Study to Evaluate the Efficacy of Delpazolid as Add-on Therapy in Refractory Mycobacterium Abscessus Complex

Nontuberculous Mycobacterium Infection Clinical Trial

Official title:

A Phase 2a, Open-label, Single-arm, Multi-center Study to Evaluate the Efficacy and Safety of LCB01-0371 (Delpazolid) as Add-on Therapy in Patients With Refractory Mycobacterium Abscessus Complex Pulmonary Disease

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT06004037
• Other study ID #: LCB01-0371-2004
• Status: Active, not recruiting
• Phase: Phase 2
• Start date: January 16, 2024
• Est. completion date: May 29, 2026

Study information

• Verified date: April 2024
• Source: LigaChem Biosciences, Inc.
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the efficacy and safety of delpazolid add-on therapy in Patients with Refractory Mycobacterium abscessus Complex Pulmonary disease

Description:

Delpazolid, which demonstrates effects similar to other oxazolidinone-class drugs and has confirmed good safety, aims to evaluate its efficacy in MABC-PD patients who are unresponsive to guideline-based treatments

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 20
• Est. completion date: May 29, 2026
• Est. primary completion date: July 29, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 19 Years and older

Eligibility

Inclusion Criteria:

• Pre-screening: Adults aged 19 years or above
• Pre-screening: Patients diagnosed with MABC (including subspecies abscessus, bolletii, and massiliense) pulmonary disease in radiologic and microbiologic evaluations
• LCB01-0371 MIC = 4 µg/mL for MABC
• Patients who continue to show positivity for MABC even after treatments based on the guidelines of ATS/ERS/ESCMID/IDSA for at least 6 months prior to screening, and who

meet all of the following criteria:

1. Patients who have been confirmed positive at least once in the last sputum or bronchoscopy sample culture performed prior to screening

2. Patients who have not achieved culture conversion (at least 3 consecutive negative mycobacteria cultures in the sputum or bronchoscopy sample collected at an interval of at least 4 weeks) within 6 months prior to screening

• Patients who can voluntarily expectorate sputum at screening
• Patients with a life expectancy of 12 weeks or more
• Patients with adequate organ function who meet the following criteria:

1. Hemoglobin > 9.0 g/dL (without transfusion within 2 weeks prior to measurement)

2. Absolute neutrophil count = 1,500/µL (without administration of G-CSF within 2 weeks prior to measurement)

3. Platelet = 100,000/µL

4. Total bilirubin = 1.5 × upper limit of normal (ULN)

5. Alanine aminotransferase/aspartate aminotransferase (ALT/AST) = 2.5 × ULN

6. Serum creatinine = 1.5 × ULN or creatinine clearance >30 mL/min (calculated with the Cockcroft-Gault formula)

• Patients who voluntarily provided a written consent to participate in the clinical study

Exclusion Criteria:

• Patients who cannot swallow the study drug tablet due to dysphagia, nasogastric tube insertion, etc.
• Patients diagnosed with cystic fibrosis
• Patients who have received a lung transplant
• Patients with disseminated or extrapulmonary nontuberculous mycobacteria
• Patients with known active pulmonary tuberculosis
• Patients with NTM infections other than MABC
• Patients with an active pulmonary malignancy within 1 year prior to screening or Patients with other malignancies that require chemotherapy or radiotherapy
• Patients who were administered linezolid for more than 2 weeks to treat MABC
• Patients with known HIV positivity or a suspected infection thereof or Patients with a known active hepatitis B or C infection
• Patients who currently have a clinically significant cardiovascular disease

1. Patients with severe cardiac failure (New York Heart Association [NYHA] class III/IV) that occurred within 24 weeks prior to screening

2. Patients with pulmonary embolism or deep venous thrombosis that occurred within 24 weeks prior to screening

• Patients whose multidrug therapy for treatment of MABC was changed within 4 weeks prior to screening (Discontinuation, dose adjustment, change of administration route, etc., are allowed.)
• Patients for whom the administration of contraindicated concomitant drugs that correspond to the following cannot be discontinued during the clinical study or for whom their administration is necessary

1. Administration of a new antibacterial agent for the prioritized treatment of NTM, especially MABC, other than background therapy

2. Monoamine oxidase inhibitors

3. Serotonin reuptake inhibitor or serotonin 5-HT1 receptor agonists

4. Meperidine or buspirone

5. Drugs that lower epilepsy threshold; tramadol, etc.

6. Other investigational products: If there is a history of administration within 30 days prior to screening, it falls under the exclusion criteria.

• Pregnant or breastfeeding women and women of childbearing potential who do not agree to practice appropriate contraceptive methods*:

Related Conditions & MeSH terms

• Communicable Diseases
• Infections
• Mycobacterium Abscessus Infection
• Mycobacterium Infections
• Mycobacterium Infections, Nontuberculous
• Nontuberculous Mycobacterium Infection

Intervention

Drug:
• Delpazolid
Three tablets (400 mg/tablet) of delpazolid will be orally administered once daily for 12 weeks. After 3 months (12 weeks) of administration, if the investigator determines that there are clinical benefits, an additional extended treatment of up to 9 months (40 weeks) may be given, amounting to 1 year of treatment in total.

Locations

Country	Name	City	State
Korea, Republic of	Asan Medical Center	Seoul
Korea, Republic of	Bundang Seoul National University Hospital	Seoul
Korea, Republic of	Samsung Medical Center	Seoul
Korea, Republic of	Seoul National University Bundang Hospital	Seoul
Korea, Republic of	Severance Hospital	Seoul

Sponsors (1)

Lead Sponsor	Collaborator
LigaChem Biosciences, Inc.

Country where clinical trial is conducted

Korea, Republic of, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change from baseline in the semi-quantitative scale (SQS)	The SQS using liquid media and solid media will be scored a point of 1-7, with lower scores representing a reducing bacterial load.	12 weeks
Secondary	Change from baseline in SQS	The SQS using liquid media and solid media will be scored a point of 1-7, with lower scores representing a reducing bacterial load.	4 weeks and 8 weeks
Secondary	Sputum culture conversion rate	neg culture x3( sputum conversion)	12 weeks
Secondary	Time to culture conversion	from the date of assignment to the first negative result.	12 weeks
Secondary	Time to positivity in the liquid culture automated system (MGIT)	time to detection of positive in MGIT system	12 weeks
Secondary	Negative sputum culture rate at each time point after baseline	negative culture results in MGIT and solid media	12 weeks
Secondary	Change from baseline in the inflammatory marker	erythrocyte sedimentation rate [ESR]) at each time point	12 weeks
Secondary	Change from baseline in the CT score	The CT scan score will be transformed onto a scale of 0-42, with lower scores representing improved lung presentations.	12 weeks
Secondary	Quality of Life Questionnaire-Bronchiectasis	The QOL-B respiratory symptoms score was transformed onto a scale of 0-100, with higher scores representing a better quality of life.	12 weeks
Secondary	Six-minute walk test	Six-minute walk test	12 weeks