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SepsisPhase 4NCT03764085

Efficacy and Safety of Rheosorbilact® Solution for Infusion, in a Complex Therapy of Sepsis.

A Phase 4 study testing Rheosorbilact® and Ringer lactate in people with Sepsis and Intoxication; Septic, run by Yuria-Pharm at 13 sites in 5 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

This study evaluates the efficacy and safety of Rheosorbilact®, solution for infusion ("Yuria-Pharm" LLC), in comparison with Ringer's Lactate, solution for infusion, in a complex therapy of sepsis. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Sepsis, Intoxication; Septic
What is being tested?
Rheosorbilact® and Ringer lactate
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
180 participants
Where
13 sitesin 5 countries
Study dates
6 Dec 2016to 11 Dec 2019
Phase
Phase 4
Are there results?
None posted in the registry

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 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Male and female aged 18 to 60 years inclusive
  • Sepsis diagnosed according to ACCP / SCCM criteria (no later than 24 hours from the time of diagnosis of sepsis to screening visit) (Annex 1: Sequence Diagnostic Criteria for SCCM / ESICM / ACCP / ATS / SIS)
  • Informed consent for participation in the study signed by subject's own hand.
  • The baseline value of the SOFA scale ≥ 2 points.
  • Non-inclusion Criteria:
  • The presence of any of the criteria for severe sepsis by ACCP / SCCM (presence of signs of organ failure - Annex 1: criteria for diagnosis of sepsis SCCM / ESICM / ACCP / ATS / SIS)
Show all 25Show fewer
  • Individual intolerance of the components of the study drug and the comparator;
  • Hypersensitivity to sodium lactate;
  • Intravenous infusions of lactate- or sorbitol-containing products within 24 hours before enrollment;
  • Pregnancy or breast-feeding;
  • Severe renal dysfunction (creatinine is more than 300 μmol/l or estimated creatinine clearance is less than 30 ml/min);
  • Metabolic alkalosis;
  • Severe metabolic acidosis;
  • Intracerebral hemorrhage;
  • Any thromboembolism;
  • Decompensated cardiovascular failure;
  • Arterial hypertension III st;
  • Conditions associated with immunodeficiency (the use of cytostatics or system steroids, AIDS);
  • Extracellular hyperhydration or hypervolemia;
  • Severe renal insuffiency (with oliguria / anuria);
  • Hyperkalaemia;
  • Hypercalcemia;
  • Ascites associated with cirrhosis;
  • Conditions associated with increased lactate levels (hyperlactatemia > 2 mmol / l), including lactic acidosis, or impaired lactate uptake (including due severe hepatic insufficiency);
  • Concomitant therapy with cardiac glycosides;

Who cannot join

  • Infusion of the study drug or the comparator is started more than 12 hours after randomization;
  • Lack of data for sepsis (diagnosis not confirmed);
  • Withdrawal of the informed consent by the subject;
  • Investigator considers that the infusion therapy with either study drug or comparator may not be continued for safety reasons;
  • Development of conditions that prevent further use of the study drug/comparator before efficacy evaluation visit (Visit 3);
  • Subject needs concomitant therapy prohibited in the study before efficacy evaluation visit (Visit 3);
  • Development of conditions (including serious adverse events) which make it impossible to evaluate the primary endpoint;
  • Confirmation of pregnancy at any time of the study.

Trial locations and contacts

13 sites in 5 countries.

13 sites in 5 countries

Ukraine6 sites
  • Dnipro's Medical Academy of Ministry of Health of Ukraine

    Dnipro, 49005

  • Zaicev's Institute of general and urgent surgery NMA Ukraine

    Kharkiv, 61018

  • Khmelnytskyi Regional Clinical Hospital

    Khmelnytskyi, 29000

  • HSEE of Ukraine "Ukrainian Medical Stomatological Academy"; Poltava Central District Hospital

    Poltava

  • Central District Clinical Hospital

    Vinnitsa, 21029

  • Zaporizka Medical Academy of postgraduate education, Zaporizkyi Clinical Hospital N9

