Oritavancin Versus IV Vancomycin for the Treatment of Patients With Acute Bacterial Skin and Skin Structure Infection

Study Overview
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Brief Summary
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The purpose of this Phase 3 trial is to evaluate the efficacy, safety, and tolerability of oritavancin in ABSSSIs, including those caused by MRSA and to evaluate the potential economic benefit of oritavancin administered as a single 1200 mg IV dose.

Detailed Description
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This is a Phase 3, multicenter, randomized, double-blind, parallel, comparative efficacy and safety study of single-dose IV oritavancin/IV placebo versus IV vancomycin for 7 to 10 days in adults with acute bacterial skin and skin structure infection (ABSSSI) suspected or proven to be caused by Gram-positive pathogens. Approximately 960 patients will be randomized at 100 centers globally. In addition, this study will characterize the PK and PK/PD properties of a single 1200 mg IV dose of oritavancin and evaluate the potential health economic benefits offered by this dosing strategy.

Official Title
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A Multicenter, Double-Blind, Randomized Study to Evaluate the Efficacy and Safety of Single-Dose IV Oritavancin Versus IV Vancomycin for the Treatment of Patients With Acute Bacterial Skin and Skin Structure Infection (SOLO II)

Conditions
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Wound Infection, Abscess, Systemic Inflammation, Cellulitis

Intervention / Treatment
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* Drug: Single-Dose IV Oritavancin Diphosphate
* Drug: IV Vancomycin


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects may be included in the study if they meet all of the following inclusion criteria: Males or females ≥18 years old Diagnosis of ABSSSI suspected or confirmed to be caused by a Gram-positive pathogen requiring at least 5 days of IV therapy An ABSSSI includes one of the following infections Wound infections, Cellulitis/erysipelas, Major cutaneous abscess ABSSSI must present with at least 2 signs and symptoms Able to give informed consent and willing to comply with all required study procedures Exclusion Criteria: Subjects will be excluded from the study if any of the following exclusion criteria apply prior to randomization: Prior systemic or topical antibacterial therapy with activity against suspected or proven Gram-positive pathogens within the preceding 14 days The causative Gram-positive pathogen(s) isolated from the ABSSSI site is resistant in vitro to the antibacterial(s) that was administered with documented clinical progression, or Documented failure to previous ABSSSI antibiotic therapy is available. Documentation of treatment failure must be recorded Patient received a single dose of a short acting antibacterial therapy three or more days before randomization Infections associated with, or in close proximity to, a prosthetic device Severe sepsis or refractory shock Known or suspected bacteremia at time of screening ABSSSI due to or associated with any of the following: Infections suspected or documented to be caused by Gram-negative pathogens -- Wound infections (surgical or traumatic) and abscesses with only Gram-negative pathogens Diabetic foot infections Concomitant infection at another site not including a secondary ABSSSI lesion Infected burns A primary infection secondary to a pre-existing skin disease with associated inflammatory changes Decubitus or chronic skin ulcer, or ischemic ulcer due to peripheral vascular disease Any evolving necrotizing process gangrene or infection suspected or proven to be caused by Clostridium species Infections known to be caused by a Gram-positive organism with a vancomycin MIC >2 μg/mL or clinically failing prior therapy with glycopeptides Catheter site infections Allergy or intolerance to aztreonam or metronidazole in a patient with suspected or proven polymicrobial wound infection involving Gram-negative and/or anaerobic bacteria Currently receiving chronic systemic immunosuppressive therapy AIDS with CD4 count < 200 cells/mm3 Neutropenia Significant or life-threatening condition that would confound or interfere with the assessment of the ABSSSI Women who are pregnant or nursing History of immune-related hypersensitivity reaction to glycopeptides Patients that require anticoagulant monitoring with an aPTT Contraindication to vancomycin Patients unwilling to forego blood and/or blood product donation Treatment with investigational medicinal product within 30 days before enrollment and for the duration of the study Investigational device present, or removed <30 days before enrollment, or presence of device-related infection Patients unlikely to adhere to the protocol, comply with study drug administration, or complete the clinical study Severe hepatic disease Presence of hyperuricemia Unwilling to refrain from chronic use of any medication with antipyretic properties

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Single-Dose IV Oritavancin Diphosphate<br> | Drug: Single-Dose IV Oritavancin Diphosphate<br>* Intravenous oritavancin and IV placebo or IV vancomycin will be administered for a minimum of 7 days up to a maximum of 10 days.<br>|
| Active Comparator: IV Vancomycin<br> | Drug: IV Vancomycin<br>* Intravenous oritavancin and IV placebo or IV vancomycin will be administered for a minimum of 7 days up to a maximum of 10 days.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Early Clinical Response | Clinical response at the ECE visit (48-72 hours following initiation of study drug administration). Early clinical response was defined as a composite outcome based on, cessation of spreading or reduction in the size of baseline lesion, absence of fever and no rescue antibiotic medication. | 48-72 hours after the initation of study therapy | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Investigator Assessed Clinical Cure at Post Therapy Evaluation (Key Secondary Endpoint) | Compared the clinical efficacy at the Post Therapy Evaluation of Oritavancin and Vancomycin based on the Investigator examination of the signs and symptoms of the primary ABSSSI; Investigator assessment of clinical cure is complete or nearly complete resolution of baseline signs and symptoms of the primary infection such that no further treatment with antibiotics is needed | 7 to 14 days after end of therapy | 
| >= 20% Reduction in Lesion Area | Clinical response at the ECE visit (48-72 hours following initiation of study drug administration) based on changes in ABSSSI lesion size measurements from baseline. | 48-72 hours after the initation of study therapy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ABSSSI, Skin Infection, Abscess