E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Complicated Urinary Tract Infections (cUTIs) |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Bacterial Infections and Mycoses [C01] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess the noninferiority of ceftazidime-avibactam compared with doripenem with respect to symptomatic resolution of UTI-specific symptoms and resolution of, or improvement in, flank pain based on the patient-reported symptom assessment |
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E.2.2 | Secondary objectives of the trial |
•To deter. the efficacy(Ef) of CAZ-AVI compared w/ dori wrt the per pt & per-pathogen MR at the EoIVT,ToC,& LFU visits in pts who are in the mmITT,ME,& eME analysis sets(AS)
•To deter. the Ef of CAZ-AVI compared to dori wrt the symptomatic resolution of UTI-specific symptoms based on pt-reported symptom assessment at ToC, & LFU visits in mmITT AS
•To deter. the Ef of CAZ-AVI compared w/ dori wrt the investigator-determined CC at the EoIVT,ToC,& LFU visits in pts who are in the mmITT,ME,eME,& CE AS
•To eval the Ef of CAZ-AVI vs dori in pathogens resistant to ceftazidime
•To comp the time to 1st defervescence of CAZ-AVI vs dori in pts who are on IV study therapy & who have fever at study entry in the mmITT,ME,eME,& CE AS
•To eval the safety & toler. profile of CAZ-AVI compared w/ dori in the tx of pts w/ a cUTI in the safety AS
•To eval the pk of the ind. components of CAZ-AVI(avibactam & ceftazidime)
•To eval CAZ-AVI exposure & the antimicrobial response relationship
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.18 to 90 years of age inclusive
2.Female patient is authorized to participate in this clinical study if she has been surgically sterilized or postmenopausal for at least 1 year orher sexual partner has had a vasectomy and must be willing, during treatment and for at least 7 days after last dose of IV study therapy, to practice highly effective methods of birth control
3.Has pyuria with >/= 10 WBCs and has a positive urine culture within 48 hours of enrollment containing >/=10 to the fifth CFU/ml of a recognized uropathogen known to be susceptible to IV study therapy (CAZ-AVI and doripenem)
4.Demonstrates either acute pyelonephritis or complicated lower UTI without pyelonephritis |
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E.4 | Principal exclusion criteria |
1.Urine pathogen is a Gram-positive pathogen or a uropathogen resistant to CAZ-AVI or doripenem
2.Patient's urine culture at study entry isolates more than 2 microorganisms regardless of colony count or patient has a confirmed fungal UTI
3.Patient is receiving hemodialysis or peritoneal dialysis or had a renal transplant
4.Patient is immunocompromised.
5.Patient is considered unlikely to survive the 6- to 8-week study period or have a rapidly progressive or terminal illness, including septic shock that is associated with a high risk of mortality. |
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E.5 End points |
E.5.1 | Primary end point(s) |
•The proportion of patients with resolved (or return to premorbid) UTI symptoms except flank pain and resolution or improvement in flank pain based on patient-reported symptom assessment response at Day 5 visit. Timeframe: Day 5 after study drug start
•The proportion of patients with a per patient microbiological eradication and resolution (or return to premorbid) of all UTI-specified symptoms based on patient-reported symptom assessment response. Timeframe: 21 to 25 days after study drug start
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Primary Outcome measure 1 - Day 5 after start of study drug
Primary Outcome measure 2 - Day 21-25 after start of study drug |
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E.5.2 | Secondary end point(s) |
•The proportion of pts w/ a favorable per pt MR in the mmITT analysis set. Outcome measured at the following timepoints: w/in 24 hrs after IV completion, 21-25 days & 45-52 days after study drug start(SDS)
•The proportion of pts w/ a favorable per pt MR in the ME analysis set. Timeframe: w/in 24 hrs after IV completion, 21-25 days & 45-52 days after SDS
•The proportion of pts w/ a favorable per pt MR in the extended ME analysis set. Timeframe: w/in 24 hrs after IV completion, 21-25 days & 45-52 days after SDS
•The proportion of pts w/ resolution (or return to premorbid) of all UTI-specific symptoms based on the pt-reported symptom assessment response in the mmITT analysis set. Outcome measured at the following timepoints: 21-25 days & 45-52 days after SDS
•The proportion of favorable per-pathogen MR in the mmITT analysis set. Outcome measured at the following timepoints: w/in 24 hrs after IV completion, 21-25 days & 45-52 days after study drug start
