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This study will evaluate the safety, pharmacokinetics and effectiveness of a single dose of IV peramivir compared to a standard 5 day course of oral oseltamivir in the treatment of pediatric subjects with acute uncomplicated influenza.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Peramivir (IV) | Experimental | Subjects randomized to peramivir will receive an age appropriate single dose, diluted to a maximum volume of 100 mL in normal saline, administered as a short intravenous infusion over a minimum of 15 minutes.
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| Oseltamivir | Active Comparator | Subjects randomized to oral oseltamivir will receive an age appropriate dose twice daily for 5 days.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Peramivir | Drug |
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| Oseltamivir |
| Measure | Description | Time Frame |
|---|---|---|
| Safety and Tolerability, as Measured by the Number of Participants Experiencing Adverse Events. | Safety evaluation included assessment of Adverse Events (AEs). | 14 days |
| Measure | Description | Time Frame |
|---|---|---|
| Plasma Exposure of IV Peramivir as Measured by the Drug Concentration Over 6 Hours Post-dose | Up to 4 blood samples will be drawn, where possible: immediately following infusion and 30 to 60 mins, 1 to 3 hrs and 4 to 6 hrs post-infusions. AUC calculations were performed in Phoenix WinNonlin using the linear/log trapezoidal rule. AUC0-last was calculated between start of the infusion and the time of the last measurable concentration. |
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Key Inclusion Criteria:
Key Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| John Vanchiere, MD, PhD | Chief, Pediatric Infectious Diseases, Louisiana State University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peramivir Investigative Site | Shreveport | Louisiana | United States | |||
| Peramivir investigative site |
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| ID | Title | Description |
|---|---|---|
| FG000 | Peramivir | Age-appropriate dose Peramivir, administered as a single short iv infusion: Subjects ≥12 years - 600 mg. Subjects <12 years - 12 mg/kg (max. 600 mg). Subjects < 6 months - 8 mg/kg. |
| FG001 | Oseltamivir |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Nov 5, 2018 | Nov 12, 2020 |
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| up to 6 hours post peramivir infusion |
| Time to Resolution of Fever | Time for fever resolution based on subject diary record of temperature recorded twice daily. A subject had resolution of fever if he/she had oral temperature of < 99.4°F or an axillary temperature of < 98.4°F and no antipyretic medications were taken for ≥ 12 hours. The time to resolution of fever was estimated for each age group and overall using the Kaplan-Meier method with temperature and symptom relief medication information obtained from the Subject Diary data. | 14 days |
| Time to Resolution of Influenza Symptoms | Subjects or parents or caregivers were asked to provide an assessment of age-appropriate influenza symptoms on a 4-point severity scale (0,absent; 1, mild; 2, moderate; 3, severe) twice daily beginning before screening on Day 1 until symptoms resolved or until the last follow-up visit. Time to alleviation of symptoms was the number of hours from initiation of study drug until the start of the time period in which all age-appropriate symptoms of influenza were either absent or present at a level no greater than mild for at least 21.5 (24 - 10%) hours. Subjects who did not experience alleviation of symptoms were censored at the last observed symptom assessment. | 14 days |
| Time to Reduction in Viral Shedding | Assessment of viral shedding in bilateral, mid-nasal swab specimens taken at baseline and then on Day 3, 7 and 14. | 14 days |
| Changes in Influenza Virus Titer in Nasopharyngeal Samples in Response to Treatment. | Change in influenza viral titers was defined as the time-weighted change from Baseline in log_10 tissue culture infective dose_50 (TCID50/mL) and was summarized for each treatment group. | Change from baseline assessed on days 3, 7 and 14. |
| Influenza-Related Complications Assessment. | The investigator performed a full physical exam at baseline. At each follow-up visit, study personnel evaluated the subject for the presence of clinical signs and symptoms of the following influenza-related complications: sinusitis, otitis media, bronchitis, and pneumonia requiring antibiotic use, diagnosed after initiation of treatment. | 14 days |
| Dayton |
| Ohio |
| United States |
| Peramivir investigative site | Smithfield | Pennsylvania | United States |
| Peramivir Investigative Site | Houston | Texas | United States |
| Peramivir investigative site | San Antonio | Texas | United States |
| Peramivir investigative site | Splendora | Texas | United States |
| Peramivir investigative site | Draper | Utah | United States |
| Peramivir investigative site | Salt Lake City | Utah | United States |
| Peramivir investigative site | South Jordan | Utah | United States |
| Peramivir Investigative Site | Pretoria | South Africa |
Age appropriate oral dose of Oseltamivir BID for 5 days:
Subjects ≥ 13 years - 75mg dose as a capsule or oral suspension. Subjects < 13 years - weight-based dose as a capsule or oral suspension.
