Clinical trial NCT02436876: Study to Assess Safety and Clinical Activity of Local MBN-101 in Treatment of Infected Bone Sites
Official title: Phase 2a Randomized, Single-Blind, Placebo-Controlled, 12-week Escalating Dose Study to Assess the Safety, Tolerability and Clinical Activity of 3 Concentrations of Locally Applied MBN-101 to Infected Bone Sites
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Bacterial Infection
Keywords: Osteosynthesis
Complications
Infection or Inflammation
Orthopedic
Device
Fracture
Osteomyelitis
Lead sponsor: Microbion Corporation
Sponsor class: INDUSTRY
Collaborators: name: University of Pennsylvania
name: University of California, San Francisco
name: Medpace, Inc.
name: Congressionally Directed Medical Research Programs
First posted: 2015-05-07
Enrollment: 29
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study evaluates the safety and clinical benefit of MBN-101 administered intraoperatively to osteosynthesis or osteomyelitis sites for patients diagnosed with an orthopedic infection, with or without orthopaedic hardware. Three quarters of the patients will receive MBN-101, while the other one quarter will receive placebo.

Detailed description: Postoperative orthopaedic infections, particularly antibiotic-resistant infections, present a serious clinical challenge to surgeons and other treating physicians. These infections frequently involve implanted foreign materials (stabilizing orthopaedic hardware), making infection of these sites much more likely than if foreign materials were not involved. MBN-101 has broad spectrum antimicrobial activity against orthopaedic wound pathogens.

This is a randomized, single-blind, placebo-controlled, multi-center study to assess the safety and tolerability of escalating doses of MBN-101 to treat orthopaedic infections during revision surgery, (a) with or without orthopaedic hardware, and (b) with or without removal and replacement of orthopaedic hardware.

Eligibility criteria: Inclusion Criteria:

* To be eligible for this study, each of the following criteria must be satisfied with a "YES" answer (unless not applicable):

Patients who:

* have had operative fracture fixation of the upper extremity (AO/OTA class 15, 11-13, 21-23), lower extremity (AO/OTA class 31-34, 41 44, 81, 82) or pelvis (61, 62), or have undergone arthrodesis, and have subsequently been diagnosed with an apparent fracture site infection or are diagnosed with chronic or acute-on-chronic osteomyelitis of the long bone extremities (including residual amputated limbs)
* have at least one of the following:
* require surgical debridement of infected soft tissue and/or bone, with or without removal and/or placement/replacement of hardware
* male or female between the ages of 18 and 75 at the time the ICF is reviewed and signed
* patients receiving or anticipated to receive systemic antibiotic therapy as per institution's standard of care
* patients requiring postoperative hospitalization for at least 48 hours after revision surgery
* have read and signed the Informed Consent Form (ICF) after the nature of the study has been fully explained
* be willing and able to provide authorization for use and disclosure of personal health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA)

Exclusion Criteria:

* To be eligible for this study, each of the following criteria must be satisfied with a "NO" answer (unless not applicable):

  * Patients who are no longer hardware dependent or are definitively treated for their infection by hardware removal without replacement
  * Patients with multiple, non-contiguous sites of infection
  * Pathologic fracture (not including osteoporosis)
  * Patient requires immunosuppressive therapy (Topical or inhaled corticosteroids are permitted)
  * Serum creatinine, ALT, AST or Alkaline Phosphatase \>2.0 times the upper limit of the normal range of the local testing laboratory
  * Absolute neutrophil count \<1000
  * Patients without definitive soft-tissue coverage over the surgical site at time of study product administration
  * Any condition that has required treatment with any other bismuth containing compound within the last 2 weeks (i.e., Kaopectate or Pepto Bismol)
  * Participation in an investigational trial to evaluate pharmaceuticals or biologics within the past 3 months
  * Individuals undergoing surgical treatment for more than one infected site
  * Patients who are pregnant, lactating, or female patients who have a positive serum hCG (human Chorionic Gonadotropin) as determined by laboratory testing
  * Immunocompromised due to illness or organ transplant
  * History of chronic or recurrent infections (≥ 3 infections at the same site within 12 months)
  * History of any type of cancer (excluding non-melanomatous localized skin cancer or completely excised and cured carcinoma-in-situ of uterine cervix)
  * Poorly controlled diabetes mellitus
  * History of medical noncompliance
  * Other medical conditions which, in the opinion of the Principal Investigator, would jeopardize the safety of the study subject or impact the validity of the study results.
  * Current incarceration

Primary outcomes:
measure: Number of Participants With Adverse Events
timeFrame: 12 weeks
Secondary outcomes:
measure: Number of Treatment Failures
timeFrame: 12 weeks
measure: Treatment Failure in Subjects With Antibiotic-resistant Infections
timeFrame: Up to 12weeks
Other outcomes:
Locations:
city: San Francisco
country: United States
facility: Orthopedic Trauma Institute, University of California San Francisco
state: California
city: San Francisco
country: United States
facility: UCSF - Parnassus
state: California
city: Baltimore
country: United States
facility: LifeBridge Health, Inc.
state: Maryland
city: Columbus
country: United States
facility: OhioHealth Research Institute
state: Ohio
city: Philadelphia
country: United States
facility: University of Pennsylvania
state: Pennsylvania
city: Houston
country: United States
facility: The University of Texas - Health Science Center & Medical School at Houston
state: Texas
Study officials:
affiliation: Microbion Corporation
name: Brett Baker, MSc, DC
role: STUDY_CHAIR
References: