Clinical trial • Phase I/II • Infectious Disease|Respiratory

DEMERECVIRIDAE BACTERIOPHAGE AGAINST KLEBESIELLA PNEUMONIAE (113.073 BP), DREXLERVIRIDAE BACTERIOPHAGE AGAINST KLEBESIELLA PNEUMONIAE (45.423 BP), MYOVIRIDAE BACTERIOPHAGE AGAINST KLEBESIELLA PNEUMONIAE (169.802 BP), MYOVIRIDAE BACTERIOPHAGE AGAINST PSEUDOMONAS AERUGINOSA (65.855 BP), MYOVIRIDAE BACTERIOPHAGE AGAINST PSEUDOMONAS AERUGINOSA (92.792 BP), SIPHOVIRIDAE BACTERIOPHAGE AGAINST PSEUDOMONAS AERUGINOSA (43.020 BP) for Ventilator-associated pneumonia

Phase I/II trial of DEMERECVIRIDAE BACTERIOPHAGE AGAINST KLEBESIELLA PNEUMONIAE (113.073 BP), DREXLERVIRIDAE BACTERIOPHAGE AGAINST KLEBESIELLA PNEUMONIAE…

Overview

Trial Therapeutic Area
Infectious Disease|Respiratory
Trial Disease
Ventilator-associated pneumonia
Trial Stage
Phase I/II
Drug Modality
Other

Key dates

Initial CTIS Submission Date
20-05-2025
First CTIS Authorization Date
09-09-2025

Trial design

Randomised, open-label, standard of care (soc) alone; excipient mixture (solvent): sodium chloride 0.9% w/v; tromethamine tris® 0.30% w/v; polysorbate 80 0.02% w/v; glycerol 5% v/v; mannitol 0.6% w/v; hydrochloric acid q.s. (placebo). no dose or schedule for tp-122a or placebo specified in available data.-controlled Phase I/II trial across 8 sites in Portugal, Netherlands.

Randomised
Yes
Open Label
Yes
Comparator
Standard of Care (SoC) alone; Excipient mixture (solvent): Sodium Chloride 0.9% w/v; Tromethamine TRIS® 0.30% w/v; Polysorbate 80 0.02% w/v; Glycerol 5% v/v; Mannitol 0.6% w/v; Hydrochloric Acid q.s. (placebo). No dose or schedule for TP-122A or placebo specified in available data.
Target Sample Size
38

Eligibility

Recruits 38 Able and willing to sign the ICF. If the subject is unable to do so, the legally designated representative should provide consent or in specific situation at discretion of the investigator in emergency situations as per local country regulations and institution specific guidelines. In all cases, once the patient’s clinical situation allows, informed consent will be sought from the patient themselves as soon as possible, even if prior consent was obtained through a legal representative or under emergency regulations..

Pregnancy Exclusion
Subjects who are pregnant, breastfeeding, planning pregnancy, or unable/unwilling to comply with the required contraceptive measures descrived in Section 10.2 are excluded from participation.
Vulnerable Population
Able and willing to sign the ICF. If the subject is unable to do so, the legally designated representative should provide consent or in specific situation at discretion of the investigator in emergency situations as per local country regulations and institution specific guidelines. In all cases, once the patient’s clinical situation allows, informed consent will be sought from the patient themselves as soon as possible, even if prior consent was obtained through a legal representative or under emergency regulations.

