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    Summary
    EudraCT Number:2011-002860-26
    Sponsor's Protocol Code Number:TR701-113
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2011-10-28
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2011-002860-26
    A.3Full title of the trial
    A Phase 3 Randomized, Double-Blind, Multicenter Study Comparing
    the Efficacy and Safety of Intravenous to Oral 6-Day TR-701 Free
    Acid and Intravenous to Oral 10-Day Linezolid for the Treatment of
    Acute Bacterial Skin and Skin Structure Infections
    Estudio de fase 3 aleatorizado, doble ciego, multicéntrico para comparar la eficacia y la seguridad de la administración de TR-701 ácido libre por vía primero intravenosa y luego oral durante 6 días con las de linezolid por vía primero intravenosa y luego oral durante 10 días para el tratamiento de infecciones bacterianas agudas de la piel y los anejos cutáneos
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    The purpose of this study is to learn if an experimental antibiotic called
    TR-701 FA can safely and effectively treat an acute bacterial skin or skin
    structure infection. The experimental antibiotic will be tested against the
    already approved antibiotic Linezolid adminstered intravenous to oral. The sponsor of the study wants to prove, that the new medication isn't inferior regarding efficacy and safety as compared to the already approved medication Linezolid.
    El propósito de este estudio es conocer si un antibiótico experimental llamado TR-701 FA puede tratar de manera segura y efectiva una infección bacteriana aguda de la piel o anejos cutáneos. El antibiótico experimental se pondrá a prueba frente al antibiótico ya aprobado Linezolid, administrado por vía intravenosa y luego oral, para demostrar que el nuevo medicamento, en comparación con el medicamento ya aprobado Linezolid, no es inferior con respecto a la eficacia y seguridad.
    A.4.1Sponsor's protocol code numberTR701-113
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorTrius Therapeutics, Inc.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportTrius Therapeutics, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationTrius Therapeutics, Inc.
    B.5.2Functional name of contact pointEdward Fang, MD
    B.5.3 Address:
    B.5.3.1Street Address6310 Nancy Ridge Dr, Ste 105
    B.5.3.2Town/ citySan Diego
    B.5.3.3Post codeCA 92121
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1858452 0370 249
    B.5.5Fax number+1858452 0412
    B.5.6E-mailefang@triusrx.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameTR-701 FA
    D.3.2Product code TR-701 FA
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.1CAS number 856867-55-5
    D.3.9.2Current sponsor codeTR-701 FA
    D.3.9.3Other descriptive namefree acid phosphate pro-drug for the active oxazolidinone
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameTR-701 FA Powder for Solution for Infusion
    D.3.2Product code TR-701 FA Powder for Solution for Infusion
    D.3.4Pharmaceutical form Powder for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.1CAS number 856867-55-5
    D.3.9.2Current sponsor codeTR-701 FA
    D.3.9.3Other descriptive namefree acid phosphate pro-drug for the active oxazolidinone
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Zyvox
    D.2.1.1.2Name of the Marketing Authorisation holderPfizer; Inc.
    D.2.1.2Country which granted the Marketing AuthorisationUnited States
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.1CAS number 165800-03-3
    D.3.9.2Current sponsor codeZyvox (linezolid)
    D.3.9.3Other descriptive nameLINEZOLID
    D.3.9.4EV Substance CodeSUB08520MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number600
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Zyvoxid 2 mg/ml solución para perfusión
    D.2.1.1.2Name of the Marketing Authorisation holderPFIZER S.A
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.1CAS number 165800-03-3
    D.3.9.2Current sponsor codeZyvox (linezolid)
    D.3.9.3Other descriptive nameLINEZOLID
    D.3.9.4EV Substance CodeSUB08520MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number600
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 3
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboSolution for injection/infusion
    D.8.4Route of administration of the placeboIntravenous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Acute Bacterial Skin and Skin Structure Infections
    Tratamiento de infecciones bacterianas agudas de la piel y los anejos cutáneos.
