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I5NP for Prophylaxis of Delayed Graft Function in Kidney Transplantation

Primary Purpose

Delayed Graft Function, Other Complication of Kidney Transplant

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
I5NP
Saline
Sponsored by
Quark Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Delayed Graft Function focused on measuring Delayed Graft Function, Kidney Transplant, Renal Transplant, small interfering ribonucleic acid (siRNA)

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient is at least 18 years of age.
  2. Patient has given informed consent.
  3. Patient is willing to practice birth control. Female patients must be: (1) post-menopausal (2) surgically sterile, or (3) using an effective means of contraception (per the site-specific guidelines or using 2 methods of birth control concurrently, whichever is more stringent) which will be continued until the Study Day 90 visit with a negative pregnancy test within 48 hours prior to administration of study drug. Male patients with female partners of child bearing potential must agree to use an effective means of contraception (per the site-specific guidelines or using 2 methods of birth control concurrently, whichever is more stringent) which will be continued until the Study Day 90 visit. Note: For the purpose of this study, post menopausal is defined as the absence of menses consistent with ESRD. A woman is considered to be surgically sterilized if she has had a bilateral tubal ligation for at least 6 months prior to administration of study drug, bilateral oophorectomy, or complete hysterectomy.
  4. Women of childbearing potential test negative for pregnancy (either urine or serum) within 48 hours prior to transplant.
  5. Patient is up-to-date on cancer screening according to site-specific guidelines and the past medical history is negative for biopsy-confirmed malignancy within 5 years of randomization, with the exception of adequately treated basal cell or squamous cell carcinoma in situ.
  6. Patient is scheduled to receive kidney transplant from a deceased donor meeting the following criteria:

    Part A:

    • receipt of an extended criteria donor (ECD) kidney, or
    • receipt of a kidney donated after cardiac death (DCD), or
    • receipt of a standard criteria donor (SCD) with cold ischemia time (CIT) ≥ 24 hours.

    Part B:

    • receipt of an ECD kidney that has been preserved by cold storage (ECD/CS) for the entire period of cold ischemia time (CIT), regardless of duration
    • receipt of an ECD kidney that has been preserved by machine perfusion (ECD/MP) for any interval of time during the period of cold ischemia, where total CIT has been at least 26 hours
    • receipt of an SCD kidney that has been preserved by cold storage (SCD/CS) where total CIT has been at least 26 hours
    • receipt of an SCD kidney that has been preserved by machine perfusion (SCD/MP) for any interval of time during the period of cold ischemia, where total CIT has been at least 26 hours.
  7. Patient is dialysis dependent at the time of transplant as documented by: a) the requirement for at least 2 dialysis sessions/week during the 56 days prior to transplant, or b) the planned removal of any remaining native kidney at the time of transplant, or c) the opinion of the investigator that the patient has no remaining native renal function (Part A only), or d) the investigator has provided documentation to the Medical Monitor that the patient has no remaining native renal function (e.g., documentation that the patient is anuric, with urine output <50 mL/day) (Part B only).

Exclusion Criteria:

  1. Patient has participated in an investigational drug study in the last 30 days.
  2. Patient has known allergy or has participated in prior study with siRNA.
  3. Patient is HCV-positive
  4. Patient is HIV-positive
  5. Patient is scheduled to undergo multiorgan transplantation.
  6. Patient has a planned transplant of kidneys that are implanted en bloc (dual kidney transplant).
  7. Patient has planned transplant of kidneys from donors < 6 years of age.
  8. Patient has planned transplant of dual kidneys (from the same donor) transplanted not en bloc (as in the case of dual ECD donor kidneys).
  9. Patient is scheduled for transplantation of a kidney from a donor who is known to have received an investigational therapy (under another IND) for ischemic/reperfusion injury immediately prior to organ recovery.
  10. Patient is scheduled to receive a living donor kidney.
  11. Patient is scheduled to receive an ABO-incompatible donor kidney.
  12. Patient is scheduled to receive an organ from a donor that meets both DCD and ECD criteria.
  13. Patient is scheduled to receive an organ from a donor that meets DCD criteria (exclusion applicable to Part B only).
  14. Patient has history or presence of a medical condition or disease that in the investigator's assessment would place the patient at an unacceptable risk for study participation.

