Community-acquired Pneumonia, Bacterial Pneumonia
Conditions
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
IV solution, oral tablets
Sponsors
Study design
Eligibility
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
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) Visit | 72 to 120 hours after the first dose of test article | 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 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) Visit | 5 to 10 days after the last dose of test article | 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. |
| 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 | 5 to 10 days after the last dose of test article | 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. |
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
| Arm | Count |
|---|---|
| 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 |
| Total | 670 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 1 | 1 |
| Overall Study | COVID-19 related reasons | 2 | 1 |
| Overall Study | Death | 6 | 6 |
| Overall Study | Lost to Follow-up | 2 | 4 |
| Overall Study | Martial Law in Ukraine | 2 | 3 |
| Overall Study | Unavailability for post therapy evaluation Visit | 8 | 4 |
| Overall Study | Withdrawal by Subject | 7 | 9 |
Baseline characteristics
| Characteristic | Moxifloxacin | Total | Omadacycline |
|---|---|---|---|
| Age, Continuous | 62.2 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 Participants | 8 Participants | 4 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 330 Participants | 662 Participants | 332 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race/Ethnicity, Customized Asian | 1 Participants | 2 Participants | 1 Participants |
| Race/Ethnicity, Customized White | 333 Participants | 668 Participants | 335 Participants |
| Sex: Female, Male Female | 166 Participants | 324 Participants | 158 Participants |
| Sex: Female, Male Male | 168 Participants | 346 Participants | 178 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 6 / 336 | 6 / 332 |
| other Total, other adverse events | 32 / 336 | 36 / 332 |
| serious Total, serious adverse events | 17 / 336 | 15 / 332 |
Outcome results
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
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Omadacycline | Percentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) Visit | Clinical Success | 89.6 Percentage of participants |
| Omadacycline | Percentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) Visit | Clinical Failure | 8.6 Percentage of participants |
| Omadacycline | Percentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) Visit | Indeterminate | 1.8 Percentage of participants |
| Moxifloxacin | Percentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) Visit | Clinical Success | 87.7 Percentage of participants |
| Moxifloxacin | Percentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) Visit | Clinical Failure | 9.3 Percentage of participants |
| Moxifloxacin | Percentage of Participants With Early Clinical Response at the Early Clinical Response (ECR) Visit | Indeterminate | 3.0 Percentage of participants |
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
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Omadacycline | Percentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) Visit | Clinical Success | 86 Percentage of participants |
| Omadacycline | Percentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) Visit | Clinical Failure | 8.0 Percentage of participants |
| Omadacycline | Percentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) Visit | Indeterminate | 6.0 Percentage of participants |
| Moxifloxacin | Percentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) Visit | Clinical Success | 87.7 Percentage of participants |
| Moxifloxacin | Percentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) Visit | Clinical Failure | 6.6 Percentage of participants |
| Moxifloxacin | Percentage of Participants With Investigator Assessment of Clinical Response at the Post Therapy Evaluation (PTE) Visit | Indeterminate | 5.7 Percentage of participants |
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.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Omadacycline | 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 | Clinical Success | 94.1 Percentage of participants |
| Omadacycline | 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 | Clinical Failure | 5.9 Percentage of participants |
| Omadacycline | 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 | Indeterminate | 0 Percentage of participants |
| Moxifloxacin | 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 | Clinical Success | 95.9 Percentage of participants |
| Moxifloxacin | 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 | Clinical Failure | 4.1 Percentage of participants |
| Moxifloxacin | 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 | Indeterminate | 0 Percentage of participants |