NCT01436500

Brief 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.

Trial Health

90
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
55

participants targeted

Target at P25-P50 for phase_2

Timeline
Completed

Started Oct 2011

Typical duration for phase_2

Geographic Reach
2 countries

12 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 31, 2011

Completed
19 days until next milestone

First Posted

Study publicly available on registry

September 19, 2011

Completed
12 days until next milestone

Study Start

First participant enrolled

October 1, 2011

Completed
3.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2015

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2015

Completed
1.6 years until next milestone

Results Posted

Study results publicly available

February 14, 2017

Completed
Last Updated

March 1, 2017

Status Verified

February 1, 2017

Enrollment Period

3.7 years

First QC Date

August 31, 2011

Results QC Date

December 22, 2016

Last Update Submit

February 27, 2017

Conditions

Keywords

Hepatorenal SyndromeHRSifetroban

Outcome Measures

Primary Outcomes (3)

  • 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.

    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.

    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.

    3 days

Secondary Outcomes (4)

  • Safety: Day 28 Mortality

    28 days

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

    Day 0 through Day 5

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

    Day 0 to Day 5

  • Change in 24-hour Urine Volume

    Baseline to Hour 96

Study Arms (9)

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.

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.

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.

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.

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.

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.

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.

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.

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.

Drug: Placebo

Interventions

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

15 mg ifetroban, Type 115 mg ifetroban, Type 2150 mg ifetroban, Type 25 mg ifetroban, Type 15 mg ifetroban, Type 250 mg ifetroban, Type 150 mg ifetroban, Type 2

Sterile water with 5% Dextrose

Also known as: D5W
Placebo, Type 1Placebo, Type 2

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • 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:
  • a. 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.
  • iii. 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.
  • b. 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:
  • a. 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

You may not qualify if:

  • 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.
  • 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
  • +5 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (12)

Mayo Clinic - Arizona

Phoenix, Arizona, 85054, United States

Location

UCSD, Hillcrest Medical Center Hospital

La Jolla, California, 92093, United States

Location

UCSF (University of California-San Francisco)

San Francisco, California, 94143, United States

Location

Emory University Hospital

Atlanta, Georgia, 30322, United States

Location

Indiana University (Division of Gastroenterology/Hepatology)

Indianapolis, Indiana, 46202, United States

Location

University of Michigan Hospital

Ann Arbor, Michigan, 48109, United States

Location

NYU Langone Medical Center

New York, New York, 10016, United States

Location

The Ohio State University

Columbus, Ohio, 43210, United States

Location

Baylor All Saints Medical Center

Fort Worth, Texas, 76104, United States

Location

University of Utah Health Sciences Center

Salt Lake City, Utah, 84132, United States

Location

Virginia Commonwealth University

Richmond, Virginia, 23298, United States

Location

MIDAS Multispeciality Hospital PVT LTD

Nagpur, Maharashtra, 440010, India

Location

MeSH Terms

Conditions

Hepatorenal Syndrome

Interventions

ifetroban

Condition Hierarchy (Ancestors)

Liver DiseasesDigestive System DiseasesKidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital Diseases

Results Point of Contact

Title
Jerry Fox, DVM
Organization
Cumberland Pharmaceuticals Inc

Study Officials

  • Brendan McGuire, MD

    University of Alabama at Birmingham

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restriction Type
OTHER
Restrictive Agreement
Yes

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 31, 2011

First Posted

September 19, 2011

Study Start

October 1, 2011

Primary Completion

June 1, 2015

Study Completion

July 1, 2015

Last Updated

March 1, 2017

Results First Posted

February 14, 2017

Record last verified: 2017-02

Data Sharing

IPD Sharing
Will not share

Locations