A Study to Investigate the Safety and Efficacy of Fidaxomicin (Oral Suspension or Tablets) and Vancomycin (Oral Liquid or Capsules) in Pediatric Subjects With Clostridium Difficile-associated Diarrhea (CDAD)

NCT ID: NCT02218372

Last Updated: 2024-11-26

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

148 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-01-09

Study Completion Date

2018-03-07

Brief Summary

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The purpose of this study was to investigate the clinical response to fidaxomicin oral suspension or tablets and vancomycin oral liquid or capsules in pediatric participants with Clostridium difficile-associated diarrhea (CDAD). It also investigated the recurrence/sustained clinical response to and safety of fidaxomicin and vancomycin, as well as acceptance of the fidaxomicin oral suspension formulation.

Detailed Description

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Conditions

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Clostridium Difficile-associated Diarrhea (CDAD)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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Fidaxomicin

Participants from birth to \< 6 years of age received weight based doses of fidaxomicin oral suspension (32 mg/kg/day with a maximum dose of 400 mg/day divided in 2 doses) 2 times daily for 10 days. Participants aged ≥ 6 years to \< 18 years of age received a 200 mg fidaxomicin tablet 2 times daily for 10 days.

Group Type EXPERIMENTAL

Fidaxomicin oral suspension

Intervention Type DRUG

Participants from birth to \< 6 years of age received weight based doses of fidaxomicin oral suspension (32 mg/kg/day with a maximum dose of 400 mg/day divided in 2 doses) 2 times daily for 10 days.

Fidaxomicin tablets

Intervention Type DRUG

Participants aged ≥ 6 years to \< 18 years of age received a 200 mg fidaxomicin tablet 2 times daily for 10 days.

Vancomycin

Participants from birth to \< 6 years of age received weight based doses of vancomycin oral liquid (40 mg/kg/day with a maximum dose of 500 mg/day divided in 4 doses) 4 times daily for 10 days. Participants aged ≥ 6 years to \< 18 years of age received a 125 mg vancomycin capsule 4 times daily for 10 days.

Group Type ACTIVE_COMPARATOR

Vancomycin oral liquid

Intervention Type DRUG

Participants from birth to \< 6 years of age received weight based doses of vancomycin oral liquid (40 mg/kg/day with a maximum dose of 500 mg/day divided in 4 doses) 4 times daily for 10 days.

Vancomycin capsules

Intervention Type DRUG

Participants aged ≥ 6 years to \< 18 years of age received a 125 mg vancomycin capsule 4 times daily for 10 days.

Interventions

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Fidaxomicin oral suspension

Participants from birth to \< 6 years of age received weight based doses of fidaxomicin oral suspension (32 mg/kg/day with a maximum dose of 400 mg/day divided in 2 doses) 2 times daily for 10 days.

Intervention Type DRUG

Fidaxomicin tablets

Participants aged ≥ 6 years to \< 18 years of age received a 200 mg fidaxomicin tablet 2 times daily for 10 days.

Intervention Type DRUG

Vancomycin oral liquid

Participants from birth to \< 6 years of age received weight based doses of vancomycin oral liquid (40 mg/kg/day with a maximum dose of 500 mg/day divided in 4 doses) 4 times daily for 10 days.

Intervention Type DRUG

Vancomycin capsules

Participants aged ≥ 6 years to \< 18 years of age received a 125 mg vancomycin capsule 4 times daily for 10 days.

Intervention Type DRUG

Other Intervention Names

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Dificid Dificlir Dificlir Dificid

Eligibility Criteria

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Inclusion Criteria

* Subject is diagnosed with CDAD according to local diagnostic criteria. As a minimum there must be positive detection, within 72 hours prior to randomization, of either toxin A and/or toxin B in stool or positive detection of toxigenic C. difficile in stool and:

* Subject from Birth to \< 2 years: watery diarrhea in the 24 hours prior to screening.
* Subject ≥ 2 years to \< 18 years: ≥ 3 unformed bowel movements in the 24 hours prior to screening.
* Male and female subjects aged from birth to \< 18 years: Note that in the United States of America subjects can only be included if aged ≥ 6 months to \< 18 years.
* For subjects \< 5 years: Negative rotavirus test.
* Female subject of childbearing potential:

* must have a negative urine pregnancy test at Screening, and
* must abstain from sexual activity for the duration of the study, or
* must use two forms of birth control (at least one of which must be a barrier method) starting at Screening and throughout the study period and for 28 days after the final study drug administration.
* Female subject must not be breastfeeding at Screening or during the study period, and for 28 days after the final study drug administration.
* Female subject must not donate ova starting at Screening and throughout the study period, and for 28 days after the final study drug administration.

Exclusion Criteria

* Concurrent use of metronidazole, oral vancomycin or any other antibiotic treatments for CDAD. If the investigator feels the clinical imperative is to begin treatment before knowing the laboratory result for toxigenic C. difficile, up to four doses but no more than 24 hours of treatment with metronidazole, oral vancomycin or any other effective treatment for CDAD are allowed.
* Subject has pseudomembranous colitis, fulminant colitis, toxic megacolon or ileus.
* Subject has a history of inflammatory bowel disease (e.g., ulcerative colitis or Crohn's disease etc.).
* Subject has diarrhea caused by an agent other than C. difficile (e.g. infections, infestations, drugs etc.).
* Subject has known hypersensitivity to fidaxomicin, vancomycin or their excipients or to teicoplanin.
* Subject has received an investigational therapy within 28 days, prior to Screening, with the exception of studies with primary treatment for cancer without novel Investigational Medicinal Product (IMP) and which do not affect the assessment of diarrhea.
Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role collaborator

Astellas Pharma Europe B.V.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clinical Research Physician

Role: STUDY_DIRECTOR

Astellas Pharma Europe B.V.

Locations

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Site US10015

Orange, California, United States

Site Status

Site US10010

Chicago, Illinois, United States

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Site US10004

Indianapolis, Indiana, United States

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Site US10025

Louisville, Kentucky, United States

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Site US10032

Kansas City, Missouri, United States

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Site US10030

Omaha, Nebraska, United States

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Site US10008

Stony Brook, New York, United States

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Site US10028

Chapel Hill, North Carolina, United States

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Site US10027

Cincinnati, Ohio, United States

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Site US10014

Toledo, Ohio, United States

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Site US10034

Johnson City, Tennessee, United States

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Site US10022

Memphis, Tennessee, United States

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Site US10038

Fort Worth, Texas, United States

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Site US10037

Salt Lake City, Utah, United States

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Site BE32001

Brussels, Flemish Brabant, Belgium

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Site BE32003

Ghent, , Belgium

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Site BE32002

Liège, , Belgium

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Site CA15003

Oshawa, Ontario, Canada

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Site FR33002

La Tronche, , France

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Site FR33001

Nice, , France

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Site FR33007

Nice, , France

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Site FR33005

Paris, , France

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Site FR33008

Strasbourg, , France

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Site DE49010

Essen, , Germany

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Site DE49002

Frankfurt Am M., , Germany

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Site DE49006

Freiburg im Breisgau, , Germany

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Site DE49004

Mainz, , Germany

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Site DE49001

Münster, , Germany

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Site DE49003

Saint Augustin, , Germany

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Site HU36006

Budapest, , Hungary

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Site HU36004

Szeged, , Hungary

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Site IT39004

Milan, , Italy

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Site IT39001

Roma, , Italy

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Site PL48002

Warsaw, Masovian Voivodeship, Poland

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Site PL48012

Bialystok, , Poland

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Site PL48007

Bydgoszcz, , Poland

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Site PL48004

Dębica, , Poland

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Site PL48014

Rzeszów, , Poland

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Site PL48006

Tarnów, , Poland

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Site RO40005

Bucharest, , Romania

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Site ES34002

Barcelona, , Spain

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Site ES34007

Madrid, , Spain

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Site ES34004

Madrid, , Spain

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Site ES34003

Valencia, , Spain

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Countries

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United States Belgium Canada France Germany Hungary Italy Poland Romania Spain

References

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Wolf J, Kalocsai K, Fortuny C, Lazar S, Bosis S, Korczowski B, Petit A, Bradford D, Croos-Dabrera R, Incera E, Melis J, van Maanen R. Safety and Efficacy of Fidaxomicin and Vancomycin in Children and Adolescents with Clostridioides (Clostridium) difficile Infection: A Phase 3, Multicenter, Randomized, Single-blind Clinical Trial (SUNSHINE). Clin Infect Dis. 2020 Dec 17;71(10):2581-2588. doi: 10.1093/cid/ciz1149.

Reference Type DERIVED
PMID: 31773143 (View on PubMed)

Borali E, De Giacomo C. Clostridium Difficile Infection in Children: A Review. J Pediatr Gastroenterol Nutr. 2016 Dec;63(6):e130-e140. doi: 10.1097/MPG.0000000000001264.

Reference Type DERIVED
PMID: 27182626 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

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https://astellasclinicalstudyresults.com/study.aspx?ID=362

Link to results on Astellas Clinical Study Results website

Other Identifiers

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2013-000508-40

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

SUNSHINE

Identifier Type: OTHER

Identifier Source: secondary_id

2819-CL-0202

Identifier Type: -

Identifier Source: org_study_id

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