Clinical Trial Results:
A PHASE 3, MULTICENTER, RANDOMIZED, DOUBLE-BLIND, COMPARATOR-CONTROLLED STUDY TO EVALUATE THE SAFETY AND EFFICACY OF INTRAVENOUS TO ORAL DELAFLOXACIN IN ADULT SUBJECTS WITH COMMUNITY-ACQUIRED BACTERIAL PNEUMONIA
Summary
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EudraCT number |
2015-003026-14 |
Trial protocol |
HU ES LV BG DE SI PL |
Global end of trial date |
07 Aug 2018
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Results information
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Results version number |
v1(current) |
This version publication date |
01 Mar 2020
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First version publication date |
01 Mar 2020
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Other versions |
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Summary report(s) |
A Phase 3 Study to Compare Delafloxacin With Moxifloxacin for the Treatment of Adults With Community-Acquired Bacterial Pneumonia (DEFINE-CABP) |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
ML-3341-306
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT02679573 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Melinta Therapeutics, Inc.
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Sponsor organisation address |
44 Whippany Rd, Suite 280, Morristown, NJ, United States, 07960
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Public contact |
Sue Cammarata, Melinta Therapeutics, Inc., 1 3127249401, scammarata@melinta.com
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Scientific contact |
Sue Cammarata, Melinta Therapeutics, Inc., 1 3127249401, scammarata@melinta.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
15 Mar 2019
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
07 Aug 2018
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Global end of trial reached? |
Yes
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Global end of trial date |
07 Aug 2018
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
The primary objective was to to assess the clinical efficacy of intravenous (IV) and oral delafloxacin in adult subjects with Community Acquired Bacterial Pneumonia (CABP) at 5 to 10 days after the last dose of study drug (Test-of-Cure visit, TOC) compared to IV and oral comparator in the Intent-to-Treat (ITT) population.
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Protection of trial subjects |
The study was conducted in compliance with the protocol and all regulatory requirements, in accordance with Good Clinical Practice (GCP), including International Council for Harmonisation (ICH) guidelines, and was in general conformity with the most recent version of the Declaration of Helsinki.
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Background therapy |
None. | ||
Evidence for comparator |
Moxifloxacin 400 mg IV or oral once daily was the recommended dosage in treatment of patients with CABP. Moxifloxacin has the antibacterial coverage to treat the range of gram-positive and gram-negative pathogens seen in CABP such as Streptococcus pneumoniae and Haemophilus influenzae as well as atypical pathogens. At the investigator’s discretion, in patients with confirmed infection due to methicillin-resistant Staphylococcus aureus (MRSA), IV linezolid could be substituted for moxifloxacin. Linezolid is approved for treatment of CABP at a dose of 600 mg BID. Linezolid is one of the currently recommended treatments for patients with confirmed MRSA infections. | ||
Actual start date of recruitment |
14 Dec 2016
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Poland: 28
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Country: Number of subjects enrolled |
Romania: 59
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Country: Number of subjects enrolled |
Slovenia: 15
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Country: Number of subjects enrolled |
Spain: 24
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Country: Number of subjects enrolled |
Bulgaria: 58
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Country: Number of subjects enrolled |
Germany: 1
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Country: Number of subjects enrolled |
Hungary: 26
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Country: Number of subjects enrolled |
Latvia: 40
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Country: Number of subjects enrolled |
Argentina: 20
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Country: Number of subjects enrolled |
Colombia: 20
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Country: Number of subjects enrolled |
Dominican Republic: 2
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Country: Number of subjects enrolled |
Georgia: 95
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Country: Number of subjects enrolled |
Peru: 4
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Country: Number of subjects enrolled |
Russian Federation: 80
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Country: Number of subjects enrolled |
Serbia: 142
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Country: Number of subjects enrolled |
South Africa: 71
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Country: Number of subjects enrolled |
Ukraine: 168
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Country: Number of subjects enrolled |
United States: 6
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Worldwide total number of subjects |
859
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EEA total number of subjects |
251
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
477
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From 65 to 84 years |
354
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85 years and over |
28
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Recruitment
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Recruitment details |
A total of 859 patients were enrolled as part of the ITT population at 86 centers in Western and Eastern Europe, South Africa, Latin America, and the United States. The first patient was enrolled on 14 December 2016, the last patient was enrolled on 13 July 2018, and the final study visit was conducted on 07 August 2018. | |||||||||||||||||||||||||||||||||
Pre-assignment
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Screening details |
Patients 18 years and older were screened for baseline chest radiography with evidence of CABP, clinical signs and symptoms of CABP, and Pneumonia Patient Outcomes Research Team (PORT) Risk Class II, III, IV, or V. A total of 937 patients were screened and 77 subjects screen failed due to meeting exclusion or failing to meet inclusion criteria. | |||||||||||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall Trial (overall period)
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Is this the baseline period? |
Yes | |||||||||||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | |||||||||||||||||||||||||||||||||
Roles blinded |
Subject, Investigator, Monitor, Data analyst, Carer, Assessor | |||||||||||||||||||||||||||||||||
Blinding implementation details |
An unblinded pharmacist obtained treatment assignments and provided blinded treatment to the blinded investigator for administration. A placebo infusion was given in the same manner as moxifloxacin once daily to patients receiving delafloxacin. All personnel evaluating efficacy and safety were blinded, except for an unblinded statistician who generated tables for the bioanalytical an dosing data. For oral dosing, placebo tablets were used similarly to maintain the blind between groups.
