Clinical trial • Phase II • Infectious Disease|Musculoskeletal

Vancomycin for Prosthetic joint infection

Phase II trial of Vancomycin for Prosthetic joint infection.

Overview

Trial Therapeutic Area
Infectious Disease|Musculoskeletal
Trial Disease
Prosthetic joint infection
Trial Stage
Phase II
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
08-03-2024
First CTIS Authorization Date
19-03-2024

Trial design

Randomised, placebo impregnated bone graft: morselized bone graft impregnated with 8 ml nacl (placebo); antibiotic impregnated bone graft: 8 ml of tobramycin (80 mg/ml) aspirated and used to dissolve 1 g vancomycin powder, solution mixed with morselized bone graft (single intraoperative application).-controlled Phase II trial across 13 sites in Sweden.

Randomised
Yes
Comparator
Placebo impregnated bone graft: Morselized bone graft impregnated with 8 ml NaCl (placebo); Antibiotic impregnated bone graft: 8 ml of tobramycin (80 mg/ml) aspirated and used to dissolve 1 g vancomycin powder, solution mixed with morselized bone graft (single intraoperative application).
Target Sample Size
1100
Trial Duration For Participant
1825

Eligibility

Recruits 1100 Vulnerable populations are not selected (isVulnerablePopulationSelected=false). Participants must be adults (Age ≥ 18) and willing to provide informed consent. Mental inability, reluctance, or language difficulties that impair understanding are listed as exclusion criteria. No assent procedures or specific consent-by-proxy arrangements are described..

Pregnancy Exclusion
Pregnant females
Vulnerable Population
Vulnerable populations are not selected (isVulnerablePopulationSelected=false). Participants must be adults (Age ≥ 18) and willing to provide informed consent. Mental inability, reluctance, or language difficulties that impair understanding are listed as exclusion criteria. No assent procedures or specific consent-by-proxy arrangements are described.

Inclusion criteria

  • {"criterion_text":"- Age ≥ 18 years\n- Hip arthroplasty requiring bone graft\n- Willing to provide informed consent\n- For females of childbearing potential; a negative pregnancy test prior to reoperation"}

Exclusion criteria

  • {"criterion_text":"- Ongoing prosthetic joint infection\n- Known allergies and contraindications for the use of vancomycin or tobramycin\n- Mental inability, reluctance, or language difficulties that according to investigator judgement, result in difficulty understanding the meaning of study participation\n- Expected difficulties to complete 2-year follow-up\n- Females of child bearing potential not using contraception\n- Pregnant females\n- Nursing females"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Reoperation due to infection or diagnosed PJI with bacteria that are sensitive to either vancomycin or tobramycin, in the same hip joint, within two years after hip arthroplasty","definition_or_measurement_approach":"Event-based: occurrence of reoperation due to infection or diagnosed prosthetic joint infection (PJI) with bacteria sensitive to vancomycin or tobramycin in the operated hip within 2 years after hip arthroplasty."}

Secondary endpoints

  • {"endpoint_text":"- Time and cause for reoperation for any reason within 2 and 5 years","definition_or_measurement_approach":"Time-to-event measurement: time from index surgery to reoperation and recorded cause, assessed at 2 and 5 years."}
  • {"endpoint_text":"- Time and cause for implant revision due to any reason within 2 and 5 years","definition_or_measurement_approach":"Time-to-event measurement: time from index surgery to implant revision and recorded reason, assessed at 2 and 5 years."}
  • {"endpoint_text":"- Type of microbe and antibiotic resistance pattern for cases complicated with postoperative infection","definition_or_measurement_approach":"Microbiological assessment of isolates from postoperative infections, with species identification and antibiotic susceptibility/resistance patterns."}
  • {"endpoint_text":"- Differences between the two experimental groups regarding the frequencies of adverse events","definition_or_measurement_approach":"Frequency counts and comparative analysis of reported adverse events between groups."}
  • {"endpoint_text":"- Differences between the two experimental groups regarding the rates of revision due to aseptic loosening","definition_or_measurement_approach":"Comparative assessment of rates of revision surgery attributed to aseptic loosening between groups over follow-up."}

Recruitment

Planned Sample Size
1100
Recruitment Window Months
109
Consent Approach
Informed consent required from participants; adults (≥18) provide consent. Consent documentation referenced (Subject information and informed consent form: L1-SIS and ICF_RCT and cohort). No details on assent or multiple-language documents provided in the record.

