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Hepatorenal SyndromePhase 2NCT01436500

Safety and Pharmacokinetics of Ifetroban in Hepatorenal Syndrome Patients

A Phase 2 study testing Ifetroban Injection in people with Hepatorenal Syndrome, run by Cumberland Pharmaceuticals at 12 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

A study of ifetroban in the treatment of hepatorenal syndrome (HRS) in hospitalized adult patients to assess the safety and pharmacokinetics of 3 days of intravenous ifetroban. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Hepatorenal Syndrome
What is being tested?
Ifetroban Injection
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
55 participants
Where
12 sitesin 2 countries
Study dates
Oct 2011to Jul 2015
Phase
Phase 2
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

  • Chronic liver disease, defined as cirrhosis with ascites based on clinical findings (biopsy not necessary).
  • Subjects with either Type 1 or Type 2 HRS defined in a and b below:
  • Type 1: i. At least a doubling of the serum creatinine to a minimum of 220 µmol/L (2.5 mg/dL) at enrollment, occurring over a period of less than 14 days, OR ii. A 50% or greater reduction in the estimated glomerular filtration rate (GFR - calculated by the method of Cockcroft-Gault) to below 20 mL/min at enrollment occurring over a period of less than 14 days.
  • A projected doubling of serum creatinine to a minimum of 2.5 mg/dL, expected to occur in less than 14 days based on the rate of change observed.
  • Type 2: defined as at least a 33% reduction in creatinine clearance occurring over a period of greater than 2 weeks, with a serum creatinine (SCr) > 133µmol/L (1.5 mg/dL).
  • Oliguria occurring within 48 hours prior to the first administration CTM. Oliguria is defined as an average urine output of < 35 mL/hr (measured for a minimum of 4 hours) under either of the following circumstances:
  • When measured central venous pressure (CVP) > 12 mmHg, OR b. following a fluid challenge consisting of either: i. at minimum 20 mL/kg isotonic fluid (e.g. any combination of 5% albumin, normal saline, blood or blood products) given over no more than 6 hours ii. at minimum 1 g/kg of hypertonic fluid (e.g. 25% albumin) given over no more than 24 hours iii. an equivalent combination of 3.b.i and 3.b.ii

Who cannot join

  • History of allergy or hypersensitivity to ifetroban
  • Pregnant or nursing
  • Less than 18 years of age
  • Serum creatinine at the time of enrollment greater than or equal to 5.0 mg/dL
  • Platelet count at screening less than 30 x 10^3 platelets/µL
  • Anticipated of planned need for dialysis within 5 days of first CTM dose.
Show all 20Show fewer
  • Active gastrointestinal hemorrhage (where active is defined as evidence of bleeding within 48 hours of the first dose of CTM)
  • Evidence of current (within past 30 days) obstructive (post-renal) or intrinsic renal disease [including but not limited to: acute tubular necrosis (ATN), glomerular diseases/glomerulonephritis, acute interstitial nephritis (AIN), known urinary obstruction, proteinuria > 500 mg/day, microhematuria (> 50 RBCs/high power field), abnormal renal ultrasound, fractional excretion of sodium (FeNa) > 2.0%, any urinary casts other than hyaline.
  • Current or recent (within the preceding 5 days) treatment with nephrotoxic drugs including but not limited to: NSAIDs (prior 48 hours), angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARB), calcineurin inhibitors (cyclosporine, tacrolimus), aminoglycosides, amphotericin B, antiretrovirals and antivirals (adefovir, cidofovir, tenofovir, acyclovir, indinavir), cisplatin, methotrexate, cyclosporine, amphotericin B contrast agents, foscarnet, zoledronate, etc.
  • Presence of shock defined as hypotension, with a mean arterial pressure less than 50 mmHG.
  • New York Heart Association class 3 or 4 heart failure.
  • Presence of hepatocellular carcinoma not transplantable by Milan criteria
  • Cardiopulmonary arrest without full recovery of mental status
  • Moribund and death expected within five days
  • Bacterial or fungal infections which have been unresponsive to at least 24 hours of appropriate antimicrobial therapy
  • Burns > 30% body surface area
  • Exposed to investigational drugs within 30 days before 1st CTM administration.
  • Inability to understand the requirements of the study. (Subjects must be willing to provide written informed consent or consent of legally recognized representative, as evidenced by signature on an informed consent document approved by an Institutional Review Board [IRB], and agree to abide by the study restrictions. If the subject is incapacitated, informed consent will be sought from a legally recognized representative).
  • Refusal to provide written authorization for use and disclosure of protected health information.
  • Be otherwise unsuitable for the study, in the opinion of the Investigator.

Trial locations and contacts

12 sites in 2 countries.

12 sites in 2 countries

United States11 sites
  • University of Michigan Hospital

    Ann Arbor, Michigan, 48109

  • Emory University Hospital

    Atlanta, Georgia, 30322

  • The Ohio State University

    Columbus, Ohio, 43210

  • Baylor All Saints Medical Center

    Fort Worth, Texas, 76104

  • Indiana University (Division of Gastroenterology/Hepatology)

    Indianapolis, Indiana, 46202

  • UCSD, Hillcrest Medical Center Hospital

    La Jolla, California, 92093

  • NYU Langone Medical Center

    New York, New York, 10016

  • Mayo Clinic - Arizona

    Phoenix, Arizona, 85054

  • Virginia Commonwealth University

    Richmond, Virginia, 23298

  • University of Utah Health Sciences Center

    Salt Lake City, Utah, 84132

  • UCSF (University of California-San Francisco)

    San Francisco, California, 94143

Other trials in United States

India1 site
  • MIDAS Multispeciality Hospital PVT LTD

    Nagpur, Maharashtra, 440010

Other trials in India

About this study

Official title: A Multi-Center, Double-Blind, Randomized, Controlled Study to Determine the Safety and Pharmacokinetics of Ifetroban Injection in Hepatorenal Syndrome

A study of ifetroban in the treatment of hepatorenal syndrome (HRS) in hospitalized adult patients to assess the safety and pharmacokinetics of 3 days of intravenous ifetroban.

