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A Study to Assess the Efficacy, Safety and Pharmacokinetics of Intravenous Conivaptan (Vaprisol®) in Pediatric Subjects With Euvolemic or Hypervolemic Hyponatremia

Primary Purpose

Hyponatremia

Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Conivaptan hydrochloride
Placebo
Sponsored by
Cumberland Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hyponatremia focused on measuring Serum Sodium, Euvolemia, Hypervolemia, Vaprisol®, Conivaptan, YM087

Eligibility Criteria

2 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subject is euvolemic or hypervolemic hyponatremia upon clinical presentation
  • Subject has serum sodium value ≥ 115 mEq/L (115 mmol/L) and < 130 mEq/L (130 mmol/L) during the 24 hours preceding inclusion into the study
  • Female subject of childbearing potential must have a negative serum pregnancy test and must be premenarchal, surgically sterile or must practice a method of birth control

Exclusion Criteria:

  • Female subject is pregnant or lactating
  • Subject has a body mass index (BMI) < the 3rd percentile or > the 97th percentile for their age and stature according to the World Health Organization; Body mass index-for-age percentiles charts for boys and girls ages 2 to 20
  • Subject has clinical evidence of volume depletion, dehydration or hypovolemia
  • Subject with hypovolemic hyponatremia or transient causes of hyponatremia that are likely to resolve during the time of study participation
  • Subjects with a cause of hyponatremia that is most appropriately corrected by alternative therapies
  • Subject is expected to receive emergent treatment for hyponatremia during the treatment period of the study
  • Subject has clinical evidence of hypotension
  • Subject has uncontrolled hypertension > the 99th percentile for their age
  • Subject has uncontrolled bradyarrhythmias or tachyarrhythmias requiring emergent pacemaker placement or treatment
  • Subject has untreated severe hypothyroidism, hyperthyroidism or adrenal insufficiency
  • Subject has known urinary outflow obstruction, unless subject is, or can be catheterized during the study
  • Subject has estimated creatinine clearance < 30 mL/min during the seven days prior to study drug administration
  • Subject has alanine aminotransferase (ALT) or aspartate aminotransferase (AST) elevations > 3 times the upper limit of normal reference range during the seven days prior to study drug administration
  • Subject has serum albumin ≤ 1.5 g/dL during the seven days prior to study drug administration
  • Subject has white blood cell count (WBC) < 3000/micro-liter documented any time during seven days prior to study drug administration or anticipated drop in WBC to < 3000/micro-liter during the period of the study due to chemotherapy
  • Subject currently has unstable hepatic function or a history of hepatic encephalopathy, or bleeding esophageal varices within the last 3 months
  • Subject has acute heart failure. Prior history of heart failure is allowed if there are no current signs/symptoms
  • Subject has a non-fasting blood glucose value ≥ 275 mg/dL
  • Subject requires or is suspected to require treatment with potent inhibitors or potent inducers of CYP3A4
  • Subject was administered hypertonic saline or oral salt supplement within 24 hours prior to study drug administration
  • Subject requires the use of medications used in the treatment of Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH): including lithium salts, urea or demeclocycline during the week prior to screening and throughout the study drug treatment period
  • Subject has any condition that may interfere with treatment or evaluation of safety
  • Subject has received investigational therapy (including placebo) within 28 days or 5 half lives, whichever is longer

Sites / Locations

  • Children's Hospital of New York - Presbyterian
  • Fundación Cardioinfantil - Instituto Cardiológico
  • Fundación Valle del Lili

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Conivaptan hydrochloride

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Mean Change From Baseline to the End of the 48-hour Treatment Period in Serum Sodium

