A Phase 3 interventional study of Dalbavancin and Dalbavancin-matching Placebo in Abscess, Wound Infection and Surgical Site Infection, sponsored by Durata Therapeutics Inc., an affiliate of Allergan plc. Completed at 78 sites in 12 countries. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2018-09-28.
Sponsored by Durata Therapeutics Inc., an affiliate of Allergan plc · Phase 3, Interventional, and Treatment
To compare the efficacy of treatment with a single dose of dalbavancin 1500 mg to treatment with a two dose regimen of dalbavancin (1000 mg on Day 1 followed by 500 mg on Day 8) in participants with known or suspected Gram-positive acute bacterial skin and skin structure infections (ABSSSI) at 48 -72 hours after initiation of treatment.
6,687 studies on the registry are indexed under Infections; 807 are open to participants now.
This study's enrollment of 698 is above the median of 120 across 4,200 interventional studies indexed under Infections.
Browse Infections studies →Durata Therapeutics Inc., an affiliate of Allergan plc is the lead sponsor of 6 studies on the registry; none are open to participants now.
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Exclusion Criteria:
Single-dose of dalbavancin 1500 mg intravenous (IV) infusion over 30 minutes on Day 1 followed by dalbavancin-matching placebo IV infusion over 30 minutes on Day 8 for participants with creatinine clearance (CrCl) ≥30 mL/min or with CrCl \<30 mL/min who were receiving regular hemodialysis or peritoneal dialysis. For participants with CrCl \<30 mL/min who were not receiving regular hemodialysis or peritoneal dialysis, the dalbavancin dose was 1000 mg.
Drug: Dalbavancin · Drug: Dalbavancin-matching Placebo
Two-dose regimen of dalbavancin 1000 mg IV infusion over 30 minutes on Day 1 followed by 500 mg IV infusion over 30 minutes on Day 8 for participants with CrCl ≥30 mL/min or with CrCl \<30 mL/min who were receiving regular hemodialysis or peritoneal dialysis. For participants with CrCl \<30 mL/min who were not receiving regular hemodialysis or peritoneal dialysis, the dalbavancin doses were 750 mg on Day 1 and 375 mg on Day 8.
Drug: Dalbavancin
Dalbavancin IV infusion over 30 minutes.
Also known as: DALVANCE®
Dalbavancin-matching placebo IV infusion over 30 minutes.
Percentage of Participants Who Were Clinical Responders 48-72 Hours After the Initiation of Study Drug
Clinical responder was defined as a participant who was alive and had received no rescue therapy for acute bacterial skin and skin structure infection (ABSSSI) prior to the 48-72 hour infection site assessment (if an antibiotic has been given for another reason, the participant will not be considered a non-responder for this reason); and examination of the participant's ABSSSI lesion demonstrates a decrease of ≥ 20% in lesion area (calculated as the longest length multiplied by the longest perpendicular width) relative to the baseline measurement.
Time frame: Up to 48-72 hours after the initiation of study drug
Percentage of Participants by Clinical Status at End of Treatment (EOT) and Final Visit (FV)
Clinical Success is defined as follows: For evaluation at EOT visit, lesion area must be decreased by ≥80% from baseline and at FV lesion area must be decreased by ≥90% from baseline; Temperature is ≤37.6°C; Local signs of tenderness to palpation and swelling/induration are no worse than mild; For evaluation at EOT visit, local signs of fluctuance and localized heat/warmth must be improved from baseline and no worse than mild, and at FV local signs of fluctuance and localized heat/warmth must be absent; for participants with a wound infection the severity of purulent drainage is improved and no worse than mild relative to baseline. Clinical Failure is defined as the opposite to success or if the participant died during the study period up to visit or received study therapy for ABSSSI beyond the protocol treatment period. Clinical status is Indeterminate if any of the data needed to determine clinical success or clinical failure were missing.
Time frame: End of Treatment (Day 14-15 after the initiation of study drug) and Final Visit (28 ±2 days after the initiation of study drug)
Percentage of Participants by Clinical Status Based on Localized Fluctuance and Heat/Warmth at End of Treatment (EOT)
Clinical Success was defined as localized fluctuance and heat/warmth that if present at Baseline must be improved and no worse than mild. Clinical Failure was defined as the opposite to success. Clinical status was Indeterminate if any of the data needed to determine clinical success or clinical failure were missing.