    E.1.1.1Medical condition in easily understood language
    Acute infection of the skin or structure of the skin due to bacteria
    Tratamiento de infecciones bacterianas agudas de la piel y los anejos cutáneos.
    E.1.1.2Therapeutic area Diseases [C] - Bacterial Infections and Mycoses [C01]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 14.0
    E.1.2Level PT
    E.1.2Classification code 10040872
    E.1.2Term Skin infection
    E.1.2System Organ Class 10021881 - Infections and infestations
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    El objetivo principal es determinar la no inferioridad (NI) de la tasa de respuesta clínica inicial a la administración durante 6 días de TR-701 ácido libre (AL) por vía primero intravenosa (i.v.) y luego oral en comparación con una pauta de linezolid durante 10 días por vía primero i.v. y luego oral 48-72 horas después de la primera infusión del fármaco del estudio en el grupo de análisis por intención de tratar (IT) en pacientes con infecciones bacterianas agudas de la piel y los anejos cutáneos (IBAPAC).
    E.2.2Secondary objectives of the trial
    The secondary objectives include the following:
    ? To compare the programmatic clinical response of 6-day TR-701 FA and 10 day linezolid treatment at the End of Therapy (EOT) Visit (Day 11) in the ITT and Clinically Evaluable at EOT (CE-EOT) analysis sets
    ? To compare the Investigator?s assessment of clinical success at the Post-Therapy Evaluation (PTE) Visit (7-14 days after the EOT Visit) in the ITT and Clinically Evaluable at PTE (CE PTE) analysis sets
    ? To compare the Investigator?s assessment of clinical response at the 48-72 Hour and Day 7 Visits in the ITT analysis set
    ? To compare patient-reported pain, by study visit
    ? To evaluate the safety profile of TR-701 FA in comparison with that of linezolid
    ? To assess the population pharmacokinetic (PK) profile of TR-700
    Los objetivos secundarios son los siguientes:
    ?Comparar la respuesta clínica automática a los tratamientos de 6 días con TR-701 AL y de 10 días con linezolid en la visita de final del tratamiento (FDT) (día 11) en los grupos de análisis IT y evaluable desde el punto de vista clínico al final del tratamiento (EC-FDT).
    ?Comparar la evaluación del éxito clínico realizada por el investigador en la visita de evaluación posterior al tratamiento (EPT) (7-14 días después de la visita FDT) en los grupos de análisis IT y evaluable clínicamente en la EPT (EC-EPT).
    ?Comparar la evaluación de la respuesta clínica realizada por el investigador en las visitas de 48-72 horas y del día 7 en el grupo de análisis IT.
    ?Comparar el dolor notificado por el paciente en cada visita del estudio.
    ?Evaluar el perfil de seguridad de TR-701 AL en comparación con el de linezolid.
    ?Evaluar el perfil de farmacocinética (FC) poblacional de TR-700.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Patients who meet all of the following diagnostic and inclusion criteria for ABSSSI are eligible for the study:
    1. Males or females ? 18 years old
    2. Adequate venous access for a minimum of 2 IV doses of study drug
    3. ABSSSI meeting at least 1 of the clinical syndrome definitions listed below and requiring IV antibiotic therapy. Local symptoms must have started within 7 days before the Screening Visit.
