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SepsisPhase 3SAILSNCT00979121

Statins for Acutely Injured Lungs From Sepsis

A Phase 3 study testing Rosuvastatin in people with Sepsis and Acute Lung Injury, run by National Heart, Lung, and Blood Institute (NHLBI) at 40 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Objective: assess the efficacy and safety of oral rosuvastatin in patients with sepsis-induced Acute Lung Injury (ALI). Hypothesis: Rosuvastatin therapy will improve mortality in patients with sepsis-induced ALI. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Sepsis, Acute Lung Injury
What is being tested?
Rosuvastatin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
745 participants
Where
40 sitesUnited States
Study dates
Jan 2010to Nov 2013
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 1. Systemic inflammatory response syndrome (SIRS) defined as meeting at least criteria (a) or (b)for a systemic inflammatory response:
  • White blood cell count >12,000 or <4,000 or >10% band forms
  • Body temperature >38 degrees Celsius (C) (any route) or <36 degrees C (accepting core temperatures only; indwelling catheter, esophageal, rectal)
  • Heart rate (> 90 beats/min) or receiving medications that slow heart rate or paced rhythm 2. Suspected or proven infection: Sites of infection include thorax, urinary tract, abdomen, skin, sinuses, central venous catheters, and bacterial meningitis (Appendix A).
  • 3. ALI as defined by acute onset of:
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  • PaO2 / FiO2 ≤ 300 (intubated). If altitude > 1000m, then PaO2 / FiO2 ≤ 300 x (PB/760), and
  • Bilateral infiltrates consistent with pulmonary edema on frontal chest radiograph, and
  • Requirement for positive pressure ventilation via an endotracheal tube, and
  • No clinical evidence of left atrial hypertension, or if measured, a Pulmonary Arterial Wedge Pressure (PAOP) less than or equal to 18 mm Hg. If a patient has a PAOP > 18 mmHg, then the other criteria must persist for more than 12 hours after the PAOP has declined to ≤ 18 mmHg, and still be within the 48-hour enrollment window.
  • "Acute onset" is defined as follows: the duration of the hypoxemia criterion (#1) and the chest radiograph criterion (#2) must be ≤ 28 days at the time of randomization. Opacities considered "consistent with pulmonary edema" include any patchy or diffuse opacities not fully explained by mass, atelectasis, or effusion or opacities known to be chronic (> 28 days). The findings of vascular redistribution, indistinct vessels, and indistinct cardiac borders are not considered "consistent with pulmonary edema".
  • All ALI criteria (3a-d above) must occur within the same 24 hour period. The onset of ALI is when the last ALI criterion is met. Patients must be enrolled within 48 hours of ALI onset and no more than 7 days from the initiation of mechanical ventilation. SIRS criteria must occur within the 72 hours before or the 24 hours after ALI onset. Information for determining when these time window criteria were met may come from either the Network hospital or a referring hospital reports.

Who cannot join

  • No consent/inability to obtain consent
  • Age less than 18 years
  • More than 7 days since initiation of mechanical ventilation
  • More than 48 hours since meeting ALI inclusion criteria
  • Patient, surrogate, or physician not committed to full support ).
  • Unable to receive or unlikely to absorb enteral study drug
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  • Rosuvastatin specific exclusions
  • Receiving a statin medication within 48 hours of randomization
  • Allergy or intolerance to statins
  • Physician insistence for the use or avoidance of statins during the current hospitalization
  • Creatine Kinase (CK) , alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 5 times the upper limit of normal
  • Diagnosis of hypothyroidism and not on thyroid replacement therapy
  • Pregnancy or breast feeding
  • Receiving niacin, fenofibrate or cyclosporine, gemfibrozil, atazanavir, lopinavir, ritonavir, daptomycin
  • Severe chronic liver disease
  • Moribund patient not expected to survive 24 hours
  • Chronic respiratory failure defined as PaCO2 > 60 mm Hg in the outpatient setting
  • Home mechanical ventilation (noninvasive ventilation or via tracheotomy) except for CPAP/BIPAP (Continuous Positive Airway Pressure/BiLevel Positive Airway Pressure) used solely for sleep-disordered breathing
  • Diffuse alveolar hemorrhage from vasculitis
  • Burns > 40% total body surface
  • Interstitial lung disease of severity sufficient to require continuous home oxygen therapy
  • Unwillingness or inability to utilize the ARDS network 6 ml/kg Predicted Body Weight (PBW) ventilation protocol
  • Cardiac disease classified as NYHA (New York Heart Association) class IV
  • Myocardial infarction within past 6 months
  • Intraparenchymal Central Nervous System (CNS) bleed within a month of randomization.
  • Temperature >40.3 C in the 6 hours before randomization

Trial locations and contacts

40 sites in 1 country.

