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    Summary
    EudraCT Number:2013-002528-17
    Sponsor's Protocol Code Number:AC-061A301
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2014-01-09
    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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2013-002528-17
    A.3Full title of the trial
    A multi-center, randomized, double-blind study to compare the efficacy and safety of cadazolid versus vancomycin in subjects with Clostridium difficile-associated diarrhea (CDAD)
    AC-061A301, uno studio multicentrico, randomizzato, in doppio cieco, per confrontare l’efficacia e la sicurezza di cadazolid rispetto alla vancomicina in soggetti affetti da diarrea associata a Clostridium difficile (DACD)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    International clinical study to compare cadazolid to vancomycin to treat
    CDAD
    Studio sperimentale internazionale per confrontare cadazolid e vancomicina nel trattamento della diarrea associata a Clostridium difficile (DACD)
    A.4.1Sponsor's protocol code numberAC-061A301
    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 SponsorActelion Pharmaceuticals Ltd
    B.1.3.4CountrySwitzerland
    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 supportActelion Pharmaceuticals Ltd
    B.4.2CountrySwitzerland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationActelion Pharmaceuticals Ltd
    B.5.2Functional name of contact pointGlobal Medical Information
    B.5.3 Address:
    B.5.3.1Street AddressGewerbestrasse 16
    B.5.3.2Town/ cityAllschwil
    B.5.3.3Post code4123
    B.5.3.4CountrySwitzerland
    B.5.6E-mailmedinfo_ch@actelion.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 nameCadazolid
    D.3.2Product code ACT-179811
    D.3.4Pharmaceutical form Granules for oral suspension in sachet
    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.3.8INN - Proposed INNCadazolid
    D.3.9.2Current sponsor codeACT-179811
    D.3.9.3Other descriptive nameCadazolid
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number250
    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 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 Vancocin
    D.2.1.1.2Name of the Marketing Authorisation holderViroPharma Incorporated
    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 Capsule, hard
    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.3.8INN - Proposed INNVANCOMYCIN
    D.3.9.1CAS number 1404-90-6
    D.3.9.4EV Substance CodeSUB05076MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number125
    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 placeboGranules for oral suspension
    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 placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Clostridium difficile-associated diarrhea (CDAD)
    Diarrea associata a Clostridium difficile (DACD)
    E.1.1.1Medical condition in easily understood language
    Intestinal infection due to Clostridium difficile
    Infezione instestinale causata da Clostridium difficile
    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 16.1
    E.1.2Level PT
    E.1.2Classification code 10054236
    E.1.2Term Clostridium difficile 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
    To determine whether the clinical response after 10-day oral
    administration of cadazolid is non-inferior to oral vancomycin
    in subjects with CDAD.
    Stabilire se la risposta clinica dopo la somministrazione orale di cadazoid per 10 giorni è non inferiore alla vancomicina assunta per via orale in soggetti affetti da DACD.
    E.2.2Secondary objectives of the trial
    To determine whether oral administration of cadazolid for
    10 days is superior to oral vancomycin in the sustained clinical
    response of subjects with CDAD.
    To determine whether the resolution of diarrhea (ROD) is
    more rapid with oral administration of cadazolid compared to
    vancomycin.
    To determine whether CDAD symptoms, as reported by the
    subject, show larger improvements from baseline with oral
    administration of cadazolid compared to vancomycin.
    Stabilire se la somministrazione orale di cadazolid per 10 giorni è superiore all’assunzione orale di vancomicina nella risposta clinica prolungata di soggetti con DACD;
    -Stabilire se la risoluzione della diarrea (ROD) è più rapida con la somministrazione orale di cadazolid rispetto alla somministrazione della vancomicina;
    -Stabilire se i sintomi della DACD, secondo quanto riferito dal soggetto, mostrano miglioramenti più marcati dalla baseline con la somministrazione orale di cadazolid rispetto alla vancomicina
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    - Signed Informed Consent.
    - Male or female ≥ 18 years of age. Females of childbearing potential must agree to use an adequate and reliable method of contraception.
    - Subject with a diagnosis of mild-moderate or severe CDAD (first occurrence or first recurrence within 3 months) with:
    Diarrhea: a change in bowel habits with > 3 liquid or unformed bowel movements (UBM) within 24 hours prior to randomization,
    AND
    Positive C. difficile toxin test on a stool sample produced within 72 hours prior to randomization.
    Consenso informato scritto;
    -Pazienti di sesso maschile e femminile di età ≥ 18 anni;
    -Le donne potenzialmente fertili devono accettare di usare un metodo contraccettivo adeguato;

