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Ventilator-Associated PneumoniaPhase 3NCT00589693

To Compare Safety and Efficacy of Doripenem Versus Imipenem-Cilastatin in Patients With Ventilator-Associated Pneumonia

A Phase 3 study testing Doripenem and Imipenem-Cilastatin in people with Ventilator-Associated Pneumonia, run by Johnson & Johnson Pharmaceutical Research & Development, L.L.C. at 100 sites in 21 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this study is to show that doripenem is as effective as imipenem-cilastatin in the treatment of patients with ventilator-associated pneumonia. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Ventilator-Associated Pneumonia
What is being tested?
Doripenem and Imipenem-Cilastatin
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
274 participants
Where
100 sitesin 21 countries
Study dates
Apr 2008to Jun 2011
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients must have new or worsening radiographic infiltrates consistent with ventilator-associated pneumonia that was not related to cardiac or other disease processes
  • Have at least 1 of the following: fever (core body temperature greater than 39.0°C); hypothermia (core body temperature of less than 35.0°C); leukocytosis (increased WBC count); and leukopenia (decreased WBC count)
  • Have developed ventilator-associated pneumonia and have been on mechanical ventilation for more than or equal to 48 hours and on mechanical ventilation at the time that study medication is assigned
  • Have been hospitalized or been in a chronic care facility for consecutive 5 days or more within the last 90 days
  • Have a baseline Clinical Pulmonary Infection Score (CPIS) more than or equal to 6 and an Acute Physiology and Chronic Health Evaluation (APACHE) II score more than 8 and less than 35

Who cannot join

  • Have received antibiotics for this episode of ventilator-associated pneumonia for more than 24 hours before study medication administration
  • Known presence at baseline of only methicillin-resistant Staphylococcus aureus or Stenotrophomonas infection
  • Acute respiratory distress syndrome
  • Has any of the following conditions: chest trauma with severe lung bruising or loss of stability of the thoracic cage following a fracture of the sternum, ribs, or both, increased amounts of fluid in the lung cavities requiring drainage or pus in the cavity
  • Has active seizure disorder within the last 2 years or brain injury such that imipenem cilastatin would not be administered to the patient in usual practice
  • Has lung cancer within the last 2 years, chronic bronchitis with an increase in severity within the last 30 days, chronic enlargement of the bronchi or bronchioles related to inflammatory disease or obstruction, lung abscess(s), anatomical bronchial obstruction, respiratory tuberculosis on treatment, suspected atypical pneumonia, chemical pneumonitis, cystic fibrosis, congestive heart failure, severe burns to greater than 15% of the body, evidence of severe and chronic liver disease

Trial locations and contacts

100 sites in 21 countries.

100 sites in 21 countries

United States17 sites
  • Study site

    Baltimore, Maryland

  • Study site

    Biddeford, Maine

  • Study site

    Buffalo, New York

  • Study site

    Butte, Montana

  • Study site

    Cincinnati, Ohio

  • Study site

    Detroit, Michigan

  • Study site

    Hazard, Kentucky

  • Study site

    Houston, Texas

  • Study site

    Jacksonville, Florida

  • Study site

    Jonesboro, Arkansas

  • Study site

    Milwaukee, Wisconsin

  • Study site

    Moline, Illinois

  • Study site

    Nashville, Tennessee

  • Study site

    Newark, Delaware

  • Study site

    Oklahoma City, Oklahoma

  • Study site

    Washington D.C., District of Columbia

  • Study site

    Winston-Salem, North Carolina

Other trials in United States

Brazil8 sites
  • Study site

    Belo Horizonte

  • Study site

    Curitiba

  • Study site

    Fortaleza

  • Study site

    Porto Alegre

  • Study site

    Rio de Janeiro

  • Study site

    Santo André

  • Study site

    São José do Rio Preto

  • Study site

    São Paulo

Other trials in Brazil

Argentina6 sites
  • Study site

    Buenos Aires

  • Study site

    Córdoba

  • Study site

    Entre Ríos

  • Study site

    Monte Grande

  • Study site

    Rio Negro

  • Study site

    Rosario

Other trials in Argentina

Germany6 sites
  • Study site

    Dresden

  • Study site

    Halle

  • Study site

    Homburg/Saar

  • Study site

    Lübeck

  • Study site

    Mannheim

  • Study site

    Ulm

Other trials in Germany

Turkey (Türkiye)6 sites
  • Study site

    Adana

  • Study site

    Ankara

  • Study site

    Istanbul

  • Study site

    Kayseri

  • Study site

    Samsun

  • Study site

    Trabzon

Other trials in Turkey (Türkiye)

