Trial Outcomes & Findings for China Registration Study in Patients With Skin Infections (NCT NCT00772447)

NCT ID: NCT00772447

Last Updated: 2015-03-09

Results Overview

Erythrocyte volume fraction means under certain conditions, after centrifugation pressing, the percentage of erythrocyte volume in the total volume of blood

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

265 participants

Primary outcome timeframe

baseline to TOC(test of cure), for up to 4 weeks

Results posted on

2015-03-09

Participant Flow

Overall, 265 patients were randomised (daptomycin: 131 patients, comparator: 134 patients), with 264 patients receiving study treatment

Participant milestones

Participant milestones
Measure
Daptomycin
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Overall Study
STARTED
131
134
Overall Study
COMPLETED
111
110
Overall Study
NOT COMPLETED
20
24

Reasons for withdrawal

Reasons for withdrawal
Measure
Daptomycin
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Overall Study
Withdrawal by Subject
9
5
Overall Study
Physician Decision
4
8
Overall Study
Lost to Follow-up
2
4
Overall Study
incorrect enrolment
3
4
Overall Study
Protocol Violation
0
1
Overall Study
all others
2
2

Baseline Characteristics

China Registration Study in Patients With Skin Infections

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Daptomycin
n=130 Participants
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=134 Participants
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Total
n=264 Participants
Total of all reporting groups
Age, Continuous
44.2 years
STANDARD_DEVIATION 15.77 • n=99 Participants
44.5 years
STANDARD_DEVIATION 16.02 • n=107 Participants
44.3 years
STANDARD_DEVIATION 15.87 • n=206 Participants
Sex: Female, Male
Female
90 Participants
n=99 Participants
95 Participants
n=107 Participants
185 Participants
n=206 Participants
Sex: Female, Male
Male
40 Participants
n=99 Participants
39 Participants
n=107 Participants
79 Participants
n=206 Participants

PRIMARY outcome

Timeframe: baseline to TOC(test of cure), for up to 4 weeks

Population: Only patients who had measurements in both baseline and TOC visit were included for the analysis. Change=TOC visit-baseline

Erythrocyte volume fraction means under certain conditions, after centrifugation pressing, the percentage of erythrocyte volume in the total volume of blood

Outcome measures

Outcome measures
Measure
Daptomycin
n=88 Participants
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=94 Participants
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Change of Erythrocyte Volume Fraction(Percentage of Erythrocyte Volume in Total Volume of Blood)
0.00 percentage
Standard Deviation 0.080
0.01 percentage
Standard Deviation 0.033

PRIMARY outcome

Timeframe: baseline to TOC(test of cure), for up to 4 weeks

Population: Only patients who had measurements in both baseline and TOC visit were included for the analysis. Change=TOC visit-baseline

Outcome measures

Outcome measures
Measure
Daptomycin
n=80 Participants
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=79 Participants
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Change in Creatinine Clearance
9.91 ml/min
Standard Deviation 76.851
0.99 ml/min
Standard Deviation 21.232

PRIMARY outcome

Timeframe: baseline to TOC(test of cure), for up to 4 weeks

Population: Only patients who had measurements in both baseline and TOC visit were included for the analysis. Change=TOC visit-baseline

Outcome measures

Outcome measures
Measure
Daptomycin
n=77 Participants
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=83 Participants
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Change in Serum Total Creatine Phosphokinase (CPK)
0.60 IU/L
Standard Deviation 56.89
-2.40 IU/L
Standard Deviation 46.05

PRIMARY outcome

Timeframe: baseline to TOC(test of cure), for up to 4 weeks

Population: Only patients who had measurements were included in the summary of a specific parameter at a specific time point. Change = TOC visit - baseline

Outcome measures

Outcome measures
Measure
Daptomycin
n=70 Participants
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=79 Participants
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Change in Urine pH
-0.19 pH
Standard Deviation 0.960
-0.30 pH
Standard Deviation 0.952

