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CompletedNCT01417780Updated Aug 18, 2021Results posted

Evaluation of Safety, PK and Immunomodulatory Effects of AB103 in Necrotizing Soft Tissue Infections Patients

A Phase 2 interventional study of AB103 and Placebo in Necrotizing Soft Tissue Infections, sponsored by Atox Bio Ltd. Completed at 7 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-08-18.

Sponsored by Atox Bio Ltd · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
43
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

A study to evaluate the safety and pharmacokinetics profile of different doses of AB103 administered to patients diagnosed with Necrotizing Soft Tissue Infections that are scheduled for an urgent surgical intervention as part of their standard of care.

Read the detailed description

A study to evaluate the safety and pharmacokinetics profile of different doses of AB103 administered to patients diagnosed with Necrotizing Soft Tissue Infections that are scheduled for an urgent surgical intervention as part of their standard of care. The primary study hypothesis is that AB-103 can be administered safely to the patients presenting with Necrotizing Soft Tissue Infections.

Secondary endpoints are efficacy by exploratory descriptive analyses of specific efficacy endpoints from three outcome domains to demonstrate treatment benefit of AB103 in comparison to placebo in patients with Necrotizing Soft Tissue Infections. The efficacy domains are:

  1. Clinical status domain
  2. Pharmacoeconomics domain
  3. Systemic and local inflammatory biomarker domain
02

Conditions studied

  • Necrotizing Soft Tissue Infections

Browse trials for

03

In context

Soft Tissue Infections

92 studies on the registry are indexed under Soft Tissue Infections; 14 are open to participants now.

This study's enrollment of 43 is below the median of 123 across 58 interventional studies indexed under Soft Tissue Infections.

Browse Soft Tissue Infections studies →

Lead sponsor

Atox Bio Ltd is the lead sponsor of 4 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Clinical diagnosis of NSTI due to bacterial infection (Necrotizing Fasciitis, Group A streptococcal infection or non group A streptococcal infection, Fournier's gangrene, Bacterial synergistic gangrene, Synergistic Necrotizing Cellulitis, Clostridial gas gangrene/ myonecrosis) that may be supported by specific signs and symptoms, e.g. tense edema outside area of compromised skin, pain disproportionate to appearance, skin discoloration, ecchymosis, blisters/bullae, necrosis, tense edema, crepitus and/or subcutaneous gas AND a decision for urgent surgical exploration and debridement;
  • Patient who did not receive the study drug prior to the surgery need to have a definite diagnosis of NSTI confirmed surgically (e.g. presence of necrotic tissue, thrombosed vessels in the subcutaneous tissue, lack of bleeding and "dishwater" (cloudy, thin, gray) fluid) in order to get the drug during or after operation;
  • IV drug administration within 6 hours from the clinical diagnosis and from the documented decision to have an urgent surgical exploration and debridement;
  • Signed and dated ICF as defined by the IRB and, if applicable, California Bill of Rights. By signing the ICF, the patient agrees to release any medical records pursuant to current Health Insurance Portability and Accountability Act (HIPAA) Guidelines. If patient is unable to comprehend or sign the ICF, patient's legally acceptable representative may sign the ICF;

