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Omadacycline vs. Moxifloxacin for the Treatment of Community-Acquired Bacterial Pneumonia

A Phase 3b Randomized, Double-Blind, Multi-Center Study to Compare the Safety and Efficacy of Omadacycline IV/PO to Moxifloxacin IV/PO for Treating Adult Subjects With Community-Acquired Bacterial Pneumonia (CABP)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04779242
Enrollment
670
Registered
2021-03-03
Start date
2021-02-25
Completion date
2024-03-27
Last updated
2025-04-09

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Community-acquired Pneumonia, Bacterial Pneumonia

Brief summary

The purpose of this study is to evaluate the safety and efficacy of omadacycline as compared to moxifloxacin in the treatment of adults with community-acquired bacterial pneumonia.

Interventions

IV for injection, oral tablets

DRUGMoxifloxacin

IV solution, oral tablets

Sponsors

Paratek Pharmaceuticals Inc
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Male or female subjects, age 18 or older who have signed the informed consent form * Must have a qualifying community-acquired bacterial pneumonia * Subjects must not be pregnant or nursing at the time of enrollment * Must agree to a reliable method of birth control during the study and for 30 days following the last dose of study drug

Exclusion criteria

* Known or suspected hospital-acquired pneumonia * Confirmed or suspected SARS-CoV-2 infection * Evidence of significant immunological disease * Has a life expectancy of less than or equal to 3 months or any concomitant condition that is likely to interfere with evaluation of the response of the infection under study, determination of AEs, or completion of the expected course of treatment * Has a history of contraindications, hypersensitivity, or allergic reaction to any tetracycline or fluoroquinolone antibiotic * Has received an investigational drug within the past 30 days

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) Visit72 to 120 hours after the first dose of test articleEarly clinical response is defined as clinical success, categorized by survival with improvement of at least 1 level compared to Baseline in at least 2CABP symptoms (cough, sputum production, pleuritic chest pain, and dyspnea) with no worsening in CABP symptoms. Response is determined programmatically using investigator's assessment of the CABP symptoms. The severity of the participant's CABP symptoms was evaluated on a 4-point scale (absent, mild, moderate, or severe) based upon the CABP Subject Symptom Severity Guidance Framework for Investigator Assessment. An indeterminate response is defined as one that could not be adequately inferred because the participant was not assessed because they withdrew consent, or other specified reason. Clinical failure is defined as no improvement by at least 1 level in 2CABP symptoms, worsening of CABP symptom, alternative antibacterial treatment for CABP, discontinuation due to adverse event requiring alternative antibacterial treatment, or death

Secondary

MeasureTime frameDescription
Percentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) Visit5 to 10 days after the last dose of test articleAt the PTE Visit, the investigator indicates one of the following outcomes relating to the primary infection under study: Clinical Success: survival after completion of a test article regimen without receiving any systemic antibacterial therapy other than test article, resolution of signs/symptoms of the infection present at Screening with no new symptoms/complications attributable to CABP and no need for further antibacterial therapy. Clinical Failure: alternative antibacterial treatment for CABP was required prior to the PTE Visit related to either (a) progression/development of new CABP symptoms or (b) development of infectious complications of CABP. Other reasons for clinical failure: participant received antibiotics that may have been effective for the infection under study for a different infection from the one under study; death prior to the PTE Visit. Indeterminate: the clinical response to test article could not be adequately inferred.
Percentage of Participants With the Indicated Investigator Assessment of Clinical Response in the Clinically Evaluable-Post Therapy Evaluation (CE-PTE) Population at the PTE Visit5 to 10 days after the last dose of test articleAt the PTE Visit, the investigator indicates one of the following outcomes relating to the primary infection under study: Clinical Success: survival after completion of a test article regimen without receiving any systemic antibacterial therapy other than test article, resolution of signs/symptoms of the infection present at Screening with no new symptoms/complications attributable to CABP and no need for further antibacterial therapy. Clinical Failure: alternative antibacterial treatment for CABP was required prior to the PTE Visit related to either (a) progression/development of new CABP symptoms or (b) development of infectious complications of CABP. Other reasons for clinical failure: participant received antibiotics that may have been effective for the infection under study for a different infection from the one under study; death prior to the PTE Visit. Indeterminate: the clinical response to test article could not be adequately inferred.

