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Zoliflodacin in Uncomplicated Gonorrhoea

Primary Purpose

Gonorrhea

Status
Active
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
zoliflodacin
ceftriaxone
azithromycin
Sponsored by
Global Antibiotics Research and Development Partnership
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gonorrhea

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥ 12 years old (if enrolment of minors is in agreement with local regulations and thics guidance)
  2. Weight ≥ 35 kg
  3. Signs and symptoms consistent with urethral or cervical gonorrhoea OR Urethral or cervical uncomplicated gonorrhoea as determined by either a positive culture or NAAT or Gram stain or methylene blue test/gentian violet stain in the past 14 days prior to screening OR Unprotected sexual contact with an individual reported to be infected with NG in the past 14 days prior to screening (confirmation by a positive NAAT, Gram stain or methylene blue test/ gentian violet stain or culture)
  4. For females of child-bearing potential, a negative urine pregnancy test at screening
  5. For females of child bearing potential, use of highly effective contraception for at least 28 days prior to screening and during at least 28 days after treatment. Females on oral contraceptives must also use a barrier contraception method during participation in the study.
  6. For males with a female partner of child-bearing age, willingness to delay conception for 28 days after treatment
  7. Willingness to comply with trial protocol
  8. Willingness to undergo HIV testing
  9. Willingness to abstain from sexual intercourse or use condoms for vaginal, anal and oral sex until end of trial visit
  10. Willingness and ability to give written informed consent or be consented by a legal representative or provide assent and parental consent (for minors, as appropriate).

    Exclusion Criteria:

  11. Confirmed or suspected complicated or disseminated gonorrhoea
  12. Pregnant or breastfeeding women
  13. Known concomitant infection which would require immediate additional systemic antibiotics with activity against NG (e.g. CT infection)
  14. Use of any systemic or intravaginal antibiotics with activity against NG within 30 days prior to screening
  15. Use of systemic corticoid drugs or other immunosuppressive therapy within 30 days prior to screening
  16. Use of moderate or strong CYP3A4 inducers (e.g. efavirenz, rifampicin, carbamazepine, phenobarbital) within 30 days or five half-lives of the drug, whichever is greater, prior to screening
  17. Cytotoxic or radiation therapy within 30 days prior to screening
  18. Known chronic renal, hepatic, hematologic impairment or other condition interfering with the absorption, distribution or elimination of the drug based on medical history and physical examination
  19. History of urogenital sex-reassignment surgery
  20. Immunosuppression as evidenced by medical history, clinical examination or a recent (≤ 1 month) CD4 count <200 cells/μL
  21. Know clinically relevant cardiac pro-arrhythmic conditions such as cardiac arrhythmia, congenital or documented QT prolongation
  22. Known history of severe allergy to cephalosporin, penicillin, monobactams, carbapenems or macrolide antibiotics
  23. Known or suspected allergies or hypersensitivities to lidocaine, methylparaben, lactose or any of the components of the study drugs (refer to the zoliflodacin IB and SmPC for the comparators treatments)
  24. Receipt or planned receipt of an investigational product in a clinical trial within 30 days or five half-lives of the drug, whichever is greater, prior to screening until end of participation to this clinical trial
  25. History of alcohol or drug abuse within 12 months prior to screening which would compromise trial participation in the judgment of the investigator
  26. Severe medical or psychiatric condition which, in the opinion of the investigator, may increase the risk associated with trial participation or may interfere with the interpretation of trial results or affect the individual's ability to provide informed consent
  27. Individuals whom, in the judgement of the investigator, are unlikely or unable to comply with this trial protocol
  28. Previous randomisation in this clinical trial.
  29. Use of moderate or strong CYP3A4 inhibitors within 30 days or five half-lives of the drug, whichever is greater, prior to screening

Sites / Locations

  • Jefferson County Department of Health
  • University of Alabama at Birmingham
  • San Francisco Department Of Public Health City Clinic
  • Bell Flower Clinic
  • Louisiana State University Health Sciences Center
  • Public Health - Seattle & King County STD Clinic
  • Institute of Tropical Medicine
  • Public Health Service (GGD) Amsterdam / STI Outpatient Clinic
  • SAMRC Botha's Hill Clinical Research Site
  • Masiphumelele Research Site
  • Ndlovu Research Centre
  • Wits RHI
  • Setshaba Research Centre
  • SAMRC Tongaat Clinical Research Site
  • Bangrak STI Center
  • Institute of HIV Research and Innovation
  • Silom Community Clinic

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

zoliflodacin

ceftriaxone and azithromycin combination

Arm Description

Participant in this arm will receive a single dose of zoliflodacin.

