A Study of LBP-EC01 in the Treatment of Acute Uncomplicated UTI Caused by Drug Resistant E. Coli (ELIMINATE Trial)

Last updated: February 24, 2025
Sponsor: Locus Biosciences
Overall Status: Active - Recruiting

Phase

2

Condition

Urinary Tract Infections

Treatment

LBP-EC01 0.1 x IV dose

LBP-EC01 IV Infusion Dose

LBP-EC01 0.01x IV Dose

Clinical Study ID

NCT05488340
LBx-2001
  • Ages 18-75
  • Female

Study Summary

This is a Phase 2 superiority study of LBP-EC01, a recombinant bacteriophage cocktail, with an initial open-label 3-arm pharmacokinetic (PK) lead-in portion of 30 patients to evaluate the optimal dosing regimen to be used in the subsequent 288 patient blinded portion of the study which will be randomized 1:1 comparing LBP-EC01 + antibiotic versus placebo + antibiotic in patients with a history of prior urinary tract infection (UTI) cased by E. coli. All patients will be required to have an active acute uncomplicated UTI at baseline.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • History of UTI in the past 12 months and prior or current uUTI caused by AMR E. coli (as single pathogen or part of polymicrobial infection where E. coli is thepredominant pathogen). Please note that the current infection can be used to meetthe requirement of AMR E. coli documentation.

  • Able to supply a mid-stream, clean catch urine sample for microbiological analysis.

  • Active acute uUTI infection defined by: a. Evidence of pyuria: i. >10 white blood cell (WBC)/mL3 on microscopic evaluationof spun, clean, mid-stream urine specimen or >3 WBC/high power field on unspunclean, mid-stream urine specimen, AND/OR ii. Dipstick analysis of a clean,mid-stream urine specimen positive for leukocytes, AND b. At least 2 of thefollowing signs or symptoms of UTI: dysuria, urinary frequency, urinary urgency, orsuprapubic pain

  • Willing to comply with all aspects of study design including study restrictions,blood, urine, and stool sampling, and scheduled study visits.

  • All sexually active female patients of childbearing potential must use highlyeffective contraception during the study and until 2 weeks after the last dose ofstudy drug treatment.

  • Agrees to STOP continuous low dose antimicrobial prophylaxis and/or will maintainthe same practices for post-coital antimicrobial prophylaxis to prevent UTI, asduring the prior 12-months, for the entire study duration (throughout the 6-monthfollow-up period or study discharge).

  • Agrees to not use any prescription or non-prescription medication for themicrobiological or symptomatic treatment of the presenting acute uUTI for the first 10 days of the study.

  • Capable of providing their own signed informed consent form (ICF) prior to anystudy-related procedures being performed.

  • If participating in Part 1 of the study, agrees to fast for ≥2 h prior to first doseof study drug on Day 1/Visit 1 except for drinking 240 mL of water with study drugadministration.

Exclusion

Exclusion Criteria:

  • Signs or symptoms of systemic illness such as fever greater than 38° Centigrade/Celsius, shaking chills, or other clinical manifestations suggestive of complicatedUTI.

  • Treatment with other antibacterial drugs including those that are effective fortreatment of the acute uUTI or prevention of recurrent UTI in the 5 days prior toScreening unless the recovered pathogen demonstrates resistance to the initialantibiotic and clinical symptoms persist. In postmenopausal women vaginal estrogenreplacement therapy is permitted so long as patient meets all other eligibilitycriteria, that the dose and regimen has be stable for > 3 months from Screening (D1/V1), and that there is no planned change to therapy through the 6-monthfollow-up period or study discontinuation.

  • Clinical symptoms for more than 5 days before Screening.

  • Presence of indwelling urinary bladder catheters, urinary tract anatomicalabnormalities that increase UTI risk or lead to a post void residual (PVR) urinevolume > 150mL, poorly controlled diabetes mellitus (diagnosed but is not beingtreated/managed by a physician's care or HbA1c >8), current symptomatic or largerthan 5mm renal calculi, or advanced renal dysfunction (determined by eGFR < 45mL/min/1.73 m2). Patients with vaginal prolapse beyond the hymen with Valsalva (e.g., when coughing).

  • Individuals considered to be immunocompromised.

  • Clinically significant serious unstable physical illness that in the investigator'sopinion prevents patient from completing the study or prevents interpretation orresolution of clinical symptoms.

  • Pregnant or nursing women.

  • Exposure to any investigational drugs or other phage therapy 30 days prior toScreening (D1/V1) or prior to participation in this study. Patients who participatein Part 1 are not eligible for participation in Part 2.

  • Allergies to excipients of the study drug or antibiotics.

  • History of autonomic dysreflexia.

  • History of intravenous (IV) drug abuse or is currently using or has positive resultsfor drugs of abuse at screening.

  • Patients who reside in a long-term care facility.

  • Suspected or confirmed acute coronavirus disease 2019 (COVID-19) or recent COVID-19infection with ongoing symptoms.

