Phase 3
N=1,605
Comparative Study to Evaluate Efficacy and Safety of Gepotidacin to Nitrofurantoin in Treatment of Uncomplicated Urinary Tract Infection (UTI)
Urinary Tract Infections
Bottom Line
View on ClinicalTrials.gov: NCT04187144 ↗Enrolled (actual)
1,605
Serious AEs
0.6%
Results posted
Jul 2023
Primary outcome: Primary: Number of Participants With Therapeutic Response (TR) (Combined Per Participant Clinical and Microbiological Response) at the Test-of-Cure (TOC) Visit - Micro-ITT NTF-S (IA Set) — 162; 115; 115; 149 Participants — p=0.0003
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Gepotidacin (Drug); Placebo matching nitrofurantoin (Drug); Nitrofurantoin (Drug); Placebo matching gepotidacin (Drug)
- Age
- Pediatric, Adult, Older Adult · 12+ yrs
- Sex
- Female
- Sponsor
- GlaxoSmithKline
- Primary completion
- Dec 2022
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants With Therapeutic Response (TR) (Combined Per Participant Clinical and Microbiological Response) at the Test-of-Cure (TOC) Visit - Micro-ITT NTF-S (IA Set) |
162; 115; 115; 149 | 0.0003 sig |
| PRIMARY Number of Participants With Therapeutic Response (TR) (Combined Per Participant Clinical and Microbiological Response) at the Test-of-Cure (TOC) Visit - Micro-ITT NTF-S Population |
172; 121; 120; 154 | — |
| SECONDARY Number of Participants With Clinical Outcome at the TOC Visit - Micro-ITT NTF-S Population |
199; 175; 51; 68; 20; 17 | — |
| SECONDARY Number of Participants With Clinical Response at the TOC Visit - Micro-ITT NTF-S Population |
199; 175; 93; 100 | — |
| SECONDARY Number of Participants With Microbiological Outcome (MO) at the TOC Visit - Micro-ITT NTF-S Population |
213; 158; 13; 31; 19; 52 | — |
| SECONDARY Number of Participants With Microbiological Response at the TOC Visit - Micro-ITT NTF-S Population |
213; 158; 79; 117 | — |
| SECONDARY Number of Participants With Therapeutic Response (TR) (Combined Per Participant Clinical and Microbiological Response) at the Follow up (FU) Visit - Micro-ITT NTF-S Population |
126; 95; 166; 180 | — |
| SECONDARY Number of Participants With Clinical Outcome at the Follow up (FU) Visit - Micro-ITT NTF-S Population |
168; 154; 34; 35; 15; 19 | — |
| SECONDARY Number of Participants With Clinical Response at the Follow up (FU) Visit - Micro-ITT NTF-S Population |
168; 154; 124; 121 | — |
| SECONDARY Number of Participants With Microbiological Outcome (MO) at the Follow up (FU) Visit - Micro-ITT NTF-S Population |
154; 119; 19; 44; 29; 23 | — |
| SECONDARY Number of Participants With Microbiological Response at the Follow up (FU) Visit - Micro-ITT NTF-S Population |
154; 119; 138; 156 | — |
| SECONDARY Number of Participants With Clinical Outcome at the TOC Visit - Intent-to-Treat (ITT) Population |
549; 517; 153; 199; 36; 39 | — |
| SECONDARY Number of Participants With Clinical Response at the TOC Visit - Intent-to-Treat (ITT) Population |
549; 517; 256; 283 | — |
| SECONDARY Number of Participants With Clinical Outcome at the Follow up (FU) Visit - Intent-to-Treat (ITT) Population |
478; 443; 108; 116; 40; 52 | — |
| SECONDARY Number of Participants With Clinical Response at the Follow up (FU) Visit - Intent-to-Treat (ITT) Population |
478; 443; 327; 357 | — |
| SECONDARY Number of Participants With Treatment-emergent Adverse Events (TEAEs) |
285; 200 | — |
| SECONDARY Number of Participants With Serious Adverse Events (SAEs) |
5; 5 | — |
| SECONDARY Change From Baseline in Hematology Parameters: Neutrophil Count, Lymphocyte Count, Monocyte Count, Eosinophil Count, Basophil Count and Platelet Count at On Therapy and Test of Cure Visit |
0.161; 0.163; 0.006; 0.013; 0.015; 0.018 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Hemoglobin Level |
132.5; 131.7; -1.5; -1.9; -1.3; -1.4 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Hematocrit Level |
0.4314; 0.4292; -0.0033; -0.0041; -0.0045; -0.0029 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Erythrocytes (RBC) Count |
4.539; 4.539; -0.046; -0.060; -0.038; -0.049 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Mean Corpuscular Hemoglobin (MCH) |
29.28; 29.09; -0.02; -0.02; -0.04; 0.02 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Mean Corpuscular Volume (MCV) |
95.30; 94.82; 0.26; 0.35; -0.15; 0.39 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Serum Blood Urea Nitrogen (BUN), Glucose Non-fasting, Calcium, Chloride, Sodium, Magnesium, Phosphate, and Potassium Levels |
4.742; 4.724; -0.056; -0.018; 0.022; 0.131 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Total Bilirubin, Direct Bilirubin and Creatinine Levels |
4.61; 4.47; -0.18; -0.18; -0.19; 0.15 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Albumin and Protein Levels |
45.2; 45.2; -0.4; -0.8; -0.5; -0.6 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) and Alkaline Phosphatase (ALP) Levels |
20.3; 19.5; 0.2; -0.1; 0.4; -0.2 | — |
| SECONDARY Number of Participants With Urinalysis Dipstick Results |
751; 738; 4; 5; 3; 4 | — |
| SECONDARY Absolute Mean Values of Urine Specific Gravity |
1.0172; 1.0174; 1.0176; 1.0167; 1.0179; 1.0179 | — |
| SECONDARY Absolute Mean Values of Urine Potential of Hydrogen (pH) |
5.7; 5.7; 5.6; 5.6; 5.6; 5.7 | — |
