Trial Outcomes & Findings for Retapamulin Versus Placebo in Secondarily-Infected Traumatic Lesions (SITL) (NCT NCT00684177)

NCT ID: NCT00684177

Last Updated: 2016-11-23

Results Overview

"Clinical Success" at follow-up was defined as "Resolution of clinically meaningful signs and symptoms of infection recorded at baseline including a pus/exudate Skin Infection Rating Scale (SIRS) score of "0". Clinical response at follow-up was classified as "Clinical Failure" for all other cases. The SIRS consists of seven items (pus/exudates, crusting, erythema/inflammation, tissue warmth, tissue edema, itching and pain). Each item has a score ranging from 0 to 6 (0=absent, 6=severe). The SIRS total score was calculated as the sum of the scores of all 7 SIRS items.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

508 participants

Primary outcome timeframe

Days 12-14

Results posted on

2016-11-23

Participant Flow

A total of 508 participants were randomized. One participant did not receive treatment; thus, no data were collected for this participant. Only 507 participants were included in the analysis.

Participant milestones

Participant milestones
Measure
Retapamulin
Topical retapamulin ointment, 1% twice daily for 5 days
Placebo
Matching placebo
Overall Study
STARTED
343
164
Overall Study
COMPLETED
322
141
Overall Study
NOT COMPLETED
21
23

Reasons for withdrawal

Reasons for withdrawal
Measure
Retapamulin
Topical retapamulin ointment, 1% twice daily for 5 days
Placebo
Matching placebo
Overall Study
Adverse Event
4
3
Overall Study
Lack of Efficacy
10
15
Overall Study
Protocol Violation
1
0
Overall Study
Lost to Follow-up
2
1
Overall Study
Physician Decision
2
0
Overall Study
Withdrawal by Subject
1
2
Overall Study
Other
1
2

Baseline Characteristics

Retapamulin Versus Placebo in Secondarily-Infected Traumatic Lesions (SITL)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Retapamulin
n=343 Participants
Topical retapamulin ointment, 1% twice daily for 5 days
Placebo
n=164 Participants
Matching placebo
Total
n=507 Participants
Total of all reporting groups
Age, Continuous
32.6 years
STANDARD_DEVIATION 18.77 • n=93 Participants
28.6 years
STANDARD_DEVIATION 18.32 • n=4 Participants
31.3 years
STANDARD_DEVIATION 18.70 • n=27 Participants
Sex: Female, Male
Female
144 Participants
n=93 Participants
63 Participants
n=4 Participants
207 Participants
n=27 Participants
Sex: Female, Male
Male
199 Participants
n=93 Participants
101 Participants
n=4 Participants
300 Participants
n=27 Participants
Race/Ethnicity, Customized
African American/African Heritage
144 participants
n=93 Participants
71 participants
n=4 Participants
215 participants
n=27 Participants
Race/Ethnicity, Customized
American Indian or Alaskan Native
9 participants
n=93 Participants
3 participants
n=4 Participants
12 participants
n=27 Participants
Race/Ethnicity, Customized
Asian - Central / South Asian Heritage
0 participants
n=93 Participants
1 participants
n=4 Participants
1 participants
n=27 Participants
Race/Ethnicity, Customized
Asian - East Asian Heritage
4 participants
n=93 Participants
2 participants
n=4 Participants
6 participants
n=27 Participants
Race/Ethnicity, Customized
Asian - South East Asian Heritage
33 participants
n=93 Participants
15 participants
n=4 Participants
48 participants
n=27 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
1 participants
n=93 Participants
2 participants
n=4 Participants
3 participants
n=27 Participants
Race/Ethnicity, Customized
White - Arabic/North African Heritage
1 participants
n=93 Participants
0 participants
n=4 Participants
1 participants
n=27 Participants
Race/Ethnicity, Customized
White - White/Caucasian/European Heritage
132 participants
n=93 Participants
61 participants
n=4 Participants
193 participants
n=27 Participants
Race/Ethnicity, Customized
Mixed Race
19 participants
n=93 Participants
9 participants
n=4 Participants
28 participants
n=27 Participants

PRIMARY outcome

Timeframe: Days 12-14

Population: Primary Efficacy Population: ITTC participants (par.) with baseline pus/exudate \>=3 who were enrolled under the original protocol with data captured under eCRF V1 and who were enrolled under protocol amendments with data captured under eCRF V2; ITTC (Intent-to-treat Clinical): all randomized par. who received at least one dose of study medication.