    a. Cellulitis/erysipelas defined as a diffuse skin infection, characterized by all of the following within 24 hours:
    ? Rapidly spreading areas of erythema, edema, and/or induration of a minimum total lesion surface area of 75 cm2
    ? No collection of pus apparent upon visual examination (diagnosis still consistent with cellulitis/erysipelas if pus is collected from the lesion)
    ? At least 2 of the following signs of infection:
    ? Erythema
    ? Induration
    ? Localized warmth
    ? Pain or tenderness on palpation
    ? Swelling/edema
    ? At least 1 of the following regional or systemic signs of infection:
    ? Lymph node tenderness and increase in volume or palpable proximal to the primary ABSSSI
    ? Fever, defined as body temperature ? 38°C (100.4°F) oral, ? 38.5°C (101.3°F) tympanic, or ? 39°C (102.2°F) rectal (observed by a health care provider)
    ? White blood cell (WBC) count ? 10,000 cells/mm3 or < 4000 cells/mm3
    ? > 10% immature neutrophils
    b. Major cutaneous abscess defined as an infection characterized by a collection of pus apparent upon visual examination spreading within the dermis or deeper that is accompanied by all of the following within 24 hours:
    ? Erythema, edema, and/or induration extending at least 5 cm in the shortest distance from the peripheral margin of the abscess and with a minimum total lesion surface area of 75 cm2
    ? At least 1 of the following signs of infection:
    ? Fluctuance
    ? Incision and drainage required
    ? Purulent or seropurulent drainage
    ? Localized warmth
    ? Pain or tenderness on palpation
    ? At least 1 of the following regional or systemic signs of infection:
    ? Lymph node tenderness and increase in volume or palpable proximal to the primary ABSSSI
    ? Fever, defined as body temperature ? 38°C (100.4°F) oral, ? 38.5°C (101.3°F) tympanic, or ? 39°C (102.2°F) rectal (observed by a health care provider)
    ? WBC count ? 10,000 cells/mm3 or < 4000 cells/mm3
    ? > 10% immature neutrophils
    c. Wound Infection defined as an infection of any apparent break in the skin characterized by the following:
    ? Superficial incision surgical site infection (SSI) meeting all of the following criteria:
    ? Follows clean surgery (elective, not emergency, nontraumatic, primarily closed, no acute inflammation; no break in technique; respiratory, gastrointestinal, biliary, and genitourinary tracts not entered)
    ? Involves only the skin or subcutaneous tissue around the incision, does not involve fascia
    ? Occurs within 30 days after procedure
    ? Original surgical incision ?3 cm
    ? Purulent drainage (spontaneous or therapeutic) with surrounding erythema, edema, and/or induration extending at least 5 cm in the shortest distance from the peripheral margin of the wound and with a minimum total lesion surface area of 75 cm2
    ? At least 1 of the following regional or systemic signs of infection:
    ? Lymph node tenderness and increase in volume or palpable proximal to the primary ABSSSI
    ? Fever, defined as body temperature ? 38°C (100.4°F) oral, ? 38.5°C (101.3°F) tympanic, or ? 39°C (102.2°F) rectal (observed by a health care provider)
    ? WBC count ? 10,000 cells/mm3 or < 4000 cells/mm3
    ? > 10% immature neutrophils
    ? Post traumatic wound (including penetrating trauma [needle, nail, knife]) characterized by all of the following within 24 hours:
    ? Purulent drainage (spontaneous or therapeutic) with surrounding erythema, edema, and/or induration extending at least 5 cm in the shortest distance from the peripheral margin of the wound and with a minimum total lesion surface area of 75 cm2
    ? At least 1 of the following regional or systemic signs of infection:
    ? Lymph node tenderness and increase in volume or palpable proximal to the primary ABSSSI
    ? Fever, defined as body temperature ? 38°C (100.4°F) oral, ? 38.5°C (101.3°F) tympanic, or ? 39°C (102.2°F) rectal (observed by a health care provider)
    ? WBC count ? 10,000 cells/mm3 or < 4000 cells/mm3
    ? > 10% immature neutrophils
    4. Suspected or documented gram-positive infection from baseline Gram stain or culture. The microbiological sample must have been collected using a valid sampling technique such as an aspirate, biopsy, incision, deep swab, etc. A superficial swab is not acceptable. Specimens for culture are required for abscesses and wounds at Screening; cellulitis specimens are to be collected according to standard practice at the site
    5. Able to give informed consent and willing to comply with all required study procedures
    1.Varones o mujeres 18 años.
    2.Acceso venoso adecuado para al menos dos dosis i.v. del fármaco del estudio.