Participant in this arm will receive a single dose of comparators combination (ceftriaxone and azithromycin).

Outcomes

Primary Outcome Measures

Efficacy of a single dose of zoliflodacin will be assessed compared to a combination of a single dose of ceftriaxone and azithromycin.
Microbiological cure as determined by culture at urethral or cervical sites at test of cure visit.

Secondary Outcome Measures

Safety of a single dose of zoliflodacin will be assessed compared to a combination a single dose of ceftriaxone and azithromycin.
Adverse events will be assessed.
Microbiological cure rate of pharyngeal gonorrhoea will be determined after administration of a single dose of zoliflodacin compared to a combination of a single dose of ceftriaxone and azithromycin.
Proportion of participants with microbiological cure as determined by culture at pharyngeal sites at test of cure visit.
Microbiological cure rate of rectal gonorrhoea will be determined after administration of a single dose of zoliflodacin compared to a combination of a single dose of ceftriaxone and azithromycin.
Proportion of participants with microbiological cure as determined by culture at rectal sites at test of cure visit.
The clinical cure rate of symptomatic gonorrhoea in male participants will be determined after administration of a single dose of zoliflodacin compared to a combination of single dose of ceftriaxone and azithromycin.
Proportion of male participants with clinical cure at test of cure visit.
Microbiological cure rate of urogenital gonorrhoea will be determined among women and men respectively, after administration of a single dose of zoliflodacin compared to a combination of a single dose of ceftriaxone and azithromycin.
Proportion of female and male participants respectively with microbiological cure as determined by culture at cervical or urethral site at test of cure visit.
Microbiological cure rate of Neisseria gonorrhoeae (NG) at urogenital sites will be determined.
Proportion of participants with microbiological cure as determined by culture at urethral or cervical sites at the test of cure visit and for whom the baseline antimicrobial susceptibility profile indicated pre-existing resistance to antibiotics commonly used for Neisseria gonorrhoeae (NG) treatment.
Antimicrobial susceptibility profile will be determined of gonococcal strains isolated from participants with uncomplicated gonorrhoea at baseline and the test of cure visit.
Antimicrobial susceptibility profile of gonococcal strains isolated at baseline and at test of cure visit.
The eradication rate of NG nucleic acid will be determined from urogenital rectal, pharyngeal specimens after administration of a single dose of zoliflodacin compared to a combination of a single dose of ceftriaxone and azithromycin.
Proportion of participants with a negative NG NAAT from urethral or cervical, oropharyngeal and rectal sites at test of cure visit.
The plasma concentration will be evaluated (included Area Under the Curve (AUC) over 36 hours) after a single dose of zoliflodacin.
Five PK timepoints post-treatment will be assessed.

Full Information

First Posted
May 2, 2019
Last Updated
May 11, 2023
Sponsor
Global Antibiotics Research and Development Partnership
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1. Study Identification

Unique Protocol Identification Number
NCT03959527
Brief Title
Zoliflodacin in Uncomplicated Gonorrhoea
Official Title
A Multi-center, Randomized, Open-label, Non Inferiority Trial to Evaluate the Efficacy and Safety of a Single, Oral Dose of Zoliflodacin Compared to a Combination of a Single Intramuscular Dose of Ceftriaxone and a Single Oral Dose of Azithromycin in the Treatment of Patients With Uncomplicated Gonorrhoea
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 6, 2019 (Actual)
Primary Completion Date
August 30, 2023 (Anticipated)
Study Completion Date
December 10, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Global Antibiotics Research and Development Partnership

4. Oversight

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

5. Study Description

Brief Summary
This trial is a multi-center, open label, randomized controlled, non-inferiority phase III trial evaluating the safety and efficacy of a 3 g oral dose of zoliflodacin compared to a combination of a single intra-muscular 500 mg dose of ceftriaxone and a single 1 g oral dose of azithromycin for the treatment of uncomplicated gonorrhoea.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gonorrhea

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Single dose of Zoliflodacin or comparators combination in single dose: ceftriaxone and azithromycin
Masking
None (Open Label)
Allocation
Randomized
Enrollment
1092 (Actual)

