search
Back to results

Anti-TF Antibody (ALT-836) to Treat Septic Patients With Acute Lung Injury or Acute Respiratory Distress Syndrome

Primary Purpose

Sepsis, Acute Lung Injury, Acute Respiratory Distress Syndrome

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
ALT-836
Placebo
Sponsored by
Altor BioScience
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sepsis focused on measuring Sepsis, Acute Lung Injury, Acute Respiratory Distress Syndrome, ALI/ARDS, Lung Disease

Eligibility Criteria

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

INCLUSION CRITERIA:

  1. Suspected or proven infection
  2. Hypoxemia: PaO2/FiO2is ≤300 mm Hg
  3. Bilateral infiltrates consistent with pulmonary edema
  4. Positive-pressure mechanical ventilation through an endotracheal tube
  5. No clinical evidence of left atrial hypertension to explain bilateral infiltrates
  6. Presence of at least three of the four SIRS criteria. If only two criteria are evidenced, one must be temperature or WBC

Criteria 2 and 3 must occur within a 24-hour interval. The 48-hour enrollment time window begins when criteria 2, 3, and 4 are met.

EXCLUSION CRITERIA:

  1. <18 years
  2. Inability to obtain consent
  3. Patient, surrogate, or physician not committed to full support
  4. Moribund state in which death was perceived to be imminent
  5. Morbid obesity
  6. Malignancy or other irreversible disease or condition for which 6-month mortality is estimated to be >50%
  7. Known HIV positive with known end stage processes
  8. Prior cardiac arrest requiring CPR without fully demonstrated neurological recovery; or New York Heart Association Class IV
  9. Pregnant or nursing
  10. ALI/ARDS induced by mechanical or chemical injury directly to the lung (including burns, trauma, and near drowning)
  11. >48 hours since all inclusion criteria are met
  12. Neuromuscular disease that impairs ability to ventilate without assistance
  13. Severe chronic respiratory disease, severe pulmonary hypertension, or ventilator dependency
  14. Chest wall deformity resulting in severe exercise restriction, secondary polycythemia, or respirator dependent
  15. History of organ transplant (including bone marrow)
  16. Severe chronic liver disease, as determined by a Child-Pugh Score >10
  17. Hemoglobin persistently < 7.0 g/dL
  18. Platelet count <50,000/mm3
  19. Prolonged INR >3
  20. Bleeding disorders unless corrective surgery has been performed
  21. Active internal bleeding
  22. Major surgery within 24 hours before study drug infusion, or evidence of active bleeding postoperatively, or plan for any major surgery within 3 days after study drug infusion.
  23. Diffuse alveolar hemorrhage from vasculitis
  24. Known bleeding diathesis
  25. Presence of an epidural catheter or lumbar puncture within 48 hours before study drug infusion or anticipation of receiving an epidural catheter or a lumbar puncture within 48 hours after study drug infusion
  26. Stroke within 3 months of study entry
  27. Trauma with an increased risk of life-threatening bleeding
  28. A history of severe head trauma that required hospitalization, or intracranial surgery within two months of study entry
  29. Any history of intracerebral arteriovenous malformation, cerebral aneurysm, or central nervous system mass lesion
  30. Uses of certain medications or treatment regimens such as chemotherapy, unfractionated heparin, low-molecular-weight heparin, Warfarin, antithrombin III, acetylsalicylic acid, glycoprotein IIb/IIIa antagonists, thrombolytic therapy, and activated Protein C are restricted.
  31. Participation in another experimental medication study within 30 days of study entry.

Sites / Locations

  • Los Angeles County and USC Medical Center
  • UC Davis Medical Center
  • Stanford University
  • Yale University
  • Northwestern University
  • West Suburban Hospital Medical Center
  • Illinois Lung and Critical Care Institute
  • University of Iowa
  • Kentucky Lung Clinic
  • University of Louisville-Division of Pulmonary and Critical Care
  • Baystate Medical Center
  • Saint Luke's Hospital
  • Saint Louis University
  • Mercy Hospital St. Louis
  • Mount Sinai Medical Center
  • Memorial Sloan-Kettering Cancer Center
  • Carolinas Medical Center
  • Piedmont Respiratory Research Foundation
  • Wake Forest University
  • University of Oklahoma

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

1

2

Arm Description

Participants will be randomized to receive ALT-836.

Patients will be randomized to receive placebo.