Secondary Outcome Measures

Time From the First Dose of Study Medication to a Confirmed ≥ 4 mEq/L Increase From Baseline in Serum Sodium
Number of Patients With Confirmed ≥ 4 mEq/L Increase From Baseline in Serum Sodium
Number of Subjects With Confirmed > 6 mEq/L Increase From Baseline in Serum Sodium or a Confirmed Normal Serum Sodium Level (Greater Than or Equal to 135 mEq/L)
Change From Baseline in Effective Water Clearance (EWC) Every 12 Hours
Change From Baseline in Free Water Clearance (FWC)
Number of Participants With an Overly Rapid Rise in Serum Sodium From Baseline
an absolute serum sodium of 145 mEq/L at Hour 24 or an increase in serum sodium of greater than 12 mEq/L
Population Pharmacokinetics: Clearance (CL)
Based on conivaptan concentrations, the pharmacokinetics of the study population will be analyzed to determine median CL
Population Pharmacokinetics: Volume of Distribution (Vd)
Based on conivaptan concentrations, the pharmacokinetics of the study population will be analyzed to determine median Vd

Full Information

First Posted
October 5, 2011
Last Updated
February 1, 2016
Sponsor
Cumberland Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01451411
Brief Title
A Study to Assess the Efficacy, Safety and Pharmacokinetics of Intravenous Conivaptan (Vaprisol®) in Pediatric Subjects With Euvolemic or Hypervolemic Hyponatremia
Official Title
A Phase III, Double-Blind, Randomized, Placebo-Controlled, Multi-Center, Dose-Titration Study to Assess the Efficacy, Safety and Pharmacokinetics of Intravenous Conivaptan (Vaprisol®) in Pediatric Subjects With Euvolemic or Hypervolemic Hyponatremia
Study Type
Interventional

2. Study Status

Record Verification Date
February 2016
Overall Recruitment Status
Terminated
Why Stopped
Enrollment goals were not met.
Study Start Date
February 2012 (undefined)
Primary Completion Date
January 2014 (Actual)
Study Completion Date
January 2014 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The objective of this study is to evaluate the efficacy, safety and pharmacokinetics of intravenous conivaptan in pediatric subjects with abnormally low concentration of sodium in blood.
Detailed Description
A 3:1 randomization between conivaptan and placebo will be implemented and randomization will be further stratified in a 1:1:2 ratio for age groups: 2-5 years, 6-10 years, and 11-17 years. Subjects will need to remain hospitalized for the 48-hour Treatment Period through Hour 96 (Day 4). There will be a follow-up safety visit on Day 9 or day of hospital discharge, whichever occurs first. There is a final follow-up phone call at Day 32 to assess if any serious adverse events have occurred since hospital discharge.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hyponatremia
Keywords
Serum Sodium, Euvolemia, Hypervolemia, Vaprisol®, Conivaptan, YM087

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Conivaptan hydrochloride
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Conivaptan hydrochloride
Other Intervention Name(s)
Vaprisol®, YM087
Intervention Description
Intravenous
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Intravenous
Primary Outcome Measure Information:
Title
Mean Change From Baseline to the End of the 48-hour Treatment Period in Serum Sodium
Time Frame
baseline and 48 hours
Secondary Outcome Measure Information:
Title
Time From the First Dose of Study Medication to a Confirmed ≥ 4 mEq/L Increase From Baseline in Serum Sodium
Time Frame
48 hours
Title
Number of Patients With Confirmed ≥ 4 mEq/L Increase From Baseline in Serum Sodium
Time Frame
baseline and 48 hours
Title
Number of Subjects With Confirmed > 6 mEq/L Increase From Baseline in Serum Sodium or a Confirmed Normal Serum Sodium Level (Greater Than or Equal to 135 mEq/L)
Time Frame
baseline and 48 hours
Title
Change From Baseline in Effective Water Clearance (EWC) Every 12 Hours
Time Frame
Baseline, Hours 12, 24, 36 and 48
Title
Change From Baseline in Free Water Clearance (FWC)
Time Frame
Baseline and 48 hours
Title
Number of Participants With an Overly Rapid Rise in Serum Sodium From Baseline
Description
an absolute serum sodium of 145 mEq/L at Hour 24 or an increase in serum sodium of greater than 12 mEq/L
Time Frame
baseline and Hours 3, 8, 12 and 24.
Title
Population Pharmacokinetics: Clearance (CL)
Description
Based on conivaptan concentrations, the pharmacokinetics of the study population will be analyzed to determine median CL
Time Frame
Up to Hour 60
Title
Population Pharmacokinetics: Volume of Distribution (Vd)
Description
Based on conivaptan concentrations, the pharmacokinetics of the study population will be analyzed to determine median Vd
Time Frame
Up to Hour 60