| ITT Population | Intend-to-treat (ITT) population included all randomized subjects |
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| Safety Population | Safety Population included all randomized subjects who received ≥ 1 partial dose of peramivir or oseltamivir. |
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| ITTI Population | Intent-to-treat-infected (ITTI) population included all subjects who were enrolled, treated, and had influenza confirmed by RT-PCR. |
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| E-R Population | Exposure-response (E-R) Population included all subjects in the ITTI population who had a quantifiable peramivir concentration on Day 1 and had ≥ 1 post-baseline effectiveness assessment. |
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| COMPLETED |
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| NOT COMPLETED |
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The Intent-to-Treat (ITTI) population included all randomized subjects and was the primary population for analyses of demography and subject accountability.
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| ID | Title | Description |
|---|---|---|
| BG000 | Peramivir | Age-appropriate single dose Peramivir, administered as a single short iv infusion: Subjects ≥12 years - 600 mg. Subjects <12 years - 12 mg/kg (max. 600 mg). Subjects < 6 months - 8 mg/kg. |
| BG001 | Oseltamivir | Age appropriate oral dose of Oseltamivir BID for 5 days: Subjects ≥ 13 years - 75mg dose as a capsule or oral suspension. Subjects < 13 years - weight-based dose as a capsule or oral suspension. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean age (SD) is reported for the overall ITT population and for each of the 4 age groups | Mean | Standard Deviation | Age at time of randomisation - years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Baseline Influenza Viral Titer | Count of Participants | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||
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| Primary | Safety and Tolerability, as Measured by the Number of Participants Experiencing Adverse Events. | Safety evaluation included assessment of Adverse Events (AEs). | The Safety population included all randomized subjects who received ≥ 1 partial dose of peramivir or oseltamivir. | Posted | Count of Participants | Participants | 14 days |
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| Secondary | Plasma Exposure of IV Peramivir as Measured by the Drug Concentration Over 6 Hours Post-dose | Up to 4 blood samples will be drawn, where possible: immediately following infusion and 30 to 60 mins, 1 to 3 hrs and 4 to 6 hrs post-infusions. AUC calculations were performed in Phoenix WinNonlin using the linear/log trapezoidal rule. AUC0-last was calculated between start of the infusion and the time of the last measurable concentration. | The Intent-to-Treat (ITTI) population included all randomized subjects. Of these 114 subjects, 106 had sufficient PK samples collected for inclusion in the peramivir PK analysis | Posted | Mean | Standard Deviation | ng*h/mL | up to 6 hours post peramivir infusion |
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| Secondary | Time to Resolution of Fever | Time for fever resolution based on subject diary record of temperature recorded twice daily. A subject had resolution of fever if he/she had oral temperature of < 99.4°F or an axillary temperature of < 98.4°F and no antipyretic medications were taken for ≥ 12 hours. The time to resolution of fever was estimated for each age group and overall using the Kaplan-Meier method with temperature and symptom relief medication information obtained from the Subject Diary data. | Intent to treat infected (ITTI) population. Subjects who did not have resolution of fever were censored at the time of their last non-missing post-baseline temperature assessment; this included 1 subject in the '≥ 28 days - < 2 years' cohort treated with Peramivir. Seventeen subjects were excluded from summaries due to missing data or events resolving prior to initiation of study drug. | Posted | Mean | Standard Deviation | hours | 14 days |
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| Secondary | Time to Resolution of Influenza Symptoms | Subjects or parents or caregivers were asked to provide an assessment of age-appropriate influenza symptoms on a 4-point severity scale (0,absent; 1, mild; 2, moderate; 3, severe) twice daily beginning before screening on Day 1 until symptoms resolved or until the last follow-up visit. Time to alleviation of symptoms was the number of hours from initiation of study drug until the start of the time period in which all age-appropriate symptoms of influenza were either absent or present at a level no greater than mild for at least 21.5 (24 - 10%) hours. Subjects who did not experience alleviation of symptoms were censored at the last observed symptom assessment. | Intent to treat infected (ITTI) population. Subjects with no alleviation of symptoms were censored at date of last post-baseline assessment; including 1 subject in the '≥ 28 days to < 2 yrs, Peramivir' group, 1 subject in the '≥ 2 to < 7 yrs, Peramivir' group, 4 subjects in the '≥ 7 to < 13 yrs, Peramivir' group and 1 subject each in the '≥ 13 to < 18 yrs' Peramivir and Oseltamivir groups. Seven subjects were excluded due to missing data or events resolving prior to initiation of study drug. | Posted | Mean | Standard Deviation | hours | 14 days |
