This study evaluates the effect of prophylactic antibiotics in multiple myeloma. One third of patients will received treatment with clarithromycin, one third of patients will receive treatment with sulfamethoxazole/trimethoprim and one third will be observed without prophylactic antibiotics. All patients receive concurrent anti-myeloma treatment.
There is a need for improvement of the prognosis in elderly myeloma patients. The patients are fragile due to age and severe comorbidity. Infections are frequent during the course of initial myeloma treatment and contribute to the high morbidity and mortality in elderly patients. Furthermore infections often lead to delay in myeloma treatment and to dose reduction. The use of primary antibiotic prophylaxis might influence the frequency of these complications. In the study myeloma patients who are ineligible for high-dose melphalan with stem cell support are randomised to either p.o. clarithromycin 250 mg twice daily for 180 days, p.o. sulfamethoxazole/trimethoprim 400/80 mg twice daily for 180 days or observation without prophylactic antibiotics. All patients receive concurrent myeloma treatment at the discretion of the treating physician. The choice of anti-myeloma treatment has to be settled before randomization. The study evaluates the frequency of infections in patients treated with clarithromycin, sulfamethoxazole/trimethoprim or observation
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
300
The choice of myeloma standard treatment is at the discretion of the treating investigator guided by the national Danish guidelines for treatment of multiple myeloma
P.o. clarithromycin 250 mg twice daily
P.o. sulfamethoxazole/trimethoprim 400/80 mg twice daily
Department of Hematology, Aalborg University Hospital
Aalborg, Denmark
RECRUITINGDepartment of Hematology, Aarhus University Hospital
Aarhus, Denmark
RECRUITINGDepartment of Hematology, Rigshospitalet
Comparison of frequency of infections in patients treated with clarithromycin, sulfamethoxazole/trimethoprim or observed without prophylactic antibiotic
Time frame: One year
Response rates in the group of patients treated with clarithromycin compared to the other patients in the study
Time frame: One year
Comparison of adverse events assessed by CTCAE v4.0 in patients treated with clarithromycin, sulfamethoxazole/trimethoprim or observed without prophylactic antibiotic
Time frame: 6 months
Comparison of overall survival between patients treated with clarithromycin, sulfamethoxazole/trimethoprim or observed without prophylactic antibiotic
Time frame: Three years
Quality of life assessed by EORTC QLQ-MY20
Time frame: One year
Quality of life assessed by EORTC QLQ-C30
Time frame: One year
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Observation without prophylactic antibiotic
Copenhagen, Denmark
Department of Hematology, Esbjerg Sygehus
Esbjerg, Denmark
RECRUITINGDepartment of Hematology, Herlev Hospital
Herlev, Denmark
RECRUITINGDepartment of Hematology, Hospitalsenheden Vest
Holstebro, Denmark
RECRUITINGDepartment of Hematology, Odense University Hospital
Odense, Denmark
RECRUITINGDepartment of Hematology, Roskilde Hospital
Roskilde, Denmark
RECRUITING