The goal of this clinical trial is to evaluate whether the investigational drug PLG0206 can help reduce recurrence of infection in adults who have undergone total knee replacement and are receiving a DAIR (Debridement, Antibiotics, and Implant Retention) surgical procedure to treat a Prosthetic Joint Infection (PJI). The study will also assess the safety of PLG0206 when used as an irrigation solution during the DAIR procedure. Participants will receive either PLG0206 or a placebo (an inactive substance that looks like the investigational drug), in addition to standard of care treatments. All participants will be monitored for approximately one year following their DAIR procedure.
This study is designed to assess the efficacy and safety of PLG0206 administered intraoperatively by local irrigation to participants undergoing a DAIR procedure for treatment of Prosthetic Joint Infection (PJI) occurring after total knee arthroplasty (TKA), also known as knee joint replacement. Eligible participants will undergo a DAIR procedure according to the treating hospital's standard of care (SOC). Participant eligibility will be based on clinical and diagnostic assessments, including laboratory results. Once debridement during DAIR is complete, the Investigator will follow a standardized irrigation protocol, with the final irrigation step being administration of a single dose of blinded study drug (PLG0206 or matching placebo). The study drug will be administered as a single intra-articular irrigation. Following study drug administration, all participants will receive standard post-operative care per institutional guidelines and will be discharged from the hospital in accordance with local standards. Participants may receive IV/oral antimicrobial therapy, as part of post-operative SOC. Participants will be monitored for safety and signs of PJI recurrence or persistent infection for 365 days post study drug administration. After hospital discharge, study visits will occur in-clinic on Days 14, 90, and 365, and on Days 30, 180, and 270 via a telephone or virtual visit.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
240
Clinical Trial Site
Tamarac, Florida, United States
RECRUITINGClinical Trial Site
Baltimore, Maryland, United States
RECRUITINGClinical Trial Site
Boston, Massachusetts, United States
RECRUITINGClinical Trial Site
Cincinnati, Ohio, United States
RECRUITINGClinical Trial Site
Columbus, Ohio, United States
RECRUITINGClinical Trial Site
Morgantown, West Virginia, United States
RECRUITINGReduction in Treatment Failure Post DAIR
Proportion of participants with PJI treatment failure following DAIR
Time frame: From treatment through 12 months
Reduction Rate of PJI-related Surgical Intervention
Proportion of participants with PJI requiring a PJI-related surgical intervention following DAIR
Time frame: From treatment through 12 months
Safety of PLG0206
Evaluation of adverse events
Time frame: From treatment through 12 months
Survival
Evaluation of PJI-related mortality rate
Time frame: From treatment through 12 months
Efficacy of PLG0206 on Clinical Outcome
Evaluate the rate of PJI treatment failure at specific time points
Time frame: At Days 14, 30, 90, 180, 270, and 365
Time to Treatment Failure
Evaluation on effect of PLG0206 on time to treatment failure
Time frame: From treatment through 12 months
PJI-related Healthcare Resource Utilization
Evaluate the effect of PLG0206 on the need for medical care after post-DAIR procedure discharge
Time frame: From treatment through 12 months
Frequency of PJI-related Surgical Procedures Following DAIR
Evaluate the number of surgical procedures for PJI treatment performed after the initial DAIR procedure
Time frame: From treatment through 12 months
Microbiological Efficacy Outcome
Evaluate the per-pathogen microbiological response rate following study drug administration
Time frame: From treatment through 12 months
Functional Change Post-DAIR
Evaluate the effect of PLG0206 on the functional change from baseline utilizing the Oxford Knee Scale, where total scores range from 0 (poorest function) to 48 (maximal function)
Time frame: From Baseline through 9 months
Immunogenicity of PLG0206
Evaluation of anti-drug antibodies to PLG0206
Time frame: from Baseline through 12 months
Effect of PLG0206 on the inflammatory biomarker C-reactive Protein
Evaluate the difference between the PLG0206 and placebo groups in normalization of C-reactive protein levels post treatment
Time frame: Measured at Baseline and Days 14, 90, and 365
Maximum Plasma Concentration (Cmax) of PLG0206
Time frame: From Baseline through Day 3
Time to Maximum Plasma Concentration (Tmax) of PLG0206
Time frame: Baseline through Day 3
Half-life of PLG0206 in Plasma
Time frame: Baseline through Day 3
Area Under the Concentration-time Curve Through Last Quantifiable Concentration
Characterization of systemic PK of PLG0206
Time frame: From time O (pre-dose) through last quantifiable result; last protocol specified time-point is Day 3
Area Under the Concentration-time Curve Through Infinity
Characterization of systemic PK of PLG0206
Time frame: From time O (pre-dose) to infinity [AUCinf]; last protocol specified time-point is Day 3
Concentration of PLG0206 in Irrigation Solution
Concentration of PLG0206 in irrigation solution at the end of study drug exposure
Time frame: Measured at Study Day 1 at end of study drug exposure
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