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Study to Evaluate the Safety and Activity of BB3 to Treat Heart Attack

Primary Purpose

Myocardial Infarction

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
BB3
Normal saline
Sponsored by
Angion Biomedica Corp
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myocardial Infarction focused on measuring hepatocyte growth factor mimetic, hepatocyte growth factor(HGF), Myocardial Infarction, Acute ST Segment Elevation Myocardial Infarction (STEMI), Percutaneous Coronary Intervention (PCI)

Eligibility Criteria

21 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. The subject or legally authorized representative has been informed of the nature of the study, agrees to its provisions, and has been provided and signed written informed consent, approved by the Institutional Review Board (IRB), prior to performance of any study related procedure including screening procedure.
  2. Subject is male or female
  3. Subject is 21 to 80 years of age
  4. Estimated body weight < 120 kg and BMI < 40
  5. Subject is experiencing clinical symptoms consistent with acute myocardial infarction (AMI) (e.g., chest pain, arm pain, etc.,) >30 minutes duration and unresponsive to nitroglycerin; with ST segment elevation of more than 1 mm in at least two contiguous leads of ECG or new or presumed new onset bundle branch block (BBB)
  6. Fulfills clinical center's criteria for primary PCI
  7. PCI will be done within 12 hours of onset of STEMI.
  8. The subject and his/her physician are willing to comply with the requirements of the study and the specified follow-up evaluations.
  9. If female, either surgically sterile or post-menopausal or using acceptable contraception and agree to use effective birth control regimen during the study period. Men must agree to use condoms during the study period. Women of child bearing potential must have a negative urine or serum pregnancy test.
  10. In the opinion of the Investigator, the subject is capable of understanding and complying with the protocol.

Exclusion Criteria:

  1. Pregnant or nursing subjects and those who plan pregnancy in the period up to 6 months following index procedure.
  2. Cardiogenic shock (Killip class 4) or cardiac arrest
  3. History of prior myocardial infarction or pre-existing Q waves on ECG
  4. An elective surgical procedure is planned that would necessitate interruption of anti-platelet agents during the first six months post enrollment;
  5. Any contraindication to undergo MRI imaging. This will include any of the following exclusions:

    1. Cardiac pacemaker or implantable defibrillator;
    2. Non-MRI-compatible aneurysm clip;
    3. Neural stimulator (e.g., TENS-Unit);
    4. Any implanted or magnetically activated device (e.g., insulin pump);
    5. Any type of non-MRI-compatible metallic ear implant;
    6. Metal shavings in the orbits;
    7. Any metallic foreign body, shrapnel, or bullet in a location which the physician feels would present a risk to the subject;
    8. Any history indicating contraindication to MRI, including claustrophobia or allergy to gadolinium;
    9. Inability to follow breathhold instructions or to maintain a breathhold for >15 seconds;
    10. Irregular cardiac rhythm not expected to resolve after treatment of the acute cardiac condition (e.g., chronic atrial fibrillation)
    11. Known hypersensitivity or contraindication to gadolinium contrast.
  6. Subject has active bleeding or a history of bleeding diathesis or coagulopathy (including heparin induced thrombocytopenia), or refusal to receive blood transfusions if necessary;
  7. Subjects presenting with cardiogenic shock (SBP <80 mmHg for >30 minutes, or requiring IV pressors or emergency IABP for hypotension treatment) or cardiopulmonary resuscitation prior to randomization;
  8. History of intracerebral mass, aneurysm, arteriovenous malformation, or hemorrhagic stroke; stroke or transient ischemic attack within the past 6 months, or any permanent residual neurologic defect; known preceding cardiac ventricular arrhythmia
  9. Impaired renal function (eGFR of ≤30 ml/min/1.73m2, as estimated by the MDRD4v equation) or on dialysis.
  10. Impaired hepatic function (ALT > 2x upper limit of normal, or a total bilirubin greater than 1.5 x upper limit of normal).
  11. Currently participating in or has participated in an investigational drug or medical device study within 30 days or 5 half-lives, whichever is longer, prior to enrollment into this study
  12. Have an active malignancy or history of solid, metastatic, or hematologic malignancy with the exception of basal or squamous cell carcinoma of the skin that has been removed
  13. History of positive human immunodeficiency virus (HIV) test
  14. History of rheumatoid arthritis
  15. History of proliferative retinopathy or laser surgery for retinopathy
  16. Subjects who require cytochrome P450 1A2 (CYP1A2) inhibitors, ciprofloxacin and/or fluvoxamine (Luvox®)
  17. Subject has other medical illness or known history of substance abuse (alcohol, cocaine, heroin etc.) that may cause non-compliance with the protocol, confound the data interpretation or is associated with a limited life expectancy of less than 6 months,
  18. Any significant medical condition which in the Investigator's opinion may interfere with the subject's optimal participation in the study;
  19. Subject has a known hypersensitivity or allergy to stainless steel, nickel, cobalt chromium, nitinol, titanium or known hypersensitivity or allergy to contrast media (e.g. rash) that cannot effectively be controlled by premedication with steroids and/or diphenhydramine. Subjects with hypersensitivity or allergy to any of the components of the device (structural, drug or polymer components) and subjects with true prior anaphylaxis to contrast media should not be enrolled

