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Ceftazidime -avibactam

Phase 2

Complicated Urinary Tract Infections | Small molecule | Nephrology |Pfizer, Inc.|Last Updated: Jul 11, 2018

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
RandomizedACTIVE_CONTROLLEDDMCBiomarker
Total Trials1
Total Enrollment97
FDA Designations
No designations recorded
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT02497781Evaluation of Safety, Pharmacokinetics and Efficacy of Ceftazidime and Avibactam (CAZ-AVI ) Compared With Cefepime in Children From 3 Months to Less Than 18 Years of Age With Complicated Urinary Tract Infections (cUTIs)PHASE2 COMPLETED 97Sep 24, 2015Sep 15, 2017Jul 11, 201828 United States, Czechia +7
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Study Endpoints
Primary Endpoints
Percentage of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)
Baseline until the LFU visit (up to a maximum study duration of 50 days)

An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged in-patient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent AEs were events between first dose of study drug and up to late follow-up (LFU) visit (20 to 36 days after last dose of study treatment \[IV or oral\]) that were absent before treatment or that worsened relative to pretreatment state. AEs included both SAE and non-SAE.

Percentage of Participants With Cephalosporin Class Effects and Additional Adverse Events (AEs)
Baseline until the LFU visit (up to a maximum study duration of 50 days)

Percentage of participants with Cephalosporin class effects (defined as adverse event of special interest (AEoSI) within the safety topics (ST) of hypersensitivity/anaphylaxis) and additional AEs (which included AEs of diarrhea, renal disorder, hematological disorder and liver disorder relevant to the cephalosporin class within the safety topics (ST) based on MedDRA 20.0) were reported in this outcome measure.

Change From Baseline in Pulse Rate at End of Intravenous Treatment (EOIV) Visit
Baseline, EOIV visit (anytime from Day 4 to 15)

EOIV visit occurred within 24 hours after completion of last infusion of the study drug.

Change From Baseline in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) at End of Intravenous Treatment (EOIV) Visit
Baseline, EOIV visit (anytime from Day 4 to 15)

EOIV visit occurred within 24 hours after completion of last infusion of the study drug.

Change From Baseline in Respiratory Rate at End of Intravenous Treatment (EOIV) Visit
Baseline, EOIV visit (anytime from Day 4 to 15)

EOIV visit occurred within 24 hours after completion of last infusion of the study drug.

Change From Baseline in Body Temperature at End of Intravenous Treatment (EOIV) Visit
Baseline, EOIV visit (anytime from Day 4 to 15)

EOIV visit occurred within 24 hours after completion of last infusion of the study drug.

Percentage of Participants With Abnormal Physical Examination Findings at End of Intravenous Treatment (EOIV) Visit
EOIV visit (anytime from Day 4 to 15)

Physical examination included an assessment of the following: general appearance, skin, head and neck (including ears, eyes, nose and throat), lymph nodes, thyroid, respiratory system, cardiovascular system, abdomen, musculoskeletal system (including spine and extremities), and neurological system. Participants with new or aggravated abnormal physical examination findings with regard to baseline findings were reported. Abnormality in physical examinations were based on blinded observer's discretion. EOIV visit occurred within 24 hours after completion of last infusion of the study drug.

Change From Baseline in Body Weight at End of Intravenous Treatment (EOIV) Visit
Baseline, EOIV visit (anytime from Day 4 to 15)

EOIV visit occurred within 24 hours after completion of last infusion of the study drug.

Percentage of Participants With Potentially Clinically Significant Abnormalities in Laboratory Parameters
Baseline until the LFU visit (up to a maximum study duration of 50 days)

Criteria for potentially clinically significant laboratory abnormalities: hematology (platelets: \<0.4\*lower limit of normal \[LLN\], \>2\*upper limit of normal \[ULN\], \>40% decrease from baseline \[DFB\],\>100% Increase from baseline \[IFB\]; Chemistry (Bicarbonate: \<0.7\*LLN, \>1.3\*ULN, \>50% DFB, \>30% IFB).

Percentage of Participants With Potentially Clinically Significant Abnormalities in Electrocardiogram (ECG) Parameters
Baseline until the EOIV visit (anytime from Day 4 to 15)

PCS criteria for abnormal value of ECG parameters: QT interval \>=450 milliseconds (msec); 480 msec; \>=500 msec; Increase from baseline (IFB) of \>=30 msec; \>=60 msec and \>90 msec; Decrease from baseline (DFB) of \>=30 msec; \>=60 msec and \>90 msec. QT interval using Bazett's correction (QTcB): \>=450 milliseconds (msec); 480 msec; \>=500 msec; Increase from baseline (IFB) of \>=30 msec; \>=60 msec and \>90 msec; DFB of \>=30 msec; \>=60 msec and \>90 msec. QT interval using Fridericia's correction (QTcF): \>=450 msec; 480 msec; \>=500 msec; IFB of \>=30 msec; \>=60 msec and \>90 msec; DFB of \>=30 msec; \>=60 msec and \>90 msec. EOIV visit occurred within 24 hours after completion of last infusion of the study drug.