Exclusion criteria

Exclusion Criteria

  • Age \< 18 years;
  • Weight > 150 Kg / 330 pounds;
  • Pregnant or lactating women; Female of , the patient must have a negative beta subunit hCG pregnancy test immediately prior to study entry (performed by urine or blood test, whichever is faster);
  • Patient who has been operated at least once for the current NSTI infection and had a curative deep tissue debridement (diagnostic surgery is allowed to enter into the study);
  • Known infection with \< 200 cells/mm3 or \< 14% of all lymphocytes;
  • Diabetic patients with below ankle infection;
  • Patients with overt peripheral vascular disease in the involved area - condition associated with ischemic ulcers and /or symptoms of inadequate vascular supply (e.g. intermittent claudication) where limb amputation is considered likely within 7 days;
  • Current status of: a. Mean arterial pressure \< 50 mmHg and/or systolic blood pressure \< 70 mmHg despite treatment with vasopressors and/or IV fluids or b. a patient with respiratory failure such that an SaO2 of 80% cannot be achieved or c. a patient with coagulopathy ( > 3) or d. thrombocytopenia ( count \< 20,000) that does not partially correct with administration of appropriate factors, or e. likely severe neurological impairment secondary to cardiac arrest.
  • Patients with cardiac arrest requiring cardiopulmonary resuscitation within the past 30 days;
  • Patient is not expected to survive 30 days because of underlying medical condition, such as poorly controlled neoplasm (e.g. Stage III or IV cancer);
  • Any concurrent medical condition, which in the opinion of the investigator, may compromise their safety or the objectives of the study or the patient will not benefit from treatment, (e.g. end stage organ disease {CHF { class III-IV}, {stage III-IV}, Liver dysfunction {Childs-Pugh class C}, Renal dysfunction {Dialysis}), , receiving or about to receive chemotherapy or known severe neutropenia \< 1,000 cells/mm3;
  • Patients with Necrotizing Soft Tissue Infection post intra-abdominal operation;
  • Patient with burn wounds;
  • Patient or patient's family are not committed to aggressive management of the patient's condition, or the combination of necrotizing skin infection and underlying illness makes it unlikely that life support will be maintained;
  • Previous enrolment in an previous clinical trial involving drug or a medical device within 30 days before provision of written for the study or within five half lives of the investigational drug, whichever is longer;
Terms in these criteria, in plain language(11)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

CD4 count

The number of CD4 cells, a type of white blood cell, in a given amount of blood. It is used to follow how well the immune system is doing in HIV.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
43 participants (actual)

Study arms

  • Active comparator
    AB103 0.25 mg/kg

    Drug: AB103

  • Active comparator
    AB103 0.5 mg/kg

    Drug: AB103

  • Placebo comparator
    Placebo

    Normal saline (0.9% sodium chloride)

    Drug: Placebo

Interventions

  • DrugAB103

    AB103 0.25 mg/kg or 0.5 mg/kg administered as a single IV infusion

    Also known as: p2TA

  • DrugPlacebo

    Normal saline (0.9% sodium chloride) administered as a single IV infusion

06

What researchers measure

Primary outcomes

  1. Number of Subjects With One or More Adverse Events (AEs) During the Treatment Period

    An AE is any untoward medical occurrence in a subject administered study drug and that does not necessarily have a causal relationship with the study drug. An AE could therefore be any unfavorable and unintended sign (including abnormal laboratory findings), symptom, or disease temporally associated with the use of the study drug, whether or not considered related to the study drug.

    Time frame: 7 days

  2. Number of Subjects With One or More Serious Adverse Events (SAEs)

    A serious adverse event (SAE) is an AE occurring during any study phase and at any dose of the study drug (AB103 or placebo) that fulfills one or more of the following criteria: * Results in death * Is life-threatening (i.e., the subject was, in the opinion of the Investigator, at immediate risk of death from the event as it occurred) * Requires or prolongs hospitalization * Results in persistent or significant disability or incapacity (i.e., the event causes a substantial disruption of a person's ability to conduct normal life functions) * Is a congenital anomaly or birth defect, or * Is an important and significant medical event.

    Time frame: 28 days

  3. Alanine Aminotransferase (ALT)

    Screening ALT results, Day 7 ALT results, and change in ALT from screening to Day 7

    Time frame: Screening and Day 7

  4. Aspartate Aminotransferase (AST)

    Screening AST results, Day 7 AST results, and change in AST from screening to Day 7

    Time frame: Screening and Day 7

  5. Alkaline Phosphatase (ALP)

    Screening ALP results, Day 7 ALP results, and change in ALP from screening to Day 7

    Time frame: Screening and Day 7

  6. Total Bilirubin (Tbili)

    Screening Tbili results, Day 7 Tbili results, and change in Tbili from screening to Day 7

    Time frame: Screening and Day 7

  7. Serum Creatinine (sCr)

    Screening sCr results, Day 7 sCr results, and change in sCr from screening to Day 7

    Time frame: Screening and Day 7

  8. Albumin (Alb)

    Screening Alb results, Day 7 Alb results, and change in Alb from screening to Day 7

    Time frame: Screening and Day 7

  9. Hemoglobin (Hgb)

    Screening Hgb results, Day 7 Hgb results, and change in Hgb from screening to Day 7

    Time frame: Screening and Day 7

  10. Total White Blood Cell (WBC) Count

    Screening WBC results, Day 7 WBC results, and change in WBC from screening to Day 7

    Time frame: Screening and Day 7

  11. Platelet (PLT) Count

    Screening PLT results, Day 7 PLT results, and change in PLT from screening to Day 7

    Time frame: Screening and Day 7

  12. International Normalized Ratio (INR)

    Screening INR results, Day 7 INR results, and change in INR from screening to Day 7. In general, the higher the INR value, the longer it takes for blood to form a clot.

