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NCT Number: NCT06094010

A Surveillance Study of Susceptibility to Baloxavir Marboxil in Pediatric Participants With Influenza and Transmission of Influenza to Household Contacts

This study consists of two parts: Part A Surveillance and Part B Transmission.

The main purpose of Part A is to evaluate the prevalence of pre-dose and treatment-emergent amino acid substitutions in pediatric participants' <12 years with influenza treated with baloxavir marboxil.

Part B will include a subset of Part A participants who have household contacts (HHCs) recruited to the study. Part B will evaluate the incidence of onward influenza transmission from pediatric index participants (IPs) under 5 years of age and those aged 5 to under 12 years, treated with baloxavir marboxil, to their HHCs. Participants will no longer be enrolled to Part B Transmission as per protocol version 3.

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Key information

Age range

3 week–11 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Medical Centre "Asklepii", OOD, Dupnitsa, Bulgaria

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

(Part A):

  • Participants with symptoms suggestive of influenza based on investigator's judgement with diagnosis confirmed by a positive local influenza test within 24 hours before full study screening
  • Participants with a negative severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) test within 48 hours before full study screening
  • Time interval between onset of influenza symptoms and the start of pre-dose examinations at screening is 48 hours or less

Inclusion criteria

(Part B):

[A] IP:

  • Eligible to take part in Part A
  • Lives in a household with a HHC willing to be recruited as full HHC

[B] HHCs:

  • Each HHC living in the home of an IP at the time of IP treatment must be screened for partial or full-study HHC eligibility

[C] Partial HHC:

  • Starts screening within 1 calendar day after IP treatment
  • Negative influenza and SARS-CoV-2 test at screening after IP's treatment with baloxavir marboxil
  • HHC lives in a household where 1 or more HHCs meet the full-study HHC requirements AND at least 1 full-study HHC has not received the influenza vaccine within 6 months prior to screening
  • HHC lives in a household where 1 or more HHCs meet the full-study HHC requirements, and at least 1 full-study HHC has not received the influenza vaccine within 6 months prior to screening.
  • HHC lives with other HHCs (if applicable) who fulfill all the "partial HHC" criteria

[D] Full-study HHC:

  • Fulfills the "partial HHC" criteria
  • Agrees to participate in the full study
  • Will reside in the IP's house for at least 12 of the next 15 days and will be present for scheduled study visits
  • No influenza symptoms within 7 days prior to screening
  • Does not have a moderate or worse active infections or infections requiring systemic or otherwise internally administered or otherwise internally administered antibiotic/antiviral/antifungal therapy

Exclusion criteria

(Part A):

  • Participants with severe influenza virus infection requiring inpatient treatment
  • Severely immunocompromised participants (including participants receiving immunosuppressant therapy, or those with cancer or human immunodeficiency virus [HIV] infection) as defined by the investigator
  • Participants with concurrent (non-influenza) infections requiring systemic anti-microbial and/or anti-viral therapy at the pre-dose examinations
  • Treatment with baloxavir marboxil, peramivir, laninamivir, oseltamivir, zanamivir, rimantadine, umifenovir or amantadine within 30 days prior to screening
  • Treatment with an investigational influenza-specific monoclonal antibody within 6 months or 5 half-lives, whichever is longer, prior to screening
  • Treatment with an investigational therapy within 30 days or 5 half-lives, whichever is longer, prior to screening
  • Known hypersensitivity to baloxavir marboxil or the drug product excipients
  • Females who have commenced menarche (i.e., child-bearing potential)

Exclusion criteria

(Part B):

  • IPs who fulfil an exclusion criterion for Part A
  • HHCs deemed to require influenza post-exposure prophylaxis with influenza antiviral treatment due to their risk of developing influenza-related complications in accordance with local guidelines or clinical practice
  • HHCs diagnosed with influenza by health care professional in the past 4 weeks

Treatment and study plan

Baloxavir Marboxil

Drug

Baloxavir marboxil will be administered as an oral suspension per body weight (≥80 kilograms [kg]: 80 milligrams [mg]; ≥20 kg to < 80 kg: 40 mg; <20 kg: 2 milligrams per kilogram [mg/kg]).

Other names: XOFLUZA®; RO7191686

Primary outcomes

  1. Part A: Percentage of Participants With Resistance-associated Pre-treatment Substitutions

    Time frame: Day 1 (At Baseline)

  2. Part A: Percentage of Participants With Resistance-associated Treatment-emergent Substitutions

    Time frame: Days 4, 6 and 10

Secondary outcomes

  1. Part A: Percentage of IPs With Resistance-associated Treatment-emergent Substitutions by Age Groups (<5 Years [< 1 Year, ≥ 1 Year to < 5 Years], and 5 to < 12 Years)

    Time frame: Days 4, 6 and 10

  2. Part A: Percentage of IPs With Novel Treatment-emergent Mutations in Polymerase Acidic Protein (PA)

    Time frame: Days 4, 6 and 10

  3. Part A: Percentage of IPs With Resistance-associated Treatment-emergent Substitutions by Baseline Vaccination Status

    Time frame: Days 4, 6 and 10

  4. Part A: Percentage of IPs With Influenza Virus Type (A or B) and Subtype (A/H1 or A/H3)

    Time frame: Day 1 (At Baseline)

  5. Part A: Change From Baseline in Viral Titers by Quantitative Reverse Transcriptase Polymerase Chain Reaction (RT-PCR)

    Time frame: At Baseline (Day 1); Days 4, 6 and 10

  6. Part A: Susceptibility to Baloxavir Marboxil by Phenotyping of Virus With Novel Genotypic PA Substitutions

    Time frame: Days 4, 6 and 10

  7. Part A: Number of IPs with Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Time frame: Up to Day 29

    AEs were reported according to the National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0 (NCI CTCAE v5.0).

  8. Part B: Percentage of HHCs With Transmission of Influenza Virus by Confirmed by Central RT-PCR, With Virus Subtype Consistent With the IP

    Time frame: Day 6, Day 10

  9. Part B: Percentage of HHCs Who Develops Influenza Symptoms With Transmission of Influenza Virus Confirmed by Central RT-PCR, With Virus Subtype Consistent With the IP

    Time frame: Day 6, Day 10

Other outcomes

  1. Percentage of HHCs Who Become PCR (+) for Influenza Bearing a PA/I38X Substitution (or Other Identified Substitution) Including All Data up to Day 15

    Time frame: Up to Day 15

Study contacts

Contact information is provided by the study sponsor or research team.

Reference Study ID Number: CV44536 https://forpatients.roche.com/

CONTACT

[email protected]

888-662-6728 (U.S. Only)

Sponsors and collaborators

Lead sponsor

Hoffmann-La Roche

Industry

Registry information

Official study title

A Phase IIIb Multicenter, Single-arm, Open-label Surveillance Study of Susceptibility to Baloxavir Marboxil in Pediatric Patients With Influenza and Transmission of Influenza to Household Contacts

Acronym: Pebblestone

Important dates

Study start
2023
Primary completion
2027
Study completion
2027
First posted
Oct 23, 2023
Registry last updated
May 1, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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