Being tested
Ifetroban Injection, Placebo
Keywords
Hepatorenal Syndrome, HRS, ifetroban
Medical subject headings
Hepatorenal Syndrome

What participants receive

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

  • Ifetroban InjectionDrug

    Ifetroban sodium injectable, diluted in sterile water with 5% dextrose

  • PlaceboDrug

    Also called D5W

    Sterile water with 5% Dextrose

Study groups in NCT01436500
Study groupRoleWhat they receive
5 mg ifetroban, Type 1Experimental60-minute intravenous infusion of 5 mg ifetroban given once daily for 3 days to subjects with Type 1 HRS.
Receives: Drug: Ifetroban Injection
Placebo, Type 1Placebo comparator60-minute intravenous infusion of 5% dextrose in sterile water given once daily for 3 days to subjects with Type 1 HRS.
Receives: Drug: Placebo
5 mg ifetroban, Type 2Experimental60-minute intravenous infusion of 5 mg ifetroban given once daily for 3 days to subjects with Type 1 HRS.
Receives: Drug: Ifetroban Injection
15 mg ifetroban, Type 1Experimental60-minute intravenous infusion of 15 mg ifetroban given once daily for 3 days to subjects with Type 1 HRS.
Receives: Drug: Ifetroban Injection
15 mg ifetroban, Type 2Experimental60-minute intravenous infusion of 15 mg ifetroban given once daily for 3 days to subjects with Type 2 HRS.
Receives: Drug: Ifetroban Injection
50 mg ifetroban, Type 1Experimental60-minute intravenous infusion of 50 mg ifetroban given once daily for 3 days to subjects with Type 1 HRS.
Receives: Drug: Ifetroban Injection
50 mg ifetroban, Type 2Experimental60-minute intravenous infusion of 50 mg ifetroban given once daily for 3 days to subjects with Type 2 HRS.
Receives: Drug: Ifetroban Injection
150 mg ifetroban, Type 2Experimental60-minute intravenous infusion of 150 mg ifetroban given once daily for 3 days to subjects with Type 2 HRS.
Receives: Drug: Ifetroban Injection
Placebo, Type 2Placebo comparator60-minute intravenous infusion of 5% dextrose in sterile water given once daily for 3 days to subjects with Type 2 HRS.
Receives: Drug: Placebo

What is being measured

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

  1. Half-life (T-1/2) of Ifetroban and Ifetroban Acylglucuronide

    Plasma concentrations of ifetroban and its major active metabolite were measured at Baseline and Study Hours 1, 2, 4, 8, 12, 24, 48, 49, 50, 52, 56, 60, and 72 to determine the Pharmacokinetic parameters.

    Measured: 3 days

  2. Pharmacokinetic Parameters (Exposure) of Ifetroban and Ifetroban Acylglucuronide After Three Days of Treatment

    Plasma concentrations of ifetroban and its primary active metabolite were measured at Baseline and Study Hours 1, 2, 4, 8, 12, 24, 48, 49, 50, 52, 56, 60, and 72 to determine the Pharmacokinetic parameters.

    Measured: 3 days

  3. Pharmacokinetic Parameters (Concentration) of Ifetroban and Ifetroban Acylglucuronide After Three Days of Treatment

    Plasma concentrations of ifetroban and it's major active metabolite were measured at Baseline and Study Hours 1, 2, 4, 8, 12, 24, 48, 49, 50, 52, 56, 60, and 72 to determine the Pharmacokinetic parameters.

    Measured: 3 days

Secondary outcomes (4)
  1. Safety: Day 28 Mortality

    Measured: 28 days

  2. Percentage of Patients Achieving a Treatment-period Serum Creatinine Reduction Below 1.5 mg/dL

    Measured: Day 0 through Day 5

  3. The Percentage of Patients Achieving a Reduction of Creatinine Clearance to Below Baseline on Two Consecutive Daily Measurements

    Measured: Day 0 to Day 5

  4. Change in 24-hour Urine Volume

    The volume of urine collected in a 24-hour post-treatment period minus the volume collected in a 24-hour pre-treatment period.

    Measured: Baseline to Hour 96

Timeline

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

  1. First posted19 Sep 2011 (estimated)
  2. Study startOct 2011
  3. Primary completionJun 2015
  4. Study completionJul 2015

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
55 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01436500
Sponsor's protocol ID
CPI-IFE-001
Status last verified
Feb 2017
First submitted
31 Aug 2011
Last updated
1 Mar 2017
Data monitoring committee
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Ifetroban Injection in people with Hepatorenal Syndrome, run by Cumberland Pharmaceuticals at 12 sites in 2 countries.

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 7 inclusion and 20 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: finished, as of the sponsor's last update on 1 Mar 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in United States, India. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 14 Feb 2017). 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?

Half-life (T-1/2) of Ifetroban and Ifetroban Acylglucuronide (time frame: 3 days). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 1 Mar 2017.

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