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.
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
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.
- Conditions
- Hepatorenal Syndrome
- 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 group | Role | What they receive |
|---|---|---|
| 5 mg ifetroban, Type 1 | Experimental | 60-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 1 | Placebo comparator | 60-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 2 | Experimental | 60-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 1 | Experimental | 60-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 2 | Experimental | 60-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 1 | Experimental | 60-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 2 | Experimental | 60-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 2 | Experimental | 60-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 2 | Placebo comparator | 60-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.
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
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
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)
Safety: Day 28 Mortality
Measured: 28 days
Percentage of Patients Achieving a Treatment-period Serum Creatinine Reduction Below 1.5 mg/dL
Measured: Day 0 through Day 5
The Percentage of Patients Achieving a Reduction of Creatinine Clearance to Below Baseline on Two Consecutive Daily Measurements
Measured: Day 0 to Day 5
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.
- First posted19 Sep 2011 (estimated)
- Study startOct 2011
- Primary completionJun 2015
- Study completionJul 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Hepatorenal SyndromeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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)
Sponsor and investigators
- Lead sponsor
- Cumberland Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Brendan McGuire, MD, Principal investigator, University of Alabama at Birmingham
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
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 1 Mar 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multi-Center, Double-Blind, Randomized, Controlled Study to Determine the Safety and Pharmacokinetics of Ifetroban Injection in Hepatorenal Syndrome
- ClinicalTrials.gov ID
- NCT01436500
- Acronym / sponsor ID
- CPI-IFE-001
- Conditions
- Hepatorenal Syndrome
- Keywords
- Hepatorenal Syndrome, HRS, ifetroban
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 55 participants (actual)
- Lead sponsor
- Cumberland PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- Oct 2011
- Primary completion
- Jun 2015 (actual)
- Study completion
- Jul 2015 (actual)
- First posted
- 19 Sep 2011 (estimated)
- Results
- Posted 14 Feb 2017
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 9
| Arm | Type | Receives |
|---|---|---|
| 5 mg ifetroban, Type 1 | Experimental | Drug: Ifetroban Injection60-minute intravenous infusion of 5 mg ifetroban given once daily for 3 days to subjects with Type 1 HRS. |
| Placebo, Type 1 | Placebo comparator | Drug: Placebo60-minute intravenous infusion of 5% dextrose in sterile water given once daily for 3 days to subjects with Type 1 HRS. |
| 5 mg ifetroban, Type 2 | Experimental | Drug: Ifetroban Injection60-minute intravenous infusion of 5 mg ifetroban given once daily for 3 days to subjects with Type 1 HRS. |
| 15 mg ifetroban, Type 1 | Experimental | Drug: Ifetroban Injection60-minute intravenous infusion of 15 mg ifetroban given once daily for 3 days to subjects with Type 1 HRS. |
| 15 mg ifetroban, Type 2 | Experimental | Drug: Ifetroban Injection60-minute intravenous infusion of 15 mg ifetroban given once daily for 3 days to subjects with Type 2 HRS. |
| 50 mg ifetroban, Type 1 | Experimental | Drug: Ifetroban Injection60-minute intravenous infusion of 50 mg ifetroban given once daily for 3 days to subjects with Type 1 HRS. |
| 50 mg ifetroban, Type 2 | Experimental | Drug: Ifetroban Injection60-minute intravenous infusion of 50 mg ifetroban given once daily for 3 days to subjects with Type 2 HRS. |
| 150 mg ifetroban, Type 2 | Experimental | Drug: Ifetroban Injection60-minute intravenous infusion of 150 mg ifetroban given once daily for 3 days to subjects with Type 2 HRS. |
| Placebo, Type 2 | Placebo comparator | Drug: Placebo60-minute intravenous infusion of 5% dextrose in sterile water given once daily for 3 days to subjects with Type 2 HRS. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- 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:
- 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:
Key exclusion criteria (20 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Ifetroban InjectionIfetroban sodium injectable, diluted in sterile water with 5% dextrose | Drug | 15 mg ifetroban, Type 1, 15 mg ifetroban, Type 2, 150 mg ifetroban, Type 2, 5 mg ifetroban, Type 1, 5 mg ifetroban, Type 2, 50 mg ifetroban, Type 1, 50 mg ifetroban, Type 2 |
| PlaceboAlso: D5WSterile water with 5% Dextrose | Drug | Placebo, Type 1, Placebo, Type 2 |
Primary outcome
Half-life (T-1/2) of Ifetroban and Ifetroban Acylglucuronide
Time frame: 3 days
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.
Pharmacokinetic Parameters (Exposure) of Ifetroban and Ifetroban Acylglucuronide After Three Days of Treatment
Time frame: 3 days
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.
Pharmacokinetic Parameters (Concentration) of Ifetroban and Ifetroban Acylglucuronide After Three Days of Treatment
Time frame: 3 days
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.
4 secondary outcomes
Safety: Day 28 Mortality
Time frame: 28 days
Percentage of Patients Achieving a Treatment-period Serum Creatinine Reduction Below 1.5 mg/dL
Time frame: Day 0 through Day 5
The Percentage of Patients Achieving a Reduction of Creatinine Clearance to Below Baseline on Two Consecutive Daily Measurements
Time frame: Day 0 to Day 5
Change in 24-hour Urine Volume
Time frame: Baseline to Hour 96
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Mar 2017.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Brendan McGuire, MD principal investigator
University of Alabama at Birmingham
12 sites in 2 countries: see every site and its status.
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.