MK-3415A is the combination of monoclonal antibodies to Clostridium (C.) difficile toxin A (MK-3415) and toxin B (MK-6072). This study will investigate whether: 1) treatment with MK-6072 or MK-3415A in addition to standard of care (SOC) antibiotic therapy will decrease Clostridium Difficile Infection (CDI) recurrence compared with placebo; and 2) MK-6072 and MK-3415A will be generally well tolerated in participants receiving SOC therapy for CDI compared with placebo.
An extended 9-month follow-up to assess for CDI recurrence through Month 12 will be conducted in a subset of participants.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
1,203
Single IV infusion of MK-6072 (10 mg/kg of monoclonal antibody to C. difficile Toxin B)
Single IV infusion of MK-3415A (10 mg/kg of monoclonal antibody to C. difficile Toxin A and 10 mg/kg of monoclonal antibody to C. difficile Toxin B)
Single IV infusion of normal saline (0.9% sodium chloride)
Percentage of Participants With CDI Recurrence
CDI recurrence is defined as the development of a new episode of diarrhea (3 or more loose stools in 24 or fewer hours) and a positive lab stool test (local or central) for toxigenic C. difficile after clinical cure of the initial CDI episode. Clinical cure is defined as no diarrhea \[2 or fewer loose stools per 24 hours\] for 2 consecutive days following completion of SOC therapy for the initial CDI episode in participants who received =\< 14 day regimen.
Time frame: 12 weeks
Percentage of Participants With One or More Adverse Events During 4 Weeks Following Infusion Treatment
An adverse event (AE) is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the medicinal product, whether or not considered related to the use of the product. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a preexisting condition which is temporally associated with the use of the medicinal product, is also an adverse event.
Time frame: Up to 4 weeks
Percentage of Participants With One or More Drug-related Adverse Events During 4 Weeks Following Infusion Treatment
An adverse event (AE) is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the medicinal product, whether or not considered related to the use of the product. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a preexisting condition which is temporally associated with the use of the medicinal product, is also an adverse event. A drug-related adverse event is determined by the investigator to be related to the drug.
Time frame: Up to 4 weeks
Percentage of Participants With One or More Serious Drug-related Adverse Events During 4 Weeks Following Infusion Treatment
A serious adverse event (SAE) is any AE occurring at any dose or during any use of the medicinal product that results in death; or is life threatening; or results in a persistent or significant disability/incapacity; or results in or prolongs an existing inpatient hospitalization; or is a congenital anomaly/birth defect; or other important medical events. A serious drug-related adverse event is determined by the investigator to be related to the drug.
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SOC for CDI will be prescribed for 10 to 14 days and can begin on the day of study drug infusion; but the first dose must have been administered prior to or within a few hours following study drug infusion. SOC is defined as the receipt of oral metronidazole, oral vancomycin, IV metronidazole concurrent with oral vancomycin, oral fidaxomicin, or oral fidaxomicin concurrent with IV metronidazole.
Time frame: Up to 4 weeks
Percentage of Participants Who Discontinued Study Medication Due to an Adverse Event During 4 Weeks Following Infusion Treatment
An adverse event (AE) is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the medicinal product, whether or not considered related to the use of the product. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a preexisting condition which is temporally associated with the use of the medicinal product, is also an adverse event.
Time frame: Up to 4 weeks
Percentage of Participants With One or More Infusion-specific Adverse Events on the Day of Infusion or the Day After Infusion
An adverse event (AE) is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the medicinal product, whether or not considered related to the use of the product. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a preexisting condition which is temporally associated with the use of the medicinal product, is also an adverse event.
Time frame: Up to 24 hours
Percentage of Participants With Global Cure
Global cure is defined as the clinical cure of the initial CDI episode with no CDI recurrence through Week 12. Clinical cure is defined as no diarrhea \[2 or fewer loose stools per 24 hours\] for 2 consecutive days following completion of SOC therapy for the initial CDI episode in participants who received =\< 14 day regimen.
Time frame: 12 weeks
Percentage of Participants With CDI Recurrence in Those With Clinical Cure of the Initial CDI Episode
CDI recurrence is defined as the development of a new episode of diarrhea (3 or more loose stools in 24 or fewer hours) and a positive lab stool test (local or central) for toxigenic C. difficile. Clinical cure is defined as no diarrhea \[2 or fewer loose stools per 24 hours\] for 2 consecutive days following completion of SOC therapy for the initial CDI episode in participants who received =\< 14 day regimen.