Geography

Total Number Of Sites
13
Total Number Of Participants
1100

Sweden

Earliest CTIS Part Ii Submission Date
17-01-2024
Latest Decision Or Authorization Date
30-03-2026
Processing Time Days
803
Number Of Sites
13
Number Of Participants
1100

Sites

Site Name
Region Skane Hassleholm Hospital
Department Name
orthopedi
Principal Investigator Name
Muhanned ALI
Principal Investigator Email
muhanned.ali@skane.se
Contact Person Name
Muhanned ALI
Contact Person Email
muhanned.ali@skane.se
Site Name
Region Dalarna
Department Name
orthopedi
Principal Investigator Name
Johan Risberg
Principal Investigator Email
johan.risberg@regiondalarna.se
Contact Person Name
Johan Risberg
Contact Person Email
johan.risberg@regiondalarna.se
Site Name
Sahlgrenska University Hospital-Vastra Gotalandsregionen
Department Name
orthopedi
Principal Investigator Name
Georgios Tsikandylakis
Principal Investigator Email
georgios.tsikandylakis@vgregion.se
Contact Person Name
Georgios Tsikandylakis
Site Name
Laenssjukhuset I Kalmar Region Kalmar Laen
Department Name
orthopedi
Principal Investigator Name
Rasmus Bjerre
Principal Investigator Email
rasmus.bjerre@regionkalmar.se
Contact Person Name
Rasmus Bjerre
Contact Person Email
rasmus.bjerre@regionkalmar.se
Site Name
Lasarettet I Motala Region Ostergotland
Department Name
orthopedi
Principal Investigator Name
Jonathan Brandt
Principal Investigator Email
jonathan.brandt@liu.se
Contact Person Name
Jonathan Brandt
Contact Person Email
jonathan.brandt@liu.se
Site Name
Region Skane Skanes Universitetssjukhus
Department Name
orthopedi
Principal Investigator Name
Anna Stefansdottir
Principal Investigator Email
Anna.Stefansdottir@skane.se
Contact Person Name
Anna Stefansdottir
Contact Person Email
Anna.Stefansdottir@skane.se
Site Name
Vaesterviks Sjukhus Region Kalmar Laen
Department Name
othopedi
Principal Investigator Name
Per Malmberg
Principal Investigator Email
Per.malmberg@regionkalmar.se
Contact Person Name
Per Malmberg
Contact Person Email
Per.malmberg@regionkalmar.se
Site Name
Danderyds Sjukhus AB
Department Name
orthopedi
Principal Investigator Name
Olof Sköldenberg
Principal Investigator Email
olof.skoldenberg@ki.se
Contact Person Name
Olof Sköldenberg
Contact Person Email
olof.skoldenberg@ki.se
Site Name
Region Oestergoetland
Department Name
Orthopedi
Principal Investigator Name
Jörg Schilcher
Principal Investigator Email
jorg.schilcher@liu.se
Contact Person Name
Jörg Schilcher
Contact Person Email
jorg.schilcher@liu.se
Site Name
Region Oerebro Laen
Department Name
orthopedi
Principal Investigator Name
Peter Wildeman
Principal Investigator Email
peter.wildeman@regionorebrolan.se
Contact Person Name
Peter Wildeman
Site Name
Vrinnevisjukhuset I Norrkoeping Region Oestergoetland
Department Name
Orthopedi
Principal Investigator Name
Martin Gusmark
Principal Investigator Email
region@regionostergotland.se
Contact Person Name
Martin Gusmark
Contact Person Email
region@regionostergotland.se
Site Name
Uppsala University Hospital
Department Name
Orthopedi
Principal Investigator Name
Stergios Lazarinis
Principal Investigator Email
stergios.lazarinis@akademiska.se
Contact Person Name
Stergios Lazarinis
Site Name
Region Skane Lasarettet Trelleborg
Department Name
Ortopedi
Principal Investigator Name
Anna Stefánsdóttir
Principal Investigator Email
Anna.Stefansdottir@skane.se
Contact Person Name
Anna Stefánsdóttir
Contact Person Email
Anna.Stefansdottir@skane.se

Sponsor

Primary sponsor

Full Name
Region Oestergoetland
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Sweden

Investigational products

Investigational Product Name
VANCOMYCIN
Active Substance
Vancomycin
Modality
Small molecule
Routes Of Administration
INTRAARTICULAR USE
Route
Intraarticular (impregnated bone graft applied during hip arthroplasty)
Starting Dose
1 g (vancomycin powder dissolved into solution applied to morselized bone graft intraoperatively)
Dose Levels
Single intraoperative dose of 1 g mixed into graft
Frequency
Single intraoperative application
Maximum Dose
3000 mg (maxTotalDoseAmount listed in product data)
Investigational Product Name
TOBRAMYCIN
Active Substance
Tobramycin sulfate
Modality
Small molecule
Routes Of Administration
INTRAARTICULAR USE
Route
Intraarticular (impregnated bone graft applied during hip arthroplasty)
Starting Dose
8 ml of tobramycin (80 mg/ml) → 640 mg (aspirated and used to dissolve vancomycin powder, applied to morselized bone graft intraoperatively)
Dose Levels
Single intraoperative dose of 8 ml (80 mg/ml)
Frequency
Single intraoperative application
Maximum Dose
1920 mg (maxTotalDoseAmount listed in product data)
Investigational Product Name
SALINE (placebo)
Active Substance
Saline
Modality
Other
Routes Of Administration
INTRAARTICULAR USE
Route
Intraarticular (impregnated bone graft applied during hip arthroplasty)
Starting Dose
8 ml NaCl
Dose Levels
Single intraoperative dose of 8 ml NaCl used to impregnate morselized bone graft
Frequency
Single intraoperative application
Maximum Dose
8 ml
Combination Treatment
Yes

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