Study Design

Total Participants: 318
Treatment Group(s): 6
Primary Treatment: LBP-EC01 0.1 x IV dose
Phase: 2
Study Start date:
July 13, 2022
Estimated Completion Date:
December 31, 2025

Study Description

This study will consist of two parts.

Part 1 - Dose regimen selection: An open-label, 30 patient, 3-arm PK assessment of: Arm 4 (previously 1): LBP-EC01 (approximately 2×10^12 PFU) given by IU administration on D1 and D2 and LBP-EC01 (approximately 1×10^11 PFU) IV given as a 1 milliliter (mL) bolus QD from D1 through D3 concomitantly with oral trimethoprim/sulfamethoxazole (TMP 160mg/SMX 800mg) BID from D1 through D3 (6 doses); Arm 5 (previously 2): LBP-EC01 (approximately 2×10^12 PFU) given by IU administration on D1 and D2 and LBP-EC01 (approximately 1×10^10 PFU) IV given as a 1 mL bolus QD from D1 through D3 concomitantly with oral TMP/SMX BID from D1 through D3 (6 doses); Arm 6 (previously 3): LBP-EC01 (2×10^12 PFU) given by IU administration on D1 and D2 and LBP-EC01 (approximately 1×10^12 PFU) IV given as a 100 mL IV infusion over 2 h on D1 through D3 concomitantly with oral TMP/SMX BID from D1 through D3 (6 doses).

Part 2 - Efficacy, Safety, Tolerability and Pharmacokinetics: A blinded, 288 patient, 1:1 randomized evaluation of the Arm 4 dose regimen, selected from Part 1, versus placebo + antibiotic (TMP/SMX -160 mg TMP and 800 mg SMX) given orally BID on Days 1 through 3.

Connect with a study center

  • Research Site 104

    Anniston, Alabama 36207
    United States

    Site Not Available

  • Research Site 115

    Birmingham, Alabama 35233
    United States

    Active - Recruiting

  • Research Site 112

    Tempe, Arizona 85282
    United States

    Site Not Available

  • Research Site 143

    Chula Vista, California 91910
    United States

    Active - Recruiting

  • Research Site 138

    Fresno, California 93710
    United States

    Active - Recruiting

  • Research Site 105

    Irvine, California 92604
    United States

    Site Not Available

  • Research Site 131

    Lancaster, California 93534
    United States

    Active - Recruiting

  • Research Site 123

    Los Angeles, California 90027
    United States

    Active - Recruiting

  • Research Site 125

    Montebello, California 90640
    United States

    Active - Recruiting

  • Research Site 139

    Orange, California 92868
    United States

    Active - Recruiting

  • Research Site 124

    Pomona, California 91767
    United States

    Site Not Available

  • Research Site 137

    San Diego, California 92037
    United States

    Active - Recruiting

  • Research Site 126

    Tustin, California 92780
    United States

    Active - Recruiting

  • Research Site 102

    Doral, Florida 33166
    United States

    Active - Recruiting

  • Research Site 140

    Jensen Beach, Florida 34957
    United States

    Active - Recruiting

  • Research Site 103

    Miami, Florida 33176
    United States

    Active - Recruiting

  • Research Site 106

    Miami, Florida 33173
    United States

    Completed

  • Research Site 107

    Miami, Florida 33165
    United States

    Completed

  • Research Site 100

    Palmetto Bay, Florida 33157
    United States

    Site Not Available

  • Research Site 119

    Decatur, Georgia 30030
    United States

    Active - Recruiting

  • Research Site 111

    Sandy Springs, Georgia 30328
    United States

    Site Not Available

  • Research Site 117

    Northbrook, Illinois 60062
    United States

    Active - Recruiting

  • Research Site 128

    Owings Mills, Maryland 21117
    United States

    Active - Recruiting

  • Research Site 120

    Boston, Massachusetts 02115
    United States

    Active - Recruiting

  • Research Site 113

    Canton, Michigan 48188
    United States

    Site Not Available

  • Research Site 114

    Royal Oak, Michigan 48073
    United States

    Active - Recruiting

  • Research Site 133

    Cheektowaga, New York 14225
    United States

    Site Not Available

  • Research Site 109

    Fayetteville, North Carolina 28303
    United States

    Site Not Available

  • Research Site 110

    Raleigh, North Carolina 27612
    United States

    Site Not Available

  • Research Site 118

    Winston-Salem, North Carolina 27157
    United States

    Active - Recruiting

  • Research Site 121

    Tulsa, Oklahoma 74104
    United States

    Site Not Available

  • Research Site 141

    Edinburg, Texas 78539
    United States

    Active - Recruiting

  • Research Site 108

    Forney, Texas 75126
    United States

    Site Not Available

  • Research Site 122

    Galveston, Texas 77555
    United States

    Active - Recruiting

  • Research Site 127

    Richmond, Virginia 23226
    United States

    Active - Recruiting

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