    Time frame: Screening and Day 7

  13. QT Interval With Fridericia's Correction (QTcF)

    Pre-dose QTcF, post-dose QTcF, change in QTcF from pre-dose to post-dose

    Time frame: Pre-dose and up to 24 hours post-dose

  14. Categorical Change in QTcF

    Number and percentage of patients with a change in QTcF of \> 30 msec; number and percentage of patients with a change in QTcF of \> 60 msec

    Time frame: Pre-dose and up to 24 hours post-dose

  15. Area Under the Plasma Concentration Versus Time Curve (AUC)

    Area under the plasma concentration versus time curve (AUC) from time zero to infinity following a single dose of study drug, obtained by noncompartmental methods. It is an integrated measure of study drug plasma exposure.

    Time frame: Prior to infusion, at mid infusion time, end of infusion, and at 2, 5, 10, 20, 30, 60 min and 120 minutes after completion of the IV infusion of study drug.

  16. Maximum Plasma Concentration (Cmax)

    Maximum plasma concentration (observed)

    Time frame: Prior to infusion, at mid infusion time, end of infusion, and at 2, 5, 10, 20, 30, 60 min and 120 minutes after completion of the IV infusion of study drug.

  17. Apparent Terminal Plasma Half-life (T1/2)

    Apparent terminal plasma half-life (T1/2) is the amount of time for plasma concentrations to decline by 50%.

    Time frame: Prior to infusion, at mid infusion time, end of infusion, and at 2, 5, 10, 20, 30, 60 min and 120 minutes after completion of the IV infusion of study drug.

  18. Clearance (CL)

    Clearance (CL) is the volume of plasma completely cleared of drug per unit of time.

    Time frame: Prior to infusion, at mid infusion time, end of infusion, and at 2, 5, 10, 20, 30, 60 min and 120 minutes after completion of the IV infusion of study drug.

  19. Apparent Volume of Distribution Under Steady State Conditions (Vss)

    Apparent volume of distribution under steady state conditions (Vss) based on drug concentration in plasma

    Time frame: Prior to infusion, at mid infusion time, end of infusion, and at 2, 5, 10, 20, 30, 60 min and 120 minutes after completion of the IV infusion of study drug.

Secondary outcomes

  1. C-reactive Protein (CRP)

    Screening CRP results, Day 7 CRP results, and change in CRP from screening to Day 7

    Time frame: Screening and Day 7

  2. Day 14 Sequential Organ Failure Assessment (SOFA) Score

    Day 14 SOFA score is the sum of individual SOFA score components at Day 14. Results include last observation carried forward (LOCF) imputation for missing values. SOFA total scores range from 0 to 24, with higher scores reflecting a worse clinical status or outcome. A SOFA total score of 0 or 1 reflects resolution of organ dysfunction/failure.

    Time frame: 14 days

  3. Day 14 Sequential Organ Failure Assessment (SOFA) Score Less Than or Equal to 1

    Number and percentage of patients with Day 14 Sequential Organ Failure Assessment (SOFA) score less than or equal to 1. SOFA total scores range from 0 to 24, with higher scores reflecting a worse clinical status or outcome. A SOFA total score of 0 or 1 reflects resolution of organ dysfunction/failure.

    Time frame: 14 days

  4. Hospital Length of Stay (LOS)

    The duration of hospital stay over the 28-day study period.

    Time frame: 28 days

  5. Intensive Care Unit-free Days (ICU-free Days)

    The number of intensive care unit-free days (ICU-free days)

    Time frame: 28 days

  6. Ventilator-free Days

    The number of ventilator-free days (days without ventilator use)

    Time frame: 28 days

07

Results

Posted Aug 18, 2021

Participant flow

This study was conducted by qualified investigators under the sponsorship of Atox Bio Ltd. at 7 trauma centers, of which 6 enrolled patients from December 2011 through August 2012.