    -Soggetti con una diagnosi di DACD lieve-moderata o grave (prima occorrenza o prima ricorrenza entro 3 mesi) con:
    diarrea: variazione delle abitudini intestinali con >3 defecazioni di feci liquide o informi (UBM) nelle 24 ore precedenti la randomizzazione,
    E
    Test alla tossina C. difficile positivo (indicato da immunodosaggio enzimatico approvato dallo sponsor) su un campione di feci prodotto nelle 72 ore prima della randomizzazione
    E.4Principal exclusion criteria
    - More than one previous episode of CDAD in the 3-month period prior to
    randomization.
    - Evidence of life-threatening or fulminant CDAD.
    - Likelihood of death within 72 hours from any cause.
    - History of inflammatory colitides, chronic abdominal pain, or chronic diarrhea.
    - Antimicrobial treatment active against CDAD administered for > 24 hours except for metronidazole treatment failures (MTF)
    - Known hypersensitivity or contraindication to study drugs, oxazolidinones, or quinolones.
    - Unable or unwilling to comply with all protocol requirements.
    Più un episodio precedente di DACD nel periodo di 3 mesi precedente la randomizzazione.
    -Evidenza di DACD potenzialmente letale o fulminante.
    -Probabilità di decesso entro 72 ore per qualsiasi causa.
    -Storia di coliti infiammatorie, dolore addominale cronico o diarrea cronica.
    -Impossibilità di assumere farmaci orali o soggetti con sonde di alimentazione.
    -Trattamento antimicrobico attivo contro DACD somministrato
    per > 24 ore tranne per fallimenti del trattamento con metronidazolo (MTF).
    -Trattamento programmato con farmaci concomitanti vietati.
    -Trapianto di microbiota fecale (FMT), terapia con immunoglobuline e farmaco sperimentale per prevenire o trattare DACD entro 1 mese prima della randomizzazione.
    -Anticorpi monoclonali contro C. difficile entro i 6 mesi che precedono la randomizzazione.
    -Precedente vaccinazione contro C. difficile.
    -Partecipazione precedente a uno studio clinico con Cadazolid.
    -Ipersensibilità nota o controindicazione a farmaci sperimentali, oxazolidinoni o quinoloni.
    -Donne in fase di allattamento.
    -Membri dello staff del centro sperimentale o loro parenti e dipendenti di Actelion.
    -Incapacità o mancata volontà di adeguarsi a tutti i requisiti del protocollo.
    E.5 End points
    E.5.1Primary end point(s)
    Clinical Cure defined as:
    • Resolution of Diarrhea (ROD: ≤ 3 UBMs per day for at least 2 consecutive days) on study treatment, maintained for 2 days after End of Treatment (EOT)
    AND
    • No additional antimicrobial treatment active against CDAD or FMT between first dose and 2 days after EOT (inclusive).
    Guarigione clinica definita come:
    -risoluzione della diarrea (ROD: ≤ 3 UBM al giorno per almeno 2 giorni consecutivi) durante il trattamento sperimentale, con mantenimento della condizione per 2 giorni dopo EOT
    E
    -nessun ulteriore trattamento antimicrobico attivo contro DACD o FMT tra la prima dose e 2 giorni dopo EOT (incl.).
    E.5.1.1Timepoint(s) of evaluation of this end point
    See above
    fare riferimento al punto E.5.1
    E.5.2Secondary end point(s)
    Sustained Cure defined as:
    • Clinical Cure
    AND
    • No Recurrence
    Recurrence is defined for subjects with Clinical Cure as:
    • New episode of diarrhea (NED: > 3 UBMs within 1 day) occurring between 3 days and 4 weeks after EOT
    AND
    • Positive C. difficile toxin stool test
    AND
    • Antimicrobial treatment active against CDAD or FMT started between 3 days and 4 weeks after EOT (or participation in the re-treatment extension with cadazolid).

    Time to ROD, defined as:
    • The time (h) elapsed between the first dose of study drug
    and the time when ROD is considered achieved.

    Absolute change from baseline in CDAD DaySyms Patient Reported Outcomes (PRO).
    CDAD DaysSyms total daily score change from baseline up to
    Day 12.
    Guarigione prolungata definita come:
    guarigione clinica e assenza di ricorrenze
    Per ricorrenza nei soggetti con guarigione clinica si intende:
    -nuovo episodio di diarrea (NED: > 3 UBM entro 1 giorno) che si manifesta fra 3 giorni dopo EOT e la visita 5
    E
    -test sulle feci della tossina C. difficile con esito positivo
    E
    -trattamento antimicrobico attivo contro DACD o FMT iniziato fra 3 giorni dopo EOT e la visita 5 (o partecipazione all’estensione con ripetizione del trattamento con cadazolid).

    Tempo trascorso prima di ROD, definito come:
    -il tempo (h) trascorso fra la prima dose di farmaco sperimentale e il momento in cui la soglia ROD si considera raggiunta.
    Variazione assoluta della baseline negli esiti riferiti da pazienti per DACD DaySysm (PRO):
    -variazione nel punteggio giornaliero totale per DACD DaySysm dalla baseline fino al giorno 12.
    E.5.2.1Timepoint(s) of evaluation of this end point
    See above
    fare riferimento al punto E.5.2
    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 No
    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 Yes
    E.8.2.3Other No
    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 concerned4
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA29
    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
    Canada
    Australia
    Brazil
    Peru
    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
    The end of the trial occurs when all the subjects have completed Visit 5 or Re-5 for those participating in the re-treatment extension with cadazolid.
    Lo studio sarà considerato completo quando tutti i soggetti completeranno la visita 5 o Visita 5 del trattamento aggiuntivo per coloro che parteciperanno alla fase di trattamento aggiuntivo con cadazolid.
    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 months11
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months11
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 416
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 224
    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 state23
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 200
    F.4.2.2In the whole clinical trial 640
    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)
    When a subject is declared a Clinical Failure, or at the time of recurrence if the subject does not participate in the re-treatment extension with cadazolid, the investigator/delegate will explain to subjects what treatment/medical care would be necessary and available according to local practice and regulation.
    Quando un soggetto sarà dichiarato Sceening Failure, o nel momento della ricorrenza se il soggetto non prenderà parte alla fase di trattamento aggiuntivo di estensione con cadazolid, lo sperimentatore/delegato spiegherà al soggetto quali trattamenti/cure mediche saranno necessari e disponibili in accordo alla pratica clinica e legislazione locale.
    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 Decision2014-01-17
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2014-03-18
    P. End of Trial
    P.End of Trial StatusCompleted
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