Inclusion criteria

  • {"criterion_text":"-Able and willing to sign the ICF. If the subject is unable to do so, the legally designated representative should provide consent or in specific situation at discretion of the investigator in emergency situations as per local country regulations and institution specific guidelines. In all cases, once the patient’s clinical situation allows, informed consent will be sought from the patient themselves as soon as possible, even if prior consent was obtained through a legal representative or under emergency regulations."}
  • {"criterion_text":"-Subjects with 18 years old, or older."}
  • {"criterion_text":"-Subjects intubated and on invasive mechanical ventilation in the intensive care unit for at least 48 hours with : - PaO2/FiO₂ ≥ 200 mm g and ≤300 mm g; - 0.30 ≤ FiO2 ≤ 0.60 (FiO2 within 0.3 and 0.6) - Compliance ≥ 30 mL/cm H2O; - Positive End-Expiratory Pressure (PEEP) ≤ 10 cm H2O;"}
  • {"criterion_text":"-No diagnosis of new-onset pneumonia within 72 hours before randomisation (subjects with evidence of resolved pneumonia will be eligible)"}
  • {"criterion_text":"-New or worsening infiltrate consistent with pneumonia on chest X-ray or CT Scan, within 24 hours of the event of infection of P. aeruginosa."}
  • {"criterion_text":"-New onset respiratory sign or symptom of increase in respiratory demand, evidenced by need for acute changes in the ventilator support system to enhance oxygenation, as determined by worsening oxygenation (need to increase FiO2 by 20% or more to maintain oxygen saturation), or needed changes in the amount of PEEP; OR at least two of the following signs: i. Documented fever (i.e., core body temperature [tympanic, rectal, esophageal] ≥ 38° C [100.4ºF], oral temperature ≥ 37.5°C [99.5ºF], or axillary temperature ≥ 37°C [98.6ºF]); and/or ii. Hypothermia (i.e., core body temperature [tympanic, rectal, esophageal] ≤ 35°C [95°F]); and/or iii. White Blood Cell (WBC) count ≥ 10,000 cells/mm³; and/or iv. Leukopenia with total WBC count ≤ 4500 cells/mm³; and/or v. Production of new purulent endotracheal secretions and/or vi. Physical examination findings consistent with pneumonia/ pulmonary consolidation such as auscultatory findings (e.g. rales, rhonchi, and bronchial breath sounds and/or vii. Dullness to percussion"}
  • {"criterion_text":"-Microbiological diagnosis of P. aeruginosa infection in the LRT, before randomization. (Demonstrate the presumptive presence of P. aeruginosa using a rapid diagnostic method either microbiological or molecular. Acceptable approaches include: (1) plating the sample on cetrimide selective agar and incubating for 24 hours at 37°C, with P. aeruginosa colonies typically appearing smooth, greenish (due to pyocyanin), and fluorescent under UV light (due to pyoverdine) and being oxidase positive; or (2) performing PCR testing, such as the BIOFIRE® FILMARRAY® Pneumonia Panel plus (bioMérieux) or equivalent methodologies. These methods support patient recruitment based on the presumptive identification of P. aeruginosa as the causative agent of ventilator-associated pneumonia (VAP), in accordance with the diagnostic capabilities and standard procedures of the local laboratory. Patient randomization will proceed based on this presumptive identification. Bacteria identification results from respiratory samples obtained until not more than 48h before screening are accepted)."}
  • {"criterion_text":"-Subjects with childbearing potential must have a negative highly sensitive serum pregnancy test at screening. (Male and female subjects of childbearing potential must agree to use highly effective contraception as defined in Section 10.2 from the time of informed consent until at least 30 days after the last dose of IMP.)"}

Exclusion criteria

  • {"criterion_text":"-Moderate to severe acute respiratory distress syndrome (ARDS) or a condition that, in the opinion of the Investigator, could compromise the well-being of the subject, or the course of the study, or prevent the subject from meeting/performing any study requirements/procedures."}
  • {"criterion_text":"-Subjects requiring prone position."}
  • {"criterion_text":"-Subjects who are pregnant, breastfeeding, planning pregnancy, or unable/unwilling to comply with the required contraceptive measures descrived in Section 10.2 are excluded from participation."}
  • {"criterion_text":"-Participation in another clinical trial at the time of randomization or prior participation in a clinical trial involving the administration of an IMP within 30 days before randomization or within ‘5 half-lives of the IMP’ (whichever is longer). if the clinical trial in which the patient is or was enrolled is considered relevant to patients with ventilator-associated pneumonia (VAP). The determination of such relevance must be discussed with, and receive prior approval from, the sponsor"}
  • {"criterion_text":"-Subjects with active community-acquired bacterial pneumonia, viral or fungal pneumonia (including Pneumocystis jiroveci) are excluded (patients with resolved pneumonia will be eligible). Additionally, subjects with tracheobronchitis (without documented pneumonia), chemical pneumonitis, post-obstructive pneumonia (except for subjects with a mild severity disease, that do not require pulmonary function tests), or tracheostomy (except for subjects that have tracheostomy performed while being hospitalised in the ICU) are also excluded."}
  • {"criterion_text":"-Subjects requiring Airway Pressure Release Ventilation or High Frequency Oscillatory Ventilation. Subjects needing for any form of ECLS/ECMO."}
  • {"criterion_text":"-Subjects with pleural effusions (or empyema) requiring therapeutic drainage, or lung abscess, or bronchiectasis; or cystic fibrosis, or acute exacerbation of chronic bronchitis, or active pulmonary tuberculosis; or with stage IV congestive heart failure, or cirrhotic liver disease."}
  • {"criterion_text":"-Subjects with severe asthma or reactive airway disease, according to Investigator’s decision."}
  • {"criterion_text":"-History of known hypersensitivity to any component of the investigational product."}

Endpoints

Primary endpoints

  • {"endpoint_text":"-Analysis of TP-122A arm with SoC versus SoC alone, and individual analysis per treatment arm of the following assessments: Adverse Events (AEs), Clinical laboratory parameters, Vital signs, Eletrocardiogram (ECG)","definition_or_measurement_approach":"Comparative analysis TP-122A + SoC versus SoC alone assessing Adverse Events, clinical laboratory parameters, vital signs and ECG; no additional measurement definition provided."}