PRIMARY outcome

Timeframe: baseline to TOC(test of cure), for up to 4 weeks

Population: Only patients who had both measurements at baseline and TOC visit and those who got normal ECG resluts at baseline were included in the summary. Change=TOC visit-baseline

percentage of patients who were primarily tested as normal ECG at baseline and changed into abnormal ECG at TOC visit in all the patients with normal ECG at baseline

Outcome measures

Outcome measures
Measure
Daptomycin
n=56 Participants
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=51 Participants
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Shift in ECG
5.4 percentage of patients
7.8 percentage of patients

SECONDARY outcome

Timeframe: baseline and TOC, for up to 4 weeks

Population: There were 107 patients in daptomycin arm and 101 patients in comparator arm meeting the criteria of CE population and completed TOC visit.

The percentage of patients who were cured or clinically improved in the clinical evaluable (CE) population of each arm at TOC visit was analyzed. CE population includes all the patients with no significant deviation from study protocol in full analysis set population, and meetting the following specific criteria: 1.receiving randomly dispensed study treatment at appropriate time(with a compliance of at least 80% or 4 days \[3 days for patients evaluated as treatment failure\]). 2.without the administration of potentially confounding non-investigational antibiotics (using one potentially effective non-investigational antibiotic for the treatment of primary infection due to other reasons than lack of efficacy from Day 1 to TOC \[for systemicadministration of non-glycopeptides, \>1 calendar day\]). 3.meeting the study inclusion/exclusion criteria 4.necessary clinical evaluation performed (evaluation for effectiveness at TOC visit, except for the condition confirmed as clinically ineffective)

Outcome measures

Outcome measures
Measure
Daptomycin
n=107 Participants
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=101 Participants
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Blinded Investigator's Assessement of Clinical Response at TOC(Test of Cure)
93.5 percentage of patients
90.1 percentage of patients

SECONDARY outcome

Timeframe: baseline and EOT(end of therapy), for up to 2 weeks

Population: There were 110 patients in daptomycin arm and 103 patients in comparator arm who both completed EOT visit and met the criteria of CE population

The percentage of patients who were cured or clinically improved in the clinical evaluable (CE) population at EOT visit was analyzed. CE population includes all the patients with no significant deviation from study protocol in full analysis set population, and meetting the following specific criteria: 1.receiving randomly dispensed study treatment at appropriate time(with a compliance of at least 80% or 4 days \[3 days for patients evaluated as treatment failure\]). 2.without the administration of potentially confounding non-investigational antibiotics (using one potentially effective non-investigational antibiotic for the treatment of primary infection due to other reasons than lack of efficacy from Day 1 to TOC \[for systemicadministration of non-glycopeptides, \>1 calendar day\]). 3.meeting the study inclusion/exclusion criteria 4.necessary clinical evaluation performed (evaluation for effectiveness at TOC visit, except for the condition confirmed as clinically ineffective)

Outcome measures

Outcome measures
Measure
Daptomycin
n=110 Participants
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=103 Participants
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Blinded Investigator's Assessement of Clinical Response at EOT(End of Therapy)
90.9 Percentage of patients
91.3 Percentage of patients

SECONDARY outcome

Timeframe: baseline and TOC, for up to 4 weeks

Population: ME population includes all the patients with Gram-positive pathogenic bacteria isolated at baseline in CE population. There were 83 strains isolated from ME population of daptomycin arm(78 patients) and 86 strains from ME population in comparator arm(79 patients).

The microbiological response rate (removal or presumed removal) in ME(microbiological evaluable) population of daptomycin group and comparator group at TOC visit was analyzed. ME population includes all the patients with Gram-positive pathogenic bacteria isolated at baseline in CE population. Microbiological response rate means the percentage of strains which were removed or presumably removed at TOC visit in all the strains isolated from ME population at baseline.