Participant flow — Overall Study
MilestoneAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Started151711
Completed14149
Not completed132

Outcome measures

PrimaryNumber of Subjects With One or More Adverse Events (AEs) During the Treatment Period

An AE is any untoward medical occurrence in a subject administered study drug and that does not necessarily have a causal relationship with the study drug. An AE could therefore be any unfavorable and unintended sign (including abnormal laboratory findings), symptom, or disease temporally associated with the use of the study drug, whether or not considered related to the study drug.

Time frame:
7 days
Reported as:
Count of participants · Participants
Number of Subjects With One or More Adverse Events (AEs) During the Treatment Period
ParticipantsAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Number of Subjects With One or More Adverse Events (AEs) During the Treatment Period14169
PrimaryNumber of Subjects With One or More Serious Adverse Events (SAEs)

A serious adverse event (SAE) is an AE occurring during any study phase and at any dose of the study drug (AB103 or placebo) that fulfills one or more of the following criteria: * Results in death * Is life-threatening (i.e., the subject was, in the opinion of the Investigator, at immediate risk of death from the event as it occurred) * Requires or prolongs hospitalization * Results in persistent or significant disability or incapacity (i.e., the event causes a substantial disruption of a person's ability to conduct normal life functions) * Is a congenital anomaly or birth defect, or * Is an important and significant medical event.

Time frame:
28 days
Reported as:
Count of participants · Participants
Number of Subjects With One or More Serious Adverse Events (SAEs)
ParticipantsAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Number of Subjects With One or More Serious Adverse Events (SAEs)854
PrimaryAlanine Aminotransferase (ALT)

Screening ALT results, Day 7 ALT results, and change in ALT from screening to Day 7

Time frame:
Screening and Day 7
Reported as:
Mean · units/L
Alanine Aminotransferase (ALT)
units/LAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Screening55.9 ± 99.828.1 ± 17.346.8 ± 57.2
Day 727.9 ± 18.827.3 ± 26.326.0 ± 13.2
Change from Screening to Day 7-23.2 ± 95.1-0.8 ± 31.2-19.8 ± 60.5
PrimaryAspartate Aminotransferase (AST)

Screening AST results, Day 7 AST results, and change in AST from screening to Day 7

Time frame:
Screening and Day 7
Reported as:
Mean · units/L
Aspartate Aminotransferase (AST)
units/LAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Screening35.8 ± 30.637.4 ± 28.332.0 ± 19.2
Day 730.6 ± 17.124.3 ± 10.127.4 ± 9.7
Change from Screening to Day 7-1.2 ± 30.7-9.3 ± 21.70.1 ± 9.6
PrimaryAlkaline Phosphatase (ALP)

Screening ALP results, Day 7 ALP results, and change in ALP from screening to Day 7

Time frame:
Screening and Day 7
Reported as:
Mean · units/L
Alkaline Phosphatase (ALP)
units/LAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Screening97.5 ± 53.5104.3 ± 47.7108.3 ± 44.2
Day 793.1 ± 45.284.8 ± 33.9100.6 ± 65.9
Change from Screening to Day 75.2 ± 40.1-10.6 ± 62.3-11.4 ± 34.6
PrimaryTotal Bilirubin (Tbili)

Screening Tbili results, Day 7 Tbili results, and change in Tbili from screening to Day 7

Time frame:
Screening and Day 7
Reported as:
Mean · mg/dL
Total Bilirubin (Tbili)
mg/dLAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Screening1.2 ± 0.71.2 ± 0.81.5 ± 1.7
Day 70.6 ± 0.20.6 ± 0.31.1 ± 0.8
Change from Screening to Day 7-0.8 ± 0.6-0.5 ± 0.5-0.4 ± 1.4
PrimarySerum Creatinine (sCr)

Screening sCr results, Day 7 sCr results, and change in sCr from screening to Day 7

Time frame:
Screening and Day 7
Reported as:
Mean · mg/dL
Serum Creatinine (sCr)
mg/dLAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Screening1.2 ± 0.51.2 ± 1.01.2 ± 0.7
Day 71.1 ± 0.91.3 ± 1.71.0 ± 0.4
Change from Screening to Day 7-0.1 ± 0.70.1 ± 2.0-0.2 ± 0.6
PrimaryAlbumin (Alb)

Screening Alb results, Day 7 Alb results, and change in Alb from screening to Day 7

