exclusion Criteria: Subjects who have received more than 72 hours of effective antibacterial drug therapy for treatment of the current episode of ABSSSI Subjects who have received a glycopeptide antibiotic (e.g., vancomycin, telavancin, teicoplanin) within 24 hours of randomization Subjects who have received dalbavancin within 45 days prior to randomization Subjects who have been treated with oritavancin within the last 50 days Subjects with infection suspected to be associated with a device or implant Subjects with septic shock or hemodynamic instability Subjects with ABSSSI due to, or associated with any of the following: Infection suspected or documented to be caused solely by gram-negative pathogens (e.g., human or animal bite, injury contaminated with fresh or saltwater, external malignant otitis), fungi, or viruses Wound infection (surgical or traumatic) or abscess with only gram-negative pathogens Concomitant infection at another site, not including a secondary ABSSSI lesion (e.g., septic arthritis, endocarditis, osteomyelitis). Infected burn Primary infection superimposed on a pre-existing skin disease with associated inflammatory changes, e.g., atopic dermatitis, eczema Any evolving necrotizing process (e.g., necrotizing fasciitis), gangrene, or infection suspected or proven to be caused by clostridioides species (e.g., crepitance on examination of the ABSSSI site and/or surrounding tissue(s), radiographic evidence of subcutaneous gas in proximity to the infection) Clinically significant viral infection (e.g., influenza, COVID-19) which, in the Investigator's judgement, will impact the study clinical outcome assessments (e.g., subject is febrile due to the viral infection) Subjects currently receiving chronic systemic immunosuppressive therapy Subjects with neutropenia, defined as absolute neutrophil count (ANC) <500 cells/mm3 Creatinine clearance (CrCl) < 30 mL/min/1.73 m2 as calculated using the updated Schwartz bedside formula: eGFR = k x (height in cm) ÷ serum Creatinine k = 0.33 in pre-term infants. k = 0.45 in term infants to 1 year of age. k = 0.55 in children and adolescent girls. k = 0.70 in adolescent boys Menstruating females with a positive result for the urine or serum human chorionic gonadotropin (HCG) test administered at screening Females of childbearing potential (and males with female partners of childbearing potential) unwilling to practice abstinence or use at least two methods of contraception (e.g., oral contraceptives, barrier methods, approved contraceptive implants) during the entire study period Subjects with a history of infusion-related immunoglobulin E (IgE)-mediated allergic reaction or hypersensitivity reaction to glycopeptides (e.g., vancomycin, telavancin, dalbavancin, oritavancin, teicoplanin) or any of their excipients Subjects who are taking heparin (other than heparin flush for line patency) or warfarin, and/or require anticoagulant monitoring [activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR)] Subjects receiving treatment with an investigational medicinal product or investigational device within 3 months before enrollment or during the study Subjects whom the investigator considers unlikely to adhere to the protocol, comply with Study Drug administration, or complete the clinical study (e.g., unlikely to survive 28 days from initiation of Study Drug) Subjects with alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3x ULN or total bilirubin ≥2x ULN.

Sites / Locations

  • Tampa General Hospital
  • Mount Sinai Beth IsraelRecruiting
  • Nationwide Children's HospitalRecruiting
  • Multiprofile Hospital for Active Treatment- Sveti Nikolay Chudotvoretz - LOM EOODRecruiting
  • Multiprofile Hospital For Active Treatment Dr Tota VenkovaRecruiting
  • University Multiprofile Hospital for Active Treatment Sveti Georgi EAD-66 Peshtersko Shosse blvdRecruiting
  • University Multiprofile Hospital For Active Treatment Kanev ADRecruiting
  • University Multiprofile Hospital for Active Treatment and Emergency Medicine N. I. Pirogov EAD
  • University Multiprofile Hospital for Active Treatment - Prof. Dr. Stoyan Kirkovich ADRecruiting
  • Aghia Sophia' Children's General Hospital of Athens
  • Attikon University General Hospital
  • Ippokratio General Hospital of Thessaloniki
  • Papageorgiou General Hospital of Thessaloniki
  • Daugavpils Regional HospitalRecruiting
  • Regional Hospital of Liepaja
  • Children's Clinical University HospitalRecruiting
  • Hospital of Lithuanian University of Health Sciences Kauno klinikos
  • Klaipeda Children Hospital
  • Instytut Pomnik Centrum Zdrowia Dziecka - PIN
  • Hospital de Cascais
  • Hospital de Braga
  • Louis Turcanu Emergency Clinical Hospital for ChildrenRecruiting
  • Brasov Children Clinical HospitalRecruiting
  • Hospital Universitario Vall d'Hebron - PPDS
  • Hospital Sant Joan de Deu - PIN
  • Hospital Universitario 12 de Octubre
  • Hospital Universitario La Paz - PPDS

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Orbactiv

Kimyrsa

Standard of Care

Arm Description

ORBACTIV is infused at 15mg/kg over 3 hours for all subjects not to exceed a dose of 1200mg.