Time frame: EOT (Day 14-15)
Percentage of Participants by Investigator Assessment of Clinical Outcome
A successful outcome was based on resolution or improvement of all signs and symptoms of the infection to such an extent that no further antibacterial treatment was given. An unsuccessful outcome was the opposite of successful. An Indeterminate outcome was defined as any of the data needed to determine a successful or unsuccessful outcome were missing.
Time frame: Day 3-4, Day 8, EOT (Day 14-15) and Final Visit (Day 28 +/- 2 days)
Percentage of Participants Achieving Clinical Outcome of Success Based on Key Target Pathogen at Baseline
A successful outcome was based on resolution or improvement of all signs and symptoms of the infection to such an extent that no further antibacterial treatment was given.
Time frame: Day 3-4 and EOT (Day 14-15)
Percentage of Participants With Complete Resolution of Local Signs of Infection
Resolution of Local Signs of Infection that include absence of purulence/drainage, erythema, heat/localized warmth, pain/tenderness to palpation, fluctuance, and swelling/induration.
Time frame: Day 3-4, Day 8, EOT (Day 14-15) and Final Visit (Day 28 +/- 2 days)
Change From Baseline in Participant's Assessment of Pain
Using the Brief Pain Inventory Scale, participants rated their pain "right now" on a scale where: 0=no pain to 10=pain as bad as you can imagine. A negative change from Baseline indicated improvement.
Time frame: Baseline (Day 0) to Day 3-4, Day 8, EOT (Day 14-15) and Final Visit (Day 28 + /- 2 days)
Percentage of Participants by Resource Utilization Categories
Resource Utilization Categories included: Any additional visits (including urgent care), Any additional procedures, Any additional tests, Any home visits or nursing care and Any ER Visits. The percentage of participants in each category is reported.
Time frame: Final Visit (Day 28 +/- 2 days)
Percentage of Participants by Skin and Soft Tissue Infection-Convenience (SSTI-C) Questionnaire: Overall Satisfaction Response
The SSTI-C Questionnaire is an 11-item self-reported questionnaire that measures subjective experiences of the participant. One of the items assessed was overall satisfaction with treatment. Participants answered the question: "Overall, how satisfied were you with your antibiotic treatment?" using one of the following responses: Extremely satisfied, Moderately satisfied, Not at all satisfied, Slightly satisfied and Very satisfied. The percentage of participants in each category is reported.
Time frame: EOT (Day 14-15)
| Milestone | Single-Dose Dalbavancin | Two-Dose Dalbavancin |
|---|---|---|
| Started | 349 | 349 |
| Completed | 323 | 322 |
| Not completed | 26 | 27 |
| Withdrew: Adverse event | 2 | 1 |
| Withdrew: Death | 1 | 1 |
| Withdrew: Lost to follow-up | 14 | 14 |
| Withdrew: Reason not specified | 4 | 7 |
| Withdrew: Pregnancy | 0 | 1 |
| Withdrew: Subject withdrew consent | 5 | 3 |
Clinical responder was defined as a participant who was alive and had received no rescue therapy for acute bacterial skin and skin structure infection (ABSSSI) prior to the 48-72 hour infection site assessment (if an antibiotic has been given for another reason, the participant will not be considered a non-responder for this reason); and examination of the participant's ABSSSI lesion demonstrates a decrease of ≥ 20% in lesion area (calculated as the longest length multiplied by the longest perpendicular width) relative to the baseline measurement.
| percentage of participants | Single-Dose Dalbavancin | Two-Dose Dalbavancin |
|---|---|---|
| Percentage of Participants Who Were Clinical Responders 48-72 Hours After the Initiation of Study Drug | 81.4 | 84.2 |
Clinical Success is defined as follows: For evaluation at EOT visit, lesion area must be decreased by ≥80% from baseline and at FV lesion area must be decreased by ≥90% from baseline; Temperature is ≤37.6°C; Local signs of tenderness to palpation and swelling/induration are no worse than mild; For evaluation at EOT visit, local signs of fluctuance and localized heat/warmth must be improved from baseline and no worse than mild, and at FV local signs of fluctuance and localized heat/warmth must be absent; for participants with a wound infection the severity of purulent drainage is improved and no worse than mild relative to baseline. Clinical Failure is defined as the opposite to success or if the participant died during the study period up to visit or received study therapy for ABSSSI beyond the protocol treatment period. Clinical status is Indeterminate if any of the data needed to determine clinical success or clinical failure were missing.
