Vabomere™, (meropenem-vaborbactam) is being compared to the Best Available Therapy in the treatment of adults with selected serious infections due to Carbapenem Resistant Enterobacteriaceae
In the current era of increased resistance to extended spectrum cephalosporins and penicillin/beta-lactamase inhibitor combinations, carbapenem antimicrobial agents are frequently the antibiotics of "last defense" for the most resistant pathogens in serious infections. However, the recent dissemination of serine carbapenemases (e.g. KPC) in Enterobacteriaceae within many hospitals worldwide now poses a considerable threat to carbapenems and other members of the beta-lactam class of antimicrobial agents. Infections caused by Carbapenem-Resistant Enterobacteriaceae (CRE) are associated with high mortality rates and have limited treatment options. The loss of the carbapenem class of antimicrobial agents for treatment of Enterobacteriaceae (the most frequently occurring pathogens in the hospital setting), Acinetobacter baumannii, and Pseudomonas aeruginosa represents a critical setback in modern patient care. As a result of the current lack of an optimal treatment for patients who have infections due to a CRE, physicians manage these patients with the limited anti-infective options available, including aminoglycosides, polymyxin B, colistin, tigecycline, or various combinations of these. There are limited efficacy data available for many of these therapies when used to treat serious CRE infections, particularly in combination, but with limited or no alternative therapies currently available, such treatments have become the Best Available Therapy despite the toxicities associated with many of them. Vaborbactam is a novel beta-lactamase inhibitor that has inhibitory activity against many serine beta-lactamases and was optimized for inhibition of the KPC beta-lactamase and the potentiation of carbapenems against Enterobacteriaceae. Vaborbactam is being developed for use with meropenem (a broad spectrum injectable carbapenem antibiotic) to address the challenges of treatment of serious infections caused by pathogens increasingly resistant to available treatments. Vabomere, (meropenem-vaborbactam) administered as a fixed combination by intravenous (IV) infusion, is being developed to treat serious gram-negative infections, such as complicated urinary tract infections (cUTI), acute pyelonephritis (AP), hospital-acquired bacterial pneumonia (HABP), ventilator-associated bacterial pneumonia (VABP), and bacteremia, including those infections caused by bacteria resistant to currently available carbapenems.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
77
Vabomere for IV injection, administered as a 2 g/2 g dose
Antibiotic(s) chosen by Investigator
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Hartford, Connecticut, United States
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Tampa, Florida, United States
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Augusta, Georgia, United States
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Chicago, Illinois, United States
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Chicago, Illinois, United States
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Proportion of Subjects in the Microbiological Carbapenem-resistant Enterobacteriaceae Modified Intent-to-Treat (mCRE-MITT) Population With a Response of Overall Success [Complicated Urinary Tract Infection (cUTI) or Acute Pyelonephritis (AP) Subjects]
Overall success is defined as clinical cure \& microbiological eradication. Eradication defined by FDA as the demonstration that the bacterial pathogen(s) found at baseline is reduced to \<10x4 colony forming unit (CFU)/mL urine. Clinical cure defined as complete resolution or significant improvement of the baseline signs \& symptoms, no further antimicrobial warranted.
Time frame: at Test of Cure (TOC) visit (Day 12-23)
All-cause Mortality Rate in the mCRE-MITT Population [Hospital-acquired Bacterial Pneumonia (HABP), Ventilator-associated Bacterial Pneumonia (VABP) and Bacteremia Subjects)
The All-cause mortality rate at Day 28 in the mCRE-MITT population (HABP/VABP and Bacteremia)
Time frame: Day 28
Proportion of Subjects in the mCRE-MITT Population With a Clinical Outcome of Cure [Complicated Intra-abdominal Infection (cIAI) Subjects Only]
Clinical cure defined as complete resolution or significant improvement of the baseline signs and symptoms, no further antimicrobial warranted.
