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Phase 1 Completed N=39 Randomized Treatment

Intravenous Fosfomycin Pharmacokinetics Study

Bacterial infection · Multiple-drug Resistance · Pathogen Resistance
Source: ClinicalTrials.gov NCT03910673 ↗
Enrolled (actual)
39
Serious AEs
0.0%
Results posted
Jan 2022
Primary outcomePrimary: Area Under the Concentration-time Curve (AUC 0-8 and AUC 0-inf ) of ZTI-01 — 780.9; 959.4; 1086.0 h*ug/mL

Summary

This is a Phase 1, open-label, multiple-dose trial conducted at a single center. The treatment period will consist of three 6 g doses (18 g) of ZTI-01 as a 1-hour intravenous (IV) infusion (+10 minute window). A total of 30 enrolled subjects will be randomized to undergo a single standardized bronchoscopy with bronchoalveolar lavage (BAL) at one of five sampling times. A total of 6 subjects will be assigned to each BAL-sampling time. Up to ten additional enrolled subjects will act as alternates to obtain 30 evaluable subjects. An evaluable subject is defined as a subject who receives all doses of ZTI-01, undergoes BAL at the randomized sampling timepoint with BAL return volume adequate for testing, and undergoes at least the one blood sampling timepoint that is concurrent with the assigned BAL sampling timepoint, with blood sampling volume that is adequate for testing. The objectives of the study are to assess safety and pharmacokinetics (PK) for a multiple dose regimen of IV-infused ZTI-01.

Outcome Measures

OutcomeResultp-value
PRIMARY
Area Under the Concentration-time Curve (AUC 0-8 and AUC 0-inf ) of ZTI-01
780.9; 959.4; 1086.0
PRIMARY
Clearance (CL) of ZTI-01
5.69
PRIMARY
Intrapulmonary Pharmacokinetics of ZTI-01
31.8; 17.5
PRIMARY
Maximum Measured Plasma Concentration (Cmax) of ZTI-01
297.5; 335.1
PRIMARY
Number of Participants Experiencing Abnormal Clinical Chemistry Laboratory Assessments
2; 2; 19; 19; 31; 16
PRIMARY
Number of Participants Experiencing Abnormal Clinical Hematology Laboratory Assessments
7; 1; 7; 7; 6; 0
PRIMARY
Number of Participants Experiencing Abnormal Clinical Coagulation Laboratory Assessments
9; 6
PRIMARY
Number of Participants Experiencing Abnormal Clinical Urinalysis Laboratory Assessments
2; 1; 1
PRIMARY
Number of Participants Experiencing Abnormal Physical Examination Findings
2; 3; 4; 1; 2
PRIMARY
Number of Participants Experiencing Abnormal Vital Sign Measurements
2; 3; 2; 13; 6; 9
PRIMARY
Number of Participants Experiencing Adverse Events (AEs)
15; 9; 10; 37; 1; 5
PRIMARY
Number of Participants With Prolonged QTc, PR, or QRS Intervals in Electrocardiogram (ECG) Readings
1; 0; 0
PRIMARY
Terminal Elimination Half-life (t1/2) of ZTI-01
2.62
PRIMARY
Terminal-phase Elimination Rate Constant (Lambdaz) of ZTI-01
0.2703
PRIMARY
Time to Peak Concentration (Tmax) of ZTI-01
1.07; 1.06
PRIMARY
Volume of Distribution at Steady State (Vss) of ZTI-01
18.08

Eligibility Criteria

Inclusion Criteria

  • Healthy* men and women aged 18-45 years with no clinically significant findings** at Screening and Baseline (Day -1 to Day 1)

*Healthy is defined by the absence of any medical condition described in the exclusion criteria in a subject with a normal physical exam including vital signs. If the subject has another current, ongoing medical condition, the condition cannot meet any of the following criteria: 1) first diagnosed within 3 months of enrollment; 2) is worsening in terms of clinical outcome in the last 6 months; or 3) involves need for medication.

**Including findings on medical history, physical exam, vital signs, 12-lead Electrocardiogram (ECG), or clinical laboratory tests.

  • Body Mass Index (BMI) = 18 - 30 kg / m^2, inclusive, and body weight > 50 kg (110 lbs).
  • Females who have been surgically sterilized via bilateral oophorectomy and/or hysterectomy at least 90 days prior to Screening are considered lacking childbearing potential and will be eligible*.

*Postmenopausal females are not eligible, as the definition of menopause would require age > 45, and all subjects in this study are age 140 mmHg or diastolic pressure > 90 mmHg).

  • Abnormal Electrocardiogram (ECG) at screening, as determined by the investigator to be clinically significant.
  • History or presence of renal impairment or chronic renal disease.
  • History or presence of liver disease (Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), or total bilirubin above the upper limit of normal).
  • History or presence of chronic pulmonary disease, including asthma, requiring use of medication in the year before screening.
  • History of intolerance or hypersensitivity to phosphonic acid derivative antibiotics or any of its constituents (i.e., oral or intravenous fosfomycin).
  • Have cancer or have a history of cancer within the past 5 years, with the exception of non-melanomatous skin cancer, treated, without evidence of recurrence.
  • Any medical condition that prevents a subject from undergoing bronchoscopy with bronchoalveolar lavage (BAL).
  • Serum creatinine above the upper limit of normal, or estimated creatinine clearance (CrCl) 14 drinks for males or > 7 drinks for females. One drink is equivalent to 12 g of alcohol: 12 ounces (360 mL) of beer, 5 ounces (150 mL) of wine, or 1.5 ounces (45 mL) of 80 proof distilled spirits.
  • History of > / = 10 pack-years smoking, or history of any nicotine use* in the 6 months before Baseline (Day -1 to Day 1)** or positive urinine cotinine screen at Basline (Day -1 to Day 1).

*Including cigarettes, pipe, cigar, chewing tobacco, nicotine patch.

**A positive urine cotinine at screening is allowed if negative at baseline.

  • History of illicit drug use within 6 months of Baseline (Day -1 to Day 1)*.

*Use of cannabinoids within 1 month of Baseline (Day -1 to Day 1) is excluded, but other use of cannabinoids within 6 months is permitted.

  • Use of any prescription drugs, except acceptable contraception methods listed above, within 30 days of Baseline (Day -1 to Day 1).
  • Involvement in other investigational studies of any type (drugs, devices, procedures) within 30 days of Baseline (Day -1 to Day 1).
  • Blood or blood products donation within 30 days of Baseline (Day -1 to Day 1).
  • Planning egg or sperm donation any time before Day 3 follow-up call.
  • Use of any non-prescription medications, vitamins, consumption > 2 times/week of products containing genuine licorice, caffeine, or dietary or herbal supplements within 7 days of Baseline (Day -1 to Day 1)*.

*Excluded from this list is intermittent use of acetaminophen at doses 37.8 degrees Celsius (> 100.0 degrees Fahrenheit), within 7 days of Baseline (Day -1 to Day 1).

  • Currently pregnant or breastfeeding as determined by subject report.
  • Positive tests for human immunodeficiency virus (HIV) 1 and 2 antibodies, hepatitis B surface antigen (HBsAg), or hepatitis C virus (HCV) antibody.
  • Positive urine drug
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03910673). 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.

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