40 sites in 1 country

United States40 sites
  • Johns Hopkins Bayview Medical Center

    Baltimore, Maryland

  • Johns Hopkins Hospital

    Baltimore, Maryland

  • University of Maryland Shock Trauma Center

    Baltimore, Maryland

  • Baton Rouge General Hospital-Blue Bonnet

    Baton Rouge, Louisiana

  • Baton Rouge General Hospital-Midcity

    Baton Rouge, Louisiana

  • Earl K. Long Medical Center

    Baton Rouge, Louisiana

  • Our Lady of the Lake Regional Medical Center

    Baton Rouge, Louisiana

  • University of Virginia Medical Center

    Charlottesville, Virginia

  • Cleveland Clinic Foundation

    Cleveland, Ohio

  • MetroHealth Medical Center

    Cleveland, Ohio

  • University Hospitals of Cleveland

    Cleveland, Ohio

  • Centura St. Anthony Central Hospital

    Denver, Colorado

  • Denver Health Medical Center

    Denver, Colorado

  • Rose Medical Center

    Denver, Colorado

  • University of Colorado Health Sciences Center

    Denver, Colorado

  • Duke University Medical Center

    Durham, North Carolina

  • Durham Regional Medical Center

    Durham, North Carolina

  • Providence Hospital

    Everett, Washington, 98201

  • University of San Francisco-Fresno Medical Center

    Fresno, California

  • Moses Cone Health System

    Greensboro, North Carolina

  • Wesley Long Community Hospital

    Greensboro, North Carolina

  • Baylor College of Medicine

    Houston, Texas

  • Intermountain Medical Center

    Murray, Utah

  • Vanderbilt University Medical Center

    Nashville, Tennessee

  • Medical Center of Louisiana

    New Orleans, Louisiana

  • Ochsner Clinic Foundation

    New Orleans, Louisiana

  • Tulane University Health Sciences Center

    New Orleans, Louisiana

  • McKay-Dee Hospital

    Ogden, Utah

  • Utah Valley Regional Medical Center

    Provo, Utah

  • Rochester Methodist Hospital

    Rochester, Minnesota

  • St. Mary's Hospital, Mayo Clinic

    Rochester, Minnesota

  • University of California, Davis Medical Center

    Sacramento, California

  • LDS Hospital

    Salt Lake City, Utah

  • UCSF-Moffitt Hospital

    San Francisco, California

  • University of California, San Francisco (UCSF)-Moffitt Hospital

    San Francisco, California

  • Harborview Medical Center

    Seattle, Washington

  • University of Washington

    Seattle, Washington

  • Baystate Medical Center

    Springfield, Massachusetts

  • Washington Hospital Center

    Washington D.C., District of Columbia

  • Wake Forest University Baptist Medical Center

    Winston-Salem, North Carolina

Other trials in United States

About this study

Official title: Randomized Trial of Rosuvastatin for Acutely Injured Lungs From Sepsis

Objective: assess the efficacy and safety of oral rosuvastatin in patients with sepsis-induced Acute Lung Injury (ALI).

Hypothesis: Rosuvastatin therapy will improve mortality in patients with sepsis-induced ALI.

Read the detailed description

Acute Lung Injury (ALI) and Acute Respiratory Distress Syndrome (ARDS) involves extensive inflammation in the lungs that can lead to rapid respiratory failure. These conditions are most commonly caused by pneumonia, generalized infection, or severe trauma to the lungs, but can also be less commonly caused by smoke or salt water inhalation, drug overdose, or shock.

For some people, ALI/ARDS resolves without treatment, but many severe cases result in hospitalization in the intensive care unit (ICU), where 30% to 40% of cases end in mortality. Current treatments for ALI/ARDS include assisted breathing with a ventilator, supportive care, and management of the underlying causes.

Upon admission to the ICU, Rosuvastatin or placebo was administered through an enteral feeding tube or administered orally following extubation when patients were able to safely take oral medications. The type and placement of the enteral feeding tube (nasogastric, nasoenteric, PEG, orogastric, oroenteric, etc.) and the ability to safely take oral medications was determined by the patient's primary team. Study drug was blinded with an identical appearing placebo. The first study drug dose (rosuvastatin or placebo) was administered within 4 hours of randomization as a loading dose of 40 mg.

Blood pressure, heart rate, ventilation settings, and various blood factors were measured during treatment. Phone-based follow-up assessments occurred at months 6 and 12 after ICU discharge and included measurements of health-related quality of life; psychological, neurocognitive, and physical activity outcomes; healthcare utilization; and mortality.

Being tested
Rosuvastatin, Placebo
Keywords
ALI, Sepsis, statin
Medical subject headings
Sepsis, Acute Lung Injury

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RosuvastatinDrug

    Also called Crestor

    Subjects received an initial 40mg loading dose followed by 20 mg of study drug daily by mouth or feeding tube for 28 days or until discharged from the study hospital.

