Phase 3
Completed N=148
A Study to Investigate the Safety and Efficacy of Fidaxomicin (Oral Suspension or Tablets) and Vancomycin (Oral Liquid or Capsules) in Pediatric Subjects With Clostridium Difficile-associated Diarrhea (CDAD)
Clostridium Difficile-associated Diarrhea (CDAD)
Source: ClinicalTrials.gov NCT02218372 ↗
Enrolled (actual)
148
Serious AEs
25.4%
Results posted
Dec 2018
Primary outcomePrimary: Percentage of Participants With Confirmed Clinical Response (CCR) at End of Treatment (EOT) +2 Days — 77.6; 70.5 percentage of participants
◆ Published Evidence
Established
82citations · ~14 / year
Safety and Efficacy of Fidaxomicin and Vancomycin in Children and Adolescents with Clostridioides (Clostridium) difficile Infection: A Phase 3, Multicenter, Randomized, Single-blind Clinical Trial (SUNSHINE).
Summary
The purpose of this study was to investigate the clinical response to fidaxomicin oral suspension or tablets and vancomycin oral liquid or capsules in pediatric participants with Clostridium difficile-associated diarrhea (CDAD). It also investigated the recurrence/sustained clinical response to and safety of fidaxomicin and vancomycin, as well as acceptance of the fidaxomicin oral suspension formulation.
Linked Publications (2)
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Safety and Efficacy of Fidaxomicin and Vancomycin in Children and Adolescents with Clostridioides (Clostridium) difficile Infection: A Phase 3, Multicenter, Randomized, Single-blind Clinical Trial (SUNSHINE).
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Clostridium Difficile Infection in Children: A Review.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants With Confirmed Clinical Response (CCR) at End of Treatment (EOT) +2 Days |
77.6; 70.5 | — |
| SECONDARY Percentage of Participants With Sustained Clinical Response (SCR) at EOT +9 Days |
94.7; 77.4 | — |
| SECONDARY Percentage of Participants With Global Cure (GC) at EOT +9 Days |
75.5; 54.5 | — |
| SECONDARY Percentage of Participants With Recurrence of CDAD at EOT +9 Days |
5.3; 22.6 | — |
| SECONDARY Percentage of Participants With SCR at EOT +16 Days |
89.5; 71.0 | — |
| SECONDARY Percentage of Participants With GC at EOT +16 Days |
71.4; 52.3 | — |
| SECONDARY Percentage of Participants With Recurrence of CDAD at EOT +16 Days |
7.9; 25.8 | — |
| SECONDARY Percentage of Participants With SCR at EOT +23 Days |
85.5; 71.0 | — |
| SECONDARY Percentage of Participants With GC at EOT +23 Days |
68.4; 50.0 | — |
| SECONDARY Percentage of Participants With Recurrence of CDAD at EOT +23 Days |
11.8; 29.0 | — |
| SECONDARY Percentage of Participants With SCR at End of Study (EOS) (EOT +30 Days) |
85.5; 71.0 | — |
| SECONDARY Percentage of Participants With GC at EOS (EOT +30 Days) |
68.4; 50.0 | — |
| SECONDARY Percentage of Participants With Recurrence of CDAD at EOS (EOT +30 Days) |
11.8; 29.0 | — |
| SECONDARY Time to Resolution of Diarrhea (TTROD) |
58; 97 | 0.579 |
| SECONDARY Time to Recurrence of CDAD for Participants With CCR at EOT +2 Days |
25; 26 | 0.023 sig |
| SECONDARY Number of Participants With Adverse Events (AEs) |
72; 33; 7; 5; 24; 12 | — |
| SECONDARY Plasma Concentrations of Fidaxomicin |
20.17; 15.26; 30.16; 39.41; 34.60; 48.53 | — |
| SECONDARY Plasma Concentrations of Metabolite OP-1118 |
63.04; 42.18; 105.54; 116.64; 102.38; 143.63 | — |
| SECONDARY Metabolite-to-Parent Ratio (MPRconc) |
3.18; 3.24; 3.05; 2.86; 2.95; 2.69 | — |
| SECONDARY Fecal Concentrations of Fidaxomicin |
2685.56; 2969.87; 2190.63 | — |
| SECONDARY Fecal Concentrations of Metabolite OP-1118 |
889.23; 789.15; 1059.73 | — |
| SECONDARY MPRconc Within 24 Hours of a Dose |
0.43; 0.32; 0.63 | — |
| SECONDARY Acceptance of Formulation (Palatability Assessment) in All Participants at First Administration of Study Drug and at Day 7 |
4; 5; 6; 3; 13; 6 | — |
Eligibility Criteria
Inclusion Criteria
- Subject is diagnosed with CDAD according to local diagnostic criteria. As a minimum there must be positive detection, within 72 hours prior to randomization, of either toxin A and/or toxin B in stool or positive detection of toxigenic C. difficile in stool and:
- Subject from Birth to < 2 years: watery diarrhea in the 24 hours prior to screening.
- Subject ≥ 2 years to < 18 years: ≥ 3 unformed bowel movements in the 24 hours prior to screening.
- Male and female subjects aged from birth to < 18 years: Note that in the United States of America subjects can only be included if aged ≥ 6 months to < 18 years.
- For subjects < 5 years: Negative rotavirus test.
- Female subject of childbearing potential:
- must have a negative urine pregnancy test at Screening, and
- must abstain from sexual activity for the duration of the study, or
- must use two forms of birth control (at least one of which must be a barrier method) starting at Screening and throughout the study period and for 28 days after the final study drug administration.
- Female subject must not be breastfeeding at Screening or during the study period, and for 28 days after the final study drug administration.
- Female subject must not donate ova starting at Screening and throughout the study period, and for 28 days after the final study drug administration.
- Subject agrees not to participate in another interventional study while in the study (with the exception of studies as described in exclusion criteria below).
Exclusion Criteria
- Concurrent use of metronidazole, oral vancomycin or any other antibiotic treatments for CDAD. If the investigator feels the clinical imperative is to begin treatment before knowing the laboratory result for toxigenic C. difficile, up to four doses but no more than 24 hours of treatment with metronidazole, oral vancomycin or any other effective treatment for CDAD are allowed.
- Subject has pseudomembranous colitis, fulminant colitis, toxic megacolon or ileus.
- Subject has a history of inflammatory bowel disease (e.g., ulcerative colitis or Crohn's disease etc.).
- Subject has diarrhea caused by an agent other than C. difficile (e.g. infections, infestations, drugs etc.).
- Subject has known hypersensitivity to fidaxomicin, vancomycin or their excipients or to teicoplanin.
- Subject has received an investigational therapy within 28 days, prior to Screening, with the exception of studies with primary treatment for cancer without novel Investigational Medicinal Product (IMP) and which do not affect the assessment of diarrhea.
Data sourced from ClinicalTrials.gov (NCT02218372) and the linked publication. 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. Informational only — not medical advice.