Study of Daptomycin in Subjects Undergoing Surgery for Osteomyelitis Associated With an Infected Prosthetic Caused by Staphylococci

This study has been completed.
Sponsor:
Information provided by:
Cubist Pharmaceuticals
ClinicalTrials.gov Identifier:
NCT00428844
First received: January 26, 2007
Last updated: May 13, 2011
Last verified: May 2011
  Purpose

This is a research study designed to look at the efficacy and safety of daptomycin given at a dose of 6 mg/kg or 8 mg/kg in subjects being treated for prosthetic hip or knee infections caused by Staphylococci. These types of bacteria are among the most common types of bacteria causing infections of prosthetic joints.


Condition Intervention Phase
Osteomyelitis
Drug: daptomycin
Drug: vancomycin
Drug: teicoplanin
Drug: nafcillin
Drug: oxacillin
Drug: flucloxacillin
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase 2 Randomized Study Investigating the Safety, Efficacy and Pharmacokinetics of Daptomycin 6 mg/kg and 8 mg/kg Versus Comparator in the Treatment of Subjects Undergoing Surgical Standard of Care for Osteomyelitis Associated With an Infected Prosthetic Hip or Knee Joint Caused by Staphylococci

Resource links provided by NLM:


Further study details as provided by Cubist Pharmaceuticals:

Primary Outcome Measures:
  • Any Creatine Phosphokinase (CPK) Elevation > 500 Units Per Liter (U/L) [ Time Frame: From the 3rd day of therapy to 1 week post last dose (approximately week 7) ] [ Designated as safety issue: Yes ]
    Number of subjects with CPK >500 U/L between Day 3 and 7 days following the last dose of study medication (Day 7P) as measured by the central laboratory.


Secondary Outcome Measures:
  • Safety - Notable Laboratory Abnormalities [ Time Frame: From the 1st day of therapy to maximum of 23 weeks post last dose (up to maximum of week 30) ] [ Designated as safety issue: Yes ]
    Summary of Notable Laboratory Abnormalities - description of the proportion of subjects within each treatment group that had clinical laboratory values outside the reference range.

  • Overall Clinical Outcome [ Time Frame: Approximately 6 weeks post last dose (approximately week 12) ] [ Designated as safety issue: No ]
    The sponsor determined overall clinical outcome based on blinded review of clinical, microbiological, and radiological response of the subject including, but not limited to, clinical signs and symptoms of PJI, microbiological assessments, radiographic findings, and surgical procedures performed. Subjects were a success if both clinical and microbiological responses were success. A subject who failed to respond clinically or microbiologically was a failure. If microbiological response was non-evaluable and/or clinical evaluation at TOC was not performed, the subject was non-evaluable.

  • Microbiological Response [ Time Frame: Approximately 6 weeks post last dose (approximately week 12) ] [ Designated as safety issue: No ]
    Sponsor's assessment of subject-level microbiological response at the test-of-cure visit for the modified Intent-to-Treat (mITT) population.

  • Pharmacokinetic Parameter: Maximum Plasma Concentration (Cmax) [ Time Frame: Day 4 (steady state) ] [ Designated as safety issue: No ]
    The pharmacokinetic (PK) parameters of daptomycin at steady state for the 6 mg/kg and 8 mg/kg dose groups. On treatment day 4, PK samples for daptomycin levels were to be obtained prior to start of daptomycin infusion (0 hr) and at 0.5 hr (end of infusion), 1-1.5 hr, 3-5 hr, 8-12 hr, and 24 hr after the start of daptomycin infusion.

  • Pharmacokinetic Parameter: Area Under the Concentration-time Curve During a Dosing Interval at Steady State (AUCss) [ Time Frame: Day 4 (steady state) ] [ Designated as safety issue: No ]
    The pharmacokinetic (PK) parameters of daptomycin at steady state for the 6 mg/kg and 8 mg/kg dose groups. On treatment day 4, PK samples for daptomycin levels were to be obtained prior to start of daptomycin infusion (0 hr) and at 0.5 hr (end of infusion), 1-1.5 hr, 3-5 hr, 8-12 hr, and 24 hr after the start of daptomycin infusion.


Enrollment: 75
Study Start Date: January 2007
Study Completion Date: June 2010
Primary Completion Date: March 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Daptomycin 6 mg/kg
Daptomycin (6 mg/kg every 24 hours [q24h]) as a 30 minute intravenous (IV) infusion for 6 weeks (± one week).
Drug: daptomycin
6 mg/kg
Other Name: Cubicin
Experimental: Daptomycin 8 mg/kg
Daptomycin (8 mg/kg q24h) as a 30 minute IV infusion for 6 weeks (± one week).
Drug: daptomycin
8 mg/kg
Other Name: Cubicin
Active Comparator: Comparator
Vancomycin was administered at 1 gram every 12 hours (q12h) as a 60-minute infusion and teicoplanin was administered 6 mg/kg q24h as a 30-minute infusion also for 6 weeks (±1 week). Semi-synthetic penicillin (nafcillin, oxacillin, or flucloxacillin) was administered according to standard of care for 6 weeks (±1 week).
Drug: vancomycin
1 gram
Other Name: Vancocin
Drug: teicoplanin
6 mg/kg; used only at UK sites
Other Name: Targocid
Drug: nafcillin
1-2 gram
Other Name: Unipen
Drug: oxacillin
1-2 gram
Other Name: Bactocill
Drug: flucloxacillin
1-2 mg
Other Name: Fluclox