Time frame:
Screening and Day 7
Reported as:
Mean · g/dL
Albumin (Alb)
g/dLAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Screening2.5 ± 0.92.1 ± 0.52.3 ± 0.5
Day 71.9 ± 0.91.7 ± 0.42.3 ± 0.6
Change from Screening to Day 7-0.6 ± 0.4-0.3 ± 0.20.1 ± 0.7
PrimaryHemoglobin (Hgb)

Screening Hgb results, Day 7 Hgb results, and change in Hgb from screening to Day 7

Time frame:
Screening and Day 7
Reported as:
Mean · g/dL
Hemoglobin (Hgb)
g/dLAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Screening11.5 ± 2.211.0 ± 1.510.5 ± 2.6
Day 78.8 ± 2.18.9 ± 1.19.0 ± 1.4
Change from Screening to Day 7-2.9 ± 2.1-2.5 ± 1.5-1.3 ± 2.4
PrimaryTotal White Blood Cell (WBC) Count

Screening WBC results, Day 7 WBC results, and change in WBC from screening to Day 7

Time frame:
Screening and Day 7
Reported as:
Mean · thousand cells per microliter
Total White Blood Cell (WBC) Count
thousand cells per microliterAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Screening17.8 ± 10.014.7 ± 8.821.7 ± 16.2
Day 714.3 ± 6.712.5 ± 5.112.3 ± 2.4
Change from Screening to Day 7-5.0 ± 9.3-3.0 ± 10.9-11.2 ± 14.9
PrimaryPlatelet (PLT) Count

Screening PLT results, Day 7 PLT results, and change in PLT from screening to Day 7

Time frame:
Screening and Day 7
Reported as:
Mean · thousand cells per microliter
Platelet (PLT) Count
thousand cells per microliterAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Screening300.2 ± 182.2215.1 ± 82.0255.3 ± 130.0
Day 7401.5 ± 168.8341.8 ± 140.6318.3 ± 148.2
Change from Screening to Day 781.8 ± 237.1125.1 ± 144.649.9 ± 160.2
PrimaryInternational Normalized Ratio (INR)

Screening INR results, Day 7 INR results, and change in INR from screening to Day 7. In general, the higher the INR value, the longer it takes for blood to form a clot.

Time frame:
Screening and Day 7
Reported as:
Mean · unitless
International Normalized Ratio (INR)
unitlessAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Screening1.29 ± 0.221.43 ± 0.331.41 ± 0.38
Day 71.2 ± 0.11.2 ± 0.11.3 ± 0.3
Change from Screening to Day 7-0.1 ± 0.2-0.2 ± 0.3-0.2 ± 0.3
PrimaryQT Interval With Fridericia's Correction (QTcF)

Pre-dose QTcF, post-dose QTcF, change in QTcF from pre-dose to post-dose

Time frame:
Pre-dose and up to 24 hours post-dose
Reported as:
Mean · msec
QT Interval With Fridericia's Correction (QTcF)
msecAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Pre-dose QTcF419.1 ± 39.3401.8 ± 16.8405.1 ± 38.6
Post-dose QTcF409.2 ± 23.1403.1 ± 39.3407.4 ± 29.6
Change in QTcF from pre-dose to post-dose-9.9 ± 37.21.3 ± 36.18.9 ± 31.0
PrimaryCategorical Change in QTcF

Number and percentage of patients with a change in QTcF of \> 30 msec; number and percentage of patients with a change in QTcF of \> 60 msec

Time frame:
Pre-dose and up to 24 hours post-dose
Reported as:
Count of participants · Participants
Categorical Change in QTcF
ParticipantsAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Patients with a change in QTcF of > 30 msec132
Patients with a change in QTcF of > 60 msec121
PrimaryArea Under the Plasma Concentration Versus Time Curve (AUC)

Area under the plasma concentration versus time curve (AUC) from time zero to infinity following a single dose of study drug, obtained by noncompartmental methods. It is an integrated measure of study drug plasma exposure.