Countries

Bulgaria, Croatia, Georgia, Hungary, Poland, Russia, Serbia, Ukraine

Participant flow

Recruitment details

This is a randomized, double-blind, active comparator-controlled study comparing Omadacycline and Moxifloxacin with participants with Community-Acquired Bacterial Pneumonia (CABP). The randomization was stratified by Pneumonia Outcomes Research Team (PORT) Risk Class (III or IV), and receipt of an allowed antibacterial therapy in the 72 hours prior to study treatment.

Pre-assignment details

A total of 670 participants were enrolled in approximately 75 sites globally.

Participants by arm

ArmCount
Omadacycline
Participants received Omadacycline 200 milligrams (mg) intravenously (IV) once daily or 100 mg IV twice daily on Day 1 and 100 mg IV on Day 2 and 100 mg IV or 300 mg tablets orally once daily from Day 3 through Day 10.
336
Moxifloxacin
Participants received Moxifloxacin 400 mg IV on Day 1 and Day 2, and 400 mg IV or as oral tablets from Day 3 through Day 10.
334
Total670

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event11
Overall StudyCOVID-19 related reasons21
Overall StudyDeath66
Overall StudyLost to Follow-up24
Overall StudyMartial Law in Ukraine23
Overall StudyUnavailability for post therapy evaluation Visit84
Overall StudyWithdrawal by Subject79

Baseline characteristics

CharacteristicMoxifloxacinTotalOmadacycline
Age, Continuous62.2 Years
STANDARD_DEVIATION 15.42
62.8 Years
STANDARD_DEVIATION 14.92
63.3 Years
STANDARD_DEVIATION 14.41
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants8 Participants4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
330 Participants662 Participants332 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Asian
1 Participants2 Participants1 Participants
Race/Ethnicity, Customized
White
333 Participants668 Participants335 Participants
Sex: Female, Male
Female
166 Participants324 Participants158 Participants
Sex: Female, Male
Male
168 Participants346 Participants178 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
6 / 3366 / 332
other
Total, other adverse events
32 / 33636 / 332
serious
Total, serious adverse events
17 / 33615 / 332

Outcome results

Primary

Percentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) Visit

Early clinical response is defined as clinical success, categorized by survival with improvement of at least 1 level compared to Baseline in at least 2CABP symptoms (cough, sputum production, pleuritic chest pain, and dyspnea) with no worsening in CABP symptoms. Response is determined programmatically using investigator's assessment of the CABP symptoms. The severity of the participant's CABP symptoms was evaluated on a 4-point scale (absent, mild, moderate, or severe) based upon the CABP Subject Symptom Severity Guidance Framework for Investigator Assessment. An indeterminate response is defined as one that could not be adequately inferred because the participant was not assessed because they withdrew consent, or other specified reason. Clinical failure is defined as no improvement by at least 1 level in 2CABP symptoms, worsening of CABP symptom, alternative antibacterial treatment for CABP, discontinuation due to adverse event requiring alternative antibacterial treatment, or death

Time frame: 72 to 120 hours after the first dose of test article

Population: ITT population

ArmMeasureGroupValue (NUMBER)
OmadacyclinePercentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) VisitClinical Success89.6 Percentage of participants
OmadacyclinePercentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) VisitClinical Failure8.6 Percentage of participants
OmadacyclinePercentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) VisitIndeterminate1.8 Percentage of participants
MoxifloxacinPercentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) VisitClinical Success87.7 Percentage of participants
MoxifloxacinPercentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) VisitClinical Failure9.3 Percentage of participants
MoxifloxacinPercentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) VisitIndeterminate3.0 Percentage of participants
95% CI: [-3, 6.8]
Secondary

Percentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) Visit

At the PTE Visit, the investigator indicates one of the following outcomes relating to the primary infection under study: Clinical Success: survival after completion of a test article regimen without receiving any systemic antibacterial therapy other than test article, resolution of signs/symptoms of the infection present at Screening with no new symptoms/complications attributable to CABP and no need for further antibacterial therapy. Clinical Failure: alternative antibacterial treatment for CABP was required prior to the PTE Visit related to either (a) progression/development of new CABP symptoms or (b) development of infectious complications of CABP. Other reasons for clinical failure: participant received antibiotics that may have been effective for the infection under study for a different infection from the one under study; death prior to the PTE Visit. Indeterminate: the clinical response to test article could not be adequately inferred.

Time frame: 5 to 10 days after the last dose of test article

Population: ITT Population

ArmMeasureGroupValue (NUMBER)
OmadacyclinePercentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) VisitClinical Success86 Percentage of participants
OmadacyclinePercentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) VisitClinical Failure8.0 Percentage of participants
OmadacyclinePercentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) VisitIndeterminate6.0 Percentage of participants
MoxifloxacinPercentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) VisitClinical Success87.7 Percentage of participants
MoxifloxacinPercentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) VisitClinical Failure6.6 Percentage of participants
MoxifloxacinPercentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) VisitIndeterminate5.7 Percentage of participants
95% CI: [-6.9, 3.4]
Secondary

Percentage of Participants With the Indicated Investigator Assessment of Clinical Response in the Clinically Evaluable-Post Therapy Evaluation (CE-PTE) Population at the PTE Visit

At the PTE Visit, the investigator indicates one of the following outcomes relating to the primary infection under study: Clinical Success: survival after completion of a test article regimen without receiving any systemic antibacterial therapy other than test article, resolution of signs/symptoms of the infection present at Screening with no new symptoms/complications attributable to CABP and no need for further antibacterial therapy. Clinical Failure: alternative antibacterial treatment for CABP was required prior to the PTE Visit related to either (a) progression/development of new CABP symptoms or (b) development of infectious complications of CABP. Other reasons for clinical failure: participant received antibiotics that may have been effective for the infection under study for a different infection from the one under study; death prior to the PTE Visit. Indeterminate: the clinical response to test article could not be adequately inferred.

Time frame: 5 to 10 days after the last dose of test article

Population: CE-PTE Population consisted of all ITT participants who received test article, have a qualifying Community-Acquired Bacterial Pneumonia (CABP), an assessment of outcome, and meet all other evaluability criteria.

ArmMeasureGroupValue (NUMBER)
OmadacyclinePercentage of Participants With the Indicated Investigator Assessment of Clinical Response in the Clinically Evaluable-Post Therapy Evaluation (CE-PTE) Population at the PTE VisitClinical Success94.1 Percentage of participants
OmadacyclinePercentage of Participants With the Indicated Investigator Assessment of Clinical Response in the Clinically Evaluable-Post Therapy Evaluation (CE-PTE) Population at the PTE VisitClinical Failure5.9 Percentage of participants
OmadacyclinePercentage of Participants With the Indicated Investigator Assessment of Clinical Response in the Clinically Evaluable-Post Therapy Evaluation (CE-PTE) Population at the PTE VisitIndeterminate0 Percentage of participants
MoxifloxacinPercentage of Participants With the Indicated Investigator Assessment of Clinical Response in the Clinically Evaluable-Post Therapy Evaluation (CE-PTE) Population at the PTE VisitClinical Success95.9 Percentage of participants
MoxifloxacinPercentage of Participants With the Indicated Investigator Assessment of Clinical Response in the Clinically Evaluable-Post Therapy Evaluation (CE-PTE) Population at the PTE VisitClinical Failure4.1 Percentage of participants
MoxifloxacinPercentage of Participants With the Indicated Investigator Assessment of Clinical Response in the Clinically Evaluable-Post Therapy Evaluation (CE-PTE) Population at the PTE VisitIndeterminate0 Percentage of participants
95% CI: [-5.7, 2]

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026