Sites / Locations

  • Minneapolis Heart Institute Foundation
  • Yale University Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

BB3

Normal Saline

Arm Description

Daily intravenous administration of 2 mg/kg BB3 for four (4) days

Daily intravenous administration for four (4) days

Outcomes

Primary Outcome Measures

Evaluation of Reduction in Infarct Size
Evaluation of reduction in infarct size by MRI between the BB3 and placebo treatment groups at 6 months based on index of myocardial salvage
Evaluation of the Degree of Late Ventricular Remodeling
Evaluation of the degree of late ventricular remodeling between the BB3 and placebo treatment groups at 6 months, as measured by increase in LV end-diastolic volume index (LVEDVI) from initial MR image (day 5±1) to late MR image (6 months).

Secondary Outcome Measures

Change in CK-MB and Troponin
Change in BNP Levels
Change in Symptoms and Clinical Signs of CHF
Change in LVEDVI, LVESVI and LV Ejection Fraction (EF) After MI Assessed by Cine MR (SSFP Imaging)
LVEDVI, LVESVI and LVEF After MI Assessed by 2D and 3D Echocardiography
Change Between Initial Semi-quantitative Regional Wall Motion Score (17 Segment Model) by Echocardiography
Change in Regional Myocardial Radial, Circumferential and Longitudinal Strain
Frequency of MACE
Frequency of New Onset CHF Through 6 Months
Number of Hospitalizations for CHF Through 6 Months
Incidence of Complete ST Segment Resolution 60 ± 30 Minutes After Last Angiogram
Frequency of AE, SAEs
Frequency of MACCE
All-cause Mortality
Development of Ventricular Fibrillation or Other Life-threatening Arrhythmia
Change From Baseline eCrCl
Change in Body Weight
Symptoms and Clinical Signs of CHF
Symptoms and clinical signs of CHF measured by NYHA classification

Full Information

First Posted
February 22, 2012
Last Updated
November 7, 2014
Sponsor
Angion Biomedica Corp
Collaborators
National Heart, Lung, and Blood Institute (NHLBI)
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1. Study Identification

Unique Protocol Identification Number
NCT01539590
Brief Title
Study to Evaluate the Safety and Activity of BB3 to Treat Heart Attack
Official Title
A Phase 2 Pilot Study to Evaluate the Safety and Activity of BB3 as an Adjunct to Percutaneous Coronary Intervention (PCI) in Subjects Presenting With Acute ST Segment Elevation Myocardial Infarction (STEMI)
Study Type
Interventional