KIMYRSA is infused at 15mg/kg over 1 hour for subjects ≥12 years old and weighing >40 kg not to exceed a dose of 1200mg. KIMYRSA is infused at 15mg/kg over 3 hours in subjects <12 years old or weighing ≤40 kg.

The following SoC medications below will be administered via IV infusion, per the package insert, and according to local rules and regulations. SoC medications cannot be used in combination with one another. Vancomycin Teicoplanin Clindamycin Daptomycin Semi-synthetic penicillins (e.g., nafcillin, oxacillin, cloxacillin) Cefazolin Ceftaroline

Outcomes

Primary Outcome Measures

Safety Assessments
Adverse events (AEs)

Secondary Outcome Measures

Test of Cure
All-cause mortality assessed at the Test of Cure visit.
Clinical Outcome Assessments
Clinical Outcome Definitions: Clinical response of Cure or failure at End of Treatment visit and Test of Cure visit. Cure Complete or nearly complete resolution of baseline signs and symptoms of the primary infection, including absence of fever No further treatment with antibiotics required for the primary infection Failure Use of additional antibiotic treatment for the primary infection prior to the visit (other than for gram-negative coverage, when given according to this protocol) Worsening signs and symptoms (either assessed by the investigational site or reported by the subject or subject's caregivers) of the primary infection >72 hours from the start of Study Drug treatment. Lost to Follow-up or other extenuating circumstance where the subject cannot be adequately assessed

Full Information

First Posted
October 20, 2022
Last Updated
September 13, 2023
Sponsor
Melinta Therapeutics, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT05599295
Brief Title
Study to Evaluate the Safety and Tolerability of Single-Dose Intravenous (IV) Oritavancin
Official Title
A Multicenter, Open-Label, Evaluator-Blinded, Randomized Study to Evaluate the Safety and Tolerability of Single-Dose IV Oritavancin vs SoC for the Treatment of Pediatric Subjects With Acute Bacterial Skin and Skin Structure Infections
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 15, 2023 (Actual)
Primary Completion Date
June 15, 2025 (Anticipated)
Study Completion Date
December 15, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Melinta Therapeutics, LLC

