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Cadazolid

Phase 3

Clostridium Difficile Infection | Small molecule | Other |Johnson & Johnson|Last Updated: Feb 4, 2025

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindACTIVE_CONTROLLEDDMCBiomarker
Total Trials4
Total Enrollment1,353
FDA Designations
No designations recorded
Clinical Trials (4)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT01987895Efficacy and Safety of Cadazolid Versus Vancomycin in Subjects With Clostridium Difficile - Associated DiarrheaPHASE3 COMPLETED 632Mar 27, 2014Mar 24, 2017Feb 4, 2025 -
NCT01983683Efficacy and Safety of Cadazolid Versus Vancomycin in Subjects With Clostridium Difficile-associated DiarrheaPHASE3 COMPLETED 631Dec 12, 2013May 2, 2017Feb 4, 2025 -
NCT01222702Efficacy, Safety and Tolerability of Cadazolid in Subjects With Clostridium Difficile Associated Diarrhea (CDAD)PHASE2 COMPLETED 84Jan 25, 2011Nov 12, 2012Jun 14, 201723 United States, Canada +4
NCT02053181Study to Investigate the Pharmacokinetics and Safety of Cadazolid in Patients With Clostridium Difficile InfectionPHASE1 COMPLETED 6Aug 1, 2012Sep 1, 2012Feb 3, 20141 Croatia
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Study Endpoints
Primary Endpoints
Clinical Cure Rate (CCR) in the Modified Intent-to-treat Population
Up to Day 12 on average (end-of-treatment + 2 days)

Clinical Cure (CC) is defined as: • Resolution of Diarrhea (≤ 3 unformed bowel movement per day for at least 2 consecutive days) on study treatment and maintained for 2 days after end-of-treatment (EOT), AND • No additional antimicrobial treatment active against Clostridium difficile-associated diarrhea (CDAD) or fecal microbiota transplant between first dose of study drug and 2 days after EOT. CCR is the percentage of subjects with Clinical Cure. Analyses are performed on two analysis sets. Results on the modified intent-to-treat set (mITT) are reported below.

Clinical Cure Rate (CCR) in the Per-protocol Population
Up to Day 12 on average (end-of-treatment + 2 days)

Clinical Cure (CC) is defined as: • Resolution of Diarrhea (≤ 3 unformed bowel movement per day for at least 2 consecutive days) on study treatment and maintained for 2 days after end-of-treatment (EOT), AND • No additional antimicrobial treatment active against Clostridium difficile-associated diarrhea (CDAD) or fecal microbiota transplant between first dose of study drug and 2 days after EOT. CCR is the percentage of subjects with Clinical Cure. Analyses are performed on two analysis sets. Results on the per-protocol set (PPS) are reported below.

Clinical cure rate at test-of-cure
Day 13 or 24-72 hours after end of treatment

Percentages of subjects with clinical cure are calculated, with clinical cure being defined as resolution of diarrhea with no further Clostridium Difficile-associated diarrhea (CDAD) treatment required at test-of-cure (TOC) visit. Resolution of diarrhea was defined as the occurrence of ≤ 2 semi-formed or formed stools during 24 h for at least 2 consecutive 24 h periods.

Maximum plasma concentration (Cmax) of cadazolid
144 hours

Blood samples for pharmacokinetic analysis taken immediately prior to dosing with cadazolid, and at 0.5, 1, 2, 4, 6, 8, 12, 24, 36, 48, 72, 96, 120, and 144 hours after dosing. Cmax was calculated on the basis of the blood sampling time points.

Time to reach maximum plasma concentration (tmax) of cadazolid
144 hours

Blood samples for pharmacokinetic analysis taken immediately prior to dosing with cadazolid, and at 0.5, 1, 2, 4, 6, 8, 12, 24, 36, 48, 72, 96, 120, and 144 hours after dosing. tmax was calculated on the basis of the blood sampling time points.

Area under the plasma concentration-time curve (AUC(0-144h)) of cadazolid
144 hours

Blood samples for pharmacokinetic analysis taken immediately prior to dosing with cadazolid, and at 0.5, 1, 2, 4, 6, 8, 12, 24, 36, 48, 72, 96, 120, and 144 hours after dosing. AUC(0-144) was calculated according to the linear trapezoidal rule using the measured concentration-time values above the limit of quantification.

Unchanged cadazolid in urine up to Day 7
144 hours

Urine was collected into standard-weight polyethylene containers over the following time intervals: 0-12 h, 12-24 h, 24-36 h, 36-48 h, 48-72 h, 72-96 h, 96-120 h, and 120-144 h. The concentration of cadazolid was determined using validated liquid chromatography-tandem mass spectrometry assays. The amount of drug excreted in the urine was obtained by multiplying the concentration of drug by the volume of matrix collected.

Unchanged cadazolid in faeces up to Day 7
144 hours

Faeces were collected in pre-weighed polypropylene boxes. The concentration of cadazolid was determined using validated liquid chromatography-tandem mass spectrometry assays. The amount of drug excreted in the faeces was obtained by multiplying the concentration of drug by the volume of matrix collected.

Secondary Endpoints
Sustained Cure Rate (SCR) in the Modified Intent-to-treat Population
Between Day 38 and Day 42 on average (end-of-treatment + 28-32 days)
Kaplan-Meier Estimates for Resolution of Diarrhea
Up to Day 10
Change From Baseline to Day 3 in Clostridium Difficile Infection (CDI) Daily Symptoms Patient-Reported Outcome (CDI-DaySyms PRO) Domain Scores
Day 1 (baseline) and Day 3
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Study Design & Arms
AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
CadazolidEXPERIMENTALSubjects receive oral cadazolid 250 mg twice daily (bid) and oral vancomycin-matching placebo 4 times per day (qid) for 10 days
VancomycinACTIVE_COMPARATORSubjects receive oral vancomycin 125 mg qid and oral cadazolid-matching placebo bid for 10 days
Cadazolid 250 mgEXPERIMENTALSubjects received 250 mg of reconstituted cadazolid suspension twice daily and one placebo-matching vancomycin capsule four times daily for 10 days
Cadazolid 500 mgEXPERIMENTALSubjects received 500 mg of reconstituted cadazolid suspension twice daily and one placebo-matching vancomycin capsule four times daily for 10 days
Cadazolid 1000 mgEXPERIMENTALSubjects received 1000 mg of reconstituted cadazolid suspension twice daily and one placebo-matching vancomycin capsule four times daily for 10 days
Vancomycin 125 mgACTIVE_COMPARATORSubjects received one vancomycin capsule (125 mg) four times daily and reconstituted placebo-matching cadazolid suspension twice daily for 10 days
Interventions
NameTypeDescription
CadazolidDRUGCadazolid 250 mg as oral suspension twice daily.
VancomycinDRUGVancomycin 125 mg as oral capsules 4 times daily.
Cadazolid-matching placeboDRUGPlacebo matching cadazolid and administered orally twice daily
Vancomycin-matching placeboDRUGPlacebo capsules matching vancomycin and administered orally 4 times per day
Placebo-matching cadazolidDRUGPlacebo of cadazolid powder for oral suspension
Placebo-matching vancomycinDRUGPlacebo of vancomycin capsules
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo

Inclusion Criteria: * Signed Informed Consent. * Male or female ≥ 18 years of age. Females of childbearing potential must agree to use an adequate and reliable method of contraception. * Subject with a diagnosis of mild-moderate or severe CDAD (first occurrence or first recurrence within 3 months) ...

Countries:United StatesCanadaGermanyItalySwedenUnited KingdomCroatia
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