Efficacy and Safety Study of Eravacycline Compared With Ertapenem in Complicated Intra-abdominal Infections (IGNITE1)

Tetraphase Pharmaceuticals

Status and phase: Completed; Phase 3

Conditions: Complicated Intra-abdominal Infections

Treatments: Drug: Placebo; Drug: Ertapenem; Drug: Eravacycline

Study type: Interventional

Funder types: Industry

Identifiers

NCT01844856

TP-434-008

Details and patient eligibility

About

This is a Phase 3, randomized, double-blind, double-dummy, multicenter, prospective study to assess the efficacy, safety, and pharmacokinetics of eravacycline compared with ertapenem in the treatment of adult complicated intra-abdominal infections (cIAI).

Enrollment: 541 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Male or female participant hospitalized for cIAI
2. At least 18 years of age (and not over 65 years of age for participant in India)
3. Evidence of a systemic inflammatory response
4. Abdominal pain or flank pain (with or without rebound tenderness), or pain caused by cIAI that is referred to another anatomic area
5. Able to provide informed consent
6. If male: must agree to use an effective barrier method of contraception during the study and for 90 days following the last dose if sexually active with a female of childbearing potential
7. If female, not pregnant or nursing or, if of childbearing potential: either will commit to use at least two medically accepted, effective methods of birth control (for example, condom, oral contraceptive, indwelling intrauterine device, hormonal implant /patch, injections, approved cervical ring) during study drug dosing and for 90 days following last study drug dose or practicing sexual abstinence

Exclusion criteria

1. Unlikely to survive the 6-8 week study period

2. Renal failure

3. Presence or possible signs of hepatic disease

4. Immunocompromised condition, including known human immunodeficiency virus (HIV) positivity (requiring anti-retroviral therapy or with CD4 count <300), acquired immune deficiency syndrome (AIDS), organ (bone marrow) transplant recipients, and hematological malignancy. Immunosuppressive therapy, including use of high-dose corticosteroids (for example, >40 mg prednisone or equivalent per day for greater than 2 weeks)

5. History of hypersensitivity reactions to tetracyclines, carbapenems, β-lactam antibiotics or to excipients contained in the study drug formulations

6. Participation in any investigational drug or device study within 30 days prior to study entry

7. Known or suspected current Central Nervous System disorder that may predispose to seizures or lower seizure threshold

8. Previously received eravacycline in a clinical trial

9. Antibiotic-related exclusions:

   1. Receipt of effective antibacterial drug therapy for cIAI for a continuous duration of >24 hours during the 72-hour preceding enrollment (however, participants with documented cIAI [that is, known baseline pathogen] who have received at least 72 hours of antibiotic therapy and are considered treatment failures may be enrolled. Treatment failure is defined as persistent fever and/or clinical symptoms; or the development of a new intra-abdominal abscess after ≥72 hours of antibiotic therapy), or
   2. Receipt of ertapenem or any other carbapenem, or tigecycline for the current infection or
   3. Need for concomitant systemic antimicrobial agents other than study drug

10. Refusal of mechanical ventilation, dialysis or hemofiltration, cardioversion or any other resuscitative measures and drug/fluid therapy at time of consent

11. Known or suspected inflammatory bowel disease or associated visceral abscess

12. The anticipated need for systemic antibiotics for a duration of more than 14 days

13. Systemic malignancy that required chemotherapy, immunotherapy, radiation therapy or antineoplastic therapy within the previous 3 months or that is anticipated to begin prior to the Test-of-Cure (TOC) visit

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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541 participants in 2 patient groups

Eravacycline, 1.0 mg/kg q12h

Experimental group

Description:

Eravacycline was administered intravenously (IV) at a dose of 1.0 milligram per kilogram of body weight (mg/kg) every 12 hours (q12h) for a minimum of 4 days and a maximum of 14 days. Eravacycline treatment was to be stopped when symptoms of complicated intra-abdominal infection (cIAI) resolved, there was treatment failure, or the maximum allowed number of infusion days was reached.

Treatment:

Drug: Eravacycline

Drug: Placebo

Ertapenem, 1.0 g q24h

Active Comparator group

Description:

Ertapenem was administered IV at a dose of 1.0 gram (g) every 24 hours (q24h) for a minimum of 4 days and a maximum of 14 days. Ertapenem treatment was to be stopped when symptoms of cIAI resolved, there was treatment failure, or the maximum allowed number of infusion days was reached.

Treatment:

Drug: Placebo

Drug: Ertapenem