Phase 3
N=537
Imipenem/Relebactam/Cilastatin Versus Piperacillin/Tazobactam for Treatment of Participants With Bacterial Pneumonia (MK-7655A-014)
Bacterial Pneumonia
Bottom Line
View on ClinicalTrials.gov: NCT02493764 ↗Enrolled (actual)
537
Serious AEs
29.3%
Results posted
Apr 2020
Primary outcome: Primary: Percentage of Participants With All-cause Mortality (ACM) Through Day 28 in the Modified Intention-to-treat (MITT) Population — 15.9; 21.3 Percentage of participants — p=<0.001
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Imipenem (Drug); Relebactam (Drug); Cilastatin (Drug); Piperacillin (Drug); Tazobactam (Drug); Linezolid (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Merck Sharp & Dohme LLC
- Primary completion
- Apr 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants With All-cause Mortality (ACM) Through Day 28 in the Modified Intention-to-treat (MITT) Population |
15.9; 21.3 | <0.001 sig |
| SECONDARY Percentage of Participants in the MITT Population With a Favorable Clinical Response (FCR) at Early Follow-up (EFU) Visit |
61.0; 55.8 | <0.001 sig |
| SECONDARY Percentage of Participants With ≥1 Adverse Event (AE) |
85.0; 86.6 | — |
| SECONDARY Percentage of Participants Discontinuing Study Therapy Due to an AE |
5.6; 8.2 | — |
| SECONDARY Percentage of Participants With ACM in the Microbiological Modified Intention-to-treat (mMITT) Population |
16.7; 20.2 | — |
| SECONDARY Percentage of Participants With ACM at EFU in the MITT Population |
14.8; 19.5 | — |
| SECONDARY Percentage of Participants With ACM at EFU in the mMITT Population |
15.3; 18.3 | — |
| SECONDARY Percentage of Participants in the Clinically Evaluable (CE) Population With a FCR at On-therapy Visit 1 (OTX1) [Day 3] |
70.8; 72.8 | — |
| SECONDARY Percentage of Participants in the CE Population With a FCR at OTX2 (Day 6) |
85.5; 87.8 | — |
| SECONDARY Percentage of Participants in the CE Population With a FCR at OTX3 (Day 10) |
89.6; 83.6 | — |
| SECONDARY Percentage of Participants in the CE Population With a FCR at EOT Visit |
84.7; 85.3 | — |
| SECONDARY Percentage of Participants in the CE Population With a FCR at Day 28 |
70.5; 75.6 | — |
| SECONDARY Percentage of Participants in the CE Population With a FCR at EFU Visit |
74.3; 79.4 | — |
| SECONDARY Percentage of Participants in the MITT Population With a FCR at OTX1 (Day 3) |
68.0; 64.7 | — |
| SECONDARY Percentage of Participants in the MITT Population With a FCR at OTX2 (Day 6) |
83.5; 83.1 | — |
| SECONDARY Percentage of Participants in the MITT Population With a FCR at OTX3 (Day 10) |
83.5; 80.4 | — |
| SECONDARY Percentage of Participants in the MITT Population With a FCR at EOT |
74.2; 69.7 | — |
| SECONDARY Percentage of Participants in the MITT Population With a FCR at Day 28 |
51.9; 50.6 | — |
| SECONDARY Percentage of Participants in the mMITT Population With a Favorable Microbiological Response (FMR) at End of Treatment (EOT) Visit |
77.2; 67.9 | — |
| SECONDARY Percentage of Participants in the mMITT Population With a FMR at EFU Visit |
67.9; 61.9 | — |
| SECONDARY Percentage of Participants in the Microbiologically Evaluable (ME) Population With a FMR at EOT Visit |
87.1; 85.5 | — |
| SECONDARY Percentage of Participants in the ME Population With a FMR at EFU Visit |
89.9; 86.4 | — |
Summary
This study aims to compare treatment with a fixed-dose combination (FDC) of imipenem/relebactam/cilastatin (IMI/REL) with a FDC of piperacillin/tazobactam (PIP/TAZ) in participants with hospital-acquired or ventilator-associated bacterial pneumonia (HABP or VAPB, respectively). The primary hypothesis is that IMI/REL is non-inferior to PIP/TAZ in the incidence rate of all-cause mortality.
Eligibility Criteria
Inclusion Criteria
- Requires treatment with IV antibiotic therapy for hospital-acquired bacterial pneumonia (HABP) or ventilator-associated bacterial pneumonia (VABP)
- Fulfills clinical and radiographic criteria, with onset of criteria occurring after more than 48 hours of hospitalization or within 7 days after discharge from a hospital (for HABP); or at least 48 hours after mechanical ventilation (for VABP)
- Has an adequate baseline lower respiratory tract specimen obtained for Gram stain and culture
- Has an infection known or thought to be caused by microorganisms susceptible to the IV study therapy
- Agrees to allow any bacterial isolates obtained from protocol-required specimens related to the current infection to be provided to the Central Microbiology Reference Laboratory for study-related microbiological testing, long term storage, and other future testing
- Is not of reproductive potential; or if of reproductive potential agrees to avoid impregnating a partner or avoid becoming pregnant, by practicing abstinence or using acceptable contraception
Exclusion Criteria
- Has a baseline lower respiratory tract specimen Gram stain that shows the presence of Gram-positive cocci only
- Has confirmed or suspected community-acquired bacterial pneumonia (CABP)
- Has confirmed or suspected pneumonia of viral, fungal or parasitic origin
- Has HABP/VABP caused by an obstructive process, including lung cancer or other known obstruction
- Has a carcinoid tumor or carcinoid syndrome
- Has active immunosuppression defined as either receiving immunosuppressive medications or having a medical condition associated with immunodeficiency
- Is expected to survive for less than 72 hours
- Has a concurrent condition or infection that would preclude evaluation of therapeutic response
- Has received effective antibacterial drug therapy for the index infection of HABP/VABP for more than 24 hours continuously, during the previous 72 hours
- Has a history of serious allergy, hypersensitivity or a serious reaction to any penicillin or beta-lactamase inhibitors
- Female is pregnant, expecting to conceive, is breastfeeding or plans to breastfeed
- Has a history of seizure disorder requiring ongoing prior treatment with anti-convulsive therapy within the last 3 years
- Anticipates treatment with the following: valproic acid or divalproex sodium, serotonin re-uptake inhibitors, tricyclic antidepressants, or serotonin receptor antagonists, meperidine, buspirone, concomitant systemic antibacterial agents, antifungal or antiviral therapy for the index infection of HABP/VABP
- Is currently undergoing hemodialysis or peritoneal dialysis
- Is currently participating in, has participated in during the previous 30 days, or anticipates to participate in any other clinical study involving the administration of experimental medication
- Has previously participated in this study
Data sourced from ClinicalTrials.gov (NCT02493764). 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.