4. Oversight

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

5. Study Description

Brief Summary
This protocol describes a randomized, open-label study to evaluate the safety and tolerability of single-dose intravenous (IV) oritavancin diphosphate (oritavancin) versus standard of care (SoC) antibiotics for the treatment of pediatric subjects with acute bacterial skin and skin structure infections (ABSSSIs). This study involves two oritavancin products, ORBACTIV® and KIMYRSATM. Oritavancin is the active drug substance in both ORBACTIV and KIMYRSA. This study protocol distinguishes the differences between ORBACTIV and KIMYRSA by providing product-specific data, and information and guidance for Investigators. "Oritavancin" is used to describe drug product data, and information and guidance that is not specific to ORBACTIV or KIMYRSA (i.e., applies to both). The study involves pharmacokinetic (PK) sampling and will evaluate clinical outcome assessments. The study was designed to capture adequate data while minimizing the impact to subjects and their caregivers.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Bacterial Skin and Skin Structure Infection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
200 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Orbactiv
Arm Type
Experimental
Arm Description
ORBACTIV is infused at 15mg/kg over 3 hours for all subjects not to exceed a dose of 1200mg.
Arm Title
Kimyrsa
Arm Type
Experimental
Arm Description
KIMYRSA is infused at 15mg/kg over 1 hour for subjects ≥12 years old and weighing >40 kg not to exceed a dose of 1200mg. KIMYRSA is infused at 15mg/kg over 3 hours in subjects <12 years old or weighing ≤40 kg.
Arm Title
Standard of Care
Arm Type
Active Comparator
Arm Description
The following SoC medications below will be administered via IV infusion, per the package insert, and according to local rules and regulations. SoC medications cannot be used in combination with one another. Vancomycin Teicoplanin Clindamycin Daptomycin Semi-synthetic penicillins (e.g., nafcillin, oxacillin, cloxacillin) Cefazolin Ceftaroline
Intervention Type
Drug
Intervention Name(s)
Oritavancin
Intervention Description
Oritavancin for IV infusion
Primary Outcome Measure Information:
Title
Safety Assessments
Description
Adverse events (AEs)
Time Frame
28 Days
Secondary Outcome Measure Information:
Title
Test of Cure
Description
All-cause mortality assessed at the Test of Cure visit.
Time Frame
Day 28
Title
Clinical Outcome Assessments
Description
Clinical Outcome Definitions: Clinical response of Cure or failure at End of Treatment visit and Test of Cure visit. Cure Complete or nearly complete resolution of baseline signs and symptoms of the primary infection, including absence of fever No further treatment with antibiotics required for the primary infection Failure Use of additional antibiotic treatment for the primary infection prior to the visit (other than for gram-negative coverage, when given according to this protocol) Worsening signs and symptoms (either assessed by the investigational site or reported by the subject or subject's caregivers) of the primary infection >72 hours from the start of Study Drug treatment. Lost to Follow-up or other extenuating circumstance where the subject cannot be adequately assessed
Time Frame
EoT Day 14; ToC Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Months
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, 3 months to <18 years of age at randomization Diagnosis of at least one of the following ABSSSI infections (known or suspected to be caused by a gram-positive pathogen): Wound infection: that is either traumatic or surgical in origin, defined as an infection characterized by purulent drainage from a wound with surrounding erythema, edema, and/or induration Cellulitis/erysipelas: a diffuse skin infection characterized by spreading areas of erythema, edema, and/or induration Major cutaneous abscess: an infection characterized by a collection of pus within the dermis or subcutaneous tissue that is accompanied by surrounding erythema, edema, and/or induration ABSSSI must present with at least two of the following signs and symptoms: Purulent drainage or discharge Erythema (>1 cm beyond edge of wound or abscess) Fluctuance Heat or localized warmth Edema/induration Pain or tenderness to palpation AND at least one of the following signs of systemic inflammation: Proximal lymph node swelling and tenderness Increased temperature (>38.0°C [>100.4°F]) Decreased temperature (<36.0°C [<96.8°F]) Decreased white blood count (WBC) (<4000/mm3) or increased WBC (>12,000mm3) Bandemia >10% C-reactive protein (CRP) >upper limit of normal (ULN) Written informed consent obtained from parent(s) or legal guardian(s), with written or documented verbal assent of the child obtained, when appropriate, before initiation of any assessments