Theravance Biopharma Reports Positive New Data from Multiple Studies of VIBATIV® (telavancin) at IDWeek™ 2017
The TOUR findings reported at IDWeek are based on a review of preliminary data collected from the fully enrolled registry of 1,059 patients. The Company expects future TOUR analyses to be updated as additional data become available and the study is completed. Details from the two TOUR-related IDWeek presentations are as follows:
Bone and Joint Infections in TOUR:
Researchers presented preliminary data reported for 288 patients captured in the TOUR study with bone and joint infections. Of these patients, 70.1% failed treatment with initial antibiotic therapy prior to receiving VIBATIV. A positive clinical response was reported for 72.6% of the patients after receiving VIBATIV, with 8.7% of patients failing to respond to treatment and 10.8% having an indeterminate clinical outcome at end of therapy (EOT) with VIBATIV. Eight percent were non-evaluable due to missing or undocumented outcomes. Among the patients that had an outcome assessment at EOT with VIBATIV (n = 265), 78.9% were cured or improved to step-down therapy and 9.4% failed treatment. Methicillin-resistant Staphylococcus aureus (S. aureus) or MRSA was the most commonly isolated pathogen responsible for the bone and joint infections at baseline. The median VIBATIV daily dose and duration of treatment were 750 mg and 26 days, respectively, and 75% of patients were treated as outpatients. Of the 288 patients, 58 reported an adverse event, six reported a serious adverse event, and 46 discontinued treatment due to an adverse event. The most commonly occurring adverse event was renal failure (9.0%). Four patients died during the course of the study; clinician review of each of these cases determined that none were related to VIBATIV treatment.
Bacteremia and/or Infective Endocarditis in TOUR:
Researchers presented preliminary data reported for 151 patients captured in the TOUR study with confirmed cases of bacteremia and/or infective endocarditis. Of these patients, 86.1% failed treatment with initial antibiotic therapy prior to receiving VIBATIV. A positive clinical response was reported for 64.9% of the patients after receiving VIBATIV, with 9.3% of patients failing to respond to treatment, 13.2% having an indeterminate clinical outcome at end of therapy (EOT) and 15.2% considered non-evaluable due to missing or undocumented outcomes. Among the patients that had an outcome assessment at EOT (n = 132), 74.2% were cured or improved to step-down therapy and 10.6% failed treatment. MRSA was the most commonly isolated pathogen responsible for bacteremia and/or infective endocarditis. The median VIBATIV daily dose and duration of treatment were 750 mg and 9 days, respectively, and 80.1% of patients were treated as inpatients. Of the 151 patients, 23 reported an adverse event, 18 reported a serious adverse event, and 15 discontinued treatment due to an adverse event. The most commonly occurring adverse event was renal failure (7.9%). Twenty-one patients died during the course of the study. Researchers deemed VIBATIV treatment was potentially related in two of these cases. Both patients had previously exhibited several predisposing comorbidities including sepsis, chronic renal insufficiency and diabetes.
"Bone and joint infections, bacteremia and infective endocarditis each represent a significant treatment challenge for clinicians in today's healthcare environment. We often see treatment failure against these difficult clinical conditions with first-line antibiotic treatment, which was illustrated by the high rates of VIBATIV use as a second-line treatment. This fact highlights the impressive nature of the clinical response rates that were seen with VIBATIV in these patients," said Charles R Sims, M.D., an infectious disease specialist at
Activity Against Challenging S. aureus Isolates:
In addition to data collected as part of the TOUR study, researchers also presented results from a third study evaluating the in vitro activity of several antibiotics, including VIBATIV, against more than 15,000 S. aureus clinical isolates collected from US medical centers from 2014-2016. 100% of the evaluated isolates, including both MRSA and methicillin-susceptible S. aureus (MSSA), were susceptible to VIBATIV as measured by the
"The VIBATIV potency advantages seen against multidrug-resistant pathogens are particularly important based on the fact that this study also demonstrated that multidrug-resistant MRSA rates have increased over the three years evaluated. This trend further highlights the growing threat of antibiotic resistance and the need for potent antibiotics with rapid bactericidal activity to combat the most challenging pathogens in today's healthcare environment," said
TOUR is a multi-center, observational study that has enrolled 1,059 patients from about 50 sites in the US. As a non-interventional study, all treatment decisions are at the discretion of the patient's healthcare provider. Study patients may have treatment initiated in either hospital-based settings or out-patient infusion sites. In order to qualify for enrollment in TOUR, patients must have received at least one dose of VIBATIV and meet specified inclusion criteria. By broadly collecting and examining real-world data related to VIBATIV treatment patterns, clinical effectiveness and safety outcomes in medical practice,
- Assisting in optimizing use in patients currently being treated with VIBATIV;
- Potentially highlighting subsets of patients that may be most appropriate for treatment with VIBATIV; and
- Illustrating current healthcare practitioner's patterns of VIBATIV use.