Time frame:
Prior to infusion, at mid infusion time, end of infusion, and at 2, 5, 10, 20, 30, 60 min and 120 minutes after completion of the IV infusion of study drug.
Reported as:
Median · ng*min/mL
Area Under the Plasma Concentration Versus Time Curve (AUC)
ng*min/mLAB103 0.25 mg/kgAB103 0.5 mg/kg
Area Under the Plasma Concentration Versus Time Curve (AUC)8497 (2836 to 14269)16921 (4843 to 28952)
PrimaryMaximum Plasma Concentration (Cmax)

Maximum plasma concentration (observed)

Time frame:
Prior to infusion, at mid infusion time, end of infusion, and at 2, 5, 10, 20, 30, 60 min and 120 minutes after completion of the IV infusion of study drug.
Reported as:
Median · ng/mL
Maximum Plasma Concentration (Cmax)
ng/mLAB103 0.25 mg/kgAB103 0.5 mg/kg
Maximum Plasma Concentration (Cmax)899 (98 to 2664)1484 (661 to 3418)
PrimaryApparent Terminal Plasma Half-life (T1/2)

Apparent terminal plasma half-life (T1/2) is the amount of time for plasma concentrations to decline by 50%.

Time frame:
Prior to infusion, at mid infusion time, end of infusion, and at 2, 5, 10, 20, 30, 60 min and 120 minutes after completion of the IV infusion of study drug.
Reported as:
Median · minutes
Apparent Terminal Plasma Half-life (T1/2)
minutesAB103 0.25 mg/kgAB103 0.5 mg/kg
Apparent Terminal Plasma Half-life (T1/2)2.61 (1.28 to 18.99)4.89 (1.53 to 14.16)
PrimaryClearance (CL)

Clearance (CL) is the volume of plasma completely cleared of drug per unit of time.

Time frame:
Prior to infusion, at mid infusion time, end of infusion, and at 2, 5, 10, 20, 30, 60 min and 120 minutes after completion of the IV infusion of study drug.
Reported as:
Median · mL/min/kg
Clearance (CL)
mL/min/kgAB103 0.25 mg/kgAB103 0.5 mg/kg
Clearance (CL)29.42 (17.52 to 88.14)29.55 (17.27 to 103.24)
PrimaryApparent Volume of Distribution Under Steady State Conditions (Vss)

Apparent volume of distribution under steady state conditions (Vss) based on drug concentration in plasma

Time frame:
Prior to infusion, at mid infusion time, end of infusion, and at 2, 5, 10, 20, 30, 60 min and 120 minutes after completion of the IV infusion of study drug.
Reported as:
Median · mL/kg
Apparent Volume of Distribution Under Steady State Conditions (Vss)
mL/kgAB103 0.25 mg/kgAB103 0.5 mg/kg
Apparent Volume of Distribution Under Steady State Conditions (Vss)100 (53 to 157)135 (36 to 318)
SecondaryC-reactive Protein (CRP)

Screening CRP results, Day 7 CRP results, and change in CRP from screening to Day 7

Time frame:
Screening and Day 7
Reported as:
Mean · mg/dL
C-reactive Protein (CRP)
mg/dLAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Screening29.2 ± 12.327.5 ± 6.220.6 ± 13.2
Day 711.7 ± 10.07.5 ± 4.44.0 ± 3.0
Change from Screening to Day 7-19.2 ± 14.6-22.7 ± 5.9-20.5 ± 11.0
SecondaryDay 14 Sequential Organ Failure Assessment (SOFA) Score

Day 14 SOFA score is the sum of individual SOFA score components at Day 14. Results include last observation carried forward (LOCF) imputation for missing values. SOFA total scores range from 0 to 24, with higher scores reflecting a worse clinical status or outcome. A SOFA total score of 0 or 1 reflects resolution of organ dysfunction/failure.

Time frame:
14 days
Reported as:
Mean · score on a scale
Day 14 Sequential Organ Failure Assessment (SOFA) Score
score on a scaleAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Day 14 Sequential Organ Failure Assessment (SOFA) Score1.07 ± 1.000.71 ± 0.832.70 ± 2.79
Statistical analysis
  • AB103 0.25 mg/kg vs AB103 0.5 mg/kg vs Placebo · ANOVA · p = 0.016
SecondaryDay 14 Sequential Organ Failure Assessment (SOFA) Score Less Than or Equal to 1

Number and percentage of patients with Day 14 Sequential Organ Failure Assessment (SOFA) score less than or equal to 1. SOFA total scores range from 0 to 24, with higher scores reflecting a worse clinical status or outcome. A SOFA total score of 0 or 1 reflects resolution of organ dysfunction/failure.

