The worldwide spread of resistance to antibiotics among gram-negative bacteria, particularly members of the ESKAPE group of pathogens, has resulted in a crisis in the treatment of hospital acquired infections. In particular, the presence of multi-drug resistant Acinetobacter baumannii and Pseudomonas aeruginosa in hospitals around the world poses a considerable threat. .
The United States (US) Centers for Disease Control (CDC) have listed multidrug-resistant (MDR) Acinetobacter and MDR Pseudomonas aeruginosa as serious threats \[CDC, 2019\]. Consistent with the global nature of these resistant bacteria, the World Health Organization (WHO) has designated carbapenem-resistant Acinetobacter baumannii, and carbapenem resistant Pseudomonas aeruginosa as critical threats \[WHO, 2017\]. To combat these serious threats Qpex has developed QPX9003, a next generation polymyxin that is more potent than existing polymyxins against P. aeruginosa and A. baumannii and has exhibited less nephrotoxicity in preclinical studies. There remains a significant unmet need for new IV agents to treat gram-negative infections due to resistant bacteria in hospital settings. Some progress has been made in the successful development of new agents to address drug-resistant infections, particularly IV agents for resistant gram-negative bacteria \[Talbot et al, 2019\]. While some of these agents have addressed urgent threats like carbapenem-resistant Enterobacteriaceae (CRE), their activity is largely confined to strains producing serine carbapenemases; none of these agents have reliable activity against metallo beta-lactamase producing CRE. Moreover, none of these recently approved agents have activity against carbapenem-resistant Acinetobacter baumannii \[Talbot et al, 2019\]. The increasing prevalence of multidrug-resistant gram-negative bacteria, in particular carbapenemase producing Enterobacteriaceae, A. baumannii, and P. aeruginosa, has resulted in an increase in the use of polymyxin antibiotics as salvage therapy \[Biswas et al. 2017\]. This Phase 1 study will assess the safety, tolerability and pharmacokinetics of single and multiple IV administered ascending doses (SAD/MAD) of IV QPX9003 in healthy adult subjects. Qpex is developing IV QPX9003 which is a next generation polymyxin with activity against multi-drug resistant A. baumannii and P. aeruginosa
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
104
antibiotic
Placebo comparator
Altasciences
Cypress, California, United States
Incidence of Treatment -Emergent Adverse events (AEs) by subject and by cohort (single, multiple and combination dose)
Number of patients with Treatment-Emergent AEs by treatment arm, severity and relationship to treatment
Time frame: up to 21 days
Number of patients with changes from baseline in safety parameters (single, multiple and combination dose)
Number of patients with changes in safety parameters before and after dosing by subject and treatment arm
Time frame: up to 13 days
Peak plasma Concentration measurements by subject and by cohort (Cmax) (single and combination dose)
Comparison will be performed between the cohorts for Cmax. Mean graphical presentation of the data will be reported. Statistical analysis of exposure parameters will be performed.
Time frame: up to 13 days
Area under the plasma concentration versus time curve (AUC) between cohorts (single and multiple dose)
Comparison will be performed between the cohorts for AUC. Mean graphical presentation of the data will be reported. Statistical analysis of exposure parameters will be performed.
Time frame: up to 13 days
Urine amount excreted by subject and by cohort (single and combination dose)-PK
Urine amount excreted will be calculated from urinary excretion data
Time frame: up to 13 days
Urine % dose excreted by subject and by cohort (single and multiple dose)-PK
Urine amount of % dose excreted will be calculated from urinary excretion data
Time frame: up to 13 days
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