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Evaluation of Safety and Efficacy of Lumason/SonoVue in Subjects Undergoing Pharmacologic Stress BR1-141

Primary Purpose

Coronary Artery Disease

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Lumason
Sponsored by
Bracco Diagnostics, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Coronary Artery Disease focused on measuring Lumason, Dobutamine stress echo, stress echo, coronary artery disease

Eligibility Criteria

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

Inclusion Criteria:

  • Provided written Informed Consent and was willing to comply with protocol requirements;
  • Was at least 18 years of age;
  • Had suspected or known CAD and was scheduled to undergo coronary angiography within 6 months after the LUMASON DSE.
  • Had undergone a previous echocardiography prior to enrollment; resulting in suboptimal unenhanced images at rest, defined as ≥ 2 suboptimal adjacent segments in any apical view.

Exclusion Criteria:

  • Was a pregnant or lactating female. Excluded the possibility of pregnancy by testing on site at the institution (serum or urine βHCG) within 24 hours prior to the start of LUMASON administration(s), by surgical history (e.g., tubal ligation or hysterectomy), post menopausal with a minimum 1 year without menses;
  • Had any known hypersensitivity to 1 or more ingredients of LUMASON (sulfur hexafluoride or to any components of LUMASON);
  • Had any known hypersensitivity to dobutamine;
  • Had an ongoing or recent (within the last 30 days) acute myocardial infarction;
  • Had known right-to-left, bidirectional or transient cardiac shunt (ruled out with agitated saline study performed before administration of LUMASON);
  • Had electrolyte (especially potassium and magnesium) abnormalities;
  • Had unstable pulmonary and/or systemic hemodynamic conditions e.g.:
  • decompensated or inadequately controlled congestive heart failure (NYHA Class IV);
  • hypovolemia;
  • uncontrolled hypertension, i.e. resting systolic blood pressure >200 mmHg or diastolic blood pressure >110 mmHg;
  • unstable angina;
  • acute coronary syndrome;
  • aortic dissection;
  • acute pericarditis,
  • myocarditis, or endocarditis;
  • stenosis of the main left coronary artery;
  • hemodynamically significant outflow obstruction of the left ventricle, including hypertrophic obstructive cardiomyopathy;
  • hemodynamically significant cardiac valvular defect;
  • acute pulmonary embolism;
  • Had uncontrolled cardiac arrhythmias;
  • Had significant disturbance in conduction;
  • Had hypertrophic subaortic stenosis;
  • Had an acute illness (e.g., infections, hyperthyroidism, or severe anemia);
  • Was previously entered into this study or received an investigational compound within 30 days before admission into this study;
  • Had been treated with any other contrast agent either intravascularly or orally within 48 hours of the first LUMASON administration;
  • Had any medical condition or other circumstances which would significantly decrease the chances of obtaining reliable data, achieving study objectives, or completing the study and/or postdose follow-up examinations;

In addition, due to the use of Atropine in subjects who had not reached targeted heart rate with peak dobutamine infusion, subjects with the following were excluded:

  • Glaucoma;
  • Pyloric stenosis;
  • Prostatic hypertrophy.

Sites / Locations

  • Sarver Heart Center, University of Arizona
  • University of California San Diego
  • Interventional Cardiology Medical Group, Inc.
  • Cardiology Physicians, PA
  • Community Heart and Vascular Community Hospital East
  • St. Luke's Mid-America Heart Institute
  • North Kansas City Hospital
  • Morristown Medical Center
  • The Institute for Clinical Research Holy Name Medical Center
  • Mount Sinai Medical Center
  • Mazankowski Alberta Heart Institute, University of Alberta Hospital
  • Medizinische Klinik m.S. Kardiologie und Angiologie, Charité Universitätsmedizin Berlin
  • Klinikum Lünen, St. Marien-Hospital GmbH
  • Universitätsmedizin Mainz
  • Kardiologie Klinik Dr. Müller GmbH, Peter Osypka Heart Center
  • Azienda Ospedaliera Universitaria Parma
  • Azienda Policlinico Umberto I Università degli Studi di Roma La Sapienza