Australia5 sites
  • Study site

    Adelaide

  • Study site

    Box Hill

  • Study site

    Clayton

  • Study site

    Melbourne

  • Study site

    Parkville

Other trials in Australia

France5 sites
  • Study site

    Argenteuil

  • Study site

    Limoges

  • Study site

    Paris

  • Study site

    Pierre-Bénite

  • Study site

    Tours

Other trials in France

India5 sites
  • Study site

    Bangalore

  • Study site

    Coimbatore

  • Study site

    Ludhiana

  • Study site

    New Delhi

  • Study site

    Pune

Other trials in India

Mexico5 sites
  • Study site

    Chihuahua City

  • Study site

    Guadalajara

  • Study site

    Monterrey

  • Study site

    San Luis Potosí City

  • Study site

    Zapopan

Other trials in Mexico

Russia5 sites
  • Study site

    Moscow

  • Study site

    Saint Petersburg

  • Study site

    Saratov

  • Study site

    Smolensk

  • Study site

    Yaroslavl

Other trials in Russia

Spain5 sites
  • Study site

    Barcelona

  • Study site

    L'Hospitalet de Llobregat

  • Study site

    Las Palmas de Gran Canaria

  • Study site

    Madrid

  • Study site

    Tarragona

Other trials in Spain

Canada3 sites
  • Study site

    Greenfield Park, Quebec

  • Study site

    Halifax, Nova Scotia

  • Study site

    Ottawa, Ontario

Other trials in Canada

Guatemala3 sites
  • Study site

    Cuilapa

  • Study site

    Escuintla Escuintla

  • Study site

    Guatemala City

Other trials in Guatemala

Hungary3 sites
  • Study site

    Budapest

  • Study site

    Budapest Na

  • Study site

    Székesfehérvár

Other trials in Hungary

Israel3 sites
  • Study site

    Afula

  • Study site

    Petah Tikva

  • Study site

    Ramat Gan

Other trials in Israel

Romania3 sites
  • Study site

    Brasov

  • Study site

    Târgu Mureş

  • Study site

    Timișoara

Other trials in Romania

Thailand3 sites
  • Study site

    Chiang Mai

  • Study site

    Khon Kaen

  • Study site

    Nakhonratchasima

Other trials in Thailand

Ukraine3 sites
  • Study site

    Kharkiv

  • Study site

    Kiev

  • Study site

    Odesa

Other trials in Ukraine

Belgium2 sites
  • Study site

    Brussels

  • Study site

    Ghent

Other trials in Belgium

Philippines2 sites
  • Study site

    Manila

  • Study site

    Quezon City

Other trials in Philippines

Portugal2 sites
  • Study site

    Lisbon

  • Study site

    Porto

Other trials in Portugal

About this study

Official title: A Prospective, Randomized, Double-Blind, Double-Dummy, Multicenter Study to Assess the Safety and Efficacy of Doripenem Compared With Imipenem-Cilastatin in the Treatment of Subjects With Ventilator-Associated Pneumonia

The purpose of this study is to show that doripenem is as effective as imipenem-cilastatin in the treatment of patients with ventilator-associated pneumonia.

Read the detailed description

This is a randomized (the study medication is assigned by chance), double-blind (neither physician nor patient knows the treatment that the patient receives), active-controlled (agent that is compared with a study medication to test whether the study medication has a real effect in a clinical study), double-dummy (placebo [inactive substance that is compared with a medication to test whether the medication has a real effect in a clinical study] is administered to maintain the blind when the comparator medication cannot be made identical to the study medication), parallel-group (each group of patients will be treated at the same time), multicenter study to assess the effectiveness and safety of 7 day course of doripenem, compared with 10 day course of imipenem-cilastatin in patients with ventilator-associated pneumonia. This study will consists of 3 phases: (1) a pretreatment phase with a maximum of 24 hours for the screening/baseline visit, (2) a double blind, double dummy, treatment phase of 10 days (Day 1 to Day 10) and an end-of-treatment (EOT) assessment within 24 hours after the last dose of study medication therapy administered on Day 10 or at the time of early withdrawal from study medication, and (3) a post treatment (follow-up) phase consisting of an early follow-up (EFU) visit within 7 to 14 days after the last dose of study medication, and last follow-up (LFU) visit within 28 to 35 days after the last dose of study medication for all patients including those who discontinued study medication early. Two hundred and seventy four patients will be randomly assigned to receive either doripenem or imipenem with placebo of the other medication given simultaneously to maintain the blind (eg, 1 group will receive blinded doripenem from Days 1 to 7 and imipenem placebo Days 1 to 10, other group will receive blinded imipenem Days 1 to 10 and doripenem placebo Days 1 to 7). A sample of secretions from the lower respiratory tract will be obtained by bronchoalveolar lavage (BAL) or mini-BAL within 36 hours prior to administration of study medication from the enrolled patients and sent for culture. Patients, whose baseline BAL or mini-BAL culture results will yield at least 1 qualifying pneumonia pathogen will continue to receive study medication therapy and patients, whose baseline BAL or mini-BAL culture results did not yield at least 1 qualifying pneumonia pathogen will be discontinued from study medication therapy but will remain enroll in the study and will be followed for safety. Safety evaluations including adverse events, clinical laboratory evaluations, vital signs and physical examinations will be monitored throughout the study period. The total duration of an individual patient's participation in the study will be approximately 5 to 6 weeks.