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Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Delafloxacin | |||||||||||||||||||||||||||||||||
Arm description |
Delafloxacin 300 mg was administered as a 1-hour IV infusion BID (± 2 hours) for a minimum of 6 doses, with an option to switch to delafloxacin, 450 mg tablet, administered orally BID (± 2 hours) for the remaining doses. | |||||||||||||||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||||||||||||||
Investigational medicinal product name |
Delafloxacin Powder for Intravenous Infusion
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Investigational medicinal product code |
RX-3341-83
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Other name |
ABT-492, Abbott-319492
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Pharmaceutical forms |
Powder for solution for infusion
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Routes of administration |
Intravenous use
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Dosage and administration details |
Subjects randomized to delafloxacin received intravenous (IV) product, 300 mg every 12 hours (BID), with an option to switch to oral product, 450 mg BID. Subjects that switched to oral delafloxacin, 450 mg BID, also received oral moxifloxacin placebo QD. Delafloxacin for Injection, 300 mg/vial, was a light-yellow to tan colored lyophilized powder provided in a 20-mL clear borosilicate glass vial. A single vial of delafloxacin was reconstituted and diluted in 250 mL bags of D5W as described in the pharmacy manual.
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Investigational medicinal product name |
Delafloxacin Oral Tablet
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Investigational medicinal product code |
RX-3341-83
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Other name |
ABT-492, Abbott-319492
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Subjects randomized to delafloxacin received intravenous (IV) product, 300 mg every 12 hours (BID), with an option to switch to oral product, 450 mg BID. Subjects that switched to oral delafloxacin, 450 mg BID, also received oral moxifloxacin placebo QD. Oral delafloxacin tablets are capsule-shaped tablets, beige with tan spots.
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Arm title
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Moxifloxacin | |||||||||||||||||||||||||||||||||
Arm description |
Moxifloxacin 400 mg was administered as a 1 hour IV infusion every 24 (± 2) hours for a minimum of 3 active doses, with an option to switch to moxifloxacin 400 mg (over-encapsulated tablet) administered orally every 24 (± 2) hours for the remaining doses. | |||||||||||||||||||||||||||||||||
Arm type |
Active comparator | |||||||||||||||||||||||||||||||||
Investigational medicinal product name |
Moxifloxacin hydrochloride for injection
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for infusion
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Routes of administration |
Oral use
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Dosage and administration details |
Subjects randomized to moxifloxacin received intravenous (IV) product, 400 mg every 24 hours (QD), for a minimum of 3 active doses with an option to switch to oral product, 400 mg BID for the remaining doses. Subjects randomized to moxifloxacin received IV placebo QD alternatively with active IV moxifloxacin to maintain the blind. Moxifloxacin hydrochloride for injection for this study was provided in ready-to-use 250 mL flexible bags containing 400 mg moxifloxacin in 0.8% sodium chloride aqueous solution.
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Investigational medicinal product name |
Moxifloxacin Tablets
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Subjects randomized to moxifloxacin received intravenous (IV) product, 400 mg every 24 hours (QD), for a minimum of 3 active doses with an option to switch to oral product, 400 mg BID for the remaining doses. Subjects switched to oral moxifloxacin, 400 mg QD, received oral delafloxacin placebo BID. Oral moxifloxacin hydrochloride tablets are oblong, dull red-film-coated tablets containing 400mg of active product.