    Zaporizhzhya, 69065

Other trials in Ukraine

Moldova3 sites
  • Institute of Ambulance

    Chisinau

  • Municipal Clinical Hospital "Sfinta Treime"

    Chisinau

  • Republican Clinical Hospital

    Chisinau

Other trials in Moldova

Georgia2 sites
  • "Unimedi Adjara" LLC

    Batumi

  • Kutaisi Referral Hospital

    Kutaisi

Other trials in Georgia

Kazakhstan1 site
  • Hospital of the Medical Center of the Administration of the President of the Republic of Kazakhstan

    Astana

Other trials in Kazakhstan

Uzbekistan1 site
  • Republic Centre of Ambulance

    Tashkent

Other trials in Uzbekistan

About this study

Official title: Open-label, Randomized, Controlled, With Blind Assessor, Study to Assess Efficacy and Safety of Rheosorbilact®, Solution for Infusion, in Comparison With Ringer's Lactate, Solution for Infusion, in a Complex Therapy of Sepsis.

This study evaluates the efficacy and safety of Rheosorbilact®, solution for infusion ("Yuria-Pharm" LLC), in comparison with Ringer's Lactate, solution for infusion, in a complex therapy of sepsis. Half of participants will receive Rheosorbilact® in complex therapy, while the other half will receive Ringer's Lactate in complex therapy.

Read the detailed description

Rheosorbilact® has rheological, anti-shock, detoxification, and alkalizing effects. Sorbitol and sodium lactate are the major pharmacologically active ingredients. In the liver, sorbitol is first converted into fructose, which is then converted into glucose, and then into glycogen. Part of sorbitol is used for urgent energy needs, while the other part is kept as a reserve in the form of glycogen. Isotonic sorbitol solution has a disaggregating effect and, therefore, improves microcirculation and tissue perfusion.

The management of metabolic acidosis with sodium lactate goes more slowly compared to bicarbonate solution, as far as sodium lactate enters the metabolic process; however the latter does not cause swings in pH values. The effect of sodium lactate is typically seen 20 to 30 minutes after administration.

Sodium chloride is a plasma-substituting agent that exhibits a detoxification and rehydration effect. It replenishes the deficiency of sodium and chlorine ions in various pathological conditions.

Calcium chloride replenishes deficiency of calcium ions. Calcium ions are essential in the transmission of nerve impulses, contraction of skeletal and smooth muscles, myocardial activity, bone tissue formation, and blood clotting. It reduces the permeability of cells and vascular walls, prevents the development of inflammatory reactions, enhances the resistance of the body to infections and can significantly boost phagocytosis.

Potassium chloride restores the water-electrolyte balance. It exhibits a negative chrono- and bathmotropic action and, when administered in high doses, has a negative ino- and dromotropic and moderate diuretic effect. It is involved in the process of nerve impulse conduction, increases the content of acetylcholine and causes excitation of the sympathetic segment of the autonomic nervous system and improves the contraction of skeletal muscles in subjects with muscular dystrophy or myasthenia.

Rheosorbilact® is administered to improve capillary blood flow for the prevention and treatment of traumatic, surgical, hemolytic, toxic and burn shock, acute blood loss, and burn disease; infectious diseases accompanied by intoxication, exacerbation of chronic hepatitis; sepsis, pre- and postoperative period to improve arterial and venous circulation for the prevention and treatment of thrombosis, thrombophlebitis, endarteritis, and Raynaud's disease.

Ringer's Lactate, solution for infusion will be used as a comparator. As a rehydrating agent, Ringer's Lactate has a detoxification effect, replenishes the deficiency of circulating blood volume, and stabilizes the water and electrolyte composition of blood. Ringer's Lactate normalizes the acid-base balance. Lactate is metabolized in the body to bicarbonate, so the solution has an alkalizing effect. With osmolarity at 273 mOsm/l, Ringer's Lactate is close to isotonic solution and is indicated for hypovolemia, isotonic dehydration, and metabolic alkalosis.