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| Secondary | Time to Reduction in Viral Shedding | Assessment of viral shedding in bilateral, mid-nasal swab specimens taken at baseline and then on Day 3, 7 and 14. | Intent to treat infected (ITTI) population + ITT population with positive baseline influenza viral titers [> 0.5 log10 TCID50/mL]; a total of 84 subjects. | Posted | Number | participants with positive viral titer | 14 days |
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| Secondary | Changes in Influenza Virus Titer in Nasopharyngeal Samples in Response to Treatment. | Change in influenza viral titers was defined as the time-weighted change from Baseline in log_10 tissue culture infective dose_50 (TCID50/mL) and was summarized for each treatment group. | The Intent To Treat Infected (ITTI) population included all subjects who were enrolled, received study drug, and had confirmed influenza A and/or B by PCR. Thirteen subjects were excluded due to a negative or missing baseline titer. | Posted | Median | Full Range | influenza viral titer - log10 TCID50/mL | Change from baseline assessed on days 3, 7 and 14. |
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| Secondary | Influenza-Related Complications Assessment. | The investigator performed a full physical exam at baseline. At each follow-up visit, study personnel evaluated the subject for the presence of clinical signs and symptoms of the following influenza-related complications: sinusitis, otitis media, bronchitis, and pneumonia requiring antibiotic use, diagnosed after initiation of treatment. | Intent-to-treat infected (ITTI) population | Posted | Count of Participants | Participants | 14 days |
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AEs were recorded on Day 1, Day 3, Day 7 and Day 14/Early Withdraw visit.
Adverse events were graded through use of the Division of Acquired Immune Deficiency Syndrome (DAIDS) Tables for Grading Adult and Pediatric Adverse Experiences. Influenza-related complications were not considered AEs unless they met the criteria for an SAE.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Peramivir | Age-appropriate single dose Peramivir, administered as a single short iv infusion: Subjects ≥12 years - 600 mg. Subjects <12 years - 12 mg/kg (max. 600 mg). Subjects < 6 months - 8 mg/kg. | 0 | 107 | 0 | 107 | 22 | 107 |
| EG001 | Oseltamivir | Age appropriate oral dose of Oseltamivir BID for 5 days: Subjects ≥ 13 years - 75mg dose as a capsule or oral suspension. Subjects < 13 years - weight-based dose as a capsule or oral suspension. | 0 | 23 | 0 | 23 | 5 | 23 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Vomiting | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Pyrexia | General disorders | MedDRA (18.0) | Systematic Assessment |
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| Tympanic membrane hyperaemia | Ear and labyrinth disorders | MedDRA (18.0) | Systematic Assessment |
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| Elevated aspartate aminotransferase | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Elevated blood lactate dehydrogenase | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Hallucination | Psychiatric disorders | MedDRA (18.0) | Systematic Assessment |
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| Chest discomfort | General disorders | MedDRA (18.0) | Systematic Assessment |
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| Injection site coldness | General disorders | MedDRA (18.0) | Systematic Assessment |
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| Injection site paraesthesia | General disorders | MedDRA (18.0) | Systematic Assessment |
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| Injection site rash | General disorders | MedDRA (18.0) | Systematic Assessment |
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| Gastroenteritis | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Paronychia | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Rhinitis | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Upper respiratory tract infection | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Urinary tract infection | Infections and infestations | MedDRA (18.0) | Systematic Assessment |
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| Epistaxis | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Rhinorrhoea | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Tonsillar disorder | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Tonsillar hypertrophy | Respiratory, thoracic and mediastinal disorders | MedDRA (18.0) | Systematic Assessment |
