Phase 3
N=968
Oritavancin Versus IV Vancomycin for the Treatment of Participants With Acute Bacterial Skin and Skin Structure Infection (SOLO I)
Wound Infection · Abscess · Systemic Inflammation · Cellulitis
Bottom Line
View on ClinicalTrials.gov: NCT01252719 ↗Enrolled (actual)
968
Serious AEs
7.3%
Results posted
Aug 2022
Primary outcome: Primary: Cessation Of Spread Or Reduction In Size Of Baseline Lesion, Absence Of Fever, And No Rescue Antibiotic Medication At Early Clinical Evaluation (ECE) (48 To 72 Hours) — 391; 378; 84; 101 participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Single-Dose IV Oritavancin Diphosphate (Drug); IV Vancomycin (Drug); Placebo (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Melinta Therapeutics, Inc.
- Primary completion
- Oct 2012
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Cessation Of Spread Or Reduction In Size Of Baseline Lesion, Absence Of Fever, And No Rescue Antibiotic Medication At Early Clinical Evaluation (ECE) (48 To 72 Hours) |
391; 378; 84; 101 | — |
| SECONDARY Investigator Assessed Clinical Cure Of Treatment With Single-dose IV Oritavancin Compared With IV Vancomycin For 7 To 10 Days At Post-therapy Evaluation (Key Secondary Endpoint) |
378; 383; 97; 96 | — |
| SECONDARY Number Of Participants With A Lesion Size Reduction ≥20% From Baseline At ECE |
413; 397; 62; 82 | — |
Summary
The purpose of this Phase 3 trial was to evaluate the efficacy, safety, and tolerability of oritavancin in acute bacterial skin and skin structure infections (ABSSSIs), including those caused by methicillin-resistant staphylococcus aureus (MRSA), and to evaluate the potential economic benefit of oritavancin administered as a single 1200-milligram (mg) intravenous (IV) dose.
Eligibility Criteria
Inclusion Criteria
Participants were included in the study if they met all of the following inclusion criteria:
- Males or females ≥18 years old
- Diagnosis of ABSSSI suspected or confirmed to be caused by a gram-positive pathogen requiring at least 7 days of IV therapy
- An ABSSSI included 1 of the following infections: wound infections, cellulitis/erysipelas, major cutaneous abscess
- ABSSSI must have presented with at least 2 local signs and symptoms and at least 1 sign of systemic inflammation (unless >70 years of age).
- Able to give informed consent and willing to comply with all required study procedures
Exclusion Criteria
Participants were excluded from the study if any of the following exclusion criteria applied prior to randomization:
- Prior systemic or topical antibacterial therapy with activity against suspected or proven gram-positive pathogens within the preceding 14 days unless:
- The causative gram-positive pathogen(s) isolated from the ABSSSI site was/were resistant in vitro to the antibacterial(s) that was/were administered with documented clinical progression.
- Documented failure to previous ABSSSI antibiotic therapy was available. Documentation of treatment failure must have been recorded.
- Participant received a single dose of a short-acting antibacterial therapy 3 or more days before randomization.
- Infections associated with, or in close proximity to, a prosthetic device
- Severe sepsis or refractory shock
- Known or suspected bacteremia at time of Screening
- ABSSSI due to or associated with any of the following:
- Infections suspected or documented to be caused by gram-negative pathogens
- Wound infections (surgical or traumatic) and abscesses with only gram-negative pathogens
- Diabetic foot infections
- Concomitant infection at another site not including a secondary ABSSSI lesion
- Infected burns
- A primary infection secondary to a pre-existing skin disease with associated inflammatory changes
- Decubitus or chronic skin ulcer, or ischemic ulcer due to peripheral vascular disease
- Any evolving necrotizing process gangrene or infection suspected or proven to be caused by Clostridium species
- Infections known to be caused by a gram-positive organism with a vancomycin minimum inhibitory concentration >2 micrograms/milliliter or clinically failing prior therapy with glycopeptides
- Catheter site infections
- Allergy or intolerance to aztreonam or metronidazole in a participant with suspected or proven polymicrobial wound infection involving gram-negative and/or anaerobic bacteria
- Was currently receiving chronic systemic immunosuppressive therapy
- Acquired immunodeficiency syndrome with cluster of differentiation 4 count <200 cells/cubic millimeter
- Neutropenia
- Significant or life-threatening condition that would confound or interfere with the assessment of the ABSSSI
- Women who were pregnant or nursing
- History of immune-related hypersensitivity reaction to glycopeptides
- Participants that required anticoagulant monitoring with an activated partial thromboplastin time
- Contraindication to vancomycin
- Participants unwilling to forego blood and/or blood product donation
- Treatment with investigational medicinal product within 30 days before enrollment and for the duration of the study
- Investigational device present, or removed <30 days before enrollment, or presence of device-related infection
- Participants unlikely to adhere to the protocol, comply with study drug administration, or complete the clinical study
- Severe hepatic disease
- Presence of hyperuricemia
- Unwilling to refrain from chronic use of any medication with antipyretic properties
Data sourced from ClinicalTrials.gov (NCT01252719). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.