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一项比较德拉氟沙星与莫西沙星治疗成人社区获得性细菌性肺炎的3期研究(DEFINE-CABP)。

A Phase 3 Study to Compare Delafloxacin With Moxifloxacin for the Treatment of Adults With Community-Acquired Bacterial Pneumonia (DEFINE-CABP).

作者信息

Horcajada Juan P, Salata Robert A, Álvarez-Sala Rodolfo, Nitu Floarea Mimi, Lawrence Laura, Quintas Megan, Cheng Chun-Yen, Cammarata Sue

机构信息

Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona and Universitat Pompeu Fabra, Barcelona, Spain.

Case Western Reserve University, Cleveland, Ohio, USA.

出版信息

Open Forum Infect Dis. 2019 Dec 5;7(1):ofz514. doi: 10.1093/ofid/ofz514. eCollection 2020 Jan.

Abstract

BACKGROUND

The clinical and economic burden of community-acquired bacterial pneumonia (CABP) is significant and is anticipated to increase as the population ages and pathogens become more resistant. Delafloxacin is a fluoroquinolone antibiotic approved in the United States for the treatment of adults with acute bacterial skin and skin structure infections. Delafloxacin's shape and charge profile uniquely impact its spectrum of activity and side effect profile. This phase 3 study compared the efficacy and safety of delafloxacin with moxifloxacin for the treatment of CABP.

METHODS

A randomized, double-blind, comparator-controlled, multicenter, global phase 3 study compared the efficacy and safety of delafloxacin 300 mg twice daily or moxifloxacin 400 mg once daily in adults with CABP. The primary end point was early clinical response (ECR), defined as improvement at 96 (±24) hours after the first dose of study drug. Clinical response at test of cure (TOC) and microbiologic response were also assessed.

RESULTS

In the intent-to-treat analysis population (ITT), ECR rates were 88.9% in the delafloxacin group and 89.0% in the moxifloxacin group. Noninferiority of delafloxacin compared with moxifloxacin was demonstrated. At TOC in the ITT population, the success rates were similar between groups. Treatment-emergent adverse events that were considered at least possibly related to the study drug occurred in 65 subjects (15.2%) in the delafloxacin group and 54 (12.6%) in the moxifloxacin group.

CONCLUSIONS

Intravenous/oral delafloxacin monotherapy is effective and well tolerated in the treatment of adults with CABP, providing coverage for Gram-positive, Gram-negative, and atypical pathogens.

CLINICALTRIALSGOV IDENTIFIER

NCT03534622.

摘要

背景

社区获得性细菌性肺炎(CABP)的临床和经济负担很重,且随着人口老龄化和病原体耐药性增强,预计负担还会增加。德拉氟沙星是一种在美国被批准用于治疗成人急性细菌性皮肤及皮肤结构感染的氟喹诺酮类抗生素。德拉氟沙星的形状和电荷分布对其活性谱和副作用谱有独特影响。这项3期研究比较了德拉氟沙星与莫西沙星治疗CABP的疗效和安全性。

方法

一项随机、双盲、对照、多中心、全球3期研究比较了每日两次口服300 mg德拉氟沙星或每日一次口服400 mg莫西沙星治疗成人CABP的疗效和安全性。主要终点是早期临床反应(ECR),定义为在首次服用研究药物后96(±24)小时病情改善。还评估了治愈测试(TOC)时的临床反应和微生物学反应。

结果

在意向性分析人群(ITT)中,德拉氟沙星组的ECR率为88.9%,莫西沙星组为89.0%。证明了德拉氟沙星与莫西沙星相比具有非劣效性。在ITT人群的TOC时,两组的成功率相似。德拉氟沙星组有65名受试者(15.2%)、莫西沙星组有54名受试者(12.6%)发生了被认为至少可能与研究药物相关的治疗中出现的不良事件。

结论

静脉注射/口服德拉氟沙星单药治疗成人CABP有效且耐受性良好,可覆盖革兰氏阳性、革兰氏阴性和非典型病原体。

临床试验注册号

NCT03534622。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768b/6975251/7eb9bff0a7b9/ofz514f0001.jpg

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