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| Tympanic membrane disorder | Ear and labyrinth disorders | MedDRA (18.0) | Systematic Assessment |
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| Alanine aminotransferase increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Blood creatine phosphokinase increased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Carbon dioxide decreased | Investigations | MedDRA (18.0) | Systematic Assessment |
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| Psychomotor hyperactivity | Nervous system disorders | MedDRA (18.0) | Systematic Assessment |
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| Erythema | Skin and subcutaneous tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Pruritus | Skin and subcutaneous tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Rash | Skin and subcutaneous tissue disorders | MedDRA (18.0) | Systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | MedDRA (18.0) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Study Director | BioCryst Pharmaceuticals Inc | +1 919-859-1302 | clinicaltrials@biocryst.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jul 11, 2016 | Nov 12, 2020 | SAP_001.pdf |
| ID | Term |
|---|---|
| D007251 | Influenza, Human |
| ID | Term |
|---|---|
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D009976 | Orthomyxoviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| C414210 | peramivir |
| D053139 | Oseltamivir |
| ID | Term |
|---|---|
| D000081 | Acetamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D053138 | Cyclohexenes |
| D003510 | Cyclohexanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
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| ≥ 28 days to < 2-year-old cohort |
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| ≥ 2 to < 7-year-old cohort |
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| ≥ 7 to < 13-year-old cohort |
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| ≥ 13 to < 18-year-old cohort |
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| Negative |
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| Missing |
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| Adverse Event possibly, probably, or definitely related to study drug |
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| Serious Adverse Events |
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| Adverse Event leading to discontinuation from study |
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| Adverse Event leading to Death |
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| OG003 | Peramivir (≥ 13 - < 18 Years) | 600 mg dose Peramivir, administered as a single short iv infusion |
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12 mg/kg (max. 600 mg) dose Peramivir, administered as a single short iv infusion |
| OG003 | Oseltamivir (≥ 2 - < 7 Years) | Weight-based dose of Oseltamivir as a capsule or oral suspension BID for 5 days. |
| OG004 | Peramivir (≥ 7 - < 13 Years) | Age-appropriate dose Peramivir, administered as a single short iv infusion: Subjects ≥12 years - 600 mg. Subjects <12 years - 12 mg/kg (max. 600 mg). |
| OG005 | Oseltamivir (≥ 7 - < 13 Years) | Weight-based dose of Oseltamivir as a capsule or oral suspension BID for 5 days. |
| OG006 | Peramivir (≥ 13 - < 18 Years) | 600 mg dose Peramivir, administered as a single short iv infusion |
| OG007 | Oseltamivir (≥ 13 - < 18 Years) | 75mg dose of Oseltamivir as a capsule or oral suspension BID for 5 days. |
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Weight-based dose of Oseltamivir as a capsule or oral suspension BID for 5 days. |
| OG002 | Peramivir (≥ 2 - < 7 Years) | 12 mg/kg (max. 600 mg) dose Peramivir, administered as a single short iv infusion |
| OG003 | Oseltamivir (≥ 2 - < 7 Years) | Weight-based dose of Oseltamivir as a capsule or oral suspension BID for 5 days. |
| OG004 | Peramivir (≥ 7 - < 13 Years) | Age-appropriate dose Peramivir, administered as a single short iv infusion: Subjects ≥12 years - 600 mg. Subjects <12 years - 12 mg/kg (max. 600 mg). |
| OG005 | Oseltamivir (≥ 7 - < 13 Years) | Weight-based dose of Oseltamivir as a capsule or oral suspension BID for 5 days. |
| OG006 | Peramivir (≥ 13 - < 18 Years) | 600 mg dose Peramivir, administered as a single short iv infusion |
| OG007 | Oseltamivir (≥ 13 - < 18 Years) | 75mg dose of Oseltamivir as a capsule or oral suspension BID for 5 days. |
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| OG004 | Peramivir (≥ 7 - < 13 Years) | Age-appropriate dose Peramivir, administered as a single short iv infusion: Subjects ≥12 years - 600 mg. Subjects <12 years - 12 mg/kg (max. 600 mg). |
| OG005 | Oseltamivir (≥ 7 - < 13 Years) | Weight-based dose of Oseltamivir as a capsule or oral suspension BID for 5 days. |
| OG006 | Peramivir (≥ 13 - < 18 Years) | 600 mg dose Peramivir, administered as a single short iv infusion |
| OG007 | Oseltamivir (≥ 13 - < 18 Years) | 75mg dose of Oseltamivir as a capsule or oral suspension BID for 5 days. |
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