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Baseline characteristics reporting groups
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Reporting group title |
Delafloxacin
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Reporting group description |
Delafloxacin 300 mg was administered as a 1-hour IV infusion BID (± 2 hours) for a minimum of 6 doses, with an option to switch to delafloxacin, 450 mg tablet, administered orally BID (± 2 hours) for the remaining doses. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Moxifloxacin
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Reporting group description |
Moxifloxacin 400 mg was administered as a 1 hour IV infusion every 24 (± 2) hours for a minimum of 3 active doses, with an option to switch to moxifloxacin 400 mg (over-encapsulated tablet) administered orally every 24 (± 2) hours for the remaining doses. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Subject analysis sets
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Subject analysis set title |
ITT
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Subject analysis set type |
Intention-to-treat | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Subject analysis set description |
The Intention-to-treat (ITT) population comprised all randomized subjects with a signed Informed consent form (ICF). Subjects were analyzed according to the treatment arm to which they were randomized.
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Subject analysis set title |
Safety
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Subject analysis set type |
Safety analysis | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Subject analysis set description |
The Safety population comprised all randomized subjects who received at least 1 dose of the study drug. Subjects were analyzed according to the treatment (delafloxacin or moxifloxacin) they received most often. If the duration of treatment was the same, then these subjects were summarized in the delafloxacin treatment group.
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Subject analysis set title |
modITT
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Subject analysis set type |
Modified intention-to-treat | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Subject analysis set description |
All randomized subjects who received at least one dose of study medication, classified as PORT Class III-V, analyzed according to the treatment arm to which they were randomized.
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End points reporting groups
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Reporting group title |
Delafloxacin
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Reporting group description |
Delafloxacin 300 mg was administered as a 1-hour IV infusion BID (± 2 hours) for a minimum of 6 doses, with an option to switch to delafloxacin, 450 mg tablet, administered orally BID (± 2 hours) for the remaining doses. | ||
Reporting group title |
Moxifloxacin
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Reporting group description |
Moxifloxacin 400 mg was administered as a 1 hour IV infusion every 24 (± 2) hours for a minimum of 3 active doses, with an option to switch to moxifloxacin 400 mg (over-encapsulated tablet) administered orally every 24 (± 2) hours for the remaining doses. | ||
Subject analysis set title |
ITT
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Subject analysis set type |
Intention-to-treat | ||
Subject analysis set description |
The Intention-to-treat (ITT) population comprised all randomized subjects with a signed Informed consent form (ICF). Subjects were analyzed according to the treatment arm to which they were randomized.
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Subject analysis set title |
Safety
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Subject analysis set type |
Safety analysis | ||
Subject analysis set description |
The Safety population comprised all randomized subjects who received at least 1 dose of the study drug. Subjects were analyzed according to the treatment (delafloxacin or moxifloxacin) they received most often. If the duration of treatment was the same, then these subjects were summarized in the delafloxacin treatment group.
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Subject analysis set title |
modITT
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Subject analysis set type |
Modified intention-to-treat | ||
Subject analysis set description |
All randomized subjects who received at least one dose of study medication, classified as PORT Class III-V, analyzed according to the treatment arm to which they were randomized.
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End point title |
Clinical Success at Test of Cure (TOC) | |||||||||||||||
End point description |
The Investigator defined the clinical outcome based on the assessment of the subject’s signs and symptoms of infection at TOC. The Investigator’s assessment of clinical response was categorized as:
-Success - Resolution or near resolution of the symptoms of CABP present at study entry, no use of additional antimicrobial therapy, and no new symptoms.
-Failure - Symptoms of CABP present at study entry not resolved, new symptoms developed, subject died from CABP, or use of additional nonstudy antimicrobial therapy for treatment of the current CABP due to lack of efficacy. Subjects had to receive at least 4 doses of study drug by the end of Day 3 to be called a failure.
-Indeterminate/Missing - A response could not be determined because an efficacy assessment was not completed at the visit or subject did not complete the planned course of study therapy for reasons other than lack of efficacy. Indeterminate/missing responses were considered failures for the purpose of the ITT analysis.