Being tested
Rheosorbilact®, Ringer lactate
Medical subject headings
Sepsis, Toxemia

What participants receive

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

  • Rheosorbilact®Drug

    Administered intravenously (with speed 40-60 drip per minute) at a dose of 600 to 1,000 ml (10 to 15 ml/kg body weight per 24 hours) for 3 days.

  • Ringer lactateDrug

    Administered intravenously (with speed 40-60 drip per minute) at a dose of 1,000 to 2,500 ml (15 to 40 ml/kg body weight per 24 hours) for 3 days.

Study groups in NCT03764085
Study groupRoleWhat they receive
Rheosorbilact®ExperimentalRheosorbilact® is administered as a part of the infusion therapy intravenously (with speed 40-60 drip per minute) at a dose of 600 to 1,000 ml (10 to 15 ml/kg body weight per 24 hours).The period of the treatment with the study drug lasts 3 days.
Receives: Drug: Rheosorbilact®
Ringer's LactateActive comparatorRinger's Lactate is administered as a part of the infusion therapy intravenously (with speed 40-60 drip per minute) at a dose of 1,000 to 2,500 ml (15 to 40 ml/kg body weight per 24 hours).The period of the treatment with the active comparator lasts 3 days.
Receives: Drug: Ringer lactate

What is being measured

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

  1. A change in the total SOFA score vs. baseline score upon admission;

    Sequential Organ Failure Assessment (SOFA) score is composed of scores of six organ systems: R-respiratory, C-cardiovascular, H-hepatic, Co-coagulation, Re-renal, and N-neurological graded from 0 to 4 according to the degree of dysfunction or failure.

    The SOFA score ranges from 0 to 24 points. We evaluate initial SOFA score and differences between subsequent scores (Δ-SOFA scores).

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

Secondary outcomes (36)
  1. A change in the total APACHE II score vs. baseline score upon admission;

    Acute physiology and chronic health evaluation(APACHE) II score is calculated from a patient's age (0-6 points) and 12 physiological parameters (each item 0-4 points): AaDO2 or PaO2 (depending on FiO2), Temperature (rectal), Mean arterial pressure, pH arterial, Heart rate, Respiratory rate, Sodium (serum), Potassium (serum), Creatinine, Hematocrit, White blood cell count, Glasgow Coma Scale and chronic disease health status (0-5 points).

    The APACHE II score ranges from 0 to 71 points. We evaluate initial APACHE II score and differences between subsequent scores (Δ-APACHE II scores).

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  2. A change in the total SAPS II score vs. baseline score upon admission

    The SAPS II score is made of 17 variables: 12 physiology variables, age, type of admission (scheduled surgical, unscheduled surgical, or medical), and three underlying disease variables (acquired immunodeficiency syndrome, metastatic cancer, and hematologic malignancy).

    The SAPS II score ranges from 0 to 160 points. We evaluate initial SAPS II score and differences between subsequent scores (Δ-SAPS II scores).

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  3. A change in the total MODS score vs. baseline score upon admission

    MODS (Multiple Organ Dysfunction Score) is composed of scores of six organ systems: R-respiratory, C-cardiovascular, H-hepatic, Co-coagulation, Re-renal, and N-neurological graded from 0 to 4 according to the degree of dysfunction or failure.

    The MODS score ranges from 0 to 24 points. We evaluate initial MODS score and differences between subsequent scores (MODS scores).

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  4. Concentration of glucose

    Concentration of glucose (mmol/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  5. Concentration of sodium

    Concentration of sodium (mmol/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  6. Concentration of potassium

    Concentration of potassium (mmol/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  7. Concentration of lactate

    Concentration of lactate (mmol/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  8. Concentration of pyruvate

    Concentration of pyruvate (mmol/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  9. Concentration of urea

    Concentration of urea (mmol/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  10. Concentration of creatinine

    Concentration of creatinine (µmol/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  11. Concentration of bilirubin

    Concentration of bilirubin (µmol/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  12. Concentration of alanine aminotransferase

    Concentration of alanine aminotransferase (U/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  13. Concentration of aspartate aminotransferase

    Concentration of aspartate aminotransferase (U/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  14. Concentration of lactate dehydrogenase