"Clinical Success" at follow-up was defined as "Resolution of clinically meaningful signs and symptoms of infection recorded at baseline including a pus/exudate Skin Infection Rating Scale (SIRS) score of "0". Clinical response at follow-up was classified as "Clinical Failure" for all other cases. The SIRS consists of seven items (pus/exudates, crusting, erythema/inflammation, tissue warmth, tissue edema, itching and pain). Each item has a score ranging from 0 to 6 (0=absent, 6=severe). The SIRS total score was calculated as the sum of the scores of all 7 SIRS items.

Outcome measures

Outcome measures
Measure
Retapamulin
n=246 Participants
Topical retapamulin ointment, 1% twice daily for 5 days
Placebo
n=113 Participants
Matching placebo
Number of Participants With Clinical Success and Failure at Follow-up (7-9 Days Post Therapy) for the Primary Efficacy Population
Clinical Success
184 participants
75 participants
Number of Participants With Clinical Success and Failure at Follow-up (7-9 Days Post Therapy) for the Primary Efficacy Population
Clinical Failure
62 participants
38 participants

SECONDARY outcome

Timeframe: Days 12-14

Population: ITTB subset of Primary Efficacy Population: participants in the Primary Efficacy Population (see analysis population description in the Primary Outcome section) who had at least one pathogen isolated at the baseline visit.

"Clinical Success" at follow-up was defined as "Resolution of clinically meaningful signs and symptoms of infection recorded at baseline including a pus/exudate Skin Infection Rating Scale (SIRS) score of "0". Clinical response at follow-up was classified as "Clinical Failure" for all other cases. The SIRS consists of seven items (pus/exudates, crusting, erythema/inflammation, tissue warmth, tissue edema, itching and pain). Each item has a score ranging from 0 to 6 (0=absent, 6=severe). The SIRS total score was calculated as the sum of the scores of all 7 SIRS items.

Outcome measures

Outcome measures
Measure
Retapamulin
n=182 Participants
Topical retapamulin ointment, 1% twice daily for 5 days
Placebo
n=84 Participants
Matching placebo
Number of Participants With Clinical Success and Failure at Follow-up (7-9 Days Post Therapy) for the Intent-to-Treat Bacteriology (ITTB) Subset of the Primary Efficacy Population
Clinical Failure
43 participants
30 participants
Number of Participants With Clinical Success and Failure at Follow-up (7-9 Days Post Therapy) for the Intent-to-Treat Bacteriology (ITTB) Subset of the Primary Efficacy Population
Clinical Success
139 participants
54 participants

SECONDARY outcome

Timeframe: Days 12-14

Population: ITTB subset of Primary Efficacy Population

The "by pathogen" microbiological outcome was determined by comparing the baseline culture results to those at follow-up. The "by subject" microbiological response was "Microbiological Success" if the microbiological outcomes for all baseline pathogens (bps) belong to "Eradication" (elimination of bps), "Presumed Eradication" (clinical outcome was success; no culture was obtained due to lack of culturable material), or "Colonization" (previously unidentified pathogen is identified at end of therapy in participant who is resolved/improved); otherwise, response was "Microbiological Failure".

Outcome measures

Outcome measures
Measure
Retapamulin
n=182 Participants
Topical retapamulin ointment, 1% twice daily for 5 days
Placebo
n=84 Participants
Matching placebo
Number of Participants With Microbiological Success and Failure at Follow-up (7-9 Days Post Therapy)
Microbiological Success
139 participants
54 participants
Number of Participants With Microbiological Success and Failure at Follow-up (7-9 Days Post Therapy)
Microbiological Failure
43 participants
30 participants

SECONDARY outcome

Timeframe: Days 7-9

Population: Primary Efficacy Population

Clinical outcome is determined by the investigator based on signs and symptoms (S/S) at the end of therapy evaluation. The 4 clincal outcome categories are: clinical success, resolution of clinically meaningful S/S of infection recorded at baseline (BL), including a pus/exudates score of 0; clinical improvement, improvement of S/S of infection recorded at BL to such an extent that no further antimicrobial therapy is necessary; clinical failure, insufficient improvement of deterioration of S/S of infection recorded at BL such that additional antibiotic therapy is required; unable to determine.

