E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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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 |
This study will test the primary hypothesis that AUC/MIC based vancomycin dosing, using a model-informed precision dosing calculator, increases the proportion of patients reaching the therapeutic target AUC/MIC (400-600) between [24 to 48] h after start of treatment, when compared to the use of standard-of-care dosing regimens with therapeutic drug monitoring. |
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E.2.2 | Secondary objectives of the trial |
to test hypotheses that AUC/MIC based vancomycin dosing, using a MIPD calculator - reduces the proportion of patients with (worsening) acute kidney injury during treatment with vancomycin, when compared to the use of SOC dosing regimens with therapeutic drug monitoring; - increases the proportion of patients reaching the therapeutic target 24h AUC/MIC (400-600) between [48-72] h after start of treatment, when compared to the use of SOC dosing regimens with therapeutic drug monitoring; - reduces the time to clinical cure, when compared to the use of SOC dosing regimens with therapeutic drug monitoring; - reduces the ward unit length-of-stay, when compared to the use of SOC dosing regimens with therapeutic drug monitoring; - reduces the hospital length-of-stay, when compared to the use of SOC dosing regimens with therapeutic drug monitoring; - reduces all cause 30 day mortality, when compared to the use of SOC dosing regimens with therapeutic drug monitoring; |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• age: 0-18 years • admitted to ICU or PHO unit • suspected or confirmed Gram positive infection • planned to start on intravenous intermittent (INT) or continuous infusion (CI) vancomycin treatment (if the patient was treated with vancomycin before inclusion : the minimum interval to previous vancomycin treatment episode is 48 hours) • informed consent signed by parents or legal representatives (details section 8.2) • not previously enrolled in this trial
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E.4 | Principal exclusion criteria |
• extracorporeal treatment at inclusion (extracorporeal membrane oxygenation, dialysis, body cooling) • n or p RIFLE category failure at inclusion (Day 0) • Known chronic kidney disease as defined by the KDIGO definition as: structural or functional abnormalities of the kidney regardless of GFR for < 3 months in duration or GFR < 60ml/min/1.73m² for ≥ 3 months in duration. eGFR is measured using estimated the modified Schwartz equation • note: non-limitative list for a structural abnormality of the kidney : autosomal recessive polycystic kidney disease, bilateral kidney dysplasia, unique dysplasia of the kidney, nephrotic syndrome) • patient death is deemed imminent and inevitable
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E.5 End points |
E.5.1 | Primary end point(s) |
• Proportion of patients reaching target 24hAUC (400-600) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
between 24 and 48h after start |
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E.5.2 | Secondary end point(s) |
• Proportion of patients with (worsening) AKI during vancomycin treatment • Proportion of patients reaching target 24hAUC (400-600) between [48 to 72] h after start treatment • Time to clinical cure • Ward unit length-of-stay • Hospital length-of-stay • 30 day mortality |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
up to 30 days after start dosing. |
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
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) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
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 | Yes |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
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) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
use of dosing calculator vs standard of care |
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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 | 9 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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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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 | 43 |
E.8.9.1 | In the Member State concerned days | |