Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
VABOMERE™ (meropenem and vaborbactam) was evaluated in a Phase 3 comparator-controlled clinical trial in cUTI, including pyelonephritis, which included 272 patients treated with VABOMERE and 273 patients treated with the comparator piperacillin/tazobactam 4.5 grams (piperacillin 4 g/tazobactam 0.5 g) every 8 hours. After a minimum of 15 doses of IV therapy, patients could be switched to oral levofloxacin (500 mg daily every 24 hours) to complete the treatment course. Mean duration of IV therapy was 8 days in both treatment groups. Mean duration of IV and oral therapy was 10 days; patients with baseline bacteremia could receive up to 14 days of treatment.
The mean age of patients treated with VABOMERE was 53 years (range 18 to 92 years), and 32% of patients were 65 years of age or older. Patients were predominantly female (66.5%) and White (93.4%). Most patients were enrolled in Europe (89.7%).
Serious Adverse Reactions and Adverse Reactions Leading to Discontinuation
Treatment was discontinued due to adverse reactions in 2.9% (8/272) of patients receiving VABOMERE and in 5.1% (14/273) of patients receiving piperacillin/tazobactam. Most common adverse reactions resulting in discontinuation of VABOMERE included hypersensitivity, 1.1% (3/272) and infusion-related reactions, 0.7% (2/272). Death occurred in 2 (0.7%) patients who received VABOMERE and in 2 (0.7%) patients who received piperacillin/tazobactam.
Common Adverse Reactions
The most frequently reported adverse reactions (3% or greater) in patients receiving VABOMERE in the Phase 3 cUTI trial were headache, phlebitis/infusion site reactions, and diarrhea. Table 3 provides adverse reactions occurring in 1% or greater of patients receiving VABOMERE in the Phase 3 cUTI trial.
Table 3: Adverse Reactions Occurring in 1% or Greater of Patients Receiving VABOMERE in the Phase 3 Clinical Trial in cUTI
|Phlebitis/Infusion site reactionsb||4.4||0.7|
|Alanine aminotransferase increased||1.8||0.4|
|Aspartate aminotransferase increased||1.5||0.7|
aPiperacillin/tazobactam 4.5 grams (piperacillin 4 g/tazobactam 0.5 g) IV infused over 30 minutes every 8 hours.
bInfusion site reactions include infusion/injection site phlebitis, infusion site thrombosis, and infusion site erythema.
cHypersensitivity includes hypersensitivity, drug hypersensitivity, anaphylactic reaction, rash urticaria, and bronchospasm.
Adverse Reactions Occurring in Less Than 1% of Patients Receiving VABOMERE in the Phase 3 cUTI Trial
- Blood and lymphatic system disorders: leukopenia
- General disorders and administration site conditions: chest discomfort
- Infections and infestations: pharyngitis, vulvovaginal candidiasis, oral candidiasis
- Investigations: creatinine phosphokinase increase
- Metabolism and nutrition disorders: decreased appetite, hyperkalemia, hyperglycemia, hypoglycemia
- Nervous system disorders: dizziness, tremor, paresthesia, lethargy
- Psychiatric disorders: hallucination, insomnia
- Renal and urinary disorders: azotemia, renal impairment
- Vascular disorders: deep vein thrombosis, hypotension, vascular pain
Other Adverse Reactions Associated With Meropenem
Additionally, adverse reactions reported with meropenem alone that were not reported in VABOMERE-treated patients in the Phase 3 clinical trial are listed below:
- Blood and lymphatic system disorders: thrombocytosis, neutropenia, eosinophilia, thrombocytopenia, agranulocytosis, hemolytic anemia
- Gastrointestinal disorders: abdominal pain
- Hepatobiliary disorders: jaundice
- Nervous system disorders: convulsions
- Investigations: blood alkaline phosphatase increased, blood lactate dehydrogenase increased, blood bilirubin increased, blood creatinine increased, blood urea increased, blood thromboplastin decreased, prothrombin time decreased, Direct and Indirect Coombs test positive
- Skin and subcutaneous tissue disorders: pruritus, toxic epidermal necrolysis, Stevens Johnson syndrome, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, erythema multiforme
- Immune system disorders: angioedema
- General disorders and administration site conditions: pain
See VABOMERE ordering information
Get details about VABOMERE dosing
Reference: 1. Vabomere [package insert]. Lincolnshire, IL: Melinta Therapeutics, Inc.; 2018.