NCT03337477

Brief Summary

The study is designed to determine if ZS 10g administered up to three times over 10h added to insulin and glucose in patients presenting with hyperkalemia will prove tolerable and efficacious. Patients will receive ZS or Placebo on top of standard of care treatment with insulin and glucose.

Trial Health

90
On Track

Trial Health Score

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

Enrollment
70

participants targeted

Target at P50-P75 for phase_2

Timeline
Completed

Started Feb 2018

Shorter than P25 for phase_2

Geographic Reach
4 countries

25 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

October 23, 2017

Completed
17 days until next milestone

First Posted

Study publicly available on registry

November 9, 2017

Completed
3 months until next milestone

Study Start

First participant enrolled

February 13, 2018

Completed
10 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 21, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 21, 2018

Completed
1.1 years until next milestone

Results Posted

Study results publicly available

January 28, 2020

Completed
Last Updated

January 28, 2020

Status Verified

January 1, 2020

Enrollment Period

10 months

First QC Date

October 23, 2017

Results QC Date

December 11, 2019

Last Update Submit

January 17, 2020

Conditions

Outcome Measures

Primary Outcomes (1)

  • Mean Absolute Change in S-K From Baseline Until 4h After Start of Dosing With SZC/Placebo

    The least squares means (LS-means) are derived from a linear regression model of absolute change in S-K at 4h with the following covariates: treatment group; baseline S-K; time from the start of dosing insulin to the start of dosing SZC/placebo and the dose (units/kg) of the first course of insulin. The 95% CI is associated with LS-Means.

    Baseline to 4h potassium measurements.

Secondary Outcomes (6)

  • Fraction of Patients Responding to Therapy Defined as: S-K <6.0mmol/L Between 1 and 4h and S-K <5.0mmol/L at 4h; and no Additional Potassium Lowering Therapy From 0 to 4h With Exception of the Initial Insulin Treatment

    Baseline to 4h potassium meansurements.

  • The Fraction of Patients Achieving Normokalaemia 1, 2 and 4h After Start of Dosing With SZC/Placebo

    Baseline to 4h potassium meansurements.

  • The Fraction of Patients Achieving S-K <5.5mmol/l 1, 2, and 4h After Start of Dosing With SZC/Placebo

    Baseline to 4h potassium meansurements.

  • The Fraction of Patients Achieving S-K <6.0mmol/l 1, 2, and 4h After Start of Dosing With SZC/Placebo

    Baseline to 4h potassium meansurements.

  • The Fraction of Patients Administered Additional Potassium Lowering Therapy Due to Hyperkalaemia From 0 to 4h.

    Baseline to 4h potassium meansurements.

  • +1 more secondary outcomes

Study Arms (2)

ZS+insulin+glucose

EXPERIMENTAL

ZS will be administered in addition to insulin and glucose. Insulin and glucose is the current standard of care to treat serum potassium ≥5.8mmol/L.

Drug: Sodium Zirconium Cyclosilicate(ZS)Drug: InsulinDrug: Glucose

Placebo+insulin+glucose

PLACEBO COMPARATOR

Placebo will be administered in addition to insulin and glucose. Insulin and glucose is the current standard of care to treat serum potassium ≥5.8mmol/L.

Drug: PlaceboDrug: InsulinDrug: Glucose

Interventions

Suspension administered orally for a treatment period of 24h. 2 sachets administered up to three times over 10h (at 0, 4 and 10h).

Placebo+insulin+glucose

Suspension administered orally for a treatment period of 24h. Single dose contains 2 sachets of ZS 5g. 10g administered up to three times over 10h (at 0, 4 and 10h).

Also known as: ZS, ZS-9
ZS+insulin+glucose

Insulin 0.1 units/kg administered as a bolus or for up to 30 minutes.

ZS+insulin+glucose

Glucose 25g administered IV \<15 minutes before the insulin.

ZS+insulin+glucose

Eligibility Criteria

Age18 Years - 130 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • ≥ 18 years of age
  • Potassium ≥5.8 mmol/L

You may not qualify if:

  • Possible pseudohyperkalaemia
  • Hyperkalaemia caused by any condition for which a therapy directed against the underlying cause of hyperkalaemia would be a better treatment option than treatment with insulin and glucose.
  • Dialysis session expected within 4h after randomization
  • Treated with any therapy intended to lower S-K between arriving at the hospital and randomization during Visit 1.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (25)

Research Site

Montgomery, Alabama, 36106, United States

Location

Research Site

Phoenix, Arizona, 85008, United States

Location

Research Site

Detroit, Michigan, 48201, United States

Location

Research Site

Detroit, Michigan, 48202, United States

Location

Research Site

Detroit, Michigan, 48235, United States

Location

Research Site

Royal Oak, Michigan, 48073, United States

Location

Research Site

St Louis, Missouri, 63110, United States

Location

Research Site

Stony Brook, New York, 11794, United States

Location

Research Site

Durham, North Carolina, 27710, United States

Location

Research Site

Winston-Salem, North Carolina, 27157, United States

Location

Research Site

El Paso, Texas, 79905, United States

Location

Research Site

Houston, Texas, 77030, United States

Location

Research Site

Esbjerg, 6700, Denmark

Location

Research Site

Herning, 7400, Denmark

Location

Research Site

Novara, 28100, Italy

Location

Research Site

Piombino, 57025, Italy

Location

Research Site

Kemerovo, 650002, Russia

Location

Research Site

Kemerovo, 650066, Russia

Location

Research Site

Moscow, 115516, Russia

Location

Research Site

Moscow, 121374, Russia

Location

Research Site

Perm, 614990, Russia

Location

Research Site

Ryazan, 390039, Russia

Location

Research Site

Saint Petersburg, 198205, Russia

Location

Research Site

Yaroslavl, 150062, Russia

Location

Research Site

Yekaterinburg, 620039, Russia

Location

Related Publications (1)

  • Peacock WF, Rafique Z, Vishnevskiy K, Michelson E, Vishneva E, Zvereva T, Nahra R, Li D, Miller J. Emergency Potassium Normalization Treatment Including Sodium Zirconium Cyclosilicate: A Phase II, Randomized, Double-blind, Placebo-controlled Study (ENERGIZE). Acad Emerg Med. 2020 Jun;27(6):475-486. doi: 10.1111/acem.13954. Epub 2020 Mar 28.

Related Links

MeSH Terms

Conditions

Hyperkalemia

Interventions

sodium zirconium cyclosilicateInsulinGlucose

Condition Hierarchy (Ancestors)

Water-Electrolyte ImbalanceMetabolic DiseasesNutritional and Metabolic Diseases

Intervention Hierarchy (Ancestors)

ProinsulinInsulinsPancreatic HormonesPeptide HormonesHormonesHormones, Hormone Substitutes, and Hormone AntagonistsPeptidesAmino Acids, Peptides, and ProteinsHexosesMonosaccharidesSugarsCarbohydrates

Limitations and Caveats

Recruitment was stopped at 70 patients randomized instead of 132, as initially planned.

Results Point of Contact

Title
Study Information Center
Organization
AstraZeneca Clinical

Study Officials

  • Frank Peacock, MD

    Baylor College of Medicine

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restriction Type
GT60
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

October 23, 2017

First Posted

November 9, 2017

Study Start

February 13, 2018

Primary Completion

December 21, 2018

Study Completion

December 21, 2018

Last Updated

January 28, 2020

Results First Posted

January 28, 2020

Record last verified: 2020-01

Locations