Efficacy and safety of suvratoxumab for prevention of Staphylococcus aureus ventilator-associated pneumonia (SAATELLITE): a multicentre, randomised, double-blind, placebo-controlled, parallel-group, phase 2 pilot trial
- Type de publi. : Article dans une revue
- Date de publi. : 01/09/2021
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Auteurs :
Bruno FrançoisHasan JafriJean ChastreMiguel Sánchez-GarcíaPhilippe EggimannPierre-François DequinVincent HuberlantLucia Viña SoriaThierry BoulainCédric BretonnièreJérôme PuginJosep TrenadoAna Catalina Hernandez PadillaOmar AliKathryn ShoemakerPin RenFrank CoenjaertsAlexey RuzinOlivier BarraudLeen TimbermontChristine LammensVadryn PierreYuling WuJulie VignaudSusan ColbertTerramika BellamyMark EsserFilip DubovskyMarc BontenHerman GoossensPierre-François LaterreDidier ChochradAlain DiveFrédéric ForetMarc SimonHerbert SpapenJacques CreteurYves BouckaertPatrick BistonMarc BourgeoisMartin NovacekTomas VymazalPetr SvobodaJan PachlVladimir SramekMichal HanauerTomas HrubyMartin BalikTomas SuchyAlain LepapeLaurent ArgaudFrédéric DaillerArnaud DesachyChristophe GuittonAlain MercatFerhat MezianiJean-Christophe NavellouRene RobertBertrand SouweineJean-Marc TadieAdel MaamarDjillali AnnaneFabienne TamionAntoine GrosSaad NseirCarole SchwebelGilles FranconyJean-Yves LefrantFrancis SchneiderMatthias GründlingJohann MotschLorenz ReillCaroline RolfesTobias WelteOliver CornelyFrank BloosMaria DejaKatrin SchmidtFrank WapplerAndreas Meier-HellmannApostolos KomnosVasileios BekosVasilios KoulourasIoanna SoultatiGeorgios BaltopoulosGeorgios FilntisisEpaminondas ZakynthinosSpyros ZakynthinosIoannis PnevmatikosIldikó KrémerZoltán SzentkeresztyAgnes SarkanyZsuzsa MarjanekPedro MouraMaria Consuelo Pintado DelgadoJuan Carlos Montejo GonzálezPaula RamirezAntonio Torres MartiJuan Carlos ValiaJose LorenteAna Loza VazquezRaúl de Pablo SanchezDolores EscuderoRicard Ferrer RocaJean-Luc PaganiMarco Maggiorini
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Organismes :
Centre d'Investigation Clinique de Limoges
Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques
Service de Réanimation Polyvalente [CHU Limoges]
AstraZeneca
CHU Pitié-Salpêtrière [AP-HP]
Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain]
Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital [Lausanne]
Centre d’Investigation Clinique [Tours] CIC 1415
Centre d’Etude des Pathologies Respiratoires [Tours]
Hospital Universitario Central de Asturias
Centre Hospitalier Regional d'Orléans
Hôpital Guillaume-et-René-Laennec [Saint-Herblain]
Hôpitaux Universitaires de Genève = University Hospital of Geneva [Genève]
Hospital Universitario Mutua de Terrassa
Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques
CHU Limoges
AstraZeneca
AstraZeneca
AstraZeneca
University Medical Center [Utrecht]
AstraZeneca
Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques
CHU Limoges
Antwerp University Hospital [Edegem]
Antwerp University Hospital [Edegem]
AstraZeneca
AstraZeneca
CHU Limoges
Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques
AstraZeneca
AstraZeneca
AstraZeneca
AstraZeneca
Centre d'Investigation Clinique de Limoges
Antwerp University Hospital [Edegem]
Université Catholique de Louvain = Catholic University of Louvain
- Publié dans The Lancet Infectious Diseases le 29/10/2020
Résumé : Background Staphylococcus aureus remains a common cause of ventilator-associated pneumonia, with little change in incidence over the past 15 years. We aimed to evaluate the efficacy of suvratoxumab, a monoclonal antibody targeting the α toxin, in reducing the incidence of S aureus pneumonia in patients in the intensive care unit (ICU) who are on mechanical ventilation. Methods We did a multicentre, randomised, double-blind, placebo-controlled, parallel-group, phase 2 pilot trial at 31 hospitals in Belgium, the Czech Republic, France, Germany, Greece, Hungary, Portugal, Spain, and Switzerland. Eligible patients were in the ICU, aged ≥18 years, were intubated and on mechanical ventilation, were positive for S aureus colonisation of the lower respiratory tract, as assessed by quantitative PCR (qPCR) analysis of endotracheal aspirate, and had not been diagnosed with new-onset pneumonia. Patients were excluded if they had confirmed or suspected acute ongoing staphylococcal disease; had received antibiotics for S aureus infection for more than 48 h within 72 h of randomisation; had a Clinical Pulmonary Infection Score of 6 or higher; had an acute physiology and chronic health evaluation II score of 25 or higher with a Glasgow coma scale (GCS) score of more than 5, or an acute physiology and chronic health evaluation II score of at least 30 with a GCS score of 5 or less; had a Sequential Organ Failure Assessment score of 9 or higher; or had active pulmonary disease that would impair the ability to diagnose pneumonia. Colonised patients were randomly assigned (1:1:1), by use of an interactive voice or web response system, to receive either a single intravenous infusion of suvratoxumab 2000 mg, suvratoxumab 5000 mg, or placebo. Randomisation was done in blocks of size four, stratified by country and by whether patients had received systemic antibiotics for S aureus infection. Patients, investigators, and study staff involved in the treatment or clinical evaluation of patients were masked to patient assignment. The primary efficacy endpoint was the incidence of S aureus pneumonia at 30 days, as determined by a masked independent endpoint adjudication committee, in all patients who received their assigned treatment (modified intention-to-treat [ITT] population). Primary safety endpoints were the incidence of treatment-emergent adverse events at 30 days, 90 days, and 190 days after treatment, and the incidence of treatment-emergent serious adverse events, adverse events of special interest, and new-onset chronic disease at 190 days after treatment. All primary safety endpoints were assessed in the modified ITT population. This trial is registered with ClinicalTrials.gov (NCT02296320) and the EudraCT database (2014-001097-34).
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