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替加环素与利奈唑胺治疗日本皮肤和软组织感染患者的疗效、安全性及药代动力学——一项随机、多中心3期研究的结果

Efficacy, safety and pharmacokinetics of tedizolid versus linezolid in patients with skin and soft tissue infections in Japan - Results of a randomised, multicentre phase 3 study.

作者信息

Mikamo Hiroshige, Takesue Yoshio, Iwamoto Yuji, Tanigawa Takahiko, Kato Masaharu, Tanimura Yoko, Kohno Shigeru

机构信息

Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, Aichi, Japan.

Department of Infection Prevention and Control, Hyogo College of Medicine, Hyogo, Japan.

出版信息

J Infect Chemother. 2018 Jun;24(6):434-442. doi: 10.1016/j.jiac.2018.01.010. Epub 2018 Mar 9.

Abstract

The objective of this open-label, randomised (i.e. 2:1 ratio), Phase 3 study was to compare the efficacy and safety of tedizolid phosphate 200 mg, once-daily treatment with that of linezolid 600 mg, twice-daily treatment for 7-14 days in Japanese adult patients (N = 125) with skin and soft tissue infections (SSTIs) and/or for 7-21 days for those with SSTI-related bacteraemia, caused by confirmed or highly suspected methicillin-resistant Staphylococcus aureus (MRSA). Primary outcome was clinical cure rate at test-of-cure (TOC, in SSTI: 7-14 days, in bacteraemia: 4-6 weeks after end-of-therapy [EOT]) time point in the microbiologically evaluable MRSA (ME-MRSA) population (N = 39). Secondary endpoints were clinical and microbiological response rates at EOT. Safety parameters were evaluated in the safety analysis population up to follow up. Data analysis was descriptive in nature. Baseline characteristics of patients were similar between treatment groups. At TOC in the ME-MRSA population, clinical cure rate was similar in tedizolid phosphate (92.6%) and linezolid (88.9%) groups. At EOT, clinical cure (tedizolid phosphate: 93.1%, linezolid: 90.0%) and microbiological success (tedizolid phosphate: 93.1%, linezolid: 100.0%) rates were similar in the ME-MRSA population. Both treatments were well tolerated; overall treatment-emergent adverse events (TEAEs) in tedizolid phosphate (79.5%) and linezolid (75.6%) treatment groups were similar. Drug-related TEAEs were numerically lower with tedizolid phosphate versus linezolid (30.1%; 39.0%, respectively), as well as gastrointestinal (21.7%; 26.8%) and myelosuppression-related (2.4%; 22.0%) TEAEs. One death occurred in the linezolid group. Tedizolid phosphate may be an appropriate antibiotic for the treatment of SSTIs in Japanese adult patients. International clinical trial registration number: NCT01967225. Japanese clinical trial registration number: JapicCTI-132308.

摘要

这项开放标签、随机(即2:1比例)的3期研究的目的是比较磷酸泰地唑胺200毫克每日一次治疗与利奈唑胺600毫克每日两次治疗7至14天,在日本成年患者(N = 125)中治疗由确诊或高度怀疑的耐甲氧西林金黄色葡萄球菌(MRSA)引起的皮肤和软组织感染(SSTIs)的疗效和安全性,对于患有SSTI相关菌血症的患者治疗7至21天。主要结局是在微生物学可评估的MRSA(ME-MRSA)人群(N = 39)的治愈检验(TOC,在SSTI中为7至14天,在菌血症中为治疗结束[EOT]后4至6周)时间点的临床治愈率。次要终点是EOT时的临床和微生物学反应率。在安全性分析人群中直至随访时评估安全性参数。数据分析本质上是描述性的。治疗组之间患者的基线特征相似。在ME-MRSA人群的TOC时,磷酸泰地唑胺组(92.6%)和利奈唑胺组(88.9%)的临床治愈率相似。在EOT时,ME-MRSA人群中的临床治愈率(磷酸泰地唑胺:93.1%,利奈唑胺:90.0%)和微生物学成功率(磷酸泰地唑胺:93.1%,利奈唑胺:100.0%)相似。两种治疗耐受性均良好;磷酸泰地唑胺治疗组(79.5%)和利奈唑胺治疗组(75.6%)的总体治疗中出现的不良事件(TEAEs)相似。与药物相关的TEAEs在磷酸泰地唑胺组中在数值上低于利奈唑胺组(分别为30.1%;39.0%),以及胃肠道(21.7%;26.8%)和骨髓抑制相关(2.4%;22.0%)的TEAEs。利奈唑胺组发生1例死亡。磷酸泰地唑胺可能是治疗日本成年患者SSTIs的一种合适抗生素。国际临床试验注册号:NCT01967225。日本临床试验注册号:JapicCTI - 132308。

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