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Lumason

Arm Description

Lumason (sulfur hexafluoride lipid-type A microspheres) 2 mL IV injection

Outcomes

Primary Outcome Measures

Sensitivity and Specificity for Detection or Exclusion of Coronary Artery Disease (CAD)
The diagnostic performance of the echocardiographic images was compared to the truth standard to determine sensitivity and specificity. A diagnosis of coronary artery disease (CAD) was determined for both the echo images and truth standard (positive diagnosis for CAD is defined as >/= 50% stenosis of any vessel on coronary angiography or if no coronary angiography is performed the occurence of a cardiac event based on clinical information for up to 6 months post dose; otherwise the diagnosis is negative). Results for sensitivity and specificity are reflected based on difference between contrast enhanced stress echo and unenhanced stress echo. Results for analysis of data based on majority assessment from the three off-site blinded readers are presented. Sensitivity and specificity are the percentages of correctly diagnosed subjects by stress echo over the total positive and negative subjects according to the truth standard respectively.
Reader-Specific Percentages of Participants Identified as Having a Critical Shift From Suboptimal to Optimal Echocardiographic Images
The percentage of subjects with suboptimal images (defined as >= 2 adjacent segments with inadequate left ventricular endocardial border delineation (LV EBD) in any of the 3 apical views) at unenhanced stress echo converted to adequate (reduction of suboptimal segments in any of the 3 apical views) at contrast-enhanced stress echo

Secondary Outcome Measures

Change in Total LV EBD
Measured as the change in the total LV EBD score based on the 17 segments, from peak stress unenhanced vs. peak stress contrast-enhanced. Total LV EBD score ranges from 0 to 34 and higher score is better outcome.
Number of Participants With Adverse Events
To obtain safety data in subjects administered Lumason during echocardiography

Full Information

First Posted
July 17, 2015
Last Updated
June 2, 2021
Sponsor
Bracco Diagnostics, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT02522481
Brief Title
Evaluation of Safety and Efficacy of Lumason/SonoVue in Subjects Undergoing Pharmacologic Stress BR1-141
Official Title
A Prospective Multicenter Phase III Clinical Evaluation of the Safety and Efficacy of Lumason™/SonoVue® in Subjects Undergoing Pharmacologic Stress Echocardiography With Dobutamine for the Diagnosis of Coronary Artery Disease
Study Type
Interventional

2. Study Status

Record Verification Date
June 2021
Overall Recruitment Status
Completed
Study Start Date
September 24, 2015 (Actual)
Primary Completion Date
November 7, 2017 (Actual)
Study Completion Date
February 25, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bracco Diagnostics, Inc

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study was to assess the safety and efficacy of Lumason-enhanced dobutamine stress echo (CE-DSE) in subjects having a suboptimal left ventricular endocardial border delineation (LV EBD) at rest and who were scheduled for coronary angiography.
Detailed Description
The study was designed to assess the safety and efficacy of Lumason at improving the visualization of the LV EBD during pharmacologic stress echocardiography examinations and for detection or exclusion of the coronary artery disease (CAD). The study population consisted of adult subjects referred for pharmacological stress echocardiography and with suboptimal image quality during unenhanced ultrasound imaging at rest who had known or suspected CAD. Subjects enrolled in the study represented subjects who could benefit most from contrast-enhanced ultrasound (CEUS) stress echocardiography.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease
Keywords
Lumason, Dobutamine stress echo, stress echo, coronary artery disease

