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Trial record 2 of 5 for:    pharma holdings

A Study to Evaluate the Safety and Efficacy of 3% LTX-109 for Nasal Decolonisation of Staphylococcus

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04767321
Recruitment Status : Completed
First Posted : February 23, 2021
Last Update Posted : August 30, 2021
Sponsor:
Collaborator:
CTC Clinical Trial Consultants AB
Information provided by (Responsible Party):
Pharma Holdings AS

Brief Summary:
A Phase I/IIa, double-blind, placebo-controlled, randomised study designed to evaluate the safety, tolerability, exploratory efficacy and exposure of LTX-109 administered topically to the anterior nares in subjects with persistent carriage of S. aureus (methicillin-susceptible S. aureus [MSSA] and/or methicillin-resistant S. aureus [MRSA]).

Condition or disease Intervention/treatment Phase
Nasal Decolonization of Staphylococcus Aureus Drug: LTX-109 gel, 3% w/w Drug: Placebo Phase 1 Phase 2

Detailed Description:

Approximately 60 subjects will be screened to achieve 24 persistent MSSA and/or MRSA carriers and 16 randomised and dosed subjects randomized 3:1, active to placebo.

Eligible subjects will be admitted to the clinic on Day 1 for randomisation and dosing and will remain at the clinic until Day 2. Following nasal and perineum swabs and a chlorhexidine (Hibiscrub®) shower, the investigational medicinal product (IMP) will be applied topically to both nostrils by a qualified health professional 4 times during a six hour period (every two hours at 0, 2, 4 and 6 hours) on Day 1.

Subjects will come back to the research clinic on Day 3, Day 4, Day 8 and Day 15 (Visits 4 to 7) for safety, tolerability and efficacy assessments and for blood sampling for bioanalysis. On Day 5 and Day 6, subjects will take a chlorhexidine shower at home. A final end-of-study visit (Visit 8) will take place on Day 22 (±3 days) or after early withdrawal.

All subjects will be instructed to wash the body and hair with chlorhexidine body wash and shampoo at the clinic on Day 1 (prior to the first dose) and on Day 2. Prior to leaving the clinic on Day 2, subjects will be provided with chlorhexidine body wash and shampoo for body and hair wash at home on Day 3 (prior to Visit 4), on Day 4 (prior to Visit 5) and on Day 5 and Day 6.

Each subject is expected to participate in the study for approximately 50 days including a 28 day screening period

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 15 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Randomised, Double-blind, Placebo-controlled Randomization 3:1, active to placebo
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: A Phase I/IIa, Randomised, Double-blind, Placebo-controlled Study to Evaluate the Safety and Exploratory Efficacy of 3% LTX-109 Compared to Placebo for Nasal Decolonisation of Staphylococcus Aureus
Actual Study Start Date : February 22, 2021
Actual Primary Completion Date : March 23, 2021
Actual Study Completion Date : June 1, 2021

Arm Intervention/treatment
Experimental: LTX-109 treatment
Nasal application of LTX-109 gel 3% (w/w), 250 mikroliters in each nostril, 4 times in one day, every two hours.
Drug: LTX-109 gel, 3% w/w
LTX-109 gel will be applied topically to both nostrils by a qualified health professional. On each dosing occasion, a large drop of IMP will be applied into each nostril and distributed to cover the whole area of the nostril.

Experimental: Placebo
Nasal application of placebo, 250 mikroliters in each nostril, 4 times in one day, every two hours.
Drug: Placebo
Placebo gel will be applied topically to both nostrils by a qualified health professional. On each dosing occasion, a large drop of IMP will be applied into each nostril and distributed to cover the whole area of the nostril.




Primary Outcome Measures :
  1. Assessment of safety by occurence and frequency of Adverse Events [ Time Frame: Through treatment and followup of 22 days ]
    Occurrence and frequency of Adverse Events

  2. Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point graded scale. [ Time Frame: Day 1 ]
    Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)

  3. Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point graded scale. [ Time Frame: Day 2 ]
    Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)

  4. Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale. [ Time Frame: Day 3 ]
    Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)

  5. Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale. [ Time Frame: Day 4 ]
    Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)

  6. Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale. [ Time Frame: Day 8 ]
    Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)

  7. Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale. [ Time Frame: Day 15 ]
    Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)

  8. Local tolerability assessed by a qualified health care professional by evaluation of nostrils and scoring using a 4-point scale. [ Time Frame: Day 22 ]
    Incidence of local reactions (erythema, swelling and lesions) will be assessed by a qualified health care professional . Each nostril will be evaluated separately and scored using a 4-graded scale (0-3)

  9. Local tolerability assessed by the subject by Visual Analog Scale. [ Time Frame: Day 1 ]
    Assessment of Local tolerability on Visual Analog Scale

  10. Local tolerability assessed by the subject by Visual Analog Scale. [ Time Frame: Day 2 ]
    Assessment of Local tolerability on Visual Analog Scale


Secondary Outcome Measures :
  1. Number of subjects on LTX-109 versus placebo with bacterial eradication at Test of Cure [ Time Frame: 54 hours (+ 2 hours) ]
    Assessment of eradication of bacteria defined as non-presence of Staphylococcus aureus (MSSA and/or MRSA) in quantitative cultures

  2. Number of subjects on LTX-109 versus placebo with bacterial eradication at other specified time points than Time of Cure. [ Time Frame: 4, 6, 12, 24, 78 hours and Days 8, 15 and 22 ]
    Assessment of bacterial count at specified points in time to explore effect of the intervention

  3. Number of colony forming units (CFUs) in subjects on LTX-109 versus placebo at specified points in time. [ Time Frame: 4, 6, 12, 24, 78 hours and Days 8, 15 and 22 ]
    Assessment of bacterial count at specified points in time to explore effect of the intervention