Outcomes

Primary Outcome Measures

Safety profile of the study drug
Number of ventilator-free days at Day 28

Secondary Outcome Measures

Mortality at Day 7, 14, 21, 28 and 60
Length of hospitalization at Day 28
Length of ICU stay at Day 28
Number of Non-pulmonary organ failure free days at Day 28
Changes in physiological variables of lung injury
Changes in disease severity and lung injury scores
Effects of the study drug and the etiology of the disease (i.e. pulmonary or extra-pulmonary origin)
Pharmacokinetics & Pharmacodynamics
Immunogenicity

Full Information

First Posted
April 8, 2009
Last Updated
March 20, 2015
Sponsor
Altor BioScience
Collaborators
National Heart, Lung, and Blood Institute (NHLBI)
search

1. Study Identification

Unique Protocol Identification Number
NCT00879606
Brief Title
Anti-TF Antibody (ALT-836) to Treat Septic Patients With Acute Lung Injury or Acute Respiratory Distress Syndrome
Official Title
Efficacy and Safety Evaluation of ALT-836 in Patients With Sepsis and Acute Lung Injury/Acute Respiratory Distress Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
March 2015
Overall Recruitment Status
Completed
Study Start Date
April 2009 (undefined)
Primary Completion Date
October 2012 (Actual)
Study Completion Date
January 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Altor BioScience
Collaborators
National Heart, Lung, and Blood Institute (NHLBI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a prospective, randomized (1:1), double-blind, multi-center, Phase II clinical study to test the safety and efficacy of a recombinant chimeric anti-tissue factor antibody (ALT-836) versus placebo in patients with sepsis and acute lung injury/acute respiratory distress syndrome (ALI/ARDS). This study was divided into two parts and the first part of the study has been completed. In the first part of the study, sixty patients were randomized at a 1:1 ratio to receive one dose of the study drug or placebo. In the second part of the study, ninety patients will be randomized at a 1:1 ratio to receive a multi-dose treatment regimen of single doses every 72 hours up to a maximum of 4 doses of the study drug or placebo, provided there are no safety concerns.
Detailed Description
Tissue factor (TF)-dependent procoagulant activity and associated inflammatory processes may play a role in the severity and progression of ALI/ARDS. Recent studies demonstrated that TF levels were elevated in plasma and pulmonary edema fluid of ARDS/ALI patients compared to control patients with hydrostatic pulmonary edema. These higher plasma TF levels were correlated with increased mortality, fewer ventilation-free days, the presence of disseminated intravascular coagulation and the presence of sepsis in patients with ALI/ARDS, suggesting that systemic activation of coagulation may be clinically important in ALI/ARDS. Moreover, the pulmonary TF levels in patients with ALI/ARDS were found to range between 0.5 and 2 nM, approximately 100-fold higher than simultaneous plasma levels, suggesting an intra-alveolar source of TF. Thus, anti-TF antibody blockage of TF activity may therefore provide an effective therapeutic mechanism for the treatment of inflammatory disorders such as ALI and ARDS. This study will test the hypothesis that administration of anti-TF antibody (ALT-836) to septic patients with ALI/ARDS will improve the clinical outcome by shortening the duration of mechanical ventilation for these patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sepsis, Acute Lung Injury, Acute Respiratory Distress Syndrome
Keywords
Sepsis, Acute Lung Injury, Acute Respiratory Distress Syndrome, ALI/ARDS, Lung Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
150 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Participants will be randomized to receive ALT-836.
Arm Title
2
Arm Type
Placebo Comparator
Arm Description
Patients will be randomized to receive placebo.
Intervention Type
Drug
Intervention Name(s)
ALT-836
Other Intervention Name(s)
Formerly TNX-832; Sunol-cH36
Intervention Description
In the first part of this study, recombinant chimeric anti-tissue factor antibody ALT-836 was administered as a single dose (0.06 mg/Kg) via intravenous infusion over 15 minutes. In the second part of this study, up to four doses (0.06 mg/Kg) of ALT-836 will be administered via intravenous infusion over 15 minutes.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
In the first part of this study, a single dose of Placebo was administered via intravenous infusion over 15 minutes. In the second part of this study, up to four doses of Placebo will be administered via intravenous infusion over 15 minutes.
Primary Outcome Measure Information:
Title
Safety profile of the study drug
Time Frame
Throughout the 28 days following treatment
Title
Number of ventilator-free days at Day 28
Time Frame
Determined at Day 28
Secondary Outcome Measure Information:
Title
Mortality at Day 7, 14, 21, 28 and 60
Time Frame
Determined at Day 7, 14, 21, 28 and 60
Title
Length of hospitalization at Day 28
Time Frame
Determined at Day 28
Title
Length of ICU stay at Day 28
Time Frame
Determined at Day 28
Title
Number of Non-pulmonary organ failure free days at Day 28
Time Frame
Determined at Day 28
Title
Changes in physiological variables of lung injury
Time Frame
Throughout the 28 days following treatment
Title
Changes in disease severity and lung injury scores
Time Frame
Throughout the 28 days following treatment
Title
Effects of the study drug and the etiology of the disease (i.e. pulmonary or extra-pulmonary origin)
Time Frame
Determined at Day 28
Title
Pharmacokinetics & Pharmacodynamics
Time Frame
Throughout the 28 days following treatment
Title
Immunogenicity
