Table 3.
Major Findings and Indications from Randomized Controlled Trials and Other Studies Reviewed
| Studies | Type of Study | Number of Patients Included | Indications | Comparative Drugs | Adverse Effects (AE) |
|---|---|---|---|---|---|
Boucher et al12
|
Randomised, double-blind, international, and multicentre clinical trials phase 3 |
Dalbavancin (D): 659 Vancomycin-Linezolid (V-L): 653 (both trial) |
Treatment of acute bacterial skin and skin-structure infection* | Dalbavancin: 1 g intravenously (IV) on day (d) 1, 500 mg IV on d 8 Vancomycin-Linezolid: vancomycin 1 g (or 15 mg per kilogram) IV every 12 hours for at least 3 days. Option to switch to oral linezolid 600 mg every 12 hours, to complete 10 to 14 days of therapy |
Total events (P=0.05) Dalbavancin: 32.8% Vancomycine-Linezolid: 37.9% Most common AE: Nausea: D) 2.5% V-L) 2.9% P= 0.62 Diarrhea: D) 0.8% V-L) 2.5% P=0.02 Pruritus: D) 0.6% V-L) 2.3% P=0.,01 |
|
Randomised, double-blind trial phase 3 |
Dalbavancin: 347 Cefazolin (C): 186 |
Uncomplicated skin and skin structure infection | Dalbavancin: 1 g IV D 1 ± 500mg IV D 8 Cefazolin: 500mg IV every 8h/cephalexin 500mg PO QID x 7 or 14 days |
Available only aggregate safety analyses of all seven phase 2 and 3 studies26** |
|
Randomised, double-blind trial phase 3 |
Dalbavancin: 107 Vancomycin: 49 |
Complicated skin and skin structure infection | Dalbavancin: 1 g IV D 1 ± 500mg IV D 8 Vancomycin 1000mg IV q12h/switch based upon in vitro data x 7 or 14 days |
Available only aggregate safety analyses of all seven phase 2 and 3 studies26** |
|
Randomised, double-blind trial phase 3 |
Dalbavancin: 571 Linezolid (L): 283 |
Complicated skin and skin structure infection | Dalbavancin: 1 g IV d 1 + 500 mg IV d 8 Linezolid: 600 mg intravenously or intravenously/orally every 12 h for 14 days |
Total events D) 25.4% L) 32.2% Most common AEs: Nausea: D) 3.2% L) 5.3% Diarrhea: D) 2.5% L) 5.7% Elevated blood LDH: D) 1.9% L) 1.8% Headache: D) 1.9% L) 1.8% Elevated GGT: D) 1.9% L) 1.4% Vomiting: D) 1.9% L) 1.1% Rash: D) 1.8% L) 1.8% |
|
Randomized, open-label phase 2 |
Dalbavancin: 40 D1: 7 D2: 33 Vancomycin: 34 |
Catheter-related bloodstream Infections | Dalbavancin: D1) 650mg, then 65mg daily for 7–14 days D2) 1000mg Day 1 ±500mg Day 8 Vancomycin: 1000mg IV q12h for 7–14 days |
Available only aggregate safety analyses of all seven phase 2 and 3 studies26** |
|
Randomized (1:1:1), open-label | Dalbavancin: 41 D1:21 D2: 20 Standard of care: 21 |
Skin and Skin Structure Infection (SSSI) (mixed: uncomplicated and complicated) | Dalbavancin: D1) 1100mg x 1 D2) 1000mg Day1 ±500mg Day 8 Standard of care |
Available only aggregate safety analyses of all seven phase 2 and 3 studies26** |
| Bouza et al15 | Retrospective study (real-life) |
Dalbavancin: 69 | PJI: 29% ABSSSI:21.7% osteomyelitis: 17.4% catheter related Bacteraemia: 11.6% |
Dalbavancin: 1500 mg IV, or 1000 mg + 500 mg IV | Rash 2 (2.9%) Tachycardia 2 (2.9%) Impaired renal function 2 (2.9%) Nausea 1 (1.4%) Rectal bleeding 1 (1.4%) Candidiasis 1 (1.4%) |
| Arrieta-Loitegui et al33 | Retrospective study | Dalbavancin: 102 | Skin and soft tissue Infections: 30.4% Catheter-related Bacteraemia: 15.7% Endocarditis: 13.7% Bacteraemia with Suspected endocarditis: 10.8% PJI: 10.8% Osteomyelitis:10.8% Bacteraemia: 4.9% Septic arthritis:1.9% Febrile syndrome: 1% |
Dalbavancin: 1500 mg IV from 1 to 6 times every 7/15 days Dalbavancin: 500 mg IV from 1 to 5 times every 7 days |
Total AEs: 4 (3.99%) Rash: 1 Nausea and vomiting: 1 Infusion reaction: 1 Hypersensitivity: 1 |
| Wunsch et al49 | Multicentre, retrospective study | Dalbavancin: 101 | PJI: 31% osteomyelitis: 29% endocarditis: 25% ABSSSI: 12% | Dalbavancin regimen: - 1500 mg IV once: 23.8% - 1500 mg day (d)1 + d8: 13.9% - 1500 mg d1 + d8 and in week 8: 3% - 1000 mg d1 followed by 500 mg weekly: 42.6% - 1000 mg every 14 d: 3% - other regimens: 13.9% |
Total AEs: 3 dyspnea and arterial hypertension: 1 severe fatigue: 1 (after 11w treatment) vertigo: 1 (long term therapy) |
| Durante-Mangoni et al5 | Retrospective study | Dalbavancin: 30 | ABSSSI: 8 osteomyelitis: 4 PJI: 12 catheter-related bloodstream infections: 4 infectious endocarditis: 2 |
Dalbavancin 1 g IV d1 + 500 mg Day 8 | Total AEs: 3 cases (all moderate) evanescent rash (infusion), dizziness: 1 malaise, pruritus and chills: 1 dyspnea and hypotension: 1 |
Notes: *Skin-structure infection required the presence of cellulitis, a major abscess, or a wound infection, each associated with at least 75 cm2 of erythema. **Phase 2 studies: VER001-4, VER001-5; Phase 3 studies: VER001-8, VER001-9, VER001-16, DISCOVER 1, DISCOVER 2.
Abbreviations: ABSSSI, acute bacterial skin and skin-structure infection; PJI, prosthetic joint infection; LDH, lactate dehydrogenase level; GGT, g-glutamyltransferase.