Title

Study to Assess Safety and Clinical Activity of Local MBN-101 in Treatment of Infected Bone Sites
Phase 2a Randomized, Single-Blind, Placebo-Controlled, 12-week Escalating Dose Study to Assess the Safety, Tolerability and Clinical Activity of 3 Concentrations of Locally Applied MBN-101 to Infected Bone Sites
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Study Participants

    29
This study evaluates the safety and clinical benefit of MBN-101 administered intraoperatively to osteosynthesis or osteomyelitis sites for patients diagnosed with an orthopedic infection, with or without orthopaedic hardware. Three quarters of the patients will receive MBN-101, while the other one quarter will receive placebo.
Postoperative orthopaedic infections, particularly antibiotic-resistant infections, present a serious clinical challenge to surgeons and other treating physicians. These infections frequently involve implanted foreign materials (stabilizing orthopaedic hardware), making infection of these sites much more likely than if foreign materials were not involved. MBN-101 has broad spectrum antimicrobial activity against orthopaedic wound pathogens.

This is a randomized, single-blind, placebo-controlled, multi-center study to assess the safety and tolerability of escalating doses of MBN-101 to treat orthopaedic infections during revision surgery, (a) with or without orthopaedic hardware, and (b) with or without removal and replacement of orthopaedic hardware.
Study Started
May 24
2016
Primary Completion
Oct 27
2017
Study Completion
Jul 26
2018
Results Posted
Sep 30
2021
Last Update
Sep 30
2021

Drug MBN-101

MBN-101 is a locally administered, anti-infective drug product

  • Other names: MBN-101 Drug Product

Other Placebo

The placebo is comprised of the vehicle/excipients used to formulate MBN-101, but does not contain the active pharmaceutical ingredient

  • Other names: Diluent; Vehicle

Cohort 1 Experimental

Single, intra-wound local administration of MBN-101; dosage = 0.5 µg/cm2; randomized 3:1 with placebo

Cohort 2 Experimental

Single, intra-wound local administration of MBN-101; dosage = 1.5 µg/cm2; randomized 3:1 with placebo

Cohort 3 Experimental

Single, intra-wound local administration of MBN-101; dosage = 5.0 µg/cm2; randomized 3:1 with placebo

Criteria

Inclusion Criteria:

To be eligible for this study, each of the following criteria must be satisfied with a "YES" answer (unless not applicable):

Patients who:

have had operative fracture fixation of the upper extremity (AO/OTA class 15, 11-13, 21-23), lower extremity (AO/OTA class 31-34, 41 44, 81, 82) or pelvis (61, 62), or have undergone arthrodesis, and have subsequently been diagnosed with an apparent fracture site infection or are diagnosed with chronic or acute-on-chronic osteomyelitis of the long bone extremities (including residual amputated limbs)
have at least one of the following:
require surgical debridement of infected soft tissue and/or bone, with or without removal and/or placement/replacement of hardware
male or female between the ages of 18 and 75 at the time the ICF is reviewed and signed
patients receiving or anticipated to receive systemic antibiotic therapy as per institution's standard of care
patients requiring postoperative hospitalization for at least 48 hours after revision surgery
have read and signed the Informed Consent Form (ICF) after the nature of the study has been fully explained
be willing and able to provide authorization for use and disclosure of personal health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA)

Exclusion Criteria:

To be eligible for this study, each of the following criteria must be satisfied with a "NO" answer (unless not applicable):

Patients who are no longer hardware dependent or are definitively treated for their infection by hardware removal without replacement
Patients with multiple, non-contiguous sites of infection
Pathologic fracture (not including osteoporosis)
Patient requires immunosuppressive therapy (Topical or inhaled corticosteroids are permitted)
Serum creatinine, ALT, AST or Alkaline Phosphatase >2.0 times the upper limit of the normal range of the local testing laboratory
Absolute neutrophil count <1000
Patients without definitive soft-tissue coverage over the surgical site at time of study product administration
Any condition that has required treatment with any other bismuth containing compound within the last 2 weeks (i.e., Kaopectate or Pepto Bismol)
Participation in an investigational trial to evaluate pharmaceuticals or biologics within the past 3 months
Individuals undergoing surgical treatment for more than one infected site
Patients who are pregnant, lactating, or female patients who have a positive serum hCG (human Chorionic Gonadotropin) as determined by laboratory testing
Immunocompromised due to illness or organ transplant
History of chronic or recurrent infections (≥ 3 infections at the same site within 12 months)
History of any type of cancer (excluding non-melanomatous localized skin cancer or completely excised and cured carcinoma-in-situ of uterine cervix)
Poorly controlled diabetes mellitus
History of medical noncompliance
Other medical conditions which, in the opinion of the Principal Investigator, would jeopardize the safety of the study subject or impact the validity of the study results.
Current incarceration

Summary

MBN-101 0.5 µg/cm2

MBN-101 1.5 µg/cm2

MBN-101 5.0 µg/cm2

Placebo

All Events

Event Type Organ System Event Term MBN-101 0.5 µg/cm2 MBN-101 1.5 µg/cm2 MBN-101 5.0 µg/cm2 Placebo

Number of Participants With Adverse Events

This study evaluates the safety and tolerability of single escalating doses of locally administered MBN-101 or placebo, as adjunct to standard of care antimicrobial and surgical therapy.

MBN-101 0.5 µg/cm2

Safety: Drug-related TEAEs

1.0
participants

Safety: SAEs

4.0
participants

Safety: TEAEs

5.0
participants

MBN-101 1.5 µg/cm2

Safety: Drug-related TEAEs

1.0
participants

Safety: SAEs

2.0
participants

Safety: TEAEs

4.0
participants

MBN-101 5.0 µg/cm2

Safety: Drug-related TEAEs

1.0
participants

Safety: SAEs

Safety: TEAEs

1.0
participants

Placebo

Safety: Drug-related TEAEs

1.0
participants

Safety: SAEs

3.0
participants

Safety: TEAEs

6.0
participants

Number of Treatment Failures

Treatment failure is defined as clinical course requiring additional infection-related interventions including rehospitalization, additional surgery, or additional courses of systemic antibiotics.

Cohort 1

1.0
Treatment failure events

Cohort 2

2.0
Treatment failure events

Cohort 3

1.0
Treatment failure events

Placebo

3.0
Treatment failure events

Treatment Failure in Subjects With Antibiotic-resistant Infections

Treatment failure in subjects with baseline infections resistant to one or more antibiotics based on Central Laboratory Microbiological data

Cohort 1

1.0
Failures in antibiotic-resistant subject

Cohort 2

2.0
Failures in antibiotic-resistant subject

Cohort 3

1.0
Failures in antibiotic-resistant subject

Placebo

2.0
Failures in antibiotic-resistant subject

Total

25
Participants

Age, Categorical

Race (NIH/OMB)

Sex: Female, Male

Overall Study

MBN-101 0.5 µg/cm2

MBN-101 1.5 µg/cm2

MBN-101 5.0 µg/cm2

Placebo

Drop/Withdrawal Reasons

MBN-101 0.5 µg/cm2

MBN-101 1.5 µg/cm2

MBN-101 5.0 µg/cm2

Placebo