2. Study Status

Record Verification Date
November 2014
Overall Recruitment Status
Terminated
Study Start Date
July 2012 (undefined)
Primary Completion Date
July 2013 (Actual)
Study Completion Date
November 2013 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The study will evaluate the effect of BB3 to preserve myocardial (heart) tissue and function following myocardial infarction (heart attack).
Detailed Description
Percutaneous coronary intervention (PCI) has become the mainstay for treatment of ST-segment elevation myocardial infarction (STEMI). Whereas early recanalization undoubtedly salvages myocardial tissue, reperfusion following prolonged ischemia can also exacerbate injury. Infarct size needs to be limited, and the conditions favoring adaptive ventricular healing and remodeling optimized because in patients with acute myocardial infarction (AMI) who do not die of out-of-hospital arrhythmias, long-term prognosis is dependent on the amount of myocardium that is lost, and the outcome of ventricular remodeling. Angion Biomedical Corp. has identified BB3, a small molecule mimetic of hepatocyte growth factor/scatter factor (HGF/SF) whose activity is expected to preserve tissue viability and attenuate dysfunction in the setting of organ injury while obviating the logistical difficulties associated with gene or protein therapy. HGF/SF is a naturally occurring cell survival factor that holds significant therapeutic potential. BB3 has been shown to possess HGF/SF activities, including protection against heart injury following myocardial infarction. This study is designed to evaluate clinical efficacy of BB3 in patients presenting with acute ST segment elevation myocardial infarction (A-STEMI) who undergo PCI.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myocardial Infarction
Keywords
hepatocyte growth factor mimetic, hepatocyte growth factor(HGF), Myocardial Infarction, Acute ST Segment Elevation Myocardial Infarction (STEMI), Percutaneous Coronary Intervention (PCI)

