A Phase 3, randomized, double-blind, active controlled study to compare the efficacy and safety of ridinilazole (200 mg, bid) for 10 days with vancomycin (125 mg, qid) for 10 days in the treatment of Clostridium difficile infection (CDI).
- Conditions
- Clostridium difficile infection (CDI)MedDRA version: 20.0Level: PTClassification code 10054236Term: Clostridium difficile infectionSystem Organ Class: 10021881 - Infections and infestationsTherapeutic area: Diseases [C] - Bacterial Infections and Mycoses [C01]
- Registration Number
- EUCTR2017-001642-10-LT
- Lead Sponsor
- Summit (Oxford) Limited
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- 680
Patients are eligible to be included in the study only if all the following criteria apply:
1. Patient must be at least 18 years of age, at the time of signing the informed consent.
2. Have signs and symptoms of CDI including diarrhea such that in the Investigator’s opinion CDI antimicrobial therapy is required. Diarrhea is defined as a change in bowel habits, with =3 UBMs (5, 6 or 7 on the Bristol Stool Chart) in the 24 h prior to randomization.
3. Have the presence of either toxin A and/or B of C. difficile in the stool determined by a positive free toxin test (using a Sponsor agreed test). The stool sample must be current (produced within 72 hours prior to randomization).
4. Male or Female
Male patients:
• A male patient must agree to use contraception as detailed in Section 10.4 of this protocol during the treatment period and for at least 30 days after the last dose of study treatment and refrain from donating sperm during this period.
Female patients:
• A female patient is eligible to participate if she is not pregnant (see Section 10.4), not breastfeeding, and at least one of the following conditions applies:
i. Not a woman of childbearing potential (WOCBP) as defined in Section 10.4
OR
ii. A WOCBP who agrees to follow the contraceptive guidance in Appendix 4 during the treatment period and for at least 30 days after the last dose of study treatment.
5. Has provided documented signed informed consent and any authorizations required by local law (e.g. Protected Health Information [PHI]). If unable to read, understand and sign the informed consent form a legally authorized representative (LAR) may provide consent on the patient's behalf if permitted by the Institutional Review Board (IRB)/Ethics Committee (EC).
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 340
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 340
Patients are excluded from the study if any of the following criteria apply:
1. Have had more than one prior episode of CDI in the previous 3 months or more than 3 episodes in the past 12 months prior to randomization.
2. Have a history of chronic diarrheal disease including inflammatory bowel disease (Crohn’s disease or ulcerative colitis).
3. Have had a positive diagnostic test for other GI pathogens considered to be clinically relevant, within 2 weeks of randomization.
4. Have had major gastrointestinal (GI) tract surgery (e.g. significant bowel resection or pancreatectomy) within 3 months of randomization (this does not include appendectomy or cholecystectomy); or the presence of a colostomy or ileostomy or likely requirement of an ostomy during the study.
5. a) Have confirmed, or suspected, severe complicated CDI with evidence of fulminant colitis, life threatening infection, hypotension, septic shock, colostomy or ileostomy, peritoneal signs, absence of bowel sounds or toxic megacolon. Patients will also be excluded if in the opinion of the investigator, they require the use of a course of vancomycin of dose and schedule other than 125mg QID for 10 days. b) Have mild CDI that, in the opinion of the investigator, would not require treatment with vancomycin 125mg QID for 10 days per clinical practice.
6. This number (EC #6) has been intentionally left blank.
7. Have had more than the equivalent 24 hours of dosing of antimicrobial treatment active against the current episode of CDI prior to randomization (i.e. more than four doses of oral vancomycin, two doses of fidaxomicin or teicoplanin or three doses of metronidazole).
8. Prior or current use of anti-toxin antibodies including bezlotoxumab within the past 6 months prior to randomization.
9. Are unable to discontinue products used affecting disease progression at randomization (see 6.5.1 for a list of potentially confounding medications).
10. Has been involved in a clinical trial and received an investigational medicinal product for indications other than CDI within 1 month or five half-lives (whichever is longer) or within 3 months if the investigational medical product was for CDI.
11. Have received an investigational vaccine against C. difficile.
12. Patients that the Investigator feels are inappropriate for the study this would include those;
a. patients with any other condition that, in the Investigator's judgment, would make the patient unsuitable for inclusion in the study, such as chronic diarrhea, vomiting
that cannot be managed with anti-emetics, inability to swallow study medication,
or being medically unstable with a critical illness (e.g. requiring vasopressors,
intubation, etc.).
b. patients who, in the opinion of the Investigator, are not likely to complete the
study, e.g. life expectancy less than 100 days.
c. patients with known hypersensitivity or intolerance to ridinilazole, vancomycin,
and/or their excipients.
d. patients or their caregivers who are unable to comply with protocol requirements,
e.g. attend study visits, report bowel movements and suspected recurrence,
provide stool samples or undergo blood draws.
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method