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
175 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Lumason
Arm Type
Experimental
Arm Description
Lumason (sulfur hexafluoride lipid-type A microspheres) 2 mL IV injection
Intervention Type
Drug
Intervention Name(s)
Lumason
Other Intervention Name(s)
SonoVue
Intervention Description
Lumason (sulfur hexafluoride-type A microspheres) an ultrasound contrast agent was administered as 2 single 2-mL IV injections during rest and stress echocardiography
Primary Outcome Measure Information:
Title
Sensitivity and Specificity for Detection or Exclusion of Coronary Artery Disease (CAD)
Description
The diagnostic performance of the echocardiographic images was compared to the truth standard to determine sensitivity and specificity. A diagnosis of coronary artery disease (CAD) was determined for both the echo images and truth standard (positive diagnosis for CAD is defined as >/= 50% stenosis of any vessel on coronary angiography or if no coronary angiography is performed the occurence of a cardiac event based on clinical information for up to 6 months post dose; otherwise the diagnosis is negative). Results for sensitivity and specificity are reflected based on difference between contrast enhanced stress echo and unenhanced stress echo. Results for analysis of data based on majority assessment from the three off-site blinded readers are presented. Sensitivity and specificity are the percentages of correctly diagnosed subjects by stress echo over the total positive and negative subjects according to the truth standard respectively.
Time Frame
Participants were followed until they had coronary angiography or up to 6 months post dose to collect clinical information on cardiac events if no coronary angiography were performed
Title
Reader-Specific Percentages of Participants Identified as Having a Critical Shift From Suboptimal to Optimal Echocardiographic Images
Description
The percentage of subjects with suboptimal images (defined as >= 2 adjacent segments with inadequate left ventricular endocardial border delineation (LV EBD) in any of the 3 apical views) at unenhanced stress echo converted to adequate (reduction of suboptimal segments in any of the 3 apical views) at contrast-enhanced stress echo
Time Frame
Participants were followed until they had coronary angiography or up to 6 months post dose to collect clinical information on cardiac events if no coronary angiography was performed
Secondary Outcome Measure Information:
Title
Change in Total LV EBD
Description
Measured as the change in the total LV EBD score based on the 17 segments, from peak stress unenhanced vs. peak stress contrast-enhanced. Total LV EBD score ranges from 0 to 34 and higher score is better outcome.
Time Frame
Participants were followed until they had coronary angiography or up to 6 months post dose to collect clinical information on cardiac events if no coronary angiography was performed
Title
Number of Participants With Adverse Events
Description
To obtain safety data in subjects administered Lumason during echocardiography
Time Frame
up to 72 hours post dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provided written Informed Consent and was willing to comply with protocol requirements; Was at least 18 years of age; Had suspected or known CAD and was scheduled to undergo coronary angiography within 6 months after the LUMASON DSE. Had undergone a previous echocardiography prior to enrollment; resulting in suboptimal unenhanced images at rest, defined as ≥ 2 suboptimal adjacent segments in any apical view. Exclusion Criteria: Was a pregnant or lactating female. Excluded the possibility of pregnancy by testing on site at the institution (serum or urine βHCG) within 24 hours prior to the start of LUMASON administration(s), by surgical history (e.g., tubal ligation or hysterectomy), post menopausal with a minimum 1 year without menses; Had any known hypersensitivity to 1 or more ingredients of LUMASON (sulfur hexafluoride or to any components of LUMASON); Had any known hypersensitivity to dobutamine; Had an ongoing or recent (within the last 30 days) acute myocardial infarction; Had known right-to-left, bidirectional or transient cardiac shunt (ruled out with agitated saline study performed before administration of LUMASON); Had electrolyte (especially potassium and magnesium) abnormalities; Had unstable pulmonary and/or systemic hemodynamic conditions e.g.: decompensated or inadequately controlled congestive heart failure (NYHA Class IV); hypovolemia; uncontrolled hypertension, i.e. resting systolic blood pressure >200 mmHg or diastolic blood pressure >110 mmHg; unstable angina; acute coronary syndrome; aortic dissection; acute pericarditis, myocarditis, or endocarditis; stenosis of the main left coronary artery; hemodynamically significant outflow obstruction of the left ventricle, including hypertrophic obstructive cardiomyopathy; hemodynamically significant cardiac valvular defect; acute pulmonary embolism; Had uncontrolled cardiac arrhythmias; Had significant disturbance in conduction; Had hypertrophic subaortic stenosis; Had an acute illness (e.g., infections, hyperthyroidism, or severe anemia); Was previously entered into this study or received an investigational compound within 30 days before admission into this study; Had been treated with any other contrast agent either intravascularly or orally within 48 hours of the first LUMASON administration; Had any medical condition or other circumstances which would significantly decrease the chances of obtaining reliable data, achieving study objectives, or completing the study and/or postdose follow-up examinations; In addition, due to the use of Atropine in subjects who had not reached targeted heart rate with peak dobutamine infusion, subjects with the following were excluded: Glaucoma; Pyloric stenosis; Prostatic hypertrophy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Melