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Studying Complement Inhibition in Early, Newly Developing Septic Organ Dysfunction (SCIENS)

Primary Purpose

Severe Sepsis, Septic Shock

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
CaCP29
Placebo
Sponsored by
InflaRx GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Severe Sepsis focused on measuring Sepsis, Severe Sepsis, Septic Shock, Systemic Inflammatory Response Syndrome, Organ Dysfunction

Eligibility Criteria

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

Key Inclusion Criteria at screening:

  1. Male or female patients >= 18 years old
  2. Written informed consent
  3. Occurrence of at least two criteria of a systemic inflammatory response syndrome (SIRS) not explained by other reasons. These criteria should be present within 12 hours prior to screening
  4. Suspected or confirmed abdominal or pulmonary infection at screening
  5. Broad spectrum i.v. antimicrobial therapy to treat abdominal or pulmonary infection
  6. At least one of the following acute organ dysfunctions due to sepsis. Each organ dysfunction must have occurred within 12 hours prior to screening, cannot mainly be explained by other disease processes than sepsis and is judged by the investigator as being caused or directly related to an abdominal or pulmonary infectious focus:

    1. respiratory
    2. renal
    3. hematologic
    4. metabolic
    5. cardiovascular (occurred within the last three hours)
  7. Reasonable likelihood that administration of study drug can be started within 3.5 hours after start of screening process

Key Exclusion Criteria at screening:

  1. Sepsis of other primary cause than pulmonary or abdominal source
  2. Weight > 130 kg at screening
  3. Any other disease and condition that is likely to interfere with evaluation of study product, outcome assessment or satisfactory conduct of the study
  4. Patients receiving the following concomitant medication within 14 days prior to screening:

    1. Calcineurin inhibitors (e.g., ciclosporine, tacrolimus)
    2. Proliferation inhibitors (e.g., everolimus, sirolimus)
    3. Anti-metabolites (e.g., mycophenolate, mycophenolic acid, azathioprine)
    4. High dose corticosteroids (e.g., > 50mg prednisolon per day or equivalent)
  5. Patients receiving high dose immunoglobulins within 3 months prior to screening
  6. Patients with following abnormal laboratory result: Neutrocytopenia with neutrophil count < 1,000/mm3 unless likely due to sepsis
  7. General criteria:

    1. Pregnant (in women of childbearing potential an urine pregnancy test has to be performed) or breast-feeding women
    2. Women with childbearing potential (defined as within two years of their last menstruation) not willing to practice appropriate contraceptive measures (e.g., implanon, injections, oral contraceptives, intrauterine devices, partner with vasectomy, abstinence) while participating in the trial
    3. Participation in any interventional clinical trial within the last three months
    4. Prior participation in this clinical trial
    5. Patient is chronically bed-bound prior to the onset of sepsis
    6. Known intravenous drug abuse
    7. Employee at the study site, spouse/partner or relative of any study staff (e.g., investigator, sub-investigators, or study nurse) or relationship to the sponsor
    8. No commitment to full aggressive life support (e.g., do not resuscitate order)

Inclusion Criteria at randomisation:

  1. At least one of the sepsis related organ dysfunction detected at screening is still present
  2. Current treatment with broad spectrum i.v. antibiotics has been started or is ongoing

Exclusion Criteria at randomisation:

  1. Time frame between detection of a non cardiovascular organ dysfunction and start of randomization procedure is more than 15 hours
  2. Time frame between detection of a cardiovascular organ dysfunction and start of randomization is more than six hours
  3. Organ dysfunctions are unlikely to be persistent for next three hours

Sites / Locations

  • Study Site
  • Study Site
  • Study Site
  • Study Site
  • Study Site
  • Study Site
  • Study Site
  • Study Site
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Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

CaCP29

Placebo

Arm Description

dose escalating i.v. administration of CaCP29 (verum)

dose escalation mimicing i.v. placebo treatment:

Outcomes

Primary Outcome Measures

Plasma Concentration of CaCP29
Pharmacokinetic measures include Plasma concentration over time Maximum observed concentration per infusion Concentration measured immediately before next dosing Area under the curve of plasma concentration per infusion Mean concentration per infusion Terminal phase half-life
Assess the pharmacodynamic (PD) effects of CaCP29 on the change from baseline in plasma concentrations of C5a
Safety variables will be summarized using descriptive statistics based on adverse event collection