conducted solely for study purposes. Exclusion Criteria: Subjects who have received more than 72 hours of effective antibacterial drug therapy for treatment of the current episode of ABSSSI Subjects who have received a glycopeptide antibiotic (e.g., vancomycin, telavancin, teicoplanin) within 24 hours of randomization Subjects who have received dalbavancin within 45 days prior to randomization Subjects who have been treated with oritavancin within the last 50 days Subjects with infection suspected to be associated with a device or implant Subjects with septic shock or hemodynamic instability Subjects with ABSSSI due to, or associated with any of the following: Infection suspected or documented to be caused solely by gram-negative pathogens (e.g., human or animal bite, injury contaminated with fresh or saltwater, external malignant otitis), fungi, or viruses Wound infection (surgical or traumatic) or abscess with only gram-negative pathogens Concomitant infection at another site, not including a secondary ABSSSI lesion (e.g., septic arthritis, endocarditis, osteomyelitis). Infected burn Primary infection superimposed on a pre-existing skin disease with associated inflammatory changes, e.g., atopic dermatitis, eczema Any evolving necrotizing process (e.g., necrotizing fasciitis), gangrene, or infection suspected or proven to be caused by clostridioides species (e.g., crepitance on examination of the ABSSSI site and/or surrounding tissue(s), radiographic evidence of subcutaneous gas in proximity to the infection) Clinically significant viral infection (e.g., influenza, COVID-19) which, in the Investigator's judgement, will impact the study clinical outcome assessments (e.g., subject is febrile due to the viral infection) Subjects currently receiving chronic systemic immunosuppressive therapy Subjects with neutropenia, defined as absolute neutrophil count (ANC) <500 cells/mm3 Creatinine clearance (CrCl) < 30 mL/min/1.73 m2 as calculated using the updated Schwartz bedside formula: eGFR = k x (height in cm) ÷ serum Creatinine k = 0.33 in pre-term infants. k = 0.45 in term infants to 1 year of age. k = 0.55 in children and adolescent girls. k = 0.70 in adolescent boys Menstruating females with a positive result for the urine or serum human chorionic gonadotropin (HCG) test administered at screening Females of childbearing potential (and males with female partners of childbearing potential) unwilling to practice abstinence or use at least two methods of contraception (e.g., oral contraceptives, barrier methods, approved contraceptive implants) during the entire study period Subjects with a history of infusion-related immunoglobulin E (IgE)-mediated allergic reaction or hypersensitivity reaction to glycopeptides (e.g., vancomycin, telavancin, dalbavancin, oritavancin, teicoplanin) or any of their excipients Subjects who are taking heparin (other than heparin flush for line patency) or warfarin, and/or require anticoagulant monitoring [activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR)] Subjects receiving treatment with an investigational medicinal product or investigational device within 3 months before enrollment or during the study Subjects whom the investigator considers unlikely to adhere to the protocol, comply with Study Drug administration, or complete the clinical study (e.g., unlikely to survive 28 days from initiation of Study Drug) Subjects with alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3x ULN or total bilirubin ≥2x ULN.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Richard J Lazauskas, DC
Phone
1-844-633-6568
Email
rlazauskas@melinta.com
First Name & Middle Initial & Last Name or Official Title & Degree
William Waverczak, MS
Phone
1-844-633-6568
Email
wwaverczak@melinta.com
Facility Information:
Facility Name
Tampa General Hospital
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Mount Sinai Beth Israel
City
New York
State/Province
New York
ZIP/Postal Code
10003-2925
Country
United States
Individual Site Status
Recruiting
Facility Contact:
Phone
212-420-2890
Email
czeranthoney.lim@mountsinai.org
First Name & Middle Initial & Last Name & Degree
Czer Lim, MD
Facility Name
Nationwide Children's Hospital
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43205-2664
Country
United States
Individual Site Status
Recruiting
Facility Contact:
Phone
614-722-8925
Email
guliz.erdem@nationwidechildrens.org
First Name & Middle Initial & Last Name & Degree
Guliz Erdem, MD
Facility Name
Multiprofile Hospital for Active Treatment- Sveti Nikolay Chudotvoretz - LOM EOOD
City
Lom
State/Province
Montana
ZIP/Postal Code
3600
Country
Bulgaria
Individual Site Status
Recruiting
Facility Contact:
Email
chavdar.antonov@fidelis-research.com
First Name & Middle Initial & Last Name & Degree
Chavdar Antonov, MD
Facility Name
Multiprofile Hospital For Active Treatment Dr Tota Venkova
City
Gabrovo