Secondary endpoints

  • {"endpoint_text":"-Proportion of subjects achieving “Clinical Cure” (CR)","definition_or_measurement_approach":""}
  • {"endpoint_text":"-Time to achieve “Clinical Cure”.","definition_or_measurement_approach":""}
  • {"endpoint_text":"-Proportion of subjects achieving Microbiological Response (MR) of “Eradication” or “Presumed Eradication” of TP-122A target bacteria","definition_or_measurement_approach":""}
  • {"endpoint_text":"-Time to achieve MR “Eradication” or “Presumed Eradication”.","definition_or_measurement_approach":""}
  • {"endpoint_text":"-Number of days of antibiotic usage.","definition_or_measurement_approach":""}
  • {"endpoint_text":"-Number of days with MV.","definition_or_measurement_approach":""}
  • {"endpoint_text":"-Number of days to discharge from ICU.","definition_or_measurement_approach":""}
  • {"endpoint_text":"-Overall Survival: all-cause mortality, at FUp2.","definition_or_measurement_approach":""}

Recruitment

Planned Sample Size
38
Recruitment Window Months
9
Consent Approach
Adults (≥18 years) able and willing to sign the informed consent form (ICF) must provide consent. If the subject is unable to sign, the legally designated representative should provide consent; in specified emergency situations the investigator may enroll per local regulations and institution-specific guidelines. As soon as the patient's condition permits, informed consent will be sought from the patient themselves even if prior consent was obtained via a legal representative or emergency procedures. ICF/SIS documents are available in Portuguese and Dutch (L1_SIS and ICF PT and NL files listed). No assent procedures (paediatric) required because inclusion is 18+.

Geography

Total Number Of Sites
8
Total Number Of Participants
38

Portugal

Earliest CTIS Part Ii Submission Date
17-07-2025
Latest Decision Or Authorization Date
09-09-2025
Processing Time Days
54
Number Of Sites
5
Number Of Participants
19

Sites

Site Name
Unidade Local De Saude De Loures-Odivelas EPE
Department Name
Intensive Care Medicine
Contact Person Name
Carlos Simões Pereira
Site Name
CCAB Centro Clinico Academico Braga Associacao
Department Name
Intensive Care Medicine
Contact Person Name
Pedro Silveira
Contact Person Email
pedro.silveira@hb.min-saude.pt
Site Name
Unidade Local De Saude De Coimbra E.P.E.
Department Name
Intensive Care Medicine
Contact Person Name
João Pedro Baptista
Site Name
Hospital De Vila Franca De Xira E.P.E.
Department Name
Intensive Care Medicine
Contact Person Name
João Gonçalves Pereira
Contact Person Email
cdi@hvfx.min-saude.pt
Site Name
Galo Saude Parcerias Cascais S.A.
Department Name
Intensive Care Medicine
Contact Person Name
Carina Carvalho

Netherlands

Earliest CTIS Part Ii Submission Date
28-08-2025
Latest Decision Or Authorization Date
09-09-2025
Processing Time Days
12
Number Of Sites
3
Number Of Participants
19

Sites

Site Name
Universitair Medisch Centrum Utrecht
Department Name
Intensive Care
Contact Person Name
Lennie Derde
Contact Person Email
lderde@umcutrecht.nl
Site Name
Amsterdam UMC Stichting
Department Name
Pneumology- Intensive Care
Contact Person Name
Lieuwe Durk Jacobus Bos
Contact Person Email
l.d.bos@amc.uva.nl
Site Name
Radboud universitair medisch centrum Stichting
Department Name
Intensive Care Medicine
Contact Person Name
Jeroen Schouten
Contact Person Email
jeroen.schouten@radboudumc.nl

Sponsor

Primary sponsor

Full Name
Technophage Investigacao E Desenvolvimento Em Biotecnologia S.A.
Organisation Type
Pharmaceutical company
Country Of Registered Address
Portugal

Investigational products

Investigational Product Name
TP-122
Active Substance
DEMERECVIRIDAE BACTERIOPHAGE AGAINST KLEBESIELLA PNEUMONIAE (113.073 BP), DREXLERVIRIDAE BACTERIOPHAGE AGAINST KLEBESIELLA PNEUMONIAE (45.423 BP), MYOVIRIDAE BACTERIOPHAGE AGAINST KLEBESIELLA PNEUMONIAE (169.802 BP), MYOVIRIDAE BACTERIOPHAGE AGAINST PSEUDOMONAS AERUGINOSA (65.855 BP), MYOVIRIDAE BACTERIOPHAGE AGAINST PSEUDOMONAS AERUGINOSA (92.792 BP), SIPHOVIRIDAE BACTERIOPHAGE AGAINST PSEUDOMONAS AERUGINOSA (43.020 BP)
Modality
Other
Routes Of Administration
INHALATION USE
Route
INHALATION USE
First In Human
Yes
Investigational Product Name
Excipient mixture (solvent):Sodium Chloride 0.9% w/v ;Tromethamine TRIS® 0.30% w/v; Polysorbate 80 0.02% w/v; Glycerol 5% v/v; Mannitol 0.6% w/v; Hydrochloric Acid q.s.
Modality
Other
Combination Treatment
Yes

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