Phase 2
N=124
Effect of Exeporfinium Chloride (XF-73) Gel on Nasal S.Aureus in Patients at Risk of Post-op Staphylococcal Infection
Staphylococcal Infections · Surgical Site Infection
Bottom Line
View on ClinicalTrials.gov: NCT03915470 ↗Enrolled (actual)
124
Serious AEs
7.3%
Results posted
Jun 2022
Primary outcome: Primary: Change in S. Aureus Log CFU/mL From Baseline to Pre-surgery — -2.842; -0.469 log10 (CFU/mL)
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- XF-73 (Drug); Placebo (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Destiny Pharma Plc
- Primary completion
- Jan 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change in S. Aureus Log CFU/mL From Baseline to Pre-surgery |
-2.842; -0.469 | — |
| SECONDARY Change in S. Aureus Log CFU/mL From Baseline to Immediately Post-surgery |
-2.773; -0.314 | — |
| SECONDARY Change in S. Aureus Log CFU/mL From Baseline to 48 Hours After Surgery |
-2.700; -1.477 | — |
| SECONDARY Change in S. Aureus Log CFU/mL From Baseline to Immediately After Surgery to 6 Days (± 24hours) After Surgery |
-3.106; -2.399 | — |
| SECONDARY Number of Participants With Staphylococcal Post-operative Infections During the 30-day Period After Surgery (90 Days in the Case of Foreign Implant) |
0; 0 | — |
| SECONDARY Incidence of Treatment-emergent Adverse Events From the First Dose of Study Medication to 6 Days (± 24hours) After Last Dose of Study Medication. |
67; 68 | — |
| SECONDARY Changes in Nasal Examination. |
0; 0 | — |
| SECONDARY Changes in Brief Smell Identification Test (B-SIT). |
52; 50; 4; 5; 2; 1 | — |
Summary
This study looks at the difference between XF-73 and placebo in reducing the carriage of a bacteria S. aureus in the nose before, during and after heart surgery. Only people who normally have S.aureus in their nose will be enrolled onto the study. This will be confirmed by analysis of a nasal swab (a cotton bud placed in the nose) before entering the study. It is expected 125 people will participate in this study. Participation will be confirmed by analysis of a nasal swab (a cotton bud placed in the nose) before entering the study. XF-73 or placebo will be given 5 times, with an equal chance of participants receiving either XF-73 or placebo. During the hospital stay more nasal swabs will be taken to determine the amount of S.aureus present in the participant's nose. Other tests such as blood samples, blood pressure and an examination of the nose and sense of smell will be performed as part of the safety assessment. After the hospital stay participants will be followed up for 30 days or if a device has been inserted into the body as part of the surgery for 90 days to look at the rates of post-operative infection between the placebo and XF-73 groups. The study will run for about 18 months. During this period, an independent data monitoring committee will review the study to make sure that the balance of benefits and risks of participating in the study does not change.
Eligibility Criteria
Individuals who meet all of the following criteria are eligible to participate in the study.
- Male or female patients between 18 and 75 years of age.
- Patients who are confirmed nasal S. aureus carriers by polymerase chain reaction (PCR) screen assay, and due to undergo surgical procedure.
- Patients who are willing to provide written informed consent.
- Patients who are willing and able (as per Investigator judgment) to complete all protocol specified visits and assessments.
- Woman of childbearing potential* with a negative urine pregnancy test (sensitive to 25 IU human chorionic gonadotropin (hCG)).
- Women of childbearing potential are defined as those women between menarche and menopause who have not undergone permanent sterilisation. Permanent sterilisation methods include hysterectomy, bilateral salpingectomy, and bilateral oophorectomy.
Individuals who meet any of the following criteria are not eligible to participate in the study.
- Pregnancy (current) or currently lactating.
- Uncontrolled acute or chronic illness (as determined by the investigator) in addition to those requiring the planned surgical intervention.
- History of atopy, allergic reactions or hypersensitivity to the study medication or its components.
- Current upper respiratory tract infection, cold or influenza with significant nasal symptoms that might impact on the patient's ability to comply with the gel application procedure.
- History of photosensitivity.
- Family history of porphyria.
- Use of intra-nasal topical or systemic antibiotics or anti-infectives within the last 4 weeks before screening. (Patients who screen positive for nasal carriage of S. aureus and receive topical or systemic antibiotics or anti-infectives which are not part of their prophylactic peri-operative SOC between screening and first dose of investigational medicinal product (IMP) will be excluded from the study.) The use of intra-nasal antibiotics or anti-infectives other than the study medication prior to surgery is not allowed.
- Use of other prescribed or over the counter nasal medication in the last 14 days, or oral decongestants in the last 7 days before first administration of study drug.
- Participation in a clinical trial within the last 12 weeks before first administration of study drug.
- Contemporaneous clinically significant abnormalities in vital signs or laboratory analyses reported within 14 days prior to randomization which in the opinion of the Investigator would preclude from the safety assessment of the medication under study.
- Nasal polyps or significant anatomical or other nasal abnormality that would prevent from appropriate administration of the study treatment or represent an excessive risk for the patient's participation.
- History of nasal surgery including cauterization.
- A recent history of frequent epistaxis and/or an episode of epistaxis within 3 months of the planned surgery.
- Use of in situ nasal jewellery or existence of open nasal piercings.
Data sourced from ClinicalTrials.gov (NCT03915470). 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.