Outcome measures

Outcome measures
Measure
Daptomycin
n=83 strains
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=86 strains
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Microbiological Response at TOC(Test of Cure)
94.0 Percentage of strains
90.7 Percentage of strains

SECONDARY outcome

Timeframe: baseline and EOT, for up to 2 weeks

Population: ME population includes all the patients with Gram-positive pathogenic bacteria isolated at baseline in CE population. There were 86 strains isolated from 81 patients in daptomycin arm and 88 strains from 81 patients in comparator arm who met the criteria of ME population at EOT visit.

The microbiological response rate (removal or presumed removal) in ME(microbiological evaluable) population of daptomycin group and comparator group at EOT visit was analyzed. ME population includes all the patients with Gram-positive pathogenic bacteria isolated at baseline in CE population. Microbiological response rate means the percentage of strains which were removed or presumably removed at EOT visit in all the strains isolated from ME population at baseline.

Outcome measures

Outcome measures
Measure
Daptomycin
n=86 strains
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=88 strains
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Microbiological Response at EOT(End of Therapy)
89.5 Percentage of strains
87.5 Percentage of strains

SECONDARY outcome

Timeframe: baseline and TOC, for up to 4 weeks

Population: There were 14 patients indentified MRSA infection in daptomycin group and 10 patients indentified with MRSA in comparator group.

This is the comparison of clinical efficacy by methicillin resistant staphylococcus aureus(MRSA) between the two groups. As the analysis was performed by specific pathogen in ME population and clinical efficacy was compared meanwhile, the clinical evaluation was based on the number of cases under the category of specific pathogen rather than the number of strains. Percentage of patients who were cured or improved at TOC visit in the patients who were identified with MRSA infection at baseline of both groups.

Outcome measures

Outcome measures
Measure
Daptomycin
n=14 Participants
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=10 Participants
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Per-pathogen(Methicillin Resistant Staphylococcus Aureus) Clinical Response at TOC(Test of Cure)
100 Percentage of patients
90 Percentage of patients

SECONDARY outcome

Timeframe: baseline and TOC(test of cure), for up to 4 weeks

Population: There were 33 patients indentified MSSA infection in daptomycin group and 37 patients indentified with MSSA in comparator group.

This is the comparison of clinical efficacy by methicillin sensitive staphylococcus aureus(MSSA) between the two groups. As the analysis was performed by specific pathogen in ME population and clinical efficacy was compared meanwhile, the clinical evaluation was based on the number of cases under the category of specific pathogen rather than the number of strains. Percentage of patients who were cured or improved at TOC visit in the patients who were identified with MSSA infection at baseline of both groups.

Outcome measures

Outcome measures
Measure
Daptomycin
n=33 Participants
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=37 Participants
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Per-pathogen(Methicillin Sensitive Staphylococcus Aureus) Clinical Response at TOC
90.9 Percentage of patients
89.2 Percentage of patients

SECONDARY outcome

Timeframe: baseline and TOC(test of cure), for up to 4 weeks

Population: There were 48 patients indentified staphylococcus aureus infection both in daptomycin group and in comparator group.

This is the comparison of clinical efficacy by staphylococcus aureus between the two groups. As the analysis was performed by specific pathogen in ME population and clinical efficacy was compared meanwhile, the clinical evaluation was based on the number of cases under the category of specific pathogen rather than the number of strains. Percentage of patients who were cured or improved at TOC visit in the patients who were identified with staphylococcus aureus infection at baseline of both groups.

