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Septic ShockPhase 3ARISSNCT03869385

Albumin Replacement Therapy in Septic Shock

A Phase 3 study testing Albutein® 200 g/L or Plasbumin® 20 in people with Septic Shock, run by Jena University Hospital at 27 sites in Germany.

Terminated

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

Official record
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Trial summary

Albumin is a key regulator of fluid distribution within the extracellular space and possesses several properties beyond its oncotic activity, including binding and transport of several endogenous molecules, anti-inflammatory and anti-oxidant actions, nitric oxide modulation, and buffer function. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Septic Shock
What is being tested?
Albutein® 200 g/L or Plasbumin® 20
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
440 participants
Where
27 sitesGermany
Study dates
21 Oct 2019to 13 Jun 2023
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

  • The presence of septic shock meeting all of the following criteria:
  • Clinically possible or probable or microbiologically confirmed infection taking into account the definitions of the "International Sepsis Forum (ISF)"
  • Despite adequate volume therapy, vasopressors are required to maintain mean arterial pressure (MAP) ≥ 65 mm Hg for at least 1 hour
  • Serum lactate level > 2 mmol/l (18 mg/dl) despite adequate volume therapy
  • Start of septic shock less than 24 hours prior to inclusion, so that the start dose of the trial drug in the albumin group will be possible within 6-24 hours after the start of the septic shock
  • Age: ≥ 18 years
  • Written informed consent of the patient or his/her legal representative or confirmation of the urgency of participation in the clinical trial and possible benefit to the patient by an independent consultant or the implementation of other established procedures according to the local regulations of the contributing centre to include patients who are unable to provide informed consent in whom subsequent consent may be obtained retrospectively.
  • Patients of childbearing age: negative pregnancy test

Who cannot join

  • Moribund conditions with life expectancy less than 28 days because of comorbid conditions or advanced malignant disease and palliative situations with life expectancy less than 6 months
  • Presence of an "end of life" decision prior to obtaining informed consent: "Do Not Resuscitate (DNR)" and "Withhold/Withdraw Life-Sustaining measures"
  • Previous participation in this study
  • Participation in another interventional clinical trial within the past 3 months
  • Shock states that can be explained by other causes, e.g. cardiogenic shock, anaphylactic shock, neurogenic shock
  • History of hypersensitivity to albumin or any other component of the trial drug, e.g., B., sodium caprylate, sodium N-acetyltryptophanate
Show all 9Show fewer
  • Diseases in which albumin administration may be deleterious, e.g., decompensated heart failure or traumatic brain injury
  • Clinical conditions where albumin administration is indicated, e.g., hepatorenal syndrome, nephrosis, burns, intestinal malabsorption syndrome
  • Lactation

Trial locations and contacts

27 sites in 1 country.

27 sites in 1 country

Germany27 sites
  • Klinikum Augsburg, Klinik für Anästhesiologie und Operative Intensivmedizin

    Augsburg, 86156

  • Helios Klinikum Bad Saarow, Klinik für Intensivmedizin

    Bad Saarow, 15526

  • Vivantes Humboldt Klinikum, Klinik für Innere Medizin, Kardiologie und konservative Intensivmedizin

    Berlin, 13509

  • Universitätsklinikum Bonn, Klinik für Anästesiologie und Operative Intensivmedizin

    Bonn, 53105

  • St. Elisabeth Krankenhaus, Klinik für Anästhesiologie, Operative Intensivmedizin und Schmerztherapie

    Cologne, 50935

  • Universitätsklinikum Erlangen, Anästesiologische Klinik

    Erlangen, 91054

  • Universitätsklinikum Freiburg, Klinik für Allgemein- und Viszeralchirurgie, Chir. Intensivstation

    Freiburg im Breisgau, 79106

  • Universitätsmedizin Göttingen, Klinik für Anästhesiologie, Rettungs- und Intensivmedizin

    Göttingen, 37075

  • Universitätsmedizin Greifswald, Klinik für Anästhesiologie, Intensiv-, Notfall- und Schmerzmedizin

    Greifswald, 17475

  • Universitätsklinikum Hamburg-Eppendorf, Klinik für Intensivmedizin

    Hamburg, 20246

  • Universitätsklinikum Heidelberg, Klinik für Anästhesiologie

    Heidelberg, 69120

  • Klinikum Herford, Medizinische Klinik III, Kardiologie

    Herford, 32049

  • Marien Hospital Herne, Universitätsklinikum der Ruhr-Universität Bochum, Klinik für Anästhesiologie, Operative Intensivmedizin, Schmerztherapie, Palliativmedizin

    Herne, 44625

  • Universitätsklinikum des Saarlandes, Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie

    Homburg, 66421

  • Universitätsklinikum Jena, Innere Medizin I, Kardiologie

    Jena, 07747

  • Universitätsklinikum Jena, Klinik für Innere Medizin I, Kardiologie

    Jena, 07747

  • Universitätsklinikum Schleswig-Holstein, Klinik für Operative Intensivmedizin

    Kiel, 24105

  • Universitätsklinikum Leipzig, Interdisziplinäre Internistische Intensivmedizin

    Leipzig, 04103

  • Universitätsklinikum Leipzig, Klinik für Anästhesiologie u. Intensivtherapie

    Leipzig, 04103

  • Universitätsklinikum Leipzig, Klinik und Poliklinik für Neurologie

    Leipzig, 04103

  • Universitätsklinikum Magdeburg, Klinik für Innere Medizin, Kardiologie und Angiologie

    Magdeburg, 39120

  • Universitätsklinikum Magdeburg, Klinik für Anästhesiologie und Intensivmedizin

    Magdeburg

  • Universitätsklinikum der Johannes-Gutenberg-Universität Mainz, Klinik für Anästhesiologie

    Mainz, 55131

  • Klinikum der LMU München, Klinik für Anästhesiologie

    München, 81377

  • Klinikum rechts der Isar der TU München, Klinik für Anästhesiologie und Intensivmedizin

    München, 81675

  • Universitätsklinikum Münster, Klinik für Anästesiologie, operative Intensivmedizin und Schmerztherapie

    Münster, 48149

  • Universitätsklinikum Regensburg, Klinik und Poliklinik für Chirurgie

    Regensburg, 93053

Other trials in Germany

About this study

Official title: Randomised Controlled Multicentre Study of Albumin Replacement Therapy in Septic Shock

Albumin is a key regulator of fluid distribution within the extracellular space and possesses several properties beyond its oncotic activity, including binding and transport of several endogenous molecules, anti-inflammatory and anti-oxidant actions, nitric oxide modulation, and buffer function. The accumulating evidence suggests that supplementation of albumin may provide survival advantages only when the insult is severe as in patients with septic shock. Prospective randomized trials on the possible impact of albumin replacement in these patients with septic shock are lacking. The aim of the study is to investigate whether the replacement with albumin and the maintenance of its serum levels at least at 30 g/l for 28 days improve survival in patients with septic shock compared to resuscitation and volume maintenance without albumin. In this prospective, multicenter, randomised trial, adult patients (≥18 years) with septic shock will be randomly assigned within a maximum of 24 hours after the onset of septic shock after obtaining informed consents to treatment or control groups. Patients assigned to the treatment group will receive a 60 g loading dose of human albumin 20% over 2-3 hours. Serum albumin levels will be maintained at least at 30 g/l in the ICU for a maximum of 28 days following randomization using 40-80 g human albumin 20% infusion. The control group will be treated according to the usual practice with crystalloids as the first choice for the resuscitation and maintenance phase of septic shock. The primary end point is 90 days mortality and secondary end points include 28-day, 60-day, ICU, and in-hospital mortality, organ dysfunction/failure, and length of ICU and hospital stay. In total 1412 patients need to be analyzed, 706 per group. Assuming a dropout rate of 15%, a total of 1662 patients need to be allocated.

Read the detailed description

This is a prospective, multicentre, randomised, controlled, parallel-grouped, open-label, interventional clinical trial in which 1662 patients are planned to be allocated. Subjects will be randomized in a 1:1 ratio to receive either Albumin or routine treatment with crystalloids. Treatment will be continued at maximum for 28 days or until the patient leaves the ICU. Primary endpoint measurement will be carried out 90 days after randomisation

Conditions
Septic Shock
Being tested
Albutein® 200 g/L or Plasbumin® 20
Keywords
Human albumin, Sepsis
Medical subject headings
Shock, Septic, Sepsis

What participants receive

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

  • Albutein® 200 g/L or Plasbumin® 20Drug

    Also called Human Albumin 20%

    The initial dose of the trial drug must be started within 6 to 24 hours after the beginning of the septic shock. Starting dose: 60 g human albumin 20% (Albutein® 200 g/L, infusion solution) over 2-3 h Daily administration of the trial drug will be based on the serum albumin concentration measured each day. Dose adjustment will follow a predetermined schedule with the aim of maintaining a serum albumin concentration of at least 30 g/l. Administration of the trial drug will continue for a maximum of 28 study days after randomisation and only as long as the participant is being treated in the ICU.