Time frame: 12 weeks
Percentage of Participants With CDI Recurrence in Those With a History of CDI in the 6 Months Prior to Enrollment
CDI recurrence is defined as the development of a new episode of diarrhea (3 or more loose stools in 24 or fewer hours) and a positive lab stool test (local or central) for toxigenic C. difficile. Clinical cure is defined as no diarrhea \[2 or fewer loose stools per 24 hours\] for 2 consecutive days following completion of SOC therapy for the initial CDI episode in participants who received =\< 14 day regimen.
Time frame: 12 weeks
Percentage of Participants With CDI Recurrence in Those With the 027 Ribotype
CDI recurrence is defined as the development of a new episode of diarrhea (3 or more loose stools in 24 or fewer hours) and a positive lab stool test (local or central) for toxigenic C. difficile. Clinical cure is defined as no diarrhea \[2 or fewer loose stools per 24 hours\] for 2 consecutive days following completion of SOC therapy for the initial CDI episode in participants who received =\< 14 day regimen. The 027 ribotype is a more virulent, epidemic strain responsible for several outbreaks of disease associated with an increased risk of severity and mortality.
Time frame: 12 weeks
Percentage of Participants With CDI Recurrence in Those With an Epidemic Strain
CDI recurrence is defined as the development of a new episode of diarrhea (3 or more loose stools in 24 or fewer hours) and a positive lab stool test (local or central) for toxigenic C. difficile. Clinical cure is defined as no diarrhea \[2 or fewer loose stools per 24 hours\] for 2 consecutive days following completion of SOC therapy for the initial CDI episode in participants who received =\< 14 day regimen. An epidemic strain includes ribotypes 027, 014, 002, 001, 106 or 020.
Time frame: 12 weeks
Percentage of Participants With CDI Recurrence in Those With Clinically Severe CDI
CDI recurrence is defined as the development of a new episode of diarrhea (3 or more loose stools in 24 or fewer hours) and a positive lab stool test (local or central) for toxigenic C. difficile. Clinical cure is defined as no diarrhea \[2 or fewer loose stools per 24 hours\] for 2 consecutive days following completion of SOC therapy for the initial CDI episode in participants who received =\< 14 day regimen. Participants with clinically severe CDI have a Zar Score greater than or equal to 2 points based on the presence of 1 or more of the following: 1) age \>60 years old (1 point); 2) body temperature \>38.3°C (\>100°F) (1 point); 3) albumin level ˂2.5 mg/dl (1 point); 4) peripheral white blood cell count \>15,000 cells/mm\^3 within 48 hours (1 point); 5) endoscopic evidence of pseudomembranous colitis (2 points); and 6) treatment in Intensive Care Unit (2 points).
Time frame: 12 weeks
Percentage of Participants With CDI Recurrence in Those 65 Years and Older
CDI recurrence is defined as the development of a new episode of diarrhea (3 or more loose stools in 24 or fewer hours) and a positive lab stool test (local or central) for toxigenic C. difficile. Clinical cure is defined as no diarrhea \[2 or fewer loose stools per 24 hours\] for 2 consecutive days following completion of SOC therapy for the initial CDI episode in participants who received =\< 14 day regimen.
Time frame: 12 weeks
Percentage of Participants With CDI Recurrence in Those With Compromised Immunity
CDI recurrence is defined as the development of a new episode of diarrhea (3 or more loose stools in 24 or fewer hours) and a positive lab stool test (local or central) for toxigenic C. difficile. Clinical cure is defined as no diarrhea \[2 or fewer loose stools per 24 hours\] for 2 consecutive days following completion of SOC therapy for the initial CDI episode in participants who received =\< 14 day regimen. Compromised immunity is an active hematological malignancy (including leukemia, lymphoma, multiple myeloma), an active malignancy requiring recent cytotoxic chemotherapy, receipt of a prior hematopoietic stem cell transplant, receipt of a prior solid organ transplant, asplenia, or neutropenia/pancytopenia due to other conditions.
Time frame: 12 weeks