Telavancin for the treatment of hospital-acquired pneumonia in severely ill and older patients: the ATTAIN studies

Introduction

Telavancin (TLV) is an investigational lipoglycopeptide with activity against Gram-positive pathogens. The Assessment of Telavancin for Treatment of Hospital-acquired Pneumonia (ATTAIN) programme studied TLV for the treatment of hospital-acquired pneumonia (HAP). This analysis compared the clinical cure rates achieved with TLV or vancomycin (VAN) for severely ill and older patients.

Methods

ATTAIN 1 and ATTAIN 2 were methodologically identical, randomised, double-blind, phase 3 studies. Adult patients with pneumonia acquired after 48 hours in an inpatient acute-care or chronic-care facility, or acquired within 7 days after being discharged following ≥ 3 days of hospital stay were randomised to TLV 10 mg/kg intravenously every 24 hours or VAN 1 g intravenously every 12 hours for 7 to 21 days. A test-of-cure (TOC) visit was conducted 7 to 14 days after end-of-study treatment. Compliant patients who had a clinical response of either cure or failure at TOC were considered clinically evaluable (CE).

Results

Pooled clinical cure rates at TOC for several clinically relevant subgroups including the elderly as well as patients with severe HAP at baseline are presented in Figure 1. The percentage of patients reporting at least one treatment-emergent adverse event was comparable between the TLV and VAN groups (80% vs. 79%, respectively).

Figure 1

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Conclusion

Although not statistically significant, TLV achieved numerically higher cure rates than VAN for treatment of HAP in severely ill and older patients with comparable treatment-emergent adverse events.