Outcome measures

Outcome measures
Measure
Retapamulin
n=246 Participants
Topical retapamulin ointment, 1% twice daily for 5 days
Placebo
n=113 Participants
Matching placebo
Number of Participants With the Indicated Clinical Outcome at End of Therapy (2-4 Days Post Therapy)
Clinical Failure
11 participants
14 participants
Number of Participants With the Indicated Clinical Outcome at End of Therapy (2-4 Days Post Therapy)
Unable to Determine
3 participants
2 participants
Number of Participants With the Indicated Clinical Outcome at End of Therapy (2-4 Days Post Therapy)
Clinical Improvement
102 participants
45 participants
Number of Participants With the Indicated Clinical Outcome at End of Therapy (2-4 Days Post Therapy)
Clinical Success
130 participants
52 participants

SECONDARY outcome

Timeframe: Days 7-9

Population: ITTB subset of Primary Efficacy Population

The "by pathogen" microbiological outcome was determined by comparing the baseline culture results to those at follow-up. The results presented below pooled all baseline pathogens (bps). Eradication: elimination of bps. Presumed Eradication: clinical outcome was success; no culture was obtained due to lack of culturable material. Presumed Improvement: clinical outcome was improvement such that no culture was obtained due to lack of culturable material. Persistence: bps still present. Presumed persistence: clinical failure and no culture was obtained.

Outcome measures

Outcome measures
Measure
Retapamulin
n=243 Participants
Topical retapamulin ointment, 1% twice daily for 5 days
Placebo
n=110 Participants
Matching placebo
Number of Baseline Pathogens With the Indicated Microbiological Outcome at End of Therapy (2-4 Days Post Therapy)
Eradication
4 baseline pathogens
5 baseline pathogens
Number of Baseline Pathogens With the Indicated Microbiological Outcome at End of Therapy (2-4 Days Post Therapy)
Presumed Eradication
137 baseline pathogens
49 baseline pathogens
Number of Baseline Pathogens With the Indicated Microbiological Outcome at End of Therapy (2-4 Days Post Therapy)
Presumed Improvement
94 baseline pathogens
35 baseline pathogens
Number of Baseline Pathogens With the Indicated Microbiological Outcome at End of Therapy (2-4 Days Post Therapy)
Persistence
3 baseline pathogens
13 baseline pathogens
Number of Baseline Pathogens With the Indicated Microbiological Outcome at End of Therapy (2-4 Days Post Therapy)
Presumed Persistence
5 baseline pathogens
8 baseline pathogens

SECONDARY outcome

Timeframe: Follow-up (Days 12-14)

Population: ITTB subset of Primary Efficacy Population

"Therapeutic Success (Succ)" was referred to as both "Clinical Succ" and "Microbiological (Micro) Succ" at Follow-up. "Clinical Succ" was the "Resolution of baseline signs/symptoms of infection with a pus score of "0." A participant was "Micro Succ" if the micro outcome for all baseline pathogens (bps) belonged to "Eradication" (elimination of bps), "Presumed Eradication" (clinical outcome is success; no culturable material), or "Colonization" (new pathogen is identified at end of therapy in participants who are resolved/improved). All other combinations were deemed "Therapeutic Failures."

Outcome measures

Outcome measures
Measure
Retapamulin
n=182 Participants
Topical retapamulin ointment, 1% twice daily for 5 days
Placebo
n=84 Participants
Matching placebo
Number of Participants With Therapeutic Success and Failure at Follow-up (7-9 Days Post Therapy)
Success
139 participants
54 participants
Number of Participants With Therapeutic Success and Failure at Follow-up (7-9 Days Post Therapy)
Failure
43 participants
30 participants