    Concentration of lactate dehydrogenase (U/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  15. Concentration of alkaline phosphatase

    Concentration of alkaline phosphatase (U/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  16. Concentration of creatine kinase

    Concentration of creatine kinase (U/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  17. Concentration of γ-Glutamyltransferase

    Concentration of γ-Glutamyltransferase (U/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  18. Concentration of low-molecular-weight adiponectin (LMW)

    Concentration of low-molecular-weight adiponectin (U/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  19. Concentration of middle-molecular-weight adiponectin (MMW)

    Concentration of middle-molecular-weight adiponectin (U/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  20. Concentration of albumin

    Concentration of albumin in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  21. Procalcitonin level

    Concentration of procalcitonin level (µg/L) in blood serum after 8-hour fasting.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  22. White blood cells (WBC) count level

    White blood cells (billion/L) count level in blood serum after 8-hour fasting

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  23. Lymphocyte count level

    Lymphocyte count (%) level in blood serum after 8-hour fasting

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  24. Platelet count level

    Platelet count level (billion/L) in blood serum after 8-hour fasting

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  25. Calculation of Nuclear index of intoxication (NII)

    Calculated by dividing the number of myelocytes, young and stab neutrophils by number of segmented neutrophils.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  26. Calculation of Leukocyte index of intoxication (LII)

    Calculated by the formula of Kalf-Kalifa: correlation between the level of neutrophils and the content of other cells in the blood leukocytic composition.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  27. Concentration of C-reactive protein (CRP)

    Concentration of C-reactive protein (CRP) in blood serum after 8-hour fasting

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  28. Level of circulating immune complexes (CIC)

    Level of Circulating immune complexes (CIC) in blood serum after 8-hour fasting

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  29. Concentration of Interleukin-1 and 2

    Concentration of Interleukin-1 (pg/ml) and Interleukin-2 (pg/ml) in blood serum after 8-hour fasting

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  30. Calculation of neutrophil-to-lymphocyte ratio (NLR)

    Calculated by dividing the number of neutrophils (%) by number of lymphocytes (%).

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  31. Concentration of immunoglobulins

    Concentration of Ig A, Ig M and Ig G in blood serum after 8-hour fasting

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  32. Concentration of complements

    Concentration of complements (C3, C4) in blood sample after 8-hour fasting

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  33. Assessment of central hemodynamics

    Measurement of central venous pressure (mmh2o) in the central vein

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  34. A change in the total Glasgow Coma Scale (GCS) score vs. baseline score upon admission

    The GCS is composed of 3 components: ocular response (assessment 1-4 points), motor response (assessment 1-6 points) verbal response (evaluation of 1-5 points). Scores for each component are added together to get the total that will range between a minimum of 3 points (which corresponds to a patient who does not open his eyes and no motor response to stimulation or verbal response) and a maximum value of 15 points (corresponding to a patient with open eyes, obeying orders and maintaining a consistent language).

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  35. Assessment of electrocardiogram (ECG)

    Presence of clinically significant changes on ECG is evaluated.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

  36. Clinical signs

    Presence of clinical signs (adynamia, weakness, memory impairment, sleep disorder, irritability) is based on patient's subjective complaints.

    Measured: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.

Timeline

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

  1. First posted4 Dec 2018
  2. Study start6 Dec 2016
  3. Primary completion11 Dec 2019
  4. Study completion11 Dec 2019

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
180 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03764085
Sponsor's protocol ID
RheoSTAT-CP0620
Status last verified
Jan 2020
First submitted
10 Oct 2017
Last updated
21 Feb 2020
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Rheosorbilact® and Ringer lactate in people with Sepsis and Intoxication; Septic, run by Yuria-Pharm at 13 sites in 5 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 25 inclusion and 8 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 21 Feb 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in Ukraine, Moldova, Georgia, Kazakhstan, Uzbekistan. 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. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

A change in the total SOFA score vs. baseline score upon admission; (time frame: Will be evaluated for the duration of Intensive Care Unit (ICU) stay, at screening (Day 0) and Visit 3 (Day 3) of ICU stay.). 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 21 Feb 2020.

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