Time Frame
Throughout the 28 days following treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA: Suspected or proven infection Hypoxemia: PaO2/FiO2is ≤300 mm Hg Bilateral infiltrates consistent with pulmonary edema Positive-pressure mechanical ventilation through an endotracheal tube No clinical evidence of left atrial hypertension to explain bilateral infiltrates Presence of at least three of the four SIRS criteria. If only two criteria are evidenced, one must be temperature or WBC Criteria 2 and 3 must occur within a 24-hour interval. The 48-hour enrollment time window begins when criteria 2, 3, and 4 are met. EXCLUSION CRITERIA: <18 years Inability to obtain consent Patient, surrogate, or physician not committed to full support Moribund state in which death was perceived to be imminent Morbid obesity Malignancy or other irreversible disease or condition for which 6-month mortality is estimated to be >50% Known HIV positive with known end stage processes Prior cardiac arrest requiring CPR without fully demonstrated neurological recovery; or New York Heart Association Class IV Pregnant or nursing ALI/ARDS induced by mechanical or chemical injury directly to the lung (including burns, trauma, and near drowning) >48 hours since all inclusion criteria are met Neuromuscular disease that impairs ability to ventilate without assistance Severe chronic respiratory disease, severe pulmonary hypertension, or ventilator dependency Chest wall deformity resulting in severe exercise restriction, secondary polycythemia, or respirator dependent History of organ transplant (including bone marrow) Severe chronic liver disease, as determined by a Child-Pugh Score >10 Hemoglobin persistently < 7.0 g/dL Platelet count <50,000/mm3 Prolonged INR >3 Bleeding disorders unless corrective surgery has been performed Active internal bleeding Major surgery within 24 hours before study drug infusion, or evidence of active bleeding postoperatively, or plan for any major surgery within 3 days after study drug infusion. Diffuse alveolar hemorrhage from vasculitis Known bleeding diathesis Presence of an epidural catheter or lumbar puncture within 48 hours before study drug infusion or anticipation of receiving an epidural catheter or a lumbar puncture within 48 hours after study drug infusion Stroke within 3 months of study entry Trauma with an increased risk of life-threatening bleeding A history of severe head trauma that required hospitalization, or intracranial surgery within two months of study entry Any history of intracerebral arteriovenous malformation, cerebral aneurysm, or central nervous system mass lesion Uses of certain medications or treatment regimens such as chemotherapy, unfractionated heparin, low-molecular-weight heparin, Warfarin, antithrombin III, acetylsalicylic acid, glycoprotein IIb/IIIa antagonists, thrombolytic therapy, and activated Protein C are restricted. Participation in another experimental medication study within 30 days of study entry.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hing C Wong, PhD
Organizational Affiliation
Altor BioScience
Official's Role
Study Chair
Facility Information:
Facility Name
Los Angeles County and USC Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
UC Davis Medical Center
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
Stanford University
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
Yale University
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06520
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
West Suburban Hospital Medical Center
City
Oak Park
State/Province
Illinois
ZIP/Postal Code
60302
Country
United States
Facility Name
Illinois Lung and Critical Care Institute
City
Peoria
State/Province
Illinois
ZIP/Postal Code
61606
Country
United States
Facility Name
University of Iowa
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52246
Country
United States
Facility Name
Kentucky Lung Clinic
City
Hazard
State/Province
Kentucky
ZIP/Postal Code
41701
Country
United States
Facility Name
University of Louisville-Division of Pulmonary and Critical Care
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
Baystate Medical Center
City
Springfield
State/Province
Massachusetts
ZIP/Postal Code
01199
Country
United States
Facility Name
Saint Luke's Hospital
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Facility Name
Saint Louis University
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Mercy Hospital St. Louis
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63141
Country
United States
Facility Name
Mount Sinai Medical Center
City
New York City
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Carolinas Medical Center
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28203
Country
United States
Facility Name
Piedmont Respiratory Research Foundation
City
Greensboro
State/Province
North Carolina
ZIP/Postal Code
27310
Country
United States
Facility Name
Wake Forest University
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
University of Oklahoma
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
22340260
Citation
Morris PE, Steingrub JS, Huang BY, Tang S, Liu PM, Rhode PR, Wong HC. A phase I study evaluating the pharmacokinetics, safety and tolerability of an antibody-based tissue factor antagonist in subjects with acute lung injury or acute respiratory distress syndrome. BMC Pulm Med. 2012 Feb 16;12:5. doi: 10.1186/1471-2466-12-5.
Results Reference
derived
Links:
URL
http://www.altorbioscience.com
Description
Altor Bioscience Corporation, Miramar, Florida, US

Learn more about this trial

Anti-TF Antibody (ALT-836) to Treat Septic Patients With Acute Lung Injury or Acute Respiratory Distress Syndrome

We'll reach out to this number within 24 hrs