| percentage of participants | Single-Dose Dalbavancin | Two-Dose Dalbavancin |
|---|---|---|
| EOT; Clinical Success | 84.0 | 84.8 |
| EOT; Clinical Failure | 12.0 | 10.3 |
| EOT; Indeterminate | 4.0 | 4.9 |
| FV; Clinical Success | 84.5 | 85.1 |
| FV; Clinical Failure | 8.0 | 7.2 |
| FV; Indeterminate | 7.4 | 7.3 |
Clinical Success was defined as localized fluctuance and heat/warmth that if present at Baseline must be improved and no worse than mild. Clinical Failure was defined as the opposite to success. Clinical status was Indeterminate if any of the data needed to determine clinical success or clinical failure were missing.
| percentage of participants | Single-Dose Dalbavancin | Two-Dose Dalbavancin |
|---|---|---|
| Clinical Success | 84.8 | 85.4 |
| Clinical Failure | 7.7 | 6.9 |
| Indeterminate | 7.4 | 7.7 |
A successful outcome was based on resolution or improvement of all signs and symptoms of the infection to such an extent that no further antibacterial treatment was given. An unsuccessful outcome was the opposite of successful. An Indeterminate outcome was defined as any of the data needed to determine a successful or unsuccessful outcome were missing.
| percentage of participants | Single-Dose Dalbavancin | Two-Dose Dalbavancin |
|---|---|---|
| Successful Outcome (Day 3-4) | 93.4 | 93.0 |
| Unsuccessful Outcome (Day 3-4) | 0.3 | 0.9 |
| Indeterminate (Day 3-4) | 6.3 | 6.1 |
| Successful Outcome (Day 8) | 92.2 | 93.3 |
| Unsuccessful Outcome (Day 8) | 0.6 | 0.3 |
| Indeterminate (Day 8) | 7.2 | 6.4 |
| Successful Outcome (EOT) | 92.5 | 92.7 |
| Unsuccessful Outcome (EOT) | 2.9 | 1.5 |
| Indeterminate (EOT) | 4.6 | 5.8 |
| Successful Outcome (Final Visit) | 90.2 | 91.0 |
| Unsuccessful Outcome (Final Visit) | 2.6 | 1.7 |
| Indeterminate (Final Visit) | 7.2 | 7.3 |
A successful outcome was based on resolution or improvement of all signs and symptoms of the infection to such an extent that no further antibacterial treatment was given.
| percentage of participants | Single-Dose Dalbavancin | Two-Dose Dalbavancin |
|---|---|---|
| Staphylococcus aureus (Day 3-4) | 88.5 | 85.3 |
| Streptococcus agalactiae (Day 3-4) | 100.0 | 66.7 |
| Streptococcus anginosus group (Day 3-4) | 93.9 | 100.0 |
| Streptococcus dysgalactiae (Day 3-4) | 100.0 | 100.0 |
| Streptococcus pyogenes (Day 3-4) | 100.0 | 81.8 |
| Enterococcus faecalis (Day 3-4) | 100.0 | 80.0 |
| Staphylococcus aureus (EOT) | 87.8 | 91.7 |
| Streptococcus agalactiae (EOT) | 83.3 | 83.3 |
| Streptococcus anginosus group (EOT) | 81.8 | 89.5 |
| Streptococcus dysgalactiae (EOT) | 100.0 | 100.0 |
| Streptococcus pyogenes (EOT) | 92.9 | 81.8 |
| Enterococcus faecalis (EOT) | 100.0 | 100.0 |
Resolution of Local Signs of Infection that include absence of purulence/drainage, erythema, heat/localized warmth, pain/tenderness to palpation, fluctuance, and swelling/induration.