8. Arms, Groups, and Interventions

Arm Title
zoliflodacin
Arm Type
Experimental
Arm Description
Participant in this arm will receive a single dose of zoliflodacin.
Arm Title
ceftriaxone and azithromycin combination
Arm Type
Active Comparator
Arm Description
Participant in this arm will receive a single dose of comparators combination (ceftriaxone and azithromycin).
Intervention Type
Drug
Intervention Name(s)
zoliflodacin
Intervention Description
Dose: 3g, oral administration
Intervention Type
Drug
Intervention Name(s)
ceftriaxone
Intervention Description
Dose: 500mg, Intra-Muscular (IM) administration
Intervention Type
Drug
Intervention Name(s)
azithromycin
Intervention Description
Dose: 1g, oral administration
Primary Outcome Measure Information:
Title
Efficacy of a single dose of zoliflodacin will be assessed compared to a combination of a single dose of ceftriaxone and azithromycin.
Description
Microbiological cure as determined by culture at urethral or cervical sites at test of cure visit.
Time Frame
Day 6
Secondary Outcome Measure Information:
Title
Safety of a single dose of zoliflodacin will be assessed compared to a combination a single dose of ceftriaxone and azithromycin.
Description
Adverse events will be assessed.
Time Frame
Day 6 and Day 30
Title
Microbiological cure rate of pharyngeal gonorrhoea will be determined after administration of a single dose of zoliflodacin compared to a combination of a single dose of ceftriaxone and azithromycin.
Description
Proportion of participants with microbiological cure as determined by culture at pharyngeal sites at test of cure visit.
Time Frame
Day 6
Title
Microbiological cure rate of rectal gonorrhoea will be determined after administration of a single dose of zoliflodacin compared to a combination of a single dose of ceftriaxone and azithromycin.
Description
Proportion of participants with microbiological cure as determined by culture at rectal sites at test of cure visit.
Time Frame
Day 6
Title
The clinical cure rate of symptomatic gonorrhoea in male participants will be determined after administration of a single dose of zoliflodacin compared to a combination of single dose of ceftriaxone and azithromycin.
Description
Proportion of male participants with clinical cure at test of cure visit.
Time Frame
Day 6
Title
Microbiological cure rate of urogenital gonorrhoea will be determined among women and men respectively, after administration of a single dose of zoliflodacin compared to a combination of a single dose of ceftriaxone and azithromycin.
Description
Proportion of female and male participants respectively with microbiological cure as determined by culture at cervical or urethral site at test of cure visit.
Time Frame
Day 6
Title
Microbiological cure rate of Neisseria gonorrhoeae (NG) at urogenital sites will be determined.
Description
Proportion of participants with microbiological cure as determined by culture at urethral or cervical sites at the test of cure visit and for whom the baseline antimicrobial susceptibility profile indicated pre-existing resistance to antibiotics commonly used for Neisseria gonorrhoeae (NG) treatment.
Time Frame
Day 6
Title
Antimicrobial susceptibility profile will be determined of gonococcal strains isolated from participants with uncomplicated gonorrhoea at baseline and the test of cure visit.
Description
Antimicrobial susceptibility profile of gonococcal strains isolated at baseline and at test of cure visit.
Time Frame
Day 6
Title
The eradication rate of NG nucleic acid will be determined from urogenital rectal, pharyngeal specimens after administration of a single dose of zoliflodacin compared to a combination of a single dose of ceftriaxone and azithromycin.
Description
Proportion of participants with a negative NG NAAT from urethral or cervical, oropharyngeal and rectal sites at test of cure visit.
Time Frame
Day 6
Title
The plasma concentration will be evaluated (included Area Under the Curve (AUC) over 36 hours) after a single dose of zoliflodacin.
Description
Five PK timepoints post-treatment will be assessed.
Time Frame
Day 2