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
BB3
Arm Type
Experimental
Arm Description
Daily intravenous administration of 2 mg/kg BB3 for four (4) days
Arm Title
Normal Saline
Arm Type
Placebo Comparator
Arm Description
Daily intravenous administration for four (4) days
Intervention Type
Drug
Intervention Name(s)
BB3
Intervention Description
Daily intravenous administration of 2 mg/kg BB3 for four (4) days
Intervention Type
Drug
Intervention Name(s)
Normal saline
Intervention Description
Daily intravenous administration for four (4) days. The volume of normal saline will vary by estimated weight.
Primary Outcome Measure Information:
Title
Evaluation of Reduction in Infarct Size
Description
Evaluation of reduction in infarct size by MRI between the BB3 and placebo treatment groups at 6 months based on index of myocardial salvage
Time Frame
6 month
Title
Evaluation of the Degree of Late Ventricular Remodeling
Description
Evaluation of the degree of late ventricular remodeling between the BB3 and placebo treatment groups at 6 months, as measured by increase in LV end-diastolic volume index (LVEDVI) from initial MR image (day 5±1) to late MR image (6 months).
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Change in CK-MB and Troponin
Time Frame
6 months
Title
Change in BNP Levels
Time Frame
6 months
Title
Change in Symptoms and Clinical Signs of CHF
Time Frame
6 months
Title
Change in LVEDVI, LVESVI and LV Ejection Fraction (EF) After MI Assessed by Cine MR (SSFP Imaging)
Time Frame
6 months
Title
LVEDVI, LVESVI and LVEF After MI Assessed by 2D and 3D Echocardiography
Time Frame
6 months
Title
Change Between Initial Semi-quantitative Regional Wall Motion Score (17 Segment Model) by Echocardiography
Time Frame
1 and 6 months
Title
Change in Regional Myocardial Radial, Circumferential and Longitudinal Strain
Time Frame
1 and 6 months
Title
Frequency of MACE
Time Frame
6 months
Title
Frequency of New Onset CHF Through 6 Months
Time Frame
6 months
Title
Number of Hospitalizations for CHF Through 6 Months
Time Frame
6 months
Title
Incidence of Complete ST Segment Resolution 60 ± 30 Minutes After Last Angiogram
Time Frame
6 months
Title
Frequency of AE, SAEs
Time Frame
6 months
Title
Frequency of MACCE
Time Frame
6 months
Title
All-cause Mortality
Time Frame
6 months
Title
Development of Ventricular Fibrillation or Other Life-threatening Arrhythmia
Time Frame
6 months
Title
Change From Baseline eCrCl
Time Frame
6 months
Title
Change in Body Weight
Time Frame
6 months
Title
Symptoms and Clinical Signs of CHF
Description
Symptoms and clinical signs of CHF measured by NYHA classification
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject or legally authorized representative has been informed of the nature of the study, agrees to its provisions, and has been provided and signed written informed consent, approved by the Institutional Review Board (IRB), prior to performance of any study related procedure including screening procedure. Subject is male or female Subject is 21 to 80 years of age Estimated body weight < 120 kg and BMI < 40 Subject is experiencing clinical symptoms consistent with acute myocardial infarction (AMI) (e.g., chest pain, arm pain, etc.,) >30 minutes duration and unresponsive to nitroglycerin; with ST segment elevation of more than 1 mm in at least two contiguous leads of ECG or new or presumed new onset bundle branch block (BBB) Fulfills clinical center's criteria for primary PCI PCI will be done within 12 hours of onset of STEMI. The subject and his/her physician are willing to comply with the requirements of the study and the specified follow-up evaluations. If female, either surgically sterile or post-menopausal or using acceptable contraception and agree to use effective birth control regimen during the study period. Men must agree to use condoms during the study period. Women of child bearing potential must have a negative urine or serum pregnancy test. In the opinion of the Investigator, the subject is capable of understanding and complying with the protocol. Exclusion Criteria: Pregnant or nursing subjects and those who plan pregnancy in the period up to 6 months following index procedure. Cardiogenic shock (Killip class 4) or cardiac arrest History of prior myocardial infarction or pre-existing Q waves on ECG An elective surgical procedure is planned that would necessitate interruption of anti-platelet agents during the first six months post enrollment; Any contraindication to undergo MRI imaging. This will include any of the following exclusions: Cardiac pacemaker or implantable defibrillator; Non-MRI-compatible aneurysm clip; Neural stimulator (e.g., TENS-Unit); Any implanted or magnetically activated device (e.g., insulin pump); Any type of non-MRI-compatible metallic ear implant; Metal shavings in the orbits; Any metallic foreign body, shrapnel, or bullet in a location which the physician feels would present a risk to the subject; Any history indicating contraindication to MRI, including claustrophobia or allergy to gadolinium; Inability to follow breathhold instructions or to maintain a breathhold for >15 seconds; Irregular cardiac rhythm not expected to resolve after treatment of the acute cardiac condition (e.g., chronic atrial fibrillation) Known hypersensitivity or contraindication to gadolinium contrast. Subject has active bleeding or a history of bleeding diathesis or coagulopathy (including heparin induced thrombocytopenia), or refusal to receive blood transfusions if necessary; Subjects presenting with cardiogenic shock (SBP <80 mmHg for >30 minutes, or requiring IV pressors or emergency IABP for hypotension treatment) or cardiopulmonary resuscitation prior to randomization; History of intracerebral mass, aneurysm, arteriovenous malformation, or hemorrhagic stroke; stroke or transient ischemic attack within the past 6 months, or any permanent residual neurologic defect; known preceding cardiac ventricular arrhythmia Impaired renal function (eGFR of ≤30 ml/min/1.73m2, as estimated by the MDRD4v equation) or on dialysis. Impaired hepatic function (ALT > 2x upper limit of normal, or a total bilirubin greater than 1.5 x upper limit of normal). Currently participating in or has participated in an investigational drug or medical device study within 30 days or 5 half-lives, whichever is longer, prior to enrollment into this study Have an active malignancy or history of solid, metastatic, or hematologic malignancy with the exception of basal or squamous cell carcinoma of the skin that has been removed History of positive human immunodeficiency virus (HIV) test History of rheumatoid arthritis History of proliferative retinopathy or laser surgery for retinopathy Subjects who require cytochrome P450 1A2 (CYP1A2) inhibitors, ciprofloxacin and/or fluvoxamine (Luvox®) Subject has other medical illness or known history of substance abuse (alcohol, cocaine, heroin etc.) that may cause non-compliance with the protocol, confound the data interpretation or is associated with a limited life expectancy of less than 6 months, Any significant medical condition which in the Investigator's opinion may interfere with the subject's optimal participation in the study; Subject has a known hypersensitivity or allergy to stainless steel, nickel, cobalt chromium, nitinol, titanium or known hypersensitivity or allergy to contrast media (e.g. rash) that cannot effectively be controlled by premedication with steroids and/or diphenhydramine. Subjects with hypersensitivity or allergy to any of the components of the device (structural, drug or polymer components) and subjects with true prior anaphylaxis to contrast media should not be enrolled
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Weizhong Cai
Organizational Affiliation
Sponsor GmbH
Official's Role
Study Director
Facility Information:
Facility Name
Minneapolis Heart Institute Foundation
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55417-1139
Country
United States
Facility Name
Yale University Medical Center
City
New Haven
State/Province
New York
ZIP/Postal Code
06520
Country
United States

12. IPD Sharing Statement

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Study to Evaluate the Safety and Activity of BB3 to Treat Heart Attack

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