Secondary Outcome Measures

Anti-drug antibodies (ADA)
The development of ADA will be described by: Number of patients with detection of anti-drug antibody (ADA) Number of patients with detection of ADA at each time point measured
All-cause mortality rate
Morbidity
Mean SOFA until Day 10 Modified mean SOFA until day 10 (calculated by omitting the Central Nervous System sub-score and calculating the renal subscore without taking urine output into consideration) Mean SOFA Sub-scores until Day 10 Days on ICU until Day 28 Number of patients ventilated until Day 14 Ventilator-free days until Day 14 Numbers of patients with renal replacement therapy (RRT) until Day 14 RRT-free days until Day 14 Numbers of patients with administration of vasopressor until Day 14 Vasopressor-free days until Day 14 Days without antimicrobial therapy (AMT) until Day 14
Fluid balance
Mean daily total fluid intake until Day 28 (maximal until ICU discharge) Mean daily total fluid output until Day 28 (maximal until ICU discharge) Mean daily fluid balance until Day 28 (maximal until ICU discharge)
Change in routine laboratory parameters as compared to baseline
Change in ECG as compared to baseline
Change in vital signs as compared to baseline

Full Information

First Posted
September 18, 2014
Last Updated
April 22, 2016
Sponsor
InflaRx GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT02246595
Brief Title
Studying Complement Inhibition in Early, Newly Developing Septic Organ Dysfunction
Acronym
SCIENS
Official Title
A Phase II Randomized, Placebo-controlled, Double-blind, Dose Controlled Trial in Patients Suffering From Early, Newly Developing Abdominal or Pulmonary Derived Septic Organ Dysfunction to Evaluate Safety, Pharmacokinetics, Pharmacodynamics and to Estimate Efficacy of the New Humanized Monoclonal i.v. Administered Antibody CaCP29
Study Type
Interventional

2. Study Status

Record Verification Date
April 2016
Overall Recruitment Status
Completed
Study Start Date
April 2014 (undefined)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
December 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
InflaRx GmbH

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The trial enrolls patients with early severe sepsis or septic shock displaying at least one newly developed organ dysfunction and showing clinical evidence of pulmonary or abdominal infection. The primary goal of the trial is to assess the pharmacokinetics and pharmacodynamics of the new monoclonal antibody CaCP29 and to characterize safety and tolerability as well as evaluate parameters of efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Severe Sepsis, Septic Shock
Keywords
Sepsis, Severe Sepsis, Septic Shock, Systemic Inflammatory Response Syndrome, Organ Dysfunction

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
CaCP29
Arm Type
Active Comparator
Arm Description
dose escalating i.v. administration of CaCP29 (verum)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
dose escalation mimicing i.v. placebo treatment:
Intervention Type
Biological
Intervention Name(s)
CaCP29
Other Intervention Name(s)
IFX-1
Intervention Type
Biological
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Plasma Concentration of CaCP29
Description
Pharmacokinetic measures include Plasma concentration over time Maximum observed concentration per infusion Concentration measured immediately before next dosing Area under the curve of plasma concentration per infusion Mean concentration per infusion Terminal phase half-life
Time Frame
0h, 2h, 6h, 12h, 14h (only cohort 1), 24h, 26h (only cohort 2 and 3), 48h, 72h, 74h (only cohort 3), days 5, 8, 13, 28
Title
Assess the pharmacodynamic (PD) effects of CaCP29 on the change from baseline in plasma concentrations of C5a
Time Frame
0h, 2h, 6h, 12h, 14h (only cohort 1), 24h, 26h (only cohort 2 and 3), 48h, 72h, 74h (only cohort 3), days 5, 8, 13, 28
Title
Safety variables will be summarized using descriptive statistics based on adverse event collection
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Anti-drug antibodies (ADA)
Description
The development of ADA will be described by: Number of patients with detection of anti-drug antibody (ADA) Number of patients with detection of ADA at each time point measured
Time Frame
28 days or hospital discharge
Title
All-cause mortality rate
Time Frame
28 days
Title
Morbidity
Description
Mean SOFA until Day 10 Modified mean SOFA until day 10 (calculated by omitting the Central Nervous System sub-score and calculating the renal subscore without taking urine output into consideration) Mean SOFA Sub-scores until Day 10 Days on ICU until Day 28 Number of patients ventilated until Day 14 Ventilator-free days until Day 14 Numbers of patients with renal replacement therapy (RRT) until Day 14 RRT-free days until Day 14 Numbers of patients with administration of vasopressor until Day 14 Vasopressor-free days until Day 14 Days without antimicrobial therapy (AMT) until Day 14
Time Frame
daily
Title
Fluid balance
Description
Mean daily total fluid intake until Day 28 (maximal until ICU discharge) Mean daily total fluid output until Day 28 (maximal until ICU discharge) Mean daily fluid balance until Day 28 (maximal until ICU discharge)
Time Frame
28 days or ICU discharge
Title
Change in routine laboratory parameters as compared to baseline
Time Frame
Days 1, 2, 3, 4, 5, 8, 13, 28
Title
Change in ECG as compared to baseline
Time Frame
Days 2, 4, 8, 28
Title
Change in vital signs as compared to baseline
Time Frame
Days 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria at screening: Male or female patients >= 18 years old Written informed consent Occurrence of at least two criteria of a systemic inflammatory response syndrome (SIRS) not explained by other reasons. These criteria should be present within 12 hours prior to screening Suspected or confirmed abdominal or pulmonary infection at screening Broad spectrum i.v. antimicrobial therapy to treat abdominal or pulmonary infection At least one of the following acute organ dysfunctions due to sepsis. Each organ dysfunction must have occurred within 12 hours prior to screening, cannot mainly be explained by other disease processes than sepsis and is judged by the investigator as being caused or directly related to an abdominal or pulmonary infectious focus: respiratory renal hematologic metabolic cardiovascular (occurred within the last three hours) Reasonable likelihood that administration of study drug can be started within 3.5 hours after start of screening process Key Exclusion Criteria at screening: Sepsis of other primary cause than pulmonary or abdominal source Weight > 130 kg at screening Any other disease and condition that is likely to interfere with evaluation of study product, outcome assessment or satisfactory conduct of the study Patients receiving the following concomitant medication within 14 days prior to screening: Calcineurin inhibitors (e.g., ciclosporine, tacrolimus) Proliferation inhibitors (e.g., everolimus, sirolimus) Anti-metabolites (e.g., mycophenolate, mycophenolic acid, azathioprine) High dose corticosteroids (e.g., > 50mg prednisolon per day or equivalent) Patients receiving high dose immunoglobulins within 3 months prior to screening Patients with following abnormal laboratory result: Neutrocytopenia with neutrophil count < 1,000/mm3 unless likely due to sepsis General criteria: Pregnant (in women of childbearing potential an urine pregnancy test has to be performed) or breast-feeding women Women with childbearing potential (defined as within two years of their last menstruation) not willing to practice appropriate contraceptive measures (e.g., implanon, injections, oral contraceptives, intrauterine devices, partner with vasectomy, abstinence) while participating in the trial Participation in any interventional clinical trial within the last three months Prior participation in this clinical trial Patient is chronically bed-bound prior to the onset of sepsis Known intravenous drug abuse Employee at the study site, spouse/partner or relative of any study staff (e.g., investigator, sub-investigators, or study nurse) or relationship to the sponsor No commitment to full aggressive life support (e.g., do not resuscitate order) Inclusion Criteria at randomisation: At least one of the sepsis related organ dysfunction detected at screening is still present Current treatment with broad spectrum i.v. antibiotics has been started or is ongoing Exclusion Criteria at randomisation: Time frame between detection of a non cardiovascular organ dysfunction and start of randomization procedure is more than 15 hours Time frame between detection of a cardiovascular organ dysfunction and start of randomization is more than six hours Organ dysfunctions are unlikely to be persistent for next three hours
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Bauer, Prof. Dr.
Organizational Affiliation
University Hospital Jena
Official's Role
Principal Investigator
Facility Information:
Facility Name
Study Site
City
Aachen
Country
Germany
Facility Name
Study Site
City
Augsburg
Country
Germany
Facility Name
Study Site
City
Bad Saarow
Country
Germany
Facility Name
Study Site
City
Berlin
Country
Germany
Facility Name
Study Site
City
Greifswald
Country
Germany
Facility Name
Study Site
City
Göttingen
Country
Germany
Facility Name
Study Site
City
Hamburg
Country
Germany
Facility Name
Study Site
City
Jena
Country
Germany
Facility Name
Study Site
City
Kiel
Country
Germany
Facility Name
Study Site
City
Leipzig
Country
Germany
Facility Name
Study Site
City
Oldenburg
Country
Germany

12. IPD Sharing Statement

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Studying Complement Inhibition in Early, Newly Developing Septic Organ Dysfunction

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