Outcome measures

Outcome measures
Measure
Daptomycin
n=48 Participants
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
n=48 Participants
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Per-pathogen(Staphylococcus Aureus) Microbiological Response at TOC
91.7 Percentage of patients
87.5 Percentage of patients

Adverse Events

Daptomycin

Serious events: 1 serious events
Other events: 30 other events
Deaths: 0 deaths

Vancomycin, or Vancomycin Switch to Cloxacillin

Serious events: 3 serious events
Other events: 39 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Daptomycin
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Infections and infestations
Pneumonia
0.76%
1/131 • Number of events 1
0.00%
0/133
Infections and infestations
lung infection
0.00%
0/131
0.75%
1/133 • Number of events 1
Infections and infestations
tuberculosis
0.00%
0/131
0.75%
1/133 • Number of events 1
Hepatobiliary disorders
Hepatic Cirrhosis
0.00%
0/131
0.75%
1/133 • Number of events 1
Renal and urinary disorders
renal failure chronic
0.00%
0/131
0.75%
1/133 • Number of events 1

Other adverse events

Other adverse events
Measure
Daptomycin
daptomycin 4mg/kg iv every 24hours
Vancomycin, or Vancomycin Switch to Cloxacillin
vancomycin 1g per 12 hours, for 7-14 days; or switch to cloxacillin: 1 g every 6 hours or 2 g every 8 hours
Investigations
ALANINE AMINOTRANSFERASE INCREASED
5.3%
7/131 • Number of events 7
5.3%
7/133 • Number of events 7
Investigations
Aspartate Aminotransferase Increased
4.6%
6/131 • Number of events 6
4.5%
6/133 • Number of events 6
Investigations
Blood Creatine Phosphokinase Increased
3.1%
4/131 • Number of events 4
0.00%
0/133
Investigations
WHITE BLOOD CELL COUNT DECREASED
0.76%
1/131 • Number of events 1
1.5%
2/133 • Number of events 2
Investigations
Blood Lactate Dehydrogenase Increased
0.76%
1/131 • Number of events 1
0.75%
1/133 • Number of events 1
Investigations
RED BLOOD CELLS URINE POSITIVE
0.76%
1/131 • Number of events 1
0.75%
1/133 • Number of events 1
Investigations
Blood Alkaline Phosphatase Increased
0.00%
0/131
0.75%
1/133 • Number of events 1
Investigations
BLOOD CREATININE INCREASED
0.00%
0/131
0.75%
1/133 • Number of events 1
Investigations
Blood Potassium Decreased
0.00%
0/131
1.5%
2/133 • Number of events 2
Investigations
Blood Urine Present
0.76%
1/131 • Number of events 1
0.00%
0/133
Investigations
ELECTROCARDIOGRAM QRS COMPLEX PROLONGE0D
0.76%
1/131 • Number of events 1
0.00%
0/133
Investigations
Electrocardiogram T Wave Abnormal
0.76%
1/131 • Number of events 1
0.00%
0/133
Investigations
GAMMA-GLUTAMYLTRANSFERASE INCREASED
0.00%
0/131
0.75%
1/133 • Number of events 1
Investigations
Monocyte Percentage Increased
0.00%
0/131
0.75%
1/133 • Number of events 1
Investigations
Platelet Count Decreased
0.00%
0/131
0.75%
1/133 • Number of events 1
Investigations
WHITE BLOOD CELLS URINE POSITIVE
0.76%
1/131 • Number of events 1
0.00%
0/133
Skin and subcutaneous tissue disorders
PRURITUS
0.00%
0/131
2.3%
3/133 • Number of events 5
Skin and subcutaneous tissue disorders
Rash
0.76%
1/131 • Number of events 2
1.5%
2/133 • Number of events 7
Infections and infestations
UPPER RESPIRATORY TRACT INFECTION
2.3%
3/131 • Number of events 3
1.5%
