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Safety and Efficacy Study of a Single Dose of NA-1 in Patients Undergoing Endovascular Repair of Ruptured Aneurysms (ENACT-2)

Primary Purpose

Subarachnoid Hemorrhage, Ruptured Intracranial Aneurysm

Status
Withdrawn
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
NA-1
Placebo
Sponsored by
NoNO Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Subarachnoid Hemorrhage focused on measuring Endovascular repair, Subarachnoid hemorrhage, Ruptured intracranial aneurysm, Stroke, Coiling, NA-1

Eligibility Criteria

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

Inclusion Criteria:

  • 1. A diagnosis of a ruptured brain aneurysm deemed suitable for repair by neuroendovascular techniques involving intraluminal occlusion by detachable platinum coils, or any neuroendovascular technique such as balloon-assisted coiling, stenting, or flowed diversion.
  • 2. Patient should be Grade II-IV on the WFNS grading scale for SAH.
  • 3. Male or female with a minimum age of 18 years on the day of enrolment.
  • 4. Female subjects of childbearing potential: Negative pregnancy test.
  • 5. Non-surgically sterile males or males with partners of childbearing potential must be willing to use condoms with spermicide for 3 months after completion of dosing.
  • 6. Body weight less than or equal to 180 kg.
  • 7. Vital signs on admission:

    • Blood pressure between 80-180 mm Hg systolic/50-100 mm Hg diastolic;
    • Body temperature ≤ 38.5C.
  • 8. Informed consent and availability of the subject for the entire study period and willingness of the subject to adhere to protocol requirements.

Exclusion Criteria:

  • 1. Prior SAH within 6 months of presentation.
  • 2. Dissecting or mycotic brain aneurysm.
  • 3. Planned endovascular vessel sacrifice as the primary modality for aneurysm treatment.
  • 4. Known history of life-threatening allergic reaction to any medication.
  • 5. Chronic renal disease defined as a baseline serum creatinine > 150 µmol/L.
  • 6. Women who are pregnant, or have a positive urine or blood (β-hCG) pregnancy test.
  • 7. Women who are breastfeeding.
  • 8. Any clinically significant psychiatric or psychological disease, which would preclude the patient from completing the protocol.
  • 9. Pre-morbid (estimated) modified Rankin scale score of >1.
  • 10. Previous major stroke.
  • 11. Patients with known HIV infection.
  • 12. Participation in a clinical trial with an investigational drug within 30 days preceding this study.
  • 13. Previous participation in the ENACT trial (e.g, to treat a prior aneurysm), participation in another trial involving NA-1 or prior receipt of NA-1.
  • 14. Any other medical condition that the site investigator deems would put the patient at excessive risk of participation in the study or an expected life expectancy less than 1 year or that would result in inability to collect clinical outcomes at 90 days.

Sites / Locations

  • Barrow Neurological Institute
  • Colorado Neurological Institute
  • University of Michigan - Neurosurgery
  • Oregon Health and Science University
  • University of Wisconsin
  • Foothills Medical Centre
  • QEII Health Sciences Centre - Halifax Infirmary
  • London Health Sciences Centre
  • Sunnybrook Health Sciences Centre
  • St. Michael's Hospital
  • Toronto Western Hospital
  • Hopital de l'Enfant Jesus

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

NA-1

Placebo

Arm Description

20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and an 11 amino acid domain that enables the peptide to cross the blood-brain barrier. Single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion.

Single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion.

Outcomes

Primary Outcome Measures

Modified Rankin Scale (mRS)
Proportion of subjects achieving independent functioning as defined as a score of 0-1 on the mRS at Day 90.

Secondary Outcome Measures

Modified Rankin Scale (mRS)
Proportion of subjects achieving a good outcome as defined as a score of 0-1 on the mRS at Day 30-45.
National Institutes of Health Stroke Scale (NIHSS)
Proportion of subjects achieving a good outcome as defined as a score of 0-1 on the NIHSS at Day 90.
Mortality
Rate of subarachnoid hemorrhage related mortality over the 90 day study period.
In-hospital length of stay
Duration of in-hospital length of stay.

Full Information

First Posted
February 4, 2014
Last Updated
August 3, 2015
Sponsor
NoNO Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02056574
Brief Title
Safety and Efficacy Study of a Single Dose of NA-1 in Patients Undergoing Endovascular Repair of Ruptured Aneurysms
Acronym
ENACT-2
Official Title
Phase 2, Multicenter Randomized, Double-Blind, Placebo-Controlled, Safety and Efficacy Study Evaluating a Single Dose of Intravenous NA-1 in Patients With Subarachnoid Hemorrhage Undergoing Endovascular Repair of Ruptured Intracranial Aneurysms
Study Type
Interventional