Being tested
Doripenem, Imipenem-Cilastatin, Placebo
Keywords
Ventilator-Associated Pneumonia, Pneumonia, hospital-acquired, Doripenem, Imipenem-cilastatin
Medical subject headings
Pneumonia, Ventilator-Associated, Healthcare-Associated Pneumonia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • DoripenemDrug

    Type=exact number, number=1, unit=g, form=solution for injection, route=intravenously. 1 gram 4-hour infusion of doripenem will be administered every 8 hours for 7 days.

  • Imipenem-CilastatinDrug

    Type=exact number, number=1, unit=g, form=solution for injection, route=intravenously. 1 gram 1-hour infusion of imipenem-cilastatin will be administered every 8 hours for 10 days.

  • PlaceboDrug

    Form=solution, route=intravenous. Doripenem pacebo will be administered from Days 1 to 7 in imipenem-cilastatin arm and imipenem-cilastatin placebo will be administered in doripenem arm.

Study groups in NCT00589693
Study groupRoleWhat they receive
DoripenemExperimentalDoripenem from Days 1 to 7 and imipenem-cilastatin placebo from Days 1 to 10
Receives: Drug: Doripenem; Drug: Placebo
Imipenem-CilastatinActive comparatorImipenem-Cilastatin Days 1 to 10 and doripenem placebo from Days 1 to 7
Receives: Drug: Imipenem-Cilastatin; Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Clinical Cure Rate at the End-of-treatment (EOT) Visit

    The number of patients who achieved clinical cure at the EOT visit on Day 10. The patient's were classified as clinical cure if they had resolution of signs and symptoms and objective findings of pneumonia to such an extent that no further antimicrobial therapy was necessary.

    Measured: End-of-treatment (Day 10 or Day 11)

Secondary outcomes (4)
  1. Clinical Cure Rate at the End-of-treatment (EOT) Visit in Patients From Whom a Qualifying P. Aeruginosa Was Isolated at Baseline

    The clinical cure rate at the EOT visit in patients, whose bronchoalveolar lavage (BAL) or mini-BAL culture results yielded qualifying pneumonia pathogen P. aeruginosa at baseline.

    Measured: End-of-treatment (Day 10 or Day 11)

  2. Clinical Cure Rate at the End-of-treatment (EOT) Visit in Patients From Whom at Least 1 of the Gram-negative Qualifying Pneumonia Pathogens (Enterobacteriaceae, P. Aeruginosa, and Acinetobacter Spp) Was Isolated at Baseline

    The clinical cure rate at the EOT visit in patients whose BAL or mini-BAL culture results yielded at least 1 of the following Gram-negative qualifying pneumonia pathogens was isolated at baseline: any Enterobacteriaceae, P. aeruginosa, and Acinetobacter Spp.

    Measured: End-of-treatment (Day 10 or Day 11)

  3. Number of Patients Who Had Emergence of P. Aeruginosa Resistance

    Number of patients who had P. aeruginosa isolates with a 4 fold or greater increase in minimum inhibitory concentration (MIC) at anytime during the study (after the study medication is received) from baseline

    Measured: Up to 6 weeks

  4. 28-day All-cause Mortality Rate

    Number of deaths which occured up to 28 days of the study period due to all causes

    Measured: Up to 28 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Jan 2008 (estimated)
  2. Study startApr 2008
  3. Primary completionJun 2011
  4. Study completionJun 2011

Why it stopped: Observed lower cure rates and higher mortality rates in one of the treatment groups.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
274 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00589693
Sponsor's protocol ID
CR014038
Other IDs
DORINOS3008, 2007-004646-33
Status last verified
Dec 2012
First submitted
21 Dec 2007
Last updated
28 Dec 2012
Data monitoring committee
Yes

Publications

  • Kollef MH, Chastre J, Clavel M, Restrepo MI, Michiels B, Kaniga K, Cirillo I, Kimko H, Redman R. A randomized trial of 7-day doripenem versus 10-day imipenem-cilastatin for ventilator-associated pneumonia. Crit Care. 2012 Nov 13;16(6):R218. doi: 10.1186/cc11862.

    PubMed 23148736

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Doripenem and Imipenem-Cilastatin in people with Ventilator-Associated Pneumonia, run by Johnson & Johnson Pharmaceutical Research & Development, L.L.C. at 100 sites in 21 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 28 Dec 2012. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 100 sites in United States, Brazil, Argentina, Germany, Turkey (Türkiye) and 16 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 18 Jul 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Clinical Cure Rate at the End-of-treatment (EOT) Visit (time frame: End-of-treatment (Day 10 or Day 11)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00589693, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Dec 2012.

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