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End point type |
Primary
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End point timeframe |
Test of Cure (TOC) = 5 to 10 days after last dose
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Statistical analysis title |
Non-inferiority Hypothesis Test | |||||||||||||||
Statistical analysis description |
The null (H0) and alternative (Ha) hypotheses tested to establish the noninferiority of delafloxacin were the following:
H0: Pd – Pm ≤ ‒0.1
Ha: Pd – Pm > ‒0.1
where Pd and Pm were the probabilities of the clinical outcome rates for delafloxacin and moxifloxacin, respectively.
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Comparison groups |
Delafloxacin v Moxifloxacin
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Number of subjects included in analysis |
859
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Analysis specification |
Pre-specified
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Analysis type |
non-inferiority | |||||||||||||||
Method |
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Parameter type |
Difference in Cure Rate | |||||||||||||||
Point estimate |
0.8
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Confidence interval |
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level |
95% | |||||||||||||||
sides |
2-sided
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lower limit |
-3.3 | |||||||||||||||
upper limit |
4.8 |
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End point title |
Early Clinical Response (ECR) Responders | |||||||||||||||
End point description |
The following symptoms for the ECR were evaluated by the investigator on a four-point scale (absent, mild, moderate, severe): pleuritic chest pain, frequency or severity of cough, amount and quality of productive sputum, and dyspnea (difficulty breathing). Improvement was defined as at least a 1-point improvement (decrease) from baseline to the assessment at 96 (± 24) hours after first dose of study drug (e.g., from severe to moderate).
- Responders: Improvement at 96 (± 24) hours after first dose of study drug in at least 2 of the symptoms, and no worsening of the other symptoms.
- Non-responders: Improvement was not achieved at 96 (± 24) hours after the first dose of study drug in at least 2 of the symptoms; or there was use of additional nonstudy antimicrobial therapy for treatment of the current CABP due to lack of efficacy; or the subject died from the current CABP. Indeterminate/missing assessments were mapped to nonresponders in the ITT statistical analysis.
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End point type |
Secondary
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End point timeframe |
96 (± 24) hours - Due to the ±2-hour window for study drug administration, programmatically, 70 - 122 hours after the start date/time of first IV infusion was considered for the Early Clinical Response (ECR) timepoint.
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Statistical analysis title |
Noninferiority Hypothesis | |||||||||||||||
Statistical analysis description |
The null (H0) and alternative (Ha) hypotheses tested to establish the noninferiority of delafloxacin were the following:
H0: Pd – Pm ≤ ‒0.125
Ha: Pd – Pm > ‒0.125
where Pd and Pm were the probabilities of the ECR for delafloxacin and moxifloxacin, respectively.
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Comparison groups |
Delafloxacin v Moxifloxacin
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Number of subjects included in analysis |
859
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Analysis specification |
Pre-specified
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Analysis type |
non-inferiority | |||||||||||||||
Method |
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Parameter type |
Difference in ECR Rate | |||||||||||||||
Point estimate |
-0.2
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Confidence interval |
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level |
95% | |||||||||||||||
sides |
2-sided
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lower limit |
-4.4 | |||||||||||||||
upper limit |
4.1 |
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Adverse events information
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Timeframe for reporting adverse events |
From signature of the Informed Consent to Day 28 (+/- 2 days) after start of study drug.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
19.1
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Reporting groups
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Reporting group title |
Delafloxacin
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Reporting group description |
Delafloxacin 300 mg was administered as a 1-hour IV infusion BID (± 2 hours) for a minimum of 6 doses, with an option to switch to delafloxacin, 450 mg tablet, administered orally BID (± 2 hours) for the remaining doses. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Moxifloxacin
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Reporting group description |
Moxifloxacin 400 mg was administered as a 1 hour IV infusion every 24 (± 2) hours for a minimum of 3 active doses, with an option to switch to moxifloxacin 400 mg (over-encapsulated tablet) administered orally every 24 (± 2) hours for the remaining doses. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 2% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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15 Dec 2015 |
• Allowed for the inclusion of PORT Risk Class V subjects in the study.
• Added exclusion criterion to specify restrictions associated with use of linezolid (known uncontrolled arterial hypertension, pheochromocytoma, carcinoid thyrotoxicosis) and restrictions associated with use of moxifloxacin (lactose intolerance, lactase deficiency and glucose-galactose malabsorption).