    3.IBAPAC que cumpla al menos una de las definiciones del síndrome clínico recogidas a continuación y que exija tratamiento antibiótico i.v. Los síntomas locales deben haber comenzado durante los 7 días previos a la visita de selección.
    a.Celulitis/erisipela definida como infección cutánea difusa.
    b.Absceso cutáneo grave definido como infección caracterizada por una acumulación de pus evidente a la exploración visual que se extiende hacia el interior de la dermis o hacia tejidos más profundos.
    c.Herida infectada definida como una infección de cualquier discontinuidad manifiesta de la piel. 4.Infección por bacterias grampositivas sospechada o documentada mediante tinción de Gram o cultivo en el momento basal. La muestra microbiológica debe haberse obtenido con una técnica válida, como aspiración, biopsia, incisión, hisopo profundo, etc. No son aceptables las muestras superficiales obtenidas con hisopo. En la selección hay que obtener muestras para cultivo en el caso de abscesos y úlceras; las muestras de celulitis se recogerán según la práctica habitual en el centro.
    5.Capaces de otorgar el consentimiento informado y dispuestos a cumplir los procedimientos del estudio.
    E.4Principal exclusion criteria
    Patients who meet any of the following criteria are not eligible to participate in this study:
    1. Uncomplicated skin and skin structure infections such as furuncles, minor abscesses (area of suppuration not surrounded by cellulitis/erysipelas), impetiginous lesions, superficial or limited cellulitis/erysipelas, and minor wound infections (eg, stitch abscesses)
    2. Infections associated with, or in close proximity to, a prosthetic device
    3. Severe sepsis or septic shock
    4. Known bacteremia at time of screening
    5. ABSSSI due to or associated with any of the following:
    ? Suspected or documented gram-negative pathogens in patients with cellulitis/erysipelas or major cutaneous abscess that require an antibiotic with specific gram-negative coverage. Patients with wound infections where gram negative adjunctive therapy is warranted may be enrolled if they meet the other eligibility criteria
    ? Diabetic foot infection, gangrene, or perianal abscess
    ? Concomitant infection at another site not including a secondary ABSSSI lesion (eg, septic arthritis, endocarditis, osteomyelitis)
    ? Infected burns
    ? Decubitus or chronic skin ulcer, or ischemic ulcer due to peripheral vascular disease (arterial or venous)
    ? Any evolving necrotizing process (ie, necrotizing fasciitis)
    ? Infected human or animal bites. However, arthropod (eg, insects, spiders, ?bugs?) bites are allowed; these are not considered animal bites in this study
    ? Infections at vascular catheter sites or involving thrombophlebitis
    ? Incision SSI with any of the following characteristics:
    ? Follows clean-contaminated surgery (urgent or emergency case that is otherwise clean, elective opening of respiratory, gastrointestinal, biliary, or genitourinary tract with minimal spillage [eg, appendectomy] not encountering infected urine or bile; minor technique break)
    ? Follows contaminated surgery (nonpurulent inflammation; gross spillage from gastrointestinal tract; entry into biliary or genitourinary tract in the presence of infected bile or urine; major break in technique; chronic open wounds to be grafted or covered)
    ? Follows dirty surgery (purulent inflammation [eg, abscess]; preoperative perforation of respiratory, gastrointestinal, biliary, or genitourinary tract)
    ? Extends into the fascial or muscle layers, organs, or spaces
    6. Use of antibiotics as follows:
    ? Systemic antibiotic with gram-positive cocci activity for the treatment of any infection within 96 hours before the first infusion of study drug
    ? Patients who failed prior therapy for the primary infection site are also excluded from enrollment
    ? Topical antibiotic on the primary lesion except for antibiotic/antiseptic-coated dressing applied to the clean postsurgical wound
    7. Administration of linezolid within 30 days before the first infusion of study drug
    8. Recent history of opportunistic infections where the underlying cause of these infections is still
    active (eg, leukemia, transplant, acquired immunodeficiency syndrome [AIDS])