ZIP/Postal Code
5300
Country
Bulgaria
Individual Site Status
Recruiting
Facility Contact:
Email
dr.svetla.pashova@gmail.com
First Name & Middle Initial & Last Name & Degree
Svetla Pashova-Mihova
Facility Name
University Multiprofile Hospital for Active Treatment Sveti Georgi EAD-66 Peshtersko Shosse blvd
City
Plovdiv
ZIP/Postal Code
4000
Country
Bulgaria
Individual Site Status
Recruiting
Facility Contact:
Email
pepi_stef@hotmail.com
First Name & Middle Initial & Last Name & Degree
Penka Stefanova, MD, PhD
Facility Name
University Multiprofile Hospital For Active Treatment Kanev AD
City
Ruse
ZIP/Postal Code
7002
Country
Bulgaria
Individual Site Status
Recruiting
Facility Contact:
Email
sansiood@abv.bg
First Name & Middle Initial & Last Name & Degree
Simeon Simeonov, MD
Facility Name
University Multiprofile Hospital for Active Treatment and Emergency Medicine N. I. Pirogov EAD
City
Sofia
ZIP/Postal Code
1606
Country
Bulgaria
Individual Site Status
Active, not recruiting
Facility Name
University Multiprofile Hospital for Active Treatment - Prof. Dr. Stoyan Kirkovich AD
City
Stara Zagora
ZIP/Postal Code
6003
Country
Bulgaria
Individual Site Status
Recruiting
Facility Contact:
Email
dr.krasimira.kalinova@gmail.com
First Name & Middle Initial & Last Name & Degree
Krasimira Kalinova
Facility Name
Aghia Sophia' Children's General Hospital of Athens
City
Athens
State/Province
Attiki
ZIP/Postal Code
115 27
Country
Greece
Individual Site Status
Active, not recruiting
Facility Name
Attikon University General Hospital
City
Chaidari
State/Province
Attiki
ZIP/Postal Code
124 62
Country
Greece
Individual Site Status
Active, not recruiting
Facility Name
Ippokratio General Hospital of Thessaloniki
City
Thessaloniki
ZIP/Postal Code
546 42
Country
Greece
Individual Site Status
Active, not recruiting
Facility Name
Papageorgiou General Hospital of Thessaloniki
City
Thessaloniki
ZIP/Postal Code
56429
Country
Greece
Individual Site Status
Active, not recruiting
Facility Name
Daugavpils Regional Hospital
City
Daugavpils
State/Province
Daugavpils Aprinkis
ZIP/Postal Code
LV-5417
Country
Latvia
Individual Site Status
Recruiting
Facility Contact:
Email
vladimiroleinikov@inbox.lv
First Name & Middle Initial & Last Name & Degree
Vladimirs Oleinikovs, MD
Facility Name
Regional Hospital of Liepaja
City
Liepaja
State/Province
Liepajas Aprinkis
ZIP/Postal Code
LV-3414
Country
Latvia
Individual Site Status
Active, not recruiting
Facility Name
Children's Clinical University Hospital
City
Riga
ZIP/Postal Code
LV-1004
Country
Latvia
Individual Site Status
Recruiting
Facility Contact:
Email
ainars.gilis@bkus.lv
First Name & Middle Initial & Last Name & Degree
Ainars Gilis, MD
Facility Name
Hospital of Lithuanian University of Health Sciences Kauno klinikos
City
Kaunas
State/Province
Kauno Apskritis
ZIP/Postal Code
LT-50009
Country
Lithuania
Individual Site Status
Active, not recruiting
Facility Name
Klaipeda Children Hospital
City
Klaipeda
State/Province
Klaipedos Apskritis
ZIP/Postal Code
92140
Country
Lithuania
Individual Site Status
Active, not recruiting
Facility Name
Instytut Pomnik Centrum Zdrowia Dziecka - PIN
City
Warszawa
State/Province
Mazowieckie
ZIP/Postal Code
04-736
Country
Poland
Individual Site Status
Active, not recruiting
Facility Name
Hospital de Cascais
City
Alcabideche
State/Province
Lisboa
ZIP/Postal Code
2755-009
Country
Portugal
Individual Site Status
Active, not recruiting
Facility Name
Hospital de Braga
City
Braga
ZIP/Postal Code
4710-243
Country
Portugal
Individual Site Status
Active, not recruiting
Facility Name
Louis Turcanu Emergency Clinical Hospital for Children
City
Timisoara
State/Province
Timis
ZIP/Postal Code
300011
Country
Romania
Individual Site Status
Recruiting
Facility Contact:
Email
david.vlad@yahoo.com
First Name & Middle Initial & Last Name & Degree
Vlad David, MD, PhD
Facility Name
Brasov Children Clinical Hospital
City
Brașov
ZIP/Postal Code
500063
Country
Romania
Individual Site Status
Recruiting
Facility Contact:
Email
liviumuntean67@gmail.com
First Name & Middle Initial & Last Name & Degree
Iuliu Muntean, MD
Facility Name
Hospital Universitario Vall d'Hebron - PPDS
City
Barcelona
ZIP/Postal Code
8035
Country
Spain
Individual Site Status
Active, not recruiting
Facility Name
Hospital Sant Joan de Deu - PIN
City
Barcelona
ZIP/Postal Code
8950
Country
Spain
Individual Site Status
Active, not recruiting
Facility Name
Hospital Universitario 12 de Octubre
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Individual Site Status
Active, not recruiting
Facility Name
Hospital Universitario La Paz - PPDS
City
Madrid
ZIP/Postal Code
28046
Country
Spain
Individual Site Status
Active, not recruiting

12. IPD Sharing Statement

Learn more about this trial

Study to Evaluate the Safety and Tolerability of Single-Dose Intravenous (IV) Oritavancin

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