  • PlaceboDrug

    Subjects received placebo by mouth or feeding tube daily for 28 days or until discharged from study hospital.

Study groups in NCT00979121
Study groupRoleWhat they receive
RosuvastatinActive comparatorHalf of the subjects were randomized to the active drug (Rosuvastatin). Dosage, Form, and Frequency: drug was provided as 10mg tablets and administered through an enteral feeding tube or orally (following extubation when patients were able to safely take oral medications). An initial 40mg loading dose was administered followed by a daily 20 mg maintenance dose. Maintenance dosing was adjusted for renal failure not compensated by renal replacement therapy. Duration: drug was administered daily until: 1. 28 days after randomization or 3 days after ICU discharge (whichever comes first), 2. Discharge from study hospital, 3. Death
Receives: Drug: Rosuvastatin
PlaceboPlacebo comparatorHalf of the subjects were randomized to placebo. 10mg tablets identical to active drug were administered through an enteral feeding tube or orally (following extubation when patients were able to safely take oral medications). Dosage, frequency, and duration was provided in the same manner as the active drug.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Hospital Mortality to Day 60.

    The percentage of subjects alive at study day 60. Those subjects discharged home prior to day 60 were counted as alive at day 60.

    Measured: 60 days after randomization

Secondary outcomes (1)
  1. Ventilator Free Days at Study Day 28

    Ventilator Free Days (VFDs) to day 28 were defined as the number of days from the time of initiating unassisted breathing to day 28 after randomization, assuming survival for at least two consecutive calendar days after initiating unassisted breathing and continued unassisted breathing to day 28. If a subject received assisted breathing at day 27 or died prior to day 28, a value of zero VFDs was given.

    Measured: time of initiating unassisted breathing to day 28 after study randomization

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Sep 2009 (estimated)
  2. Study startJan 2010
  3. Primary completionNov 2013
  4. Study completionNov 2013

Why it stopped: stopped for futility

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
745 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00979121
Sponsor's protocol ID
670
Other IDs
N01HR056179
Acronym
SAILS
Status last verified
Aug 2014
First submitted
16 Sep 2009
Last updated
16 May 2016
Data monitoring committee
Yes

Publications

  • Yu SY, Ge ZZ, Xiang J, Gao YX, Lu X, Walline JH, Qin MB, Zhu HD, Li Y. Is rosuvastatin protective against sepsis-associated encephalopathy? A secondary analysis of the SAILS trial. World J Emerg Med. 2022;13(5):367-372. doi: 10.5847/wjem.j.1920-8642.2022.072.

    PubMed 36119770
  • Dinglas VD, Hopkins RO, Wozniak AW, Hough CL, Morris PE, Jackson JC, Mendez-Tellez PA, Bienvenu OJ, Ely EW, Colantuoni E, Needham DM. One-year outcomes of rosuvastatin versus placebo in sepsis-associated acute respiratory distress syndrome: prospective follow-up of SAILS randomised trial. Thorax. 2016 May;71(5):401-10. doi: 10.1136/thoraxjnl-2015-208017. Epub 2016 Mar 2.

    PubMed 26936876
  • Needham DM, Colantuoni E, Dinglas VD, Hough CL, Wozniak AW, Jackson JC, Morris PE, Mendez-Tellez PA, Ely EW, Hopkins RO. Rosuvastatin versus placebo for delirium in intensive care and subsequent cognitive impairment in patients with sepsis-associated acute respiratory distress syndrome: an ancillary study to a randomised controlled trial. Lancet Respir Med. 2016 Mar;4(3):203-12. doi: 10.1016/S2213-2600(16)00005-9. Epub 2016 Jan 29.

    PubMed 26832963
  • National Heart, Lung, and Blood Institute ARDS Clinical Trials Network; Truwit JD, Bernard GR, Steingrub J, Matthay MA, Liu KD, Albertson TE, Brower RG, Shanholtz C, Rock P, Douglas IS, deBoisblanc BP, Hough CL, Hite RD, Thompson BT. Rosuvastatin for sepsis-associated acute respiratory distress syndrome. N Engl J Med. 2014 Jun 5;370(23):2191-200. doi: 10.1056/NEJMoa1401520. Epub 2014 May 18.

    PubMed 24835849

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Rosuvastatin in people with Sepsis and Acute Lung Injury, run by National Heart, Lung, and Blood Institute (NHLBI) at 40 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 12 inclusion and 26 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 16 May 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 40 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 3 Oct 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Hospital Mortality to Day 60. (time frame: 60 days after randomization). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00979121, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 May 2016.

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Statins for Acutely Injured Lungs From Sepsis | AzTrials