VIBATIV® was discovered internally in a research program dedicated to finding new antibiotics for serious infections due to Staphylococcus aureus(S. aureus) and other Gram-positive bacteria, including MRSA and MSSA. VIBATIV is a once-daily, injectable lipoglycopeptide antibiotic with in vitro potency, in vitro bactericidal activity within six hours, and penetration into target infection sites. The drug is approved in the U.S. for the treatment of adult patients with hospital-acquired and ventilator-associated bacterial pneumonia (HABP/VABP) caused by susceptible isolates of S. aureus when alternative treatments are not suitable. In addition, VIBATIV is approved in the U.S. for the treatment of adult patients with complicated skin & skin structure infections (cSSSI) caused by susceptible isolates of Gram-positive bacteria, including S. aureus, both methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) strains. The product labeling also describes the use of VIBATIV in treating patients whose pneumonia or skin infection is complicated by concurrent bacteremia.
The product's proven efficacy against difficult-to-treat Gram-positive infections has been demonstrated in several large, multinational registrational studies, which involved one of the largest cohorts of patients with S. aureus infections studied to date. Importantly, these studies demonstrated significantly higher cure rates for VIBATIV as compared to vancomycin in HABP/VABP due to any single Gram-positive pathogen or S. aureus with MIC ≥1 µg/mL. Additionally, there is extensive and well-documented evidence of the drug's in vitro potency and in vivo activity against a broad collection of Gram-positive bacterial pathogens, including those that are considered difficult-to-treat and multidrug-resistant.
VIBATIV is also approved for marketing in
VIBATIV®(telavancin)Important Safety Information
Patients with pre-existing moderate/severe renal impairment (CrCl ≤50 mL/min) who were treated with VIBATIV® for hospital-acquired bacterial pneumonia/ventilator-associated bacterial pneumonia had increased mortality observed versus vancomycin. Use of VIBATIV in patients with pre-existing moderate/severe renal impairment (CrCl ≤50 mL/min) should be considered only when the anticipated benefit to the patient outweighs the potential risk.
New onset or worsening renal impairment occurred in patients who received VIBATIV. Renal adverse events were more likely to occur in patients with baseline comorbidities known to predispose patients to kidney dysfunction and in patients who received concomitant medications known to affect kidney function. Monitor renal function in all patients receiving VIBATIV prior to initiation of treatment, during treatment, and at the end of therapy. If renal function decreases, the benefit of continuing VIBATIV versus discontinuing and initiating therapy with an alternative agent should be assessed.
Women of childbearing potential should have a serum pregnancy test prior to administration of VIBATIV. Avoid use of VIBATIV during pregnancy unless the potential benefit to the patient outweighs the potential risk to the fetus. Adverse developmental outcomes observed in three animal species at clinically relevant doses raise concerns about potential adverse developmental outcomes in humans. If not already pregnant, women of childbearing potential should use effective contraception during VIBATIV treatment.
Intravenous unfractionated heparin sodium is contraindicated with VIBATIV administration due to artificially prolonged activated partial thromboplastin time (aPTT) test results for up to 18 hours after VIBATIV administration.
VIBATIV is contraindicated in patients with a known hypersensitivity to the drug.
Serious and potentially fatal hypersensitivity reactions, including anaphylactic reactions, may occur after first or subsequent doses. VIBATIV should be used with caution in patients with known hypersensitivity to vancomycin.
Telavancin is substantially excreted by the kidney, and the risk of adverse reactions may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection in this age group.
Infusion Related Reactions
VIBATIV is a lipoglycopeptide antibacterial agent and should be administered over a period of 60 minutes to reduce the risk of infusion-related reactions. Rapid intravenous infusions of the glycopeptide class of antimicrobial agents can cause "Red-man Syndrome" like reactions including: flushing of the upper body, urticaria, pruritus, or rash.
Caution is warranted when prescribing VIBATIV to patients taking drugs known to prolong the QT interval. In a study involving healthy volunteers, VIBATIV prolonged the QTc interval. Use of VIBATIV should be avoided in patients with congenital long QT syndrome, known prolongation of the QTc interval, uncompensated heart failure, or severe left ventricular hypertrophy.
Most Common Adverse Reactions
The most common adverse reactions (greater than or equal to 10% of patients treated with VIBATIV) were diarrhea, taste disturbance, nausea, vomiting, and foamy urine.
Full Prescribing Information, including Boxed Warning and Medication Guide in the U.S., is available at www.VIBATIV.com.
Our pipeline of internally discovered product candidates includes potential best-in-class medicines to address the unmet needs of patients being treated for serious conditions primarily in the acute care setting. VIBATIV® (telavancin), our first commercial product, is a once-daily dual-mechanism antibiotic approved in the U.S.,
In addition, we have an economic interest in future payments that may be made by
For more information, please visit www.theravance.com.
THERAVANCE®, the Cross/Star logo and VIBATIV® are registered trademarks of the
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