    9. Receiving chronic systemic immunosuppressive therapy such as prednisone doses ? 20 mg per day for ? 3 of the last 12 months OR therapies that in the Investigator?s judgment could predispose to opportunistic infections
    10. Chronic (daily for the previous 30 days) use of antipyretic medication (eg, acetaminophen, paracetamol, nonsteroidal anti-inflammatory drugs). Low-dose aspirin (? 100 mg) for cardiovascular prophylaxis is allowed
    11. Receiving treatment for active tuberculosis
    12. Last known CD4 count < 200 cells/mm3 in patients with AIDS
    13. Current or anticipated neutropenia with absolute neutrophil count (ANC) < 1000 cells/mm3
    14. Severe renal disease defined as creatinine clearance (CrCl) < 30 mL/min estimated by the Cockcroft-Gault formula OR requirement for peritoneal dialysis, plasmapheresis, hemodialysis, venovenous dialysis, or other forms of renal filtration
    15. ALT or AST ? 5 upper limit of normal OR moderate to severe hepatic disease with Child Pugh score ?7 defined by the following:
    ? Presence of ascites upon examination
    ? Evidence of encephalopathy upon examination
    ? Total bilirubin ? 2 mg/dL
    ? Serum albumin ? 3.5 g/dL
    ? Prothrombin time (PT) ? 4 seconds longer than control, or international normalized ratio (INR) ? 1.7
    To calculate the Child-Pugh score, see Section 6.1
    16. Significant or life-threatening condition or organ or system condition or disease (eg, endocarditis, meningitis) that would confound or interfere with the assessment of the ABSSSI
    17. Triptan treatment for migraine headaches within 3 years
    18. ECG finding of corrected QT interval > 500 msec using Bazett?s correction method (QTcB) or Fridericia?s correction method (QTcF)

    19. to 29. Not listed due to charakter limitations
    1.Infecciones no complicadas de la piel y los anejos cutáneos, como furúnculos, abscesos menores (área de supuración no rodeada por celulitis/erisipela), lesiones impetiginosas, celulitis/erisipela superficial o limitada o infecciones de heridas menores (por ejemplo, abscesos en la sutura).2.Infecciones asociadas con una prótesis o muy cercanas a una prótesis.
    3.Septicemia grave o shock séptico.4.Bacteriemia conocida en el momento de la selección.5.IBAPAC debida a alguna de las causas siguientes o asociada con ellas:?Presencia sospechada o documentada de patógenos gramnegativos en pacientes con celulitis/erisipela o absceso cutáneo grave que exige la administración de antibióticos con cobertura específicamente gramnegativa. Los pacientes con heridas infectadas en las que está justificado el tratamiento adyuvante gramnegativo pueden incorporarse si cumplen los demás criterios de inclusión.?Infección en un pie diabético, gangrena o absceso perianal.?Infección concomitante en otro lugar, sin incluir una lesión IBAPAC secundaria (por ejemplo, artritis séptica, endocarditis, osteomielitis).?Quemaduras infectadas.?Úlcera cutánea de decúbito o crónica o úlcera isquémica por vasculopatía periférica (arterial o venosa).?Cualquier el proceso necrosante progresivo (por ejemplo, fascitis necrosante).?Mordeduras o picaduras infectadas, producidas por seres humanos o por animales. No obstante, se admiten mordeduras de artrópodos (insectos, arañas, ?bichos?) que en este estudio no se consideran mordeduras de animales.?Infecciones en puntos de cateterización vascular o acompañadas de tromboflebitis.?Incisión quirúrgica con alguna de las características siguientes:?Sigue a una intervención quirúrgica limpia-contaminada (intervención de urgencia por lo demás limpia, intervención programada que afecta a las vías respiratoria, gastrointestinal, biliar o genitourinaria con contaminación mínima [apendicectomía, por ejemplo] en la que no se ha encontrado orina o bilis infectadas; error de poca importancia en la técnica).?Sigue a una intervención quirúrgica contaminada (inflamación no purulenta; derrame macroscópicos del tubo digestivo; penetración en las vías biliares o genitourinarias en presencia de bilis u orina infectadas; error importante en la técnica; heridas crónicas abiertas que deban injertarse o cubrirse).
    ?Sigue a una intervención quirúrgica sucia (inflamación purulenta [por ejemplo, absceso]; perforación preoperatoria de las vías respiratorias, digestiva, biliares o genitourinarias).?Se extiende hacia la fascia o la capa muscular, los órganos u otros espacios.