2/133 • Number of events 2
Infections and infestations
Lung Infection
0.00%
0/131
0.75%
1/133 • Number of events 1
Infections and infestations
PNEUMONIA
0.76%
1/131 • Number of events 1
0.00%
0/133
Infections and infestations
Tuberculosis
0.00%
0/131
0.75%
1/133 • Number of events 1
General disorders
PYREXIA
1.5%
2/131 • Number of events 2
0.75%
1/133 • Number of events 1
General disorders
CHEST DISCOMFORT
0.76%
1/131 • Number of events 1
0.00%
0/133
General disorders
CHILLS
0.00%
0/131
0.75%
1/133 • Number of events 1
General disorders
INJECTION SITE PAIN
0.00%
0/131
0.75%
1/133 • Number of events 1
Musculoskeletal and connective tissue disorders
BACK PAIN
0.00%
0/131
1.5%
2/133 • Number of events 2
Musculoskeletal and connective tissue disorders
MUSCULAR WEAKNESS
0.76%
1/131 • Number of events 1
0.75%
1/133 • Number of events 1
Musculoskeletal and connective tissue disorders
Joint Swelling
0.76%
1/131 • Number of events 1
0.00%
0/133
Musculoskeletal and connective tissue disorders
Myalgia
0.00%
0/131
0.75%
1/133 • Number of events 1
Gastrointestinal disorders
ABDOMINAL DISTENSION
1.5%
2/131 • Number of events 2
0.00%
0/133
Gastrointestinal disorders
ABDOMINAL DISCOMFORT
0.00%
0/131
0.75%
1/133 • Number of events 1
Gastrointestinal disorders
ASCITES
0.00%
0/131
0.75%
1/133 • Number of events 1
Gastrointestinal disorders
CONSTIPATION
0.76%
1/131 • Number of events 1
0.00%
0/133
Gastrointestinal disorders
NAUSEA
0.00%
0/131
0.75%
1/133 • Number of events 1
Metabolism and nutrition disorders
ANOREXIA
0.00%
0/131
0.75%
1/133 • Number of events 1
Nervous system disorders
AMNESIA
0.00%
0/131
0.75%
1/133 • Number of events 1
Nervous system disorders
Dizziness
0.00%
0/131
0.75%
1/133 • Number of events 1
Nervous system disorders
HEADACHE
0.00%
0/131
0.75%
1/133 • Number of events 1
Nervous system disorders
MUSCLE CONTRACTIONS INVOLUNTARY
0.76%
1/131 • Number of events 1
0.00%
0/133
Cardiac disorders
ANGINA PECTORIS
0.76%
1/131 • Number of events 1
0.00%
0/133
Cardiac disorders
LEFT VENTRICULAR HYPERTROPHY
0.00%
0/131
0.75%
1/133 • Number of events 1
Cardiac disorders
SUPRAVENTRICULAR EXTRASYSTOLES
0.00%
0/131
0.75%
1/133 • Number of events 1
Cardiac disorders
VENTRICULAR EXTRASYSTOLES
0.76%
1/131 • Number of events 1
0.00%
0/133
Renal and urinary disorders
DYSURIA
0.76%
1/131 • Number of events 1
0.00%
0/133
Renal and urinary disorders
HAEMATURIA
0.76%
1/131 • Number of events 1
0.00%
0/133
Renal and urinary disorders
RENAL FAILURE CHRONIC
0.00%
0/131
0.75%
1/133 • Number of events 1
Vascular disorders
Flushing
0.00%
0/131
1.5%
2/133 • Number of events 3
Hepatobiliary disorders
HEPATIC CIRRHOSIS
0.00%
0/131
0.75%
1/133 • Number of events 1
Psychiatric disorders
Insomnia
0.76%
1/131 • Number of events 1
0.00%
0/133
Reproductive system and breast disorders
PRURITUS GENITAL
0.76%
1/131 • Number of events 1
0.00%
0/133
Investigations
BLOOD PHOSPHORUS INCREASED
0.76%
1/131 • Number of events 1
0.00%
0/133
Investigations
BLOOD POTASSIUM INCREASED
0.76%
1/131 • Number of events 1
0.00%
0/133
Investigations
BLOOD URIC ACID INCREASED
0.76%
1/131 • Number of events 1
0.00%
0/133

Additional Information

Gerard Lynch

AstraZeneca

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: OTHER