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 12 years old (if enrolment of minors is in agreement with local regulations and thics guidance) Weight ≥ 35 kg Signs and symptoms consistent with urethral or cervical gonorrhoea OR Urethral or cervical uncomplicated gonorrhoea as determined by either a positive culture or NAAT or Gram stain or methylene blue test/gentian violet stain in the past 14 days prior to screening OR Unprotected sexual contact with an individual reported to be infected with NG in the past 14 days prior to screening (confirmation by a positive NAAT, Gram stain or methylene blue test/ gentian violet stain or culture) For females of child-bearing potential, a negative urine pregnancy test at screening For females of child bearing potential, use of highly effective contraception for at least 28 days prior to screening and during at least 28 days after treatment. Females on oral contraceptives must also use a barrier contraception method during participation in the study. For males with a female partner of child-bearing age, willingness to delay conception for 28 days after treatment Willingness to comply with trial protocol Willingness to undergo HIV testing Willingness to abstain from sexual intercourse or use condoms for vaginal, anal and oral sex until end of trial visit Willingness and ability to give written informed consent or be consented by a legal representative or provide assent and parental consent (for minors, as appropriate). Exclusion Criteria: Confirmed or suspected complicated or disseminated gonorrhoea Pregnant or breastfeeding women Known concomitant infection which would require immediate additional systemic antibiotics with activity against NG (e.g. CT infection) Use of any systemic or intravaginal antibiotics with activity against NG within 30 days prior to screening Use of systemic corticoid drugs or other immunosuppressive therapy within 30 days prior to screening Use of moderate or strong CYP3A4 inducers (e.g. efavirenz, rifampicin, carbamazepine, phenobarbital) within 30 days or five half-lives of the drug, whichever is greater, prior to screening Cytotoxic or radiation therapy within 30 days prior to screening Known chronic renal, hepatic, hematologic impairment or other condition interfering with the absorption, distribution or elimination of the drug based on medical history and physical examination History of urogenital sex-reassignment surgery Immunosuppression as evidenced by medical history, clinical examination or a recent (≤ 1 month) CD4 count <200 cells/μL Know clinically relevant cardiac pro-arrhythmic conditions such as cardiac arrhythmia, congenital or documented QT prolongation Known history of severe allergy to cephalosporin, penicillin, monobactams, carbapenems or macrolide antibiotics Known or suspected allergies or hypersensitivities to lidocaine, methylparaben, lactose or any of the components of the study drugs (refer to the zoliflodacin IB and SmPC for the comparators treatments) Receipt or planned receipt of an investigational product in a clinical trial within 30 days or five half-lives of the drug, whichever is greater, prior to screening until end of participation to this clinical trial History of alcohol or drug abuse within 12 months prior to screening which would compromise trial participation in the judgment of the investigator Severe medical or psychiatric condition which, in the opinion of the investigator, may increase the risk associated with trial participation or may interfere with the interpretation of trial results or affect the individual's ability to provide informed consent Individuals whom, in the judgement of the investigator, are unlikely or unable to comply with this trial protocol Previous randomisation in this clinical trial. Use of moderate or strong CYP3A4 inhibitors within 30 days or five half-lives of the drug, whichever is greater, prior to screening
Facility Information:
Facility Name
Jefferson County Department of Health
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
Facility Name
University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294-0006
Country
United States
Facility Name
San Francisco Department Of Public Health City Clinic
City
San Francisco
State/Province
California
ZIP/Postal Code
94103
Country
United States
Facility Name
Bell Flower Clinic
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Louisiana State University Health Sciences Center
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70112
Country
United States
Facility Name
Public Health - Seattle & King County STD Clinic
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
Facility Name
Institute of Tropical Medicine
City
Antwerp
ZIP/Postal Code
2000
Country
Belgium
Facility Name
Public Health Service (GGD) Amsterdam / STI Outpatient Clinic
City
Amsterdam
ZIP/Postal Code
1018 WT
Country
Netherlands
Facility Name
SAMRC Botha's Hill Clinical Research Site
City
Bothas Hill
ZIP/Postal Code
3660
Country
South Africa
Facility Name
Masiphumelele Research Site
City
Cape Town
ZIP/Postal Code
7975
Country
South Africa
Facility Name
Ndlovu Research Centre
City
Elandsdoorn
ZIP/Postal Code
0470
Country
South Africa
Facility Name
Wits RHI
City
Johannesburg
ZIP/Postal Code
2001
Country
South Africa
Facility Name
Setshaba Research Centre
City
Soshanguve
ZIP/Postal Code
0152
Country
South Africa
Facility Name
SAMRC Tongaat Clinical Research Site
City
Tongaat
ZIP/Postal Code
4400
Country
South Africa
Facility Name
Bangrak STI Center
City
Bangkok
ZIP/Postal Code
10120
Country
Thailand
Facility Name
Institute of HIV Research and Innovation
City
Bangkok
ZIP/Postal Code
10330
Country
Thailand
Facility Name
Silom Community Clinic
City
Bangkok
ZIP/Postal Code
10400
Country
Thailand

12. IPD Sharing Statement

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Zoliflodacin in Uncomplicated Gonorrhoea

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