  Eligibility

Ages Eligible for Study:   18 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Subject must be between the ages of 18 and 80, inclusive
  • Subject must have a diagnosis of prosthetic joint infection (PJI) in a hip or knee joint which has never previously been totally revised because of an infection and for which they are anticipated to undergo a two-stage replacement surgery
  • Subject must have a positive microbiological identifier of staphylococci.
  • If Subject is female of childbearing potential, must be willing to practice reliable birth control

Exclusion Criteria:

  • Subject has permanent intravascular prosthetic material such as heart valves or pacemakers
  • Subject has a creatinine clearance (CLCR) <30 mL/min as determined by the Cockcroft-Gault equation using actual body weight.
  • Subject has significant hepatic dysfunction
  • Subject has a fungal or mycobacterial PJI
  • Subject is known to be HIV-infected with CD4 count ≤ 200 cells/ mm3
  • Subject has an abnormal creatine phosphokinase (CPK) (elevated CPK level ≥ 2x ULN) at baseline as measured by central laboratory
  • Subject is currently under treatment with chemotherapeutic agents excluding chronic maintenance therapy (e.g. tamoxifen to prevent relapse of primary breast cancer)
  • Subject is pregnant, nursing, or lactating.
  • Subject is receiving or is expected to receive chronic immunosuppressive therapy during the study.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00428844

  Hide Study Locations
Locations
United States, Arkansas
UAMS College of Medicine
Little Rock, Arkansas, United States, 72205-7199
United States, Colorado
South Denver Infectious Disease Associates, PC
Englewood, Colorado, United States, 80133
United States, District of Columbia
Kane and Davis Associates
Washington, District of Columbia, United States, 20016
United States, Florida
Infectious Disease Association of Tampa Bay
Tampa, Florida, United States, 33606
United States, Idaho
Idaho Falls Infectious Diseases, PLLC
Idaho Falls, Idaho, United States, 83404
United States, Illinois
Rush St. Luke's Medical Center
Chicago, Illinois, United States, 60612
Southern Illinois University School of Medicine
Springfield, Illinois, United States, 62794
United States, Minnesota
Mayo Clinic
Rochester, Minnesota, United States, 55905
United States, Nevada
Sierra Infectious Disease
Reno, Nevada, United States, 89502
United States, New Hampshire
Dartmouth-Hitchcock Medical center
Lebanon, New Hampshire, United States, 03756
United States, North Carolina
Wake Forest University Health Sciences
Winston-Salem, North Carolina, United States, 27157
United States, Ohio
Summa Health Systems
Akron, Ohio, United States, 44304
Cleveland Clinic
Cleveland, Ohio, United States, 44195
Regional Infectious Diseases-Infusion Center
Lima, Ohio, United States, 45801
United States, Pennsylvania
Lehigh Valley Hospital Trauma and Critical Care Research
Allentown, Pennsylvania, United States, 18103
Rothman Institute
Philadelphia, Pennsylvania, United States, 19107
United States, Wisconsin
Gundersen Clinic, LTD
La Crosse, Wisconsin, United States, 54601
Russian Federation
Federal National Institution of Science "Russian Ilizarov Scientific Center" "Restorative Traumatology and Orthopedics" of Rosmedtechnology
Kurgan, Russian Federation, 640014
National Healthcare Institution of Moscow "City Clinical Hospital #64"
Moscow, Russian Federation, 117292
Federal Healthcare Institute "Novosibirsk Scientific Research Institute of Traumatology and Orthopedy Rosmeditechnology"
Novosibirsk, Russian Federation, 630091
Russian Research Institute of Traumatology and Orthopedy
Saint Petersburg, Russian Federation, 197046
National Educational Institution of Higher Professional Education "Saint Petersburg State Medical Academy n.a. Mechnikov of Roszdrav"
Saint Petersburg, Russian Federation, 195067
National Healthcare Institution "Samara Regional Clinical Hospital n.a. Kalinin"
Samara, Russian Federation, 443095
United Kingdom
Nuffield Orthopaedics Centre, Bone Infection Unit
Headington, Oxford, Oxfordshire, United Kingdom, OX37LD
The Royal Infirmary of Edinburgh at Little France
Edinburgh, Scotland, United Kingdom, EH164SA
Brownlee Centre - Gartnavel General Hospital
Glasgow, Scotland, United Kingdom, G120YN
Sponsors and Collaborators
Cubist Pharmaceuticals
Investigators
Study Director: Alistair Wheeler, MD Cubist Pharmaceuticals, 65 Hayden Ave, Lexington, MA 02421, USA
  More Information

No publications provided by Cubist Pharmaceuticals

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Ed Campanaro, VP Clinical Operations, Cubist Pharmaceuticals
ClinicalTrials.gov Identifier: NCT00428844     History of Changes
Other Study ID Numbers: DAP-OST-06-02
Study First Received: January 26, 2007
Results First Received: March 16, 2011
Last Updated: May 13, 2011
Health Authority: United States: Food and Drug Administration

Keywords provided by Cubist Pharmaceuticals:
Osteomyelitis
Prosthetic Hip
Prosthetic Knee
MRSA
Osteomyelitis Associated with an Infected Prosthetic Hip or Knee Joint
Staphylococci

Additional relevant MeSH terms:
Osteomyelitis
Bone Diseases, Infectious
Infection
Bone Diseases
Musculoskeletal Diseases
Floxacillin
Nafcillin
Oxacillin
Vancomycin
Daptomycin
Teicoplanin
Anti-Bacterial Agents
Anti-Infective Agents
Therapeutic Uses
Pharmacologic Actions

ClinicalTrials.gov processed this record on July 20, 2014