Sites / Locations

  • University of Alabama Birmingham
  • Loma Linda University Medical Center
  • University of Southern California
  • Cedars-Sinai Medical Center
  • Transplant Research Institute (TRI; formerly NIT)
  • UCLA Medical Center
  • UC Davis Medical Center
  • California Pacific Medical Center
  • UCSF Medical Center
  • University of Colorado Health Science Center
  • Washington Hospital Center
  • University of Florida
  • University of Miami
  • Lifelink Healthcare Institute
  • Piedmont Hospital
  • Emory University
  • Rush University
  • University of Illinois Chicago
  • University of Maryland
  • Johns Hopkins University
  • University of Michigan
  • Mayo Clinic Rochester
  • Saint Barnabas Medical Center
  • Columbia University
  • Cornell University
  • Duke University
  • Wake Forest University Medical Center
  • Medical University of South Carolina
  • Baylor University Medical Center
  • Baylor All Saints Medical Center
  • The Methodist Hospital
  • University of Virginia
  • Virginia Commonwealth University (MCV)
  • St. Paul's Hospital, Univeristy of BC
  • UBC - Division of Nephrology
  • QE II Capital District Health Authority, Halifax
  • MUHC Royal Victoria Hospital
  • Hôpital Pasteur
  • Hôpital Necker
  • CHU Rangueil
  • Charité - Universitätsmedizin Berlin
  • Charité, Campus Virchow-Klinikum
  • Kliniken der Stadt Köln gGmbH
  • Universitätklinikum Hamburg-Eppendorf
  • Universitätsklinikum Heidelberg
  • Universitätsmedizin Mannheim
  • Universitätsklinikum Tübingen
  • Hospital de bellvitge
  • Hospital del mar
  • Hospital Vall Hebron

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

I5NP

Saline

Arm Description

Outcomes

Primary Outcome Measures

Part A: The outcome measure is safety. Additionally, plasma blood levels will be measured to characterize the PK of I5NP in this patient population. Part B: The outcome measure will be safety and the incidence of delayed graft function.

Secondary Outcome Measures

Part B: Treatment differences in the rate of improvement in renal function over time and treatment differences in the need for renal replacement therapy.

Full Information

First Posted
December 2, 2008
Last Updated
September 8, 2014
Sponsor
Quark Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00802347
Brief Title
I5NP for Prophylaxis of Delayed Graft Function in Kidney Transplantation
Official Title
Controlled, Randomized, Prospective, Double-Blind, Multicenter, Phase I/II, Dose-Escalation Study of the Safety, PK, and Clinical Activity of I5NP for Prophylaxis of Delayed Graft Function in Patients Undergoing Deceased Donor Kidney Transplantation
Study Type
Interventional

2. Study Status

Record Verification Date
September 2014
Overall Recruitment Status
Completed
Study Start Date
December 2008 (undefined)
Primary Completion Date
November 2013 (Actual)
Study Completion Date
May 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Quark Pharmaceuticals

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine whether a single administration of QPI-1002 (also known as I5NP) can prevent DGF in patients undergoing deceased donor kidney transplantation. In this Phase I /II study, patients who are undergoing renal transplantation with organs from DCD donors, ECD donors or SCD donors with ≥ 24 hours of cold ischemia time who meet study entry criteria will be studied to evaluate the safety and pharmacokinetic profile of I5NP (Part A) and clinical activity of I5NP administration (Part B). Data from this study will be used to identify doses of I5NP to be used in follow-on efficacy studies. Part A will be a randomized, dose escalation study to determine the highest or maximum tolerated dose (MTD). Part A will enroll 40 patients at approximately 20 sites; patients will be randomized to receive either I5NP or placebo in a ratio of 8:2 in each cohort (cohorts 1-4). Part B will utilize the dose identified in Part A to further evaluate, in a double-blind manner, the safety, and clinical activity of I5NP. In Part B, up to 326 patients will participate at approximately 60 sites; up to 163 patients will be randomized to receive I5NP and up to 163 patients randomized to receive placebo.
Detailed Description
Although the etiology of DGF is not fully understood and may be multifactorial, the pathophysiology appears to be primarily related to ischemia-reperfusion (IR) injury resulting from organ preservation between the times of harvesting from the donor and reperfusion following vascular reanastomosis in the recipient. I5NP is a small interfering RNA (siRNA) that is being developed for the prophylaxis of delayed graft function (DGF) in patients receiving renal transplants.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Delayed Graft Function, Other Complication of Kidney Transplant
Keywords
Delayed Graft Function, Kidney Transplant, Renal Transplant, small interfering ribonucleic acid (siRNA)

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
374 (Actual)

8. Arms, Groups, and Interventions

Arm Title
I5NP
Arm Type
Experimental
Arm Title
Saline
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
I5NP
Other Intervention Name(s)
QPI-1002
Intervention Description
Single IV injection of I5NP Part A: dose-escalation study; cohort 1 = 0.5 mg/kg; cohort 2 = 1.5 mg/kg; cohort 3 = 5.0 mg/kg; cohort 4 = 10.0 mg/kg Part B: 10.0 mg/kg
Intervention Type
Drug
Intervention Name(s)
Saline
Intervention Description
Single IV injection of saline Part A: dose-escalation study; cohort 1 = 0.5 mg/kg; cohort 2 = 1.5 mg/kg; cohort 3 = 5.0 mg/kg; cohort 4 = 10.0 mg/kg Part B: 10.0 mg/kg
Primary Outcome Measure Information:
Title
Part A: The outcome measure is safety. Additionally, plasma blood levels will be measured to characterize the PK of I5NP in this patient population. Part B: The outcome measure will be safety and the incidence of delayed graft function.
Time Frame
Part A: DSMB review at conclusion of each cohort / Part B: Interim analyses will be performed after the 66th, 130th, and 196th patient enrolled
Secondary Outcome Measure Information:
Title
Part B: Treatment differences in the rate of improvement in renal function over time and treatment differences in the need for renal replacement therapy.
Time Frame
Part B: Interim analyses will be performed after the 66th, 130th, and 196th patient enrolled