Adverse Events

Retapamulin

Serious events: 1 serious events
Other events: 8 other events
Deaths: 0 deaths

Placebo

Serious events: 1 serious events
Other events: 4 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Retapamulin
n=342 participants at risk
Topical retapamulin ointment, 1% twice daily for 5 days
Placebo
n=165 participants at risk
Matching placebo
Cardiac disorders
Myocardial infarction
0.29%
1/342 • Adverse events (AEs) were recorded from the first dose of study medication until study completion. Serious AEs (SAEs) were collected from the time of consent and continued until study completion (including the Follow-up Period).
AEs were collected for all randomized participants (par.) who received at least one dose of study medications (i.e., ITTC Population). Safety data were analyzed based on the actual treatment received. One par. who was randomized to retapamulin treatment but actually received placebo was included in the placebo arm for the safety analyses.
0.00%
0/165 • Adverse events (AEs) were recorded from the first dose of study medication until study completion. Serious AEs (SAEs) were collected from the time of consent and continued until study completion (including the Follow-up Period).
AEs were collected for all randomized participants (par.) who received at least one dose of study medications (i.e., ITTC Population). Safety data were analyzed based on the actual treatment received. One par. who was randomized to retapamulin treatment but actually received placebo was included in the placebo arm for the safety analyses.
Infections and infestations
Pneumococcal pneumonia
0.00%
0/342 • Adverse events (AEs) were recorded from the first dose of study medication until study completion. Serious AEs (SAEs) were collected from the time of consent and continued until study completion (including the Follow-up Period).
AEs were collected for all randomized participants (par.) who received at least one dose of study medications (i.e., ITTC Population). Safety data were analyzed based on the actual treatment received. One par. who was randomized to retapamulin treatment but actually received placebo was included in the placebo arm for the safety analyses.
0.61%
1/165 • Adverse events (AEs) were recorded from the first dose of study medication until study completion. Serious AEs (SAEs) were collected from the time of consent and continued until study completion (including the Follow-up Period).
AEs were collected for all randomized participants (par.) who received at least one dose of study medications (i.e., ITTC Population). Safety data were analyzed based on the actual treatment received. One par. who was randomized to retapamulin treatment but actually received placebo was included in the placebo arm for the safety analyses.

Other adverse events

Other adverse events
Measure
Retapamulin
n=342 participants at risk
Topical retapamulin ointment, 1% twice daily for 5 days
Placebo
n=165 participants at risk
Matching placebo
General disorders
Application site pain
1.5%
5/342 • Adverse events (AEs) were recorded from the first dose of study medication until study completion. Serious AEs (SAEs) were collected from the time of consent and continued until study completion (including the Follow-up Period).
AEs were collected for all randomized participants (par.) who received at least one dose of study medications (i.e., ITTC Population). Safety data were analyzed based on the actual treatment received. One par. who was randomized to retapamulin treatment but actually received placebo was included in the placebo arm for the safety analyses.
0.00%
0/165 • Adverse events (AEs) were recorded from the first dose of study medication until study completion. Serious AEs (SAEs) were collected from the time of consent and continued until study completion (including the Follow-up Period).
AEs were collected for all randomized participants (par.) who received at least one dose of study medications (i.e., ITTC Population). Safety data were analyzed based on the actual treatment received. One par. who was randomized to retapamulin treatment but actually received placebo was included in the placebo arm for the safety analyses.
General disorders
Condition aggravated
0.88%
3/342 • Adverse events (AEs) were recorded from the first dose of study medication until study completion. Serious AEs (SAEs) were collected from the time of consent and continued until study completion (including the Follow-up Period).
AEs were collected for all randomized participants (par.) who received at least one dose of study medications (i.e., ITTC Population). Safety data were analyzed based on the actual treatment received. One par. who was randomized to retapamulin treatment but actually received placebo was included in the placebo arm for the safety analyses.
0.61%
1/165 • Adverse events (AEs) were recorded from the first dose of study medication until study completion. Serious AEs (SAEs) were collected from the time of consent and continued until study completion (including the Follow-up Period).
AEs were collected for all randomized participants (par.) who received at least one dose of study medications (i.e., ITTC Population). Safety data were analyzed based on the actual treatment received. One par. who was randomized to retapamulin treatment but actually received placebo was included in the placebo arm for the safety analyses.
General disorders
Pyrexia
0.00%
0/342 • Adverse events (AEs) were recorded from the first dose of study medication until study completion. Serious AEs (SAEs) were collected from the time of consent and continued until study completion (including the Follow-up Period).
AEs were collected for all randomized participants (par.) who received at least one dose of study medications (i.e., ITTC Population). Safety data were analyzed based on the actual treatment received. One par. who was randomized to retapamulin treatment but actually received placebo was included in the placebo arm for the safety analyses.
1.8%
3/165 • Adverse events (AEs) were recorded from the first dose of study medication until study completion. Serious AEs (SAEs) were collected from the time of consent and continued until study completion (including the Follow-up Period).
AEs were collected for all randomized participants (par.) who received at least one dose of study medications (i.e., ITTC Population). Safety data were analyzed based on the actual treatment received. One par. who was randomized to retapamulin treatment but actually received placebo was included in the placebo arm for the safety analyses.

Additional Information

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GlaxoSmithKline

Phone: 866-435-7343

Results disclosure agreements

  • Principal investigator is a sponsor employee GSK agreements may vary with individual investigators, but will not prohibit any investigator from publishing. GSK supports the publication of results from all centers of a multi-center trial but requests that reports based on single-site data not precede the primary publication of the entire clinical trial.
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Restriction type: OTHER