    6.Uso de antibióticos con las siguientes características:?Antibiótico sistémico con actividad de cocos grampositivos para el tratamiento de cualquier infección en las 96 horas previas a la primera infusión del fármaco del estudio.?Los pacientes en quienes fracasó el tratamiento previo para el foco de infección primario también deben excluirse del reclutamiento.?Antibióticos tópicos en la lesión primaria, salvo el uso de un apósito impregnado de antibiótico o antiséptico aplicado a la herida postoperatoria limpia.7.Administración de linezolid en los 30 días previos a la primera infusión del fármaco del estudio.8.Antecedentes recientes de infecciones oportunistas cuya causa subyacente sigue activa (por ejemplo, leucemia, trasplante, síndrome de inmunodeficiencia adquirida [SIDA]).
    9.Tratamiento inmunodepresor sistémico crónico equivalente a una dosis de prednisona ?20 mg al día durante 3 o más meses de los últimos 12 O tratamientos que en opinión del investigador podrían predisponer a las infecciones oportunistas.
    10.Uso crónico (a diario durante los 30 días previos) de antipiréticos (p. ej., paracetamol, antiinflamatorios no esteroideos). Se permite el ácido acetilsalicílico en dosis bajas (? 100 mg) como profilaxis cardiovascular.11.Estar en tratamiento por tuberculosis activa.12.Último recuento conocido de CD4 <200 células/mm3 en pacientes con SIDA.13.Neutropenia actual o previsible con un recuento absoluto de neutrófilos (RAN) <1.000 células/mm3.14.Enfermedad renal grave definida por un aclaramiento de creatinina (CrCl) <30 ml/min calculado con la fórmula de Cockcroft Gault O necesidad de diálisis peritoneal, plasmaféresis, hemodiálisis, diálisis venovenosa u otras formas de filtración renal.
    15 a 29 se omiten por límite de los caracteres
    E.5 End points
    E.5.1Primary end point(s)
    The primary efficacy outcome is the early clinical response rate at 48-72 hours after the first infusion of study drug in the ITT analysis set. Early clinical response (responder [afebrile with cessation of spread of the erythema, edema, and/or induration or reduction in the size (length, width, and area) of erythema, edema, and/or induration from baseline of the primary ABSSSI lesion] and nonresponder) will be determined programmatically from lesion size measurements and temperature data recorded on the electronic case report form (e-CRF)
    El criterio de valoración principal de la eficacia es la tasa de respuesta clínica inicial 48-72 horas después de la primera infusión del fármaco del estudio en el grupo de análisis IT. La respuesta clínica inicial (paciente con respuesta [sin fiebre e interrupción de la extensión del eritema, edema y/o induración o disminución del tamaño (longitud, anchura y superficie) del eritema, edema y/o induración con respecto a la situación basal de la lesión IBAPAC principal] y sin respuesta) se determinará de forma automática a partir de las mediciones del tamaño de la lesión y de los datos de temperatura registrados en el cuaderno de recogida de datos electrónico (CRDe).
    E.5.1.1Timepoint(s) of evaluation of this end point
    48-72 hours visit
    Respuesta clínica inicial 48-72 horas después de la primera infusión del fármaco del estudio en el grupo de análisis IT.
    E.5.2Secondary end point(s)
    Secondary outcome measures are the following:
    ? Clinical response at the EOT Visit in the ITT and CE-EOT analysis sets
    ? Investigator?s assessment of clinical success at the PTE Visit in the ITT and CE-PTE analysis sets. Patients assessed as a clinical failure at the EOT Visit are considered a clinical failure at the PTE Visit
    ? Investigator?s assessment of clinical response at the 48-72 Hour and Day 7 Visits
    ? Change from baseline in the pain scores at each time point

    Additional Efficacy Outcomes
    ? Change from baseline in lesion size, assessment of local signs and symptoms, and regional or systemic signs (lymphadenopathy, temperature, percentage immature neutrophils, WBC count)
    ? Per-patient favorable (eradication or presumed eradication) microbiological response at the PTE Visit in the microbiological ITT (MITT) and microbiologically evaluable (ME) analysis set. Per-patient microbiological response is based on per-pathogen outcomes
    ? Per-pathogen microbiological response at the PTE Visit in the MITT and ME analysis sets
    ? Investigator?s assessment of clinical success at the PTE Visit in the MITT and ME analysis sets
    ? Per-pathogen Investigator?s assessment of clinical success at the PTE Visit in the MITT and ME analysis sets
    Safety Outcomes

    Safety will be assessed through summaries of AEs, laboratory evaluations (hematology and chemistry), vital signs, ECGs, physical examinations.