Time frame: at TOC visit (Day 12-23)
The All-cause Mortality Rate in the mCRE-MITT Population (All Indications)
All Cause Mortality at Day 28 in the mCRE-MITT population (all indications)
Time frame: at Day 28
The All-cause Mortality Rate in the m-MITT Population (All Indications)
The All Cause Mortality rate at Day 28 in the m-MITT population (all indications)
Time frame: at Day 28
The All-cause Mortality Rate in the mCRE-MITT Population (cUTI/AP)
All Cause Mortality at Day 28 in the mCRE-MITT population (cUTI/AP subjects only)
Time frame: at Day 28
Proportion of Subjects in the mCRE-MITT Population With a Clinical Outcome of Cure (All Indications)
Clinical cure defined as complete resolution or significant improvement of the baseline signs \& symptoms, no further antimicrobial warranted.
Time frame: at End of Therapy (EOT) visit (7-14 days) and TOC visit (12-23 days)
Proportion of Subjects in the mCRE-MITT Population With a Clinical Outcome of Cure (cUTI/AP Subjects Only)
Clinical cure defined as complete resolution or significant improvement of the baseline signs \& symptoms, no further antimicrobial warranted.
Time frame: at EOT visit (7-14) and TOC visit (day 12-23)
Proportion of Subjects in the mCRE-MITT Population With a Clinical Outcome of Cure (HABP/VABP and Bacteremia)
Clinical cure defined as complete resolution or significant improvement of the baseline signs \& symptoms, no further antimicrobial warranted.
Time frame: at EOT visit (7-14) and TOC visit (day 12-23)
Proportion of Subjects in the Microbiological Modified Intent-to-Treat (m-MITT) Population With a Clinical Outcome of Cure (All Indications)
Clinical cure defined as complete resolution or significant improvement of the baseline signs and symptoms, no further antimicrobial warranted.
Time frame: at EOT visit (7-14) and TOC visit (day 12-23)
Proportion of Subjects in the m-MITT Population With a Clinical Outcome of Cure (cUTI/AP)
Clinical cure defined as complete resolution or significant improvement of the baseline signs \& symptoms, no further antimicrobial warranted.
Time frame: at EOT visit (7-14) and TOC visit (day 12-23)
Proportion of Subjects in the m-MITT Population With a Clinical Outcome of Cure (HABP/VABP and Bacteremia)
Clinical cure defined as complete resolution or significant improvement of the baseline signs \& symptoms, no further antimicrobial warranted.
Time frame: at EOT visit (7-14) and TOC visit (day 12-23)
Proportion of Subjects in the mCRE-MITT Population With a Microbiological Outcome of Eradication (All Indications)
Includes subjects with microbiologic eradication or presumed eradication as defined: microbiologic eradication of the baseline pathogen or absence of culture result (microbiologic outcome of indeterminate or not assesses) where subject is deemed as clinical cure at that visit. For cUTI/AP subjects, demonstration that the bacterial pathogen(s) found at baseline is reduced to \<10x4 CFU/mL urine (FDA).
Time frame: at EOT visit (7-14) and TOC visit (day 12-23)
Proportion of Subjects in the m-MITT Population With a Microbiological Outcome of Eradication (All Indications)
Microbiological eradication defined for cUTI/AP as the demonstration that the bacterial pathogen(s) found at baseline is reduced to \<10x4 CFU/mL urine (FDA).
Time frame: at EOT visit (7-14) and TOC visit (day 12-23)
Proportion of Subjects in the m-MITT Populations With a With a Response of Overall Success (cUTI/AP)
Proportion of subjects in m-MITT Population with response of cure and microbiological eradication or presumed eradication. Eradication defined for cUTI/AP as the demonstration that the bacterial pathogen(s) found at baseline is reduced to \<10x4 CFU/mL urine (FDA). Clinical cure defined as complete resolution or significant improvement of the baseline signs \& symptoms, no further antimicrobial warranted.
Time frame: at EOT visit (7-14) and TOC visit (day 12-23)
Proportion of Subjects in the m-MITT Populations With a With a Response of Overall Success (Bacteremia Only)
Proportion of subjects in m-MITT Population with response of cure and microbiological eradication or presumed eradication. Clinical cure defined as complete resolution or significant improvement of the baseline signs \& symptoms, no further antimicrobial warranted.
Time frame: at EOT visit (7-14) and TOC visit (day 12-23)
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Evanston, Illinois, United States
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Indianapolis, Indiana, United States
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Detroit, Michigan, United States
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Royal Oak, Michigan, United States
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New Brunswick, New Jersey, United States
...and 40 more locations