Percentage of Participants With Creatinine Clearance (CrCl) at Day 7
Day 7

CrCl is a measure of glomerular filtration rate (GMFR), an index of kidney function. It is the volume of blood plasma that is cleared of creatinine by the kidneys per unit time. Percentage of participants with CrCl in the following categories were reported: \<30 mL/min/1.73 m\^2, \>=30 to \<50 mL/min/1.73 m\^2, \>=50 mL/min/1.73 m\^2 to \<80 mL/min/1.73 m\^2, and \>=80 mL/min/1.73 m\^2.

Percentage of Participants With Creatinine Clearance (CrCl) at End of Intravenous Treatment (EOIV) Visit
EOIV visit (anytime from Day 4 to 15)

CrCl is a measure of glomerular filtration rate (GMFR), an index of kidney function. It is the volume of blood plasma that is cleared of creatinine by the kidneys per unit time. Percentage of participants with CrCl in the following categories were reported: \<30 mL/min/1.73 m\^2, \>=30 to \<50 mL/min/1.73 m\^2, \>=50 mL/min/1.73 m\^2 to \<80 mL/min/1.73 m\^2, and \>=80 mL/min/1.73 m\^2. EOIV visit occurred within 24 hours after completion of last infusion of the study drug.

Percentage of Participants With Creatinine Clearance (CrCl) at Test of Cure (TOC) Visit
TOC visit (up to a maximum study duration of 50 days)

CrCl is a measure of glomerular filtration rate (GMFR), an index of kidney function. It is the volume of blood plasma that is cleared of creatinine by the kidneys per unit time. Percentage of participants with CrCl in the following categories were reported: \<30 mL/min/1.73 m\^2, \>=30 to \<50 mL/min/1.73 m\^2, \>=50 mL/min/1.73 m\^2 to \<80 mL/min/1.73 m\^2, and \>=80 mL/min/1.73 m\^2. TOC visit occurred within 8 to 15 days after last dose of any study drug (IV or oral).

Secondary Endpoints
Plasma Concentrations of Ceftazidime and Avibactam
15, 30-90, 300-360 minutes post-dose on Day 3
Percentage of Participants With Favourable Clinical Response (CR): Intent-to-treat (ITT) Analysis Population
End of 72 hours study drug treatment, EOIV visit (anytime from Day 4 to 15), EOT visit (up to Day 16), TOC visit (up to a maximum study duration of 50 days)
Percentage of Participants With Favourable Clinical Response (CR): Microbiological ITT (Micro-ITT) Analysis Population
End of 72 hours study drug treatment, EOIV visit (anytime from Day 4 to 15), EOT visit (up to Day 16), TOC visit (up to a maximum study duration of 50 days)
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Study Design & Arms
AllocationRANDOMIZED
MaskingSINGLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
ceftazidime-avibactam (CAZ-AVI)EXPERIMENTALCAZ-AVI to be administered every 8 hours as a 2-hour infusion (CAZ-AVI dose and frequency of IV administration will depend upon body weight and renal function)
CefepimeACTIVE_COMPARATORPatients randomised to receive cefepime should receive the dose, schedule and infusion duration as recommended in the local prescribing information or as prescribed by the investigator. The maximum dose of cefepime in any single infusion should not exceed 2000 mg
Interventions
NameTypeDescription
Ceftazidime -avibactamDRUGPatients randomised (3:1) to the CAZ-AVI or cefepime treatment
CefepimeDRUGPatients randomised (3:1) to the CAZ-AVI or cefepime treatment
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Eligibility Criteria
Age Range3 Months — 17 Years
SexALL
Healthy VolunteersNo
Study Sites28

Inclusion Criteria: 1. Must be ≥3 calendar months to \<18 years of age. Patients aged ≥3 calendar months to \<1 year must have been born at term (defined as gestational age ≥37 weeks). 2. Written informed consent from parent(s) or other legally acceptable representative(s), and informed assent from...

Countries:United StatesCzechiaGreeceHungaryPolandRomaniaRussiaTaiwanTurkey (Türkiye)
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