• Revised to reflect that local laboratory results should be obtained within the 24 hours prior to first dose of study drug to verify entry criteria in order to more accurately assess the subject’s clinical condition at time of enrollment.
• Clarified that oropharyngeal and nasopharyngeal specimens may include culture and/or PCR.
• Revised to reflect C-reactive protein samples will not be collected.
• Clarified that local/regional laboratory results will be used for patient care.
• Clarified that systemic steroid use during the treatment period is allowed for a short duration (e.g., steroid burst). Inhaled steroids are allowed without any restriction.
• Treatment regimens clarified.
• Description of delafloxacin was updated to be consistent with the Investigator's Brochure.
• The statistical analysis section was revised to reflect that a shift table will be not used to analyze change from baseline for physical exam findings. Worsening from baseline was to be captured as an adverse event.
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29 Mar 2016 |
• Revised inclusion 2 to be consistent with draft guidance for industry, Community-Acquired Bacterial Pneumonia: Developing Drugs for Treatment: removed "or a change in the character of the sputum", separated vital sign abnormalities from the other clinical signs and lab abnormalities.
• Added exclusion of medical history of significant hypersensitivity or allergic reaction to study drug excipients in the judgment of the investigator to exclusion 1.
• Revised exclusion 4 to include criteria for documenting treatment failure based on clinical evidence and not pulmonary imaging alone.
• Revised exclusion 12 to include exclusion of known uncorrected hypomagnesemia at study entry.
• Revised the primary efficacy endpoint definition of improvement to include no worsening of any of the other CABP symptoms as described in the references provided in the draft guidance for industry document.
• Modified the suggested criteria for IV to oral switch to improved stability if vital sign indices, e.g. no worsening.
• Responders definition revised to include no worsening of other symptoms.
• Nonresponders definition was revised to further clarify that additional antimicrobial treatment of the current CABP infection would only meet the Nonresponders definition if the reason for treatment was due to lack of efficacy.
• Failure definition revised to clarify that additional antimicrobial treatment of the current CABP infection would only meet the Failure definition if the reason for treatment was due to lack of efficacy.
• Indeterminate/Missing definition revised to clarify that a response could not be determined if the subject did not complete the planned course of study therapy for reason other than lack of efficacy.
• Clarified that any potential sample size recalculation would be based on pooled information across the 2 treatment arms.
• Added a table that included the definitions of symptom severity: absent (0 points), mild (1), moderate (2), and severe (3). |
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04 Dec 2017 |
•Procedures of chest radiography and clinical laboratory collection performed prior to the first dose of study drug.
•All screening procedures performed in the 24 hour period prior to the first dose of study drug (unless otherwise noted).
• Added serology testing for Chlamydia at Day 1, TOC, and Follow-up
• In the PSI/PORT scoring appendix corrected a minor discrepancy in Temperature, added a converted value from BUN to urea, and added Risk Class to the scoring table.
• Added a converted value from urea to BUN in the CURB-65 scoring appendix.
• Primary and secondary objectives and endpoints, sample size calculations, populations and analyses were clarified for EMA submissions.
• Clarifications were added to Inclusion 4 and Exclusions 4, 5, and 12.
• Timing of vital signs was updated at all visits after first dose to clarify that they may be performed at any time, but should be consistent each day.
• The window for the Day 7 (oral treatment) visit was updated from ± 1 day to + 1 Day so it would not coincide with the Day 5 (oral treatment) visit.
• Procedures at EOT/TOC visits clarified that a CXR or CT scan is also required to be done only for lack of efficacy.
• General references to “sputum specimens” were changed to “respiratory specimens” throughout the protocol
• PK sections were updated to specify endpoints and analyses to be performed.
• Post-Treatment Medications section updated to clarify which data should be recorded in the eCRF.
• Adverse Events section updated to clarify the required time period to record data in the CRF and to note that progression of disease under study is not recorded as an AE.
• All references to ICH guideline E6(R1): Good Clinical Practice were updated to (R2) to align with global regulatory requirements.
• Abbreviations were added or exchanged for text throughout the protocol as per the List of Abbreviations.
• Minor grammatical and formatting changes were made throughout the text |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported | |||
Online references |
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http://www.ncbi.nlm.nih.gov/pubmed/31988972 |