  4. Number of subjects on LTX-109 vs placebo with bacterial recolonisation defined as the timepoint of recurrence of colonisation after confirmed eradication. [ Time Frame: Days 4, 8, 15 and 22 ]
    Assessment of recurrence

  5. Plasma concentrations of LTX-109 [ Time Frame: 6, 24, 54 and 78 hours ]
    Assessment of plasma concentratin by analysis of blood samples



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  1. Willing and able to give written informed consent for participation in the study.
  2. Male or female subject aged 18 to 65 years inclusive at Visit 2.
  3. Persistent nasal carrier of Staphylococcus aureus (MSSA and/or MRSA), confirmed by two positive bacterial cultures from the nose during the screening period.
  4. Clinically normal medical history, physical findings, vital signs and laboratory values at the time of screening Visit 2, as judged by the Investigator.
  5. Women of child bearing potential (WOCBP) must practice abstinence (only allowed when this is the preferred and usual lifestyle of the subject) or must agree to use a highly effective method of contraception with a failure rate of < 1% to prevent pregnancy (combined [oestrogen and progestogen containing] hormonal contraception associated with inhibition of ovulation [oral, intravaginal, transdermal], progestogen-only hormonal contraception associated with inhibition of ovulation [oral, injectable, implantable], intrauterine device [IUD]or intrauterine hormone-releasing system [IUS]) from at least 2 weeks prior to dose to 2 weeks after last dose. Female subjects must refrain from donating eggs from the date of dosing until 3 months after dosing with the IMP. Their male partner must agree to use a condom during the same time frame if he has not undergone vasectomy.

Women of non-childbearing potential are defined as pre-menopausal females who are sterilised (tubal ligation or permanent bilateral occlusion of fallopian tubes); or females who have undergone hysterectomy or bilateral oophorectomy; or post-menopausal defined as 12 months of amenorrhea (in questionable cases a blood sample with simultaneous detection of follicle stimulating hormone [FSH] 25-140 IE/L is confirmatory).

Male subjects must be willing to use condom or be vasectomised or practice sexual abstinence to prevent pregnancy and drug exposure of a partner and refrain from donating sperm from the date of dosing until 3 months after dosing with the IMP. Their female partner of child-bearing potential must use contraceptive methods with a failure rate of < 1% to prevent pregnancy (see above).

Exclusion Criteria:

  1. History of any clinically significant disease or disorder which, in the opinion of the Investigator, may either put the subject at risk because of participation in the study, or influence the results or the subject's ability to participate in the study.
  2. Any clinically significant illness, medical/surgical procedure or trauma within 4 weeks of the first administration of IMP.
  3. Severe eczema or skin wounds, dry or sensitive skin assessed as clinically significant by the Investigator.
  4. Malignancy within the past 5 years with the exception of in situ removal of basal cell carcinoma.
  5. Any positive result at screening for serum hepatitis B surface antigen, hepatitis C antibody and Human Immunodeficiency Virus (HIV).
  6. History of severe allergy/hypersensitivity or ongoing allergy/hypersensitivity, as judged by the Investigator, or history of hypersensitivity to drugs with a similar chemical structure or class to LTX-109 or chlorhexidine.
  7. S. aureus (MSSA and/or MRSA) decolonisation attempt in the 6 months prior to screening Visit 2.
  8. Inability to take medications nasally.
  9. Nasal polyps or significant anatomical nasal abnormality, as judged by the Investigator.
  10. Evidence of open wound, lesion, inflammation, erythema or infection (including active rhinitis, sinusitis or upper respiratory infection) affecting the nostril area, lip and skin close to the nose.
  11. History of multiple episodes (>3) of epistaxis within 12 months prior to screening Visit 2.
  12. Disease in the region of the application sites, significant history of trauma or skin disease in the region of the application sites, current nasal skin or nasal septum condition requiring treatment or nasal surgery in the 6 months prior to screening Visit 2.
  13. In situ nasal jewellery or open nasal piercings.
  14. Previous or concurrent treatment with antimicrobials for an infection within the last 30 days prior to the first administration of IMP.
  15. Regular use of cortisone or anticoagulation medication within 14 days prior to the first administration of IMP and regular use of nasal decongestants within 30 days prior to the first IMP administration, at the discretion of the Investigator.
  16. Planned treatment or treatment with another investigational drug within 30 days prior to Day 1. Subjects consented and screened but not dosed in previous Phase I studies are not excluded.
  17. Positive screen for drugs of abuse or alcohol at screening Visit 2 or on admission to the unit prior to administration of the IMP.
  18. History of alcohol abuse or excessive intake of alcohol, as judged by the Investigator.
  19. Presence or history of drug abuse, as judged by the Investigator.
  20. History of, or current use of, anabolic steroids.
  21. Plasma donation within 2 weeks of screening Visit 2 or blood donation (or corresponding blood loss) during the three months prior to screening.
  22. Investigator considers the subject unlikely to comply with study procedures, restrictions and requirements.
  23. Female subjects who are pregnant or who are currently breast feeding.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04767321


Locations
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Sweden
ClinSmart Sweden AB
Uppsala, Sweden, SE-752 37
Sponsors and Collaborators
Pharma Holdings AS
CTC Clinical Trial Consultants AB
Investigators
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Principal Investigator: Johan Nilsson, MD CTC Clinical Trial Consultants AB
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Responsible Party: Pharma Holdings AS
ClinicalTrials.gov Identifier: NCT04767321    
Other Study ID Numbers: C20-109-06
First Posted: February 23, 2021    Key Record Dates
Last Update Posted: August 30, 2021
Last Verified: February 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Staphylococcal Infections
Gram-Positive Bacterial Infections
Bacterial Infections
Bacterial Infections and Mycoses
Infections