Study groups in NCT03869385
Study groupRoleWhat they receive
Albumin groupExperimentalPatients assigned to the Albumin group will receive a 60 g loading dose of human albumin 20% over 2-3 hours. Serum albumin levels will be maintained at least at 30 g/l in the ICU for a maximum of 28 days following randomization using 40-80 g human albumin 20% infusion.
Receives: Drug: Albutein® 200 g/L or Plasbumin® 20
Control group without albumin:No interventionThe control group will be treated according to the usual practice with crystalloids as the first choice for the resuscitation and maintenance phase of septic shock.

What is being measured

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

  1. 90-day All Cause Mortality

    Mortality within 90 days after randomisation

    Measured: 90 days

Secondary outcomes (9)
  1. 28-day Mortality

    Mortality within 28 days after randomisation

    Measured: 28 days

  2. 60-day Mortality

    Mortality within 60 days after randomisation

    Measured: 60 days

  3. Organ Failure

    Organ failure defined as increase in the daily recorded Sequential organ Failure Assessement (SOFA) subscores; cardiovascular, respiratory, hematologic, hepatic, renal, neurologic (range 0-4 points each) from a value <2 to a value ≥ 2

    Measured: 28 days

  4. Sequential Organ Failure Assessement (SOFA) Score

    The overall degree of organ dysfunction/failure assessed daily by the total Sequential Organ Failure Score (SOFA score: range 0-24 points), with higher scores indicating higher degree of overall organ dysfunction/failure).

    Measured: 28 days

  5. ICU Length of Stay

    Intensive Care unit stay of first hospitalization after randomisation within 90 days

    Measured: 90 days

  6. Hospital Length of Stay

    Hospital stay of first hospitalization after randomisation within 90 days

    Measured: 90 days

  7. Ventilation-free Days

    Ventilation-free days within 28 days after randomisation

    Measured: 28 days

  8. Vasopressor-free Days

    Vasopressor-free days within 28 days after randomisation

    Measured: 28 days

  9. Total Amount of Fluid of Fluid Administration and Total Fluid Balance in the ICU.

    Total amount of fluid of fluid administration and total fluid balance in the ICU within 28 days after randomisation

    Measured: 28 days

Timeline

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

  1. First posted11 Mar 2019
  2. Study start21 Oct 2019
  3. Primary completion27 Jul 2022
  4. Study completion13 Jun 2023

Why it stopped: Sustained low inclusion rates.

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
Single blind
Who is masked
Outcomes assessor
Enrolment
440 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03869385
Sponsor's protocol ID
ZKSJ0112_ARISS
Other IDs
2018-001874-89, SA 2167/3-1, Nr: 328809707, ZKSJ0112, 2018
Acronym
ARISS
Status last verified
Oct 2024
First submitted
8 Mar 2019
Last updated
28 Oct 2024
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Sakr Y, Nierhaus A, Schumacher U, Utzolino S, Jaschinski U, Petros S, Fichtner F, Eimer C, Putensen C, Tanev I, Kreienbuhl L, Kluge S, Kousoulas L, Kuhn SO, Jarczak D, Quintel M, Bauer M; SepNet Critical Care Trials Group and Albumin Replacement Therapy in Septic Shock (ARISS) investigators. Albumin Replacement Therapy in Septic Shock: A Randomized Clinical Trial. JAMA Netw Open. 2026 Feb 2;9(2):e2559297. doi: 10.1001/jamanetworkopen.2025.59297.

    PubMed 41712212
  • Sakr Y, Bauer M, Nierhaus A, Kluge S, Schumacher U, Putensen C, Fichtner F, Petros S, Scheer C, Jaschinski U, Tanev I, Jacob D, Weiler N, Schulze PC, Fiedler F, Kapfer B, Brunkhorst F, Lautenschlaeger I, Wartenberg K, Utzolino S, Briegel J, Moerer O, Bischoff P, Zarbock A, Quintel M, Gattinoni L; SepNet - Critical Care Trials Group. Randomized controlled multicentre study of albumin replacement therapy in septic shock (ARISS): protocol for a randomized controlled trial. Trials. 2020 Dec 7;21(1):1002. doi: 10.1186/s13063-020-04921-y.

    PubMed 33287911

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Albutein® 200 g/L or Plasbumin® 20 in people with Septic Shock, run by Jena University Hospital at 27 sites in Germany.

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 8 inclusion and 9 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 28 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 27 sites in Germany. 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 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 28 Oct 2024). 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?

90-day All Cause Mortality (time frame: 90 days). 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 NCT03869385, which also lists 2 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 28 Oct 2024.

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