Time frame:
14 days
Reported as:
Count of participants · Participants
Day 14 Sequential Organ Failure Assessment (SOFA) Score Less Than or Equal to 1
ParticipantsAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Day 14 Sequential Organ Failure Assessment (SOFA) Score Less Than or Equal to 110134
Statistical analysis
  • AB103 0.25 mg/kg vs AB103 0.5 mg/kg vs Placebo · Chi-squared · p = 0.019
SecondaryHospital Length of Stay (LOS)

The duration of hospital stay over the 28-day study period.

Time frame:
28 days
Reported as:
Mean · days
Hospital Length of Stay (LOS)
daysAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Hospital Length of Stay (LOS)17.1 ± 7.9617.4 ± 9.0720.0 ± 6.93
Statistical analysis
  • AB103 0.25 mg/kg vs AB103 0.5 mg/kg vs Placebo · Wilcoxon (Mann-Whitney) · p = 0.11 (Wilcoxon p value represents comparison of active dose groups versus placebo group.)
SecondaryIntensive Care Unit-free Days (ICU-free Days)

The number of intensive care unit-free days (ICU-free days)

Time frame:
28 days
Reported as:
Mean · ICU-free days
Intensive Care Unit-free Days (ICU-free Days)
ICU-free daysAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Intensive Care Unit-free Days (ICU-free Days)21.7 ± 8.4821.3 ± 6.2117.1 ± 9.88
Statistical analysis
  • AB103 0.25 mg/kg vs AB103 0.5 mg/kg vs Placebo · Wilcoxon (Mann-Whitney) · p = 0.18 (Wilcoxon p value represents comparison of active dose groups versus placebo group.)
SecondaryVentilator-free Days

The number of ventilator-free days (days without ventilator use)

Time frame:
28 days
Reported as:
Mean · ventilator-free days
Ventilator-free Days
ventilator-free daysAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
Ventilator-free Days23.5 ± 8.7524.1 ± 6.2520.8 ± 9.14
Statistical analysis
  • AB103 0.25 mg/kg vs AB103 0.5 mg/kg vs Placebo · Wilcoxon (Mann-Whitney) · p = 0.19 (Wilcoxon p value represents comparison of active dose groups versus placebo group.)

Adverse events

Collected over Adverse events (AEs) included in this summary were to be collected from dosing through Day 7; serious adverse events (SAEs) included in this summary were to be collected from dosing through Day 28.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
AB103 0.25 mg/kg1/15 (6.7%)8/15 (53.3%)14/15 (93.3%)
AB103 0.5 mg/kg1/17 (5.9%)5/17 (29.4%)16/17 (94.1%)
Placebo2/11 (18.2%)4/11 (36.4%)9/11 (81.8%)
Most frequent serious events
Showing 10 of 27
Most frequent serious events
EventAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
HypotensionCardiac disorders3/151/170/11
Respiratory failureRespiratory, thoracic and mediastinal disorders2/153/171/11
Septic shockInfections and infestations0/151/171/11
Renal failure acuteRenal and urinary disorders1/151/171/11
BradycardiaCardiac disorders0/150/171/11
Cardiac arrestCardiac disorders0/150/171/11
Pleural effusionRespiratory, thoracic and mediastinal disorders0/150/171/11
Acute lung injuryRespiratory, thoracic and mediastinal disorders0/150/171/11
Supraventricular tachycardiaCardiac disorders0/150/171/11
FungemiaInfections and infestations0/150/171/11
Most frequent other events
Showing 10 of 107
Most frequent other events
EventAB103 0.25 mg/kgAB103 0.5 mg/kgPlacebo
PyrexiaGeneral disorders3/157/172/11
Blood phosphorus decreasedInvestigations6/157/171/11
Blood potassium decreasedInvestigations5/157/173/11
HypotensionVascular disorders3/153/174/11
Blood magnesium decreasedInvestigations5/156/173/11
Hematocrit decreasedInvestigations5/153/173/11
Metabolic acidosisMetabolism and nutrition disorders0/152/173/11
HyperglycemiaMetabolism and nutrition disorders2/154/172/11
ThrombocytopeniaBlood and lymphatic system disorders0/150/172/11
BradycardiaCardiac disorders0/150/172/11

Baseline characteristics

Data are from the modified intent-to-treat (mITT) population. The mITT population consisted of all randomized patients who received the proper study drug (AB103 or placebo) and dose, had a definitive surgical diagnosis of NSTI, and did not have a CD4 count \<200 cells/mm3.