| percentage of participants | Single-Dose Dalbavancin | Two-Dose Dalbavancin |
|---|---|---|
| Day 3-4 | 1.9 | 1.5 |
| Day 8 | 22.3 | 21.1 |
| EOT Visit | 56.3 | 56.2 |
| Final Visit | 85.8 | 89.8 |
Using the Brief Pain Inventory Scale, participants rated their pain "right now" on a scale where: 0=no pain to 10=pain as bad as you can imagine. A negative change from Baseline indicated improvement.
| Scores on a scale | Single-Dose Dalbavancin | Two-Dose Dalbavancin |
|---|---|---|
| Baseline | 7.7 ± 2.09 | 7.8 ± 2.12 |
| Change from Baseline to Day 3-4 | -3.9 ± 2.46 | -3.8 ± 2.43 |
| Change from Baseline to Day 8 | -5.9 ± 2.53 | -5.8 ± 2.68 |
| Change from Baseline to EOT Visit | -6.9 ± 2.37 | -6.9 ± 2.53 |
| Change from Baseline to Final Visit | -7.5 ± 2.19 | -7.4 ± 2.40 |
Resource Utilization Categories included: Any additional visits (including urgent care), Any additional procedures, Any additional tests, Any home visits or nursing care and Any ER Visits. The percentage of participants in each category is reported.
| percentage of participants | Single-Dose Dalbavancin | Two-Dose Dalbavancin |
|---|---|---|
| Any Additional Visits (including Urgent Care) | 1.2 | 0.6 |
| Any Additional Procedures | 1.5 | 1.6 |
| Any Additional Tests | 1.9 | 2.8 |
| Any Home Visits or Home Nursing Care | 1.5 | 1.2 |
| Any ER Visits | 0.3 | 0.9 |
The SSTI-C Questionnaire is an 11-item self-reported questionnaire that measures subjective experiences of the participant. One of the items assessed was overall satisfaction with treatment. Participants answered the question: "Overall, how satisfied were you with your antibiotic treatment?" using one of the following responses: Extremely satisfied, Moderately satisfied, Not at all satisfied, Slightly satisfied and Very satisfied. The percentage of participants in each category is reported.
| percentage of participants | Single-Dose Dalbavancin | Two-Dose Dalbavancin |
|---|---|---|
| Extremely Satisfied | 53.6 | 56.9 |
| Moderately Satisfied | 9.5 | 7.2 |
| Not at all Satisfied | 0.9 | 0.9 |
| Slightly Satisfied | 0.3 | 0.9 |
| Very Satisfied | 35.8 | 33.7 |
Collected over Up to 28 Days. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Single-Dose Dalbavancin | 1/349 (0.3%) | 7/349 (2%) | 0/349 (0%) |
| Two-Dose Dalbavancin | 1/346 (0.3%) | 5/346 (1.4%) | 0/346 (0%) |
| Event | Single-Dose Dalbavancin | Two-Dose Dalbavancin |
|---|---|---|
| Skin bacterial infectionInfections and infestations | 2/349 | 0/346 |
| Clostridium difficile colitisInfections and infestations | 0/349 | 1/346 |
| Necrotising fasciitisInfections and infestations | 0/349 | 1/346 |
| Renal failure acuteRenal and urinary disorders | 0/349 | 1/346 |
| Pulmonary embolismRespiratory, thoracic and mediastinal disorders | 0/349 | 1/346 |
| UrticariaSkin and subcutaneous tissue disorders | 0/349 | 1/346 |
| Vitreous haemorrhageEye disorders | 1/349 | 0/346 |
| PneumoniaInfections and infestations | 1/349 | 0/346 |
| SepsisInfections and infestations | 1/349 | 0/346 |
| Toxicity to various agentsInjury, poisoning and procedural complications | 1/349 | 0/346 |
Intent-to-treat (ITT) Population included all randomized participants.
| Age, Continuous(years) | Single-Dose Dalbavancin | Two-Dose Dalbavancin | Total |
|---|---|---|---|
| Mean | 48.0 ± 14.83 | 48.3 ± 14.74 | 48.2 ± 14.78 |
| Sex: Female, Male(Participants) | Single-Dose Dalbavancin | Two-Dose Dalbavancin | Total |
|---|---|---|---|
| Female | 145 | 146 | 291 |
| Male | 204 | 203 | 407 |
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Durata Therapeutics Inc., an affiliate of Allergan plc