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一项比较口服奈莫沙星与口服左氧氟沙星治疗社区获得性肺炎的疗效和安全性的随机、双盲、多中心 II 期研究。

A randomized, double-blind, multicenter Phase II study comparing the efficacy and safety of oral nemonoxacin with oral levofloxacin in the treatment of community-acquired pneumonia.

机构信息

Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China; China Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, China.

Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China; China Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, China.

出版信息

J Microbiol Immunol Infect. 2017 Dec;50(6):811-820. doi: 10.1016/j.jmii.2015.09.005. Epub 2015 Dec 1.

Abstract

BACKGROUND/PURPOSE: To compare the clinical efficacy and safety of nemonoxacin with levofloxacin in treating community-acquired pneumonia (CAP) in a Phase II clinical trial.

METHODS

One hundred ninety-two patients with CAP were randomized to receive oral nemonoxacin (500 mg or 750 mg) or levofloxacin (500 mg) once daily for 7-10 days. Clinical and bacteriological responses were determined at the test of cure (TOC) visit in the full analysis set (FAS).

RESULTS

The clinical cure rate of nemonoxacin (500 mg), nemonoxacin (750 mg), and levofloxacin (500 mg) was 93.3%, 87.3%, and 88.5%, respectively, in the FAS (n = 168), and 93.0%, 93.9%, and 88.9%, respectively in the per protocol set (n = 152). At the TOC visit, nemonoxacin at 500 mg and 750 mg was proven to be noninferior to levofloxacin at 500 mg in the FAS in terms of clinical efficacy. The overall bacteriological success rate was 83.3% in both nemonoxacin groups and 80.0% in the levofloxacin 500 mg group in the bacteriological FAS. The comprehensive efficacy rate was comparable among the three groups (87.5% for the nemonoxacin 500 mg group, 93.8% for the nemonoxacin 750 mg group, and 81.3% for the levofloxacin 500 mg group). Most drug-related adverse events were mild and transient, mainly gastrointestinal symptoms such as nausea and vomiting, transient neutropenia, and elevated liver enzymes. No drug-related serious adverse events occurred.

CONCLUSION

Either 500 mg or 750 mg of oral nemonoxacin taken once daily for 7-10 days demonstrated high clinical and bacteriological success rates in Chinese adult patients with CAP. Nemonoxacin at 500 mg once daily for 7-10 days is recommended for future Phase III clinical trials. ClinicalTrials.gov identifier: NCT01537250.

摘要

背景/目的:在一项 II 期临床试验中,比较奈诺沙星与左氧氟沙星治疗社区获得性肺炎(CAP)的临床疗效和安全性。

方法

192 例 CAP 患者被随机分为口服奈诺沙星(500mg 或 750mg)或左氧氟沙星(500mg),每天一次,疗程 7-10 天。在治疗结束时(TOC)访视,在全分析集(FAS)中评估临床和细菌学应答。

结果

奈诺沙星(500mg)、奈诺沙星(750mg)和左氧氟沙星(500mg)在 FAS(n=168)中的临床治愈率分别为 93.3%、87.3%和 88.5%,在方案集(n=152)中分别为 93.0%、93.9%和 88.9%。在 TOC 访视时,在 FAS 中,奈诺沙星 500mg 和 750mg 与左氧氟沙星 500mg 相比,疗效非劣效。奈诺沙星(500mg)和(750mg)的总体细菌学治愈率分别为 83.3%和 80.0%,左氧氟沙星 500mg 组为 80.0%。三组综合疗效率相当(奈诺沙星 500mg 组为 87.5%,奈诺沙星 750mg 组为 93.8%,左氧氟沙星 500mg 组为 81.3%)。大多数药物相关不良事件为轻度和短暂性的,主要为胃肠道症状如恶心和呕吐、一过性中性粒细胞减少和肝酶升高。无药物相关严重不良事件发生。

结论

中国成年 CAP 患者口服奈诺沙星 500mg 或 750mg,每天 1 次,疗程 7-10 天,具有较高的临床和细菌学治愈率。奈诺沙星 500mg,每天 1 次,疗程 7-10 天,推荐用于未来的 III 期临床试验。ClinicalTrials.gov 标识符:NCT01537250。

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