•The proportion of favorable per-pathogen MR in the ME analysis set. Timeframe: w/in 24 hrs after IV completion, 21-25 days & 45-52 days after the start of study drug(SoSD)
•The proportion of favorable per-pathogen MR in the extended ME analysis set. Timeframe: w/in 24 hrs after IV completion, 21-25 days & 45-52 days after the SoSD
•The proportion of pts w/ an investigator-determined CC in the mmITT analysis set. Outcome measured at the following timepoints: w/in 24 hrs after IV completion, 21-25 days & 45-52 days after the SoSD
•The proportion of pts w/ an investigator-determined CC in the ME analysis set. Timeframe: w/in 24 hrs after IV completion, 21-25 days & 45-52 days after the SoSD
•The proportion of pts w/ an investigator-determined CC in the extended ME analysis set. Timeframe: w/in 24 hrs after IV completion, 21 ~ 25 days & 45 ~ 52 days after the SoSD
•The proportion of pts w/ an investigator-determined CC in the CE analysis set. Timeframe: w/in 24 hrs after IV completion, 21-25 days & 45-52 days after the SoSD
•The favorable per pathogen MR by categories of minimum inhibitory concentration in the mmITT analysis set. Outcome measured at the following timepoints: w/in 24 hrs after IV completion, 21-25 days & 45-52 days after the SoSD
•The favorable per pathogen MR by categories of minimum inhibitory concentration in the ME analysis set. Outcome measured at the following timepoints: w/in 24 hrs after IV completion, 21-25days & 45-52 days after the SoSD
•The favorable per pathogen MR by categories of minimum inhibitory concentration in the extended ME analysis set. Outcome measured at the following timepoints: 24 hrs after completion of study drug, 21-25 days & 45-52 days after the SoSD
•The proportion of pts w/ favorable investigator clinical response assessment in pts infected w/ a ceftazidime resistant pathogen in the mmITT analysis set. Outcome measured at the following timepoint: 21-25 days after study drug start
•The proportion of pts w/ an investigator-determined CC in pts infected w/ a ceftazidime resistant pathogen in the ME analysis set. Outcome measured at the following timepoint: 21-25 days after study drug start
•The proportion of pts w/ an investigator-determined CC in pts infected w/ a ceftazidime resistant pathogen in the extended ME analysis set. Outcome measured at the following timepoint: 21-25 days after study drug start
•The proportion of pts w/ favorable per-pt MR for pts infected w/ a ceftazidime resistant pathogen in the mmITT analysis set. Outcome measured at the following timepoint: 21-25 days after SDS
•The proportion of pts w/ favorable per-pt MR for pts infected w/ a ceftazidime resistant pathogen in the ME analysis set. Timeframe: 21-25 days after study drug start
•The proportion of pts w/ favorable per-pt MR for pts infected w/ a ceftazidime resistant pathogen in the extended ME analysis set. Timeframe: 21-25 days after study drug start
•The proportion of pts w/ symptomatic resolution (defined in the coprimary variables) for pts infected w/ a ceftazidime resistant pathogen in the mmITT analysis set. Outcome measured at the following timepoint: Day 5 & 21-25 days after study drug start
•The time to 1st defervescence while on IV study therapy in pts in the mmITT, ME, extended ME, and CE analysis sets who have fever at study entry. Timeframe: any time after start of study drug to end of IV study therapy
•Evaluation of the pk of the individual components of CAZ-AVI (avibactam & ceftazidime)
•The safety & tolerability by incidence & severity of adverse events & serious adverse events, vital signs, clinical laboratory tests, ECGs & physical exams. Outcome measured at the following timepoints: study duration (screening visit (Day -1) through last follow up visit (up to 52 days)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | Yes |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 25 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Argentina |
Belgium |
Brazil |
Bulgaria |
Croatia |
Czech Republic |
France |
Germany |
Greece |
India |
Israel |
Japan |
Korea, Republic of |
Mexico |
Poland |
Romania |
Russian Federation |
Taiwan |
Ukraine |
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E.8.7 | Trial has a data monitoring committee | No |
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
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The end of the study is defined as the last visit of the last patient participating in the study. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 5 |
E.8.9.2 | In all countries concerned by the trial days | 28 |