Article
Author: Liu, Hua ; Huang, Huaping ; Lv, Xiaoju ; Zhu, Guangfa ; Wang, Kai ; Fu, Xiuhua ; Yang, Yanping ; Li, Ying ; Mo, Biwen ; Ying, Kejing ; Zhu, Demei ; Lu, Youjin ; Xu, Xingxiang ; Chen, Jichao ; Ye, Feng ; Peng, Liping ; Wu, Shiman ; Jin, Faguang ; Wang, Wei ; Liang, Yongjie ; Zhang, Yingyuan ; Qiu, Chen ; Ma, Zhuang ; Xiao, Zuke ; Hui, Fuxin ; Cao, Zhaolong ; Lv, Yuan ; Chang, Xiaoyue ; Huang, Yijiang ; Kuang, Jiulong ; Zhao, Li ; Yang, Hongzhong ; Xu, Jinfu ; He, Yong ; Li, Xiangyang ; Li, Chen ; Zhang, Min ; Wang, Xuefen ; Tong, Zhaohui ; Wang, Ying ; Chen, Zhang ; Qin, Zhiqiang ; Sun, Shenghua ; Zhu, Yingqun ; Liu, Deling
BACKGROUNDNemonoxacin malate is a novel non-fluorinated quinolone for oral and intravenous (IV) administration. This phase 3, multicentre, randomised, double-blind, double-dummy, parallel-controlled clinical trial (NCT02205112) evaluated the efficacy and safety of IV nemonoxacin vs. levofloxacin for the treatment of community-acquired pneumonia (CAP) in adult patients.METHODSEligible patients were randomised to receive 500 mg nemonoxacin or levofloxacin via IV infusion, once daily for 7-14 days. The primary endpoint was the clinical cure rate at the test-of-cure (TOC) visit in the modified intent-to-treat (mITT) population. Secondary efficacy and safety were also compared between nemonoxacin and levofloxacin.RESULTSOverall, 525 patients were randomised and treated with nemonoxacin (n = 349) or levofloxacin (n = 176). The clinical cure rate was 91.8% (279/304) for nemonoxacin and 85.7% (138/161) for levofloxacin in the mITT population (P > 0.05). The clinical efficacy of nemonoxacin was non-inferior to levofloxacin for treatment of CAP. Microbiological success rate with nemonoxacin was 88.8% (95/107) and with levofloxacin was 87.8% (43/49) (P > 0.05) at the TOC visit in the bacteriological mITT population. The incidence of drug-related adverse events (AEs) was 37.1% in the nemonoxacin group and 22.2% in the levofloxacin group. These AEs were mostly local reactions at the infusion site, nausea, elevated alanine aminotransferase/aspartate aminotransferase (ALT/AST), and QT interval prolongation. The nemonoxacin-related AEs were mostly mild and resolved after discontinuation of nemonoxacin.CONCLUSIONSNemonoxacin 500 mg IV once daily for 7-14 days is effective and safe and non-inferior to levofloxacin for treating CAP in adult patients.