    Pharmacokinetic Analysis
    The objectives of the population PK analysis are:
    ? To characterize the PK profile of TR-700 in patients, including estimation of typical PK
    parameters and interindividual and residual variability
    ? To estimate the effects of individual-specific covariate factors of TR-700 PK in this population
    ? To provide individual metrics of TR-700 exposure for modeling probabilities of clinical success, microbiological response, or safety outcomes
    ?Respuesta clínica en la visita FDT en los grupos de análisis IT y EC-FDT.
    ?Evaluación realizada por el investigador del éxito clínico en la visita de EPT en los grupos de análisis IT y EC-EPT. Los pacientes evaluadas como fracaso clínico en la visita FDT se considera un fracaso clínico en la visita EPT.
    ?Evaluación por el investigador de la respuesta clínica en las visitas a las 48-72 horas y del día 7.
    ?Variación con respecto al valor basal de la puntuación del dolor en cada punto temporal
    Otros criterios de valoración de la eficacia
    ?Variación con respecto al valor basal del tamaño de la lesión, evaluación de los signos y síntomas locales y de los signos regionales o sistémicos (linfadenopatía, temperatura, porcentaje de neutrófilos inmaduros, recuento de leucocitos).
    ?Respuesta microbiológica por paciente favorable (erradicación o supuesta erradicación) en la visita de EPT en los grupos de análisis IT microbiológica (ITM) y evaluable microbiológicamente (EM). La respuesta microbiológica por paciente se basa en los resultados por patógeno.
    ?Respuesta microbiológica por patógeno en la visita EPT en los grupos de análisis ITM y EM.
    ?Evaluación realizada por el investigador del éxito clínico en la visita EPT en los grupos de análisis ITM y EM.
    ?Evaluación realizada por el investigador del éxito clínico por patógeno en la visita EPT en los grupos de análisis ITM y EM.
    Criterios de valoración de seguridad
    La seguridad se evaluará mediante resúmenes de AA, evaluaciones analíticas (hematología y bioquímica), constantes vitales, ECG y exploraciones físicas.
    E.5.2.1Timepoint(s) of evaluation of this end point
    48-72 Hour Visit; Day 7 Visit; EOT Visit (Day 11); PTE Visit
    Respuesta clínica en las visitas a las 48-72 horas y del día 7.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Linezoid tablets and Linezoid IV
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA18
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Australia
    Brazil
    Germany
    New Zealand
    Philippines
    Poland
    Russian Federation
    South Africa
    Spain
    Thailand
    United States
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    Late Follow-Up
    La última visita del último paciente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months1
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months1
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1Number of subjects for this age range: 0
    F.1.1.1In Utero No
    F.1.1.1.1Number of subjects for this age range: 0
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.2.1Number of subjects for this age range: 0
    F.1.1.3Newborns (0-27 days) No
    F.1.1.3.1Number of subjects for this age range: 0
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.4.1Number of subjects for this age range: 0
    F.1.1.5Children (2-11years) No
    F.1.1.5.1Number of subjects for this age range: 0
    F.1.1.6Adolescents (12-17 years) No
    F.1.1.6.1Number of subjects for this age range: 0
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 625
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 33
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state30
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 200
    F.4.2.2In the whole clinical trial 658
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Standard care
    Práctica Clínica Habitual
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2012-01-03
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2011-12-15
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2013-01-10
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