| SECONDARY Change From Baseline in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) at On-Therapy and Test of Cure Visit |
122; 122.7; -1.1; -1.1; -0.4; -1.8 | — |
| SECONDARY Change From Baseline in Pulse Rate at On Therapy and Test of Cure Visit |
73.2; 73.7; 0.9; 1.3; 1.8; 1.7 | — |
| SECONDARY Change From Baseline in Body Temperature |
36.61; 36.63; -0.01; -0.01; -0.01; -0.04 | — |
| SECONDARY Number of Participants With Maximum Change From Baseline in Electrocardiograms (ECG) Parameter: QT Interval Corrected for Heart Rate According to Bazett's Formula (QTcB) at Worst-case Post-baseline |
675; 700; 23; 12; 1; 0 | — |
| SECONDARY Number of Participants With Maximum Change From Baseline in Electrocardiograms (ECG) Parameter- QT Interval Corrected for Heart Rate According to Fridericia's Formula (QTcF) at Worst-case Post-baseline |
721; 742; 12; 4; 0; 0 | — |
Summary
The study will be conducted to evaluate the therapeutic response (combined per participant microbiological and clinical response) of oral gepotidacin compared to oral nitrofurantoin for treatment of uncomplicated UTI (acute cystitis) in adolescent and adult female participants.
Eligibility Criteria
Inclusion Criteria
- The participant is >=12 years of age at the time of signing the informed consent/assent and has a body weight >=40 kilogram (kg).
- The participant has 2 or more of the following clinical signs and symptoms of acute cystitis with onset ]15 white blood cell [WBC]/high-power field [HPF]) or the presence of 3 plus (+)/large leukocyte esterase) from a pretreatment clean-catch midstream urine sample based on local laboratory procedures.
- The participant is female.
- The participant is capable of giving signed informed consent/assent.
Exclusion Criteria
- The participant resides in a nursing home or dependent care type-facility.
- The participant has a body mass index >=40.0 kilogram per meter square (kg/m^2) or a body mass index >=35.0 kg/m^2 and is experiencing obesity-related health conditions such as uncontrolled high blood pressure or uncontrolled diabetes.
- The participant has a history of sensitivity to the study treatment, or components thereof, or a history of a drug or other allergy that, in the opinion of the investigator or medical monitor, contraindicates her participation.
- The participant is immunocompromised or has altered immune defenses that may predispose the participant to a higher risk of treatment failure and/or complications.
- The participant has any of the following:
- Poorly controlled asthma or chronic obstructive pulmonary disease; Acute severe pain,; Active peptic ulcer disease; Parkinson disease; Myasthenia gravis; Or
- Known acute porphyria.
- Any surgical or medical condition (active or chronic) that may interfere with drug absorption, distribution, metabolism, or excretion of the study intervention .
- The participant has a known glucose-6 phosphate dehydrogenase deficiency.
- The participant has a serious underlying disease that could be imminently life threatening, or the participant is unlikely to survive for the duration of the study period.
- The participant has acute cystitis that is known or suspected to be due to fungal, parasitic, or viral pathogens; or known or suspected to be due to Pseudomonas aeruginosa or Enterobacterales (other than Escherichia coli) as the contributing pathogen.
- The participant has symptoms known or suspected to be caused by another disease process, such as asymptomatic bacteriuria, overactive bladder, chronic incontinence, or chronic interstitial cystitis, that may interfere with the clinical efficacy assessments or preclude complete resolution of acute cystitis symptoms.
- The participant has an anatomical or physiological anomaly that predisposes the participant to UTIs or may be a source of persistent bacterial colonization, including calculi, obstruction or stricture of the urinary tract, primary renal disease (for example [e.g.], polycystic renal disease), or neurogenic bladder, or the participant has a history of anatomical or functional abnormalities of the urinary tract (e.g., chronic vesico-ureteral reflux, detrusor insufficiency).
- The participant has an indwelling catheter, nephrostomy, ureter stent, or other foreign material in the urinary tract.
- The participant who, in the opinion of the investigator, has an otherwise complicated UTI, an active upper UTI (e.g., pyelonephritis, urosepsis), signs and symptom onset >=96 hours before study entry, or a temperature >=101.4 degree Fahrenheit (>=38 Degrees Celsius [C]), flank pain, chills, or any other manifestations suggestive of upper UTI.
- The participant has known anuria, oliguria, or significant impairment of renal function (creatinine clearance =12 to 450 msec or a QTc >480 msec for participants with bundle-branch block.
- The participant has a documented or recent history of uncorrected hypokalemia within the past 3 months.
- The participant has a known ALT value >2 times upper limit of normal (ULN).
- The participant has a known bilirubin value >1.5 times ULN (isolated bilirubin >1.5 times ULN is acceptable if bilirubin is fractionated and direct bilirubin <35 perce
Data sourced from ClinicalTrials.gov (NCT04187144). 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.