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is euvolemic or hypervolemic hyponatremia upon clinical presentation Subject has serum sodium value ≥ 115 mEq/L (115 mmol/L) and < 130 mEq/L (130 mmol/L) during the 24 hours preceding inclusion into the study Female subject of childbearing potential must have a negative serum pregnancy test and must be premenarchal, surgically sterile or must practice a method of birth control Exclusion Criteria: Female subject is pregnant or lactating Subject has a body mass index (BMI) < the 3rd percentile or > the 97th percentile for their age and stature according to the World Health Organization; Body mass index-for-age percentiles charts for boys and girls ages 2 to 20 Subject has clinical evidence of volume depletion, dehydration or hypovolemia Subject with hypovolemic hyponatremia or transient causes of hyponatremia that are likely to resolve during the time of study participation Subjects with a cause of hyponatremia that is most appropriately corrected by alternative therapies Subject is expected to receive emergent treatment for hyponatremia during the treatment period of the study Subject has clinical evidence of hypotension Subject has uncontrolled hypertension > the 99th percentile for their age Subject has uncontrolled bradyarrhythmias or tachyarrhythmias requiring emergent pacemaker placement or treatment Subject has untreated severe hypothyroidism, hyperthyroidism or adrenal insufficiency Subject has known urinary outflow obstruction, unless subject is, or can be catheterized during the study Subject has estimated creatinine clearance < 30 mL/min during the seven days prior to study drug administration Subject has alanine aminotransferase (ALT) or aspartate aminotransferase (AST) elevations > 3 times the upper limit of normal reference range during the seven days prior to study drug administration Subject has serum albumin ≤ 1.5 g/dL during the seven days prior to study drug administration Subject has white blood cell count (WBC) < 3000/micro-liter documented any time during seven days prior to study drug administration or anticipated drop in WBC to < 3000/micro-liter during the period of the study due to chemotherapy Subject currently has unstable hepatic function or a history of hepatic encephalopathy, or bleeding esophageal varices within the last 3 months Subject has acute heart failure. Prior history of heart failure is allowed if there are no current signs/symptoms Subject has a non-fasting blood glucose value ≥ 275 mg/dL Subject requires or is suspected to require treatment with potent inhibitors or potent inducers of CYP3A4 Subject was administered hypertonic saline or oral salt supplement within 24 hours prior to study drug administration Subject requires the use of medications used in the treatment of Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH): including lithium salts, urea or demeclocycline during the week prior to screening and throughout the study drug treatment period Subject has any condition that may interfere with treatment or evaluation of safety Subject has received investigational therapy (including placebo) within 28 days or 5 half lives, whichever is longer
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Art Wheeler, MD
Organizational Affiliation
Cumberland Pharmaceuticals, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Children's Hospital of New York - Presbyterian
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Fundación Cardioinfantil - Instituto Cardiológico
City
Bogota
Country
Colombia
Facility Name
Fundación Valle del Lili
City
Cali, Valle
Country
Colombia

12. IPD Sharing Statement

Learn more about this trial

A Study to Assess the Efficacy, Safety and Pharmacokinetics of Intravenous Conivaptan (Vaprisol®) in Pediatric Subjects With Euvolemic or Hypervolemic Hyponatremia

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