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient is at least 18 years of age. Patient has given informed consent. Patient is willing to practice birth control. Female patients must be: (1) post-menopausal (2) surgically sterile, or (3) using an effective means of contraception (per the site-specific guidelines or using 2 methods of birth control concurrently, whichever is more stringent) which will be continued until the Study Day 90 visit with a negative pregnancy test within 48 hours prior to administration of study drug. Male patients with female partners of child bearing potential must agree to use an effective means of contraception (per the site-specific guidelines or using 2 methods of birth control concurrently, whichever is more stringent) which will be continued until the Study Day 90 visit. Note: For the purpose of this study, post menopausal is defined as the absence of menses consistent with ESRD. A woman is considered to be surgically sterilized if she has had a bilateral tubal ligation for at least 6 months prior to administration of study drug, bilateral oophorectomy, or complete hysterectomy. Women of childbearing potential test negative for pregnancy (either urine or serum) within 48 hours prior to transplant. Patient is up-to-date on cancer screening according to site-specific guidelines and the past medical history is negative for biopsy-confirmed malignancy within 5 years of randomization, with the exception of adequately treated basal cell or squamous cell carcinoma in situ. Patient is scheduled to receive kidney transplant from a deceased donor meeting the following criteria: Part A: receipt of an extended criteria donor (ECD) kidney, or receipt of a kidney donated after cardiac death (DCD), or receipt of a standard criteria donor (SCD) with cold ischemia time (CIT) ≥ 24 hours. Part B: receipt of an ECD kidney that has been preserved by cold storage (ECD/CS) for the entire period of cold ischemia time (CIT), regardless of duration receipt of an ECD kidney that has been preserved by machine perfusion (ECD/MP) for any interval of time during the period of cold ischemia, where total CIT has been at least 26 hours receipt of an SCD kidney that has been preserved by cold storage (SCD/CS) where total CIT has been at least 26 hours receipt of an SCD kidney that has been preserved by machine perfusion (SCD/MP) for any interval of time during the period of cold ischemia, where total CIT has been at least 26 hours. Patient is dialysis dependent at the time of transplant as documented by: a) the requirement for at least 2 dialysis sessions/week during the 56 days prior to transplant, or b) the planned removal of any remaining native kidney at the time of transplant, or c) the opinion of the investigator that the patient has no remaining native renal function (Part A only), or d) the investigator has provided documentation to the Medical Monitor that the patient has no remaining native renal function (e.g., documentation that the patient is anuric, with urine output <50 mL/day) (Part B only). Exclusion Criteria: Patient has participated in an investigational drug study in the last 30 days. Patient has known allergy or has participated in prior study with siRNA. Patient is HCV-positive Patient is HIV-positive Patient is scheduled to undergo multiorgan transplantation. Patient has a planned transplant of kidneys that are implanted en bloc (dual kidney transplant). Patient has planned transplant of kidneys from donors < 6 years of age. Patient has planned transplant of dual kidneys (from the same donor) transplanted not en bloc (as in the case of dual ECD donor kidneys). Patient is scheduled for transplantation of a kidney from a donor who is known to have received an investigational therapy (under another IND) for ischemic/reperfusion injury immediately prior to organ recovery. Patient is scheduled to receive a living donor kidney. Patient is scheduled to receive an ABO-incompatible donor kidney. Patient is scheduled to receive an organ from a donor that meets both DCD and ECD criteria. Patient is scheduled to receive an organ from a donor that meets DCD criteria (exclusion applicable to Part B only). Patient has history or presence of a medical condition or disease that in the investigator's assessment would place the patient at an unacceptable risk for study participation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shai Erlich, Ph.D.
Organizational Affiliation
Quark Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
University of Alabama Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Loma Linda University Medical Center
City
Loma Linda
State/Province
California
ZIP/Postal Code
92354
Country
United States
Facility Name
University of Southern California
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
Cedars-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Transplant Research Institute (TRI; formerly NIT)
City
Los Angeles
State/Province
California
ZIP/Postal Code
90057
Country
United States
Facility Name
UCLA Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
UC Davis Medical Center
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
California Pacific Medical Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States
Facility Name
UCSF Medical Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
University of Colorado Health Science Center
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Washington Hospital Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Facility Name
University of Florida
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
Facility Name
University of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Lifelink Healthcare Institute
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
Piedmont Hospital
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30309
Country
United States
Facility Name
Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Rush University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
University of Illinois Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
University of Maryland
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Mayo Clinic Rochester
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Saint Barnabas Medical Center
City
Livingston
State/Province
New Jersey
ZIP/Postal Code
07039
Country
United States
Facility Name
Columbia University
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Cornell University
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Duke University
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Wake Forest University Medical Center
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Baylor University Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
Facility Name
Baylor All Saints Medical Center
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76104
Country
United States
Facility Name
The Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Facility Name
Virginia Commonwealth University (MCV)
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298
Country
United States
Facility Name
St. Paul's Hospital, Univeristy of BC
City
Vancouver
State/Province
British Columbia
Country
Canada
Facility Name
UBC - Division of Nephrology
City
Vancouver
State/Province
British Columbia
Country
Canada
Facility Name
QE II Capital District Health Authority, Halifax
City
Halifax
State/Province
Nova Scotia
Country
Canada
Facility Name
MUHC Royal Victoria Hospital
City
Montreal
State/Province
Quebec
Country
Canada
Facility Name
Hôpital Pasteur
City
Nice
Country
France
Facility Name
Hôpital Necker
City
Paris
Country
France
Facility Name
CHU Rangueil
City
Toulouse
Country
France
Facility Name
Charité - Universitätsmedizin Berlin
City
Berlin
Country
Germany
Facility Name
Charité, Campus Virchow-Klinikum
City
Berlin
Country
Germany
Facility Name
Kliniken der Stadt Köln gGmbH
City
Cologne
Country
Germany
Facility Name
Universitätklinikum Hamburg-Eppendorf
City
Hamburg
Country
Germany
Facility Name
Universitätsklinikum Heidelberg
City
Heidelberg
Country
Germany
Facility Name
Universitätsmedizin Mannheim
City
Mannheim
Country
Germany
Facility Name
Universitätsklinikum Tübingen
City
Tübingen
Country
Germany
Facility Name
Hospital de bellvitge
City
Barcelona
Country
Spain
Facility Name
Hospital del mar
City
Barcelona
Country
Spain
Facility Name
Hospital Vall Hebron
City
Barcelona
Country
Spain

12. IPD Sharing Statement

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I5NP for Prophylaxis of Delayed Graft Function in Kidney Transplantation

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