2. Study Status

Record Verification Date
March 2015
Overall Recruitment Status
Withdrawn
Study Start Date
November 2015 (undefined)
Primary Completion Date
November 2019 (Anticipated)
Study Completion Date
April 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NoNO Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a randomized, double-blind, placebo-controlled, single-dose study investigating the safety and efficacy of NA-1 in patients with subarachnoid hemorrhage (SAH) undergoing endovascular repair of ruptured intracranial aneurysms. Up to 300 male and female patients with SAH undergoing endovascular repair of a ruptured intracranial aneurysm will be dosed with 2.60 mg/kg of NA-1 or placebo as a 10 minute intravenous infusion after completion of the endovascular procedure on Day 1 of the study period. Subjects will undergo interim procedures at Day 2-4, Day 30-45, and end-of-study procedures on Day 90.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Subarachnoid Hemorrhage, Ruptured Intracranial Aneurysm
Keywords
Endovascular repair, Subarachnoid hemorrhage, Ruptured intracranial aneurysm, Stroke, Coiling, NA-1

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
NA-1
Arm Type
Experimental
Arm Description
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and an 11 amino acid domain that enables the peptide to cross the blood-brain barrier. Single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion.
Intervention Type
Drug
Intervention Name(s)
NA-1
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Modified Rankin Scale (mRS)
Description
Proportion of subjects achieving independent functioning as defined as a score of 0-1 on the mRS at Day 90.
Time Frame
90 days
Secondary Outcome Measure Information:
Title
Modified Rankin Scale (mRS)
Description
Proportion of subjects achieving a good outcome as defined as a score of 0-1 on the mRS at Day 30-45.
Time Frame
30-45 days
Title
National Institutes of Health Stroke Scale (NIHSS)
Description
Proportion of subjects achieving a good outcome as defined as a score of 0-1 on the NIHSS at Day 90.
Time Frame
90 days
Title
Mortality
Description
Rate of subarachnoid hemorrhage related mortality over the 90 day study period.
Time Frame
90 days
Title
In-hospital length of stay
Description
Duration of in-hospital length of stay.
Time Frame
90 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1. A diagnosis of a ruptured brain aneurysm deemed suitable for repair by neuroendovascular techniques involving intraluminal occlusion by detachable platinum coils, or any neuroendovascular technique such as balloon-assisted coiling, stenting, or flowed diversion. 2. Patient should be Grade II-IV on the WFNS grading scale for SAH. 3. Male or female with a minimum age of 18 years on the day of enrolment. 4. Female subjects of childbearing potential: Negative pregnancy test. 5. Non-surgically sterile males or males with partners of childbearing potential must be willing to use condoms with spermicide for 3 months after completion of dosing. 6. Body weight less than or equal to 180 kg. 7. Vital signs on admission: Blood pressure between 80-180 mm Hg systolic/50-100 mm Hg diastolic; Body temperature ≤ 38.5C. 8. Informed consent and availability of the subject for the entire study period and willingness of the subject to adhere to protocol requirements. Exclusion Criteria: 1. Prior SAH within 6 months of presentation. 2. Dissecting or mycotic brain aneurysm. 3. Planned endovascular vessel sacrifice as the primary modality for aneurysm treatment. 4. Known history of life-threatening allergic reaction to any medication. 5. Chronic renal disease defined as a baseline serum creatinine > 150 µmol/L. 6. Women who are pregnant, or have a positive urine or blood (β-hCG) pregnancy test. 7. Women who are breastfeeding. 8. Any clinically significant psychiatric or psychological disease, which would preclude the patient from completing the protocol. 9. Pre-morbid (estimated) modified Rankin scale score of >1. 10. Previous major stroke. 11. Patients with known HIV infection. 12. Participation in a clinical trial with an investigational drug within 30 days preceding this study. 13. Previous participation in the ENACT trial (e.g, to treat a prior aneurysm), participation in another trial involving NA-1 or prior receipt of NA-1. 14. Any other medical condition that the site investigator deems would put the patient at excessive risk of participation in the study or an expected life expectancy less than 1 year or that would result in inability to collect clinical outcomes at 90 days.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Tymianski, MD, PhD
Organizational Affiliation
NoNO Inc.
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Cameron G McDougall, MD
Organizational Affiliation
Barrow Neurological Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Michael D Hill, MD
Organizational Affiliation
Foothills Medical Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
Barrow Neurological Institute
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
850139
Country
United States
Facility Name
Colorado Neurological Institute
City
Englewood
State/Province
Colorado
ZIP/Postal Code
801130000
Country
United States
Facility Name
University of Michigan - Neurosurgery
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
481090000
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239-3098
Country
United States
Facility Name
University of Wisconsin
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
537920000
Country
United States
Facility Name
Foothills Medical Centre
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T2N 2T9
Country
Canada
Facility Name
QEII Health Sciences Centre - Halifax Infirmary
City
Halifax
State/Province
Nova Scotia
ZIP/Postal Code
B3H 3A7
Country
Canada
Facility Name
London Health Sciences Centre
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 5A5
Country
Canada
Facility Name
Sunnybrook Health Sciences Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M4N 3M5
Country
Canada
Facility Name
St. Michael's Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5B 1W8
Country
Canada
Facility Name
Toronto Western Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5T 2S8
Country
Canada
Facility Name
Hopital de l'Enfant Jesus
City
Quebec City
State/Province
Quebec
ZIP/Postal Code
G1J 1Z4
Country
Canada

12. IPD Sharing Statement

Learn more about this trial

Safety and Efficacy Study of a Single Dose of NA-1 in Patients Undergoing Endovascular Repair of Ruptured Aneurysms

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