Age, Continuous
Age, Continuous(years)AB103 0.25 mg/kgAB103 0.5 mg/kgPlaceboTotal
Mean46.3 ± 13.650.1 ± 15.252.5 ± 20.450.9 ± 15.2
Sex: Female, Male
Sex: Female, Male(Participants)AB103 0.25 mg/kgAB103 0.5 mg/kgPlaceboTotal
Female46414
Male119626
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)AB103 0.25 mg/kgAB103 0.5 mg/kgPlaceboTotal
Hispanic or Latino2114
Not Hispanic or Latino1314936
Unknown or Not Reported0000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)AB103 0.25 mg/kgAB103 0.5 mg/kgPlaceboTotal
American Indian or Alaska Native0011
Asian0000
Native Hawaiian or Other Pacific Islander0000
Black or African American1113
White1414735
More than one race0000
Unknown or Not Reported0011
NSTI Diagnosis
NSTI Diagnosis(Participants)AB103 0.25 mg/kgAB103 0.5 mg/kgPlaceboTotal
Fournier Gangrene56213
Other NSTI109827
Body Mass Index (BMI)
Body Mass Index (BMI)(kg/m2)AB103 0.25 mg/kgAB103 0.5 mg/kgPlaceboTotal
Mean31.0 ± 6.531.7 ± 9.729.9 ± 9.331.5 ± 8.2
Acute Physiology And Chronic Health Evaluation II (APACHE II) Score
Acute Physiology And Chronic Health Evaluation II (APACHE II) Score(units on a scale)AB103 0.25 mg/kgAB103 0.5 mg/kgPlaceboTotal
Mean7.5 ± 5.08.3 ± 4.59.6 ± 4.78.3 ± 4.7
Sequential Organ Failure Assessment (SOFA) Score
Sequential Organ Failure Assessment (SOFA) Score(units on a scale)AB103 0.25 mg/kgAB103 0.5 mg/kgPlaceboTotal
Mean2.87 ± 2.703.47 ± 2.533.10 ± 1.973.15 ± 2.42

1 further baseline measures are reported on the registry.

08

Study locations

7 sites
  • University of Southern California Los Angeles
    Los Angeles, California, United States
  • San Francisco General Hospital
    San Francisco, California, United States
  • University of Florida
    Gainesville, Florida, United States
  • University of Maryland Medical Center
    Baltimore, Maryland 21201, United States
  • Oregon Health and Science University
    Portland, Oregon, United States
  • University of Pittsburgh Medical Center
    Pittsburgh, Pennsylvania 15261, United States
  • Harborview Medical Center
    Seattle, Washington 98104, United States
09

References and documents

Publications

  • Bulger EM, Maier RV, Sperry J, Joshi M, Henry S, Moore FA, Moldawer LL, Demetriades D, Talving P, Schreiber M, Ham B, Cohen M, Opal S, Segalovich I, Maislin G, Kaempfer R, Shirvan A. A Novel Drug for Treatment of Necrotizing Soft-Tissue Infections: A Randomized Clinical Trial. JAMA Surg. 2014 Jun;149(6):528-36. doi: 10.1001/jamasurg.2013.4841. PubMed 24740134 ↗
  • Bulger EM, Maislin G, Dankner W, May A, Edgar R, Shirvan A. Critical Care Medicine, January 2018,46(1):327. Abstract 682: Early Plasma Cytokine Levels Correlate With Outcome in Necrotizing Soft Tissue Infections. https://journals.lww.com/ccmjournal/Citation/2018/01001/682

Individual participant data

Plan to share: No

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Dec 2011 to primary completion in Sep 2012, 9 months.

Results were first posted in Aug 2021, 8 years 11 months after primary completion. A results delay was requested in Jan 2021.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 11, 2011
First posted
Aug 16, 2011
StartActual
Dec 2011
Primary completionActual
Sep 2012
CompletionActual
Sep 2012
Results delay requested
Jan 26, 2021
Results first posted
Aug 18, 2021
Last update
Aug 18, 2021
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 18, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01417780
Lead sponsor
Atox Bio Ltd
Responsible party
Sponsor
First posted
Aug 16, 2011
Start date
Dec 2011
Primary completion
Sep 2012
Completion
Sep 2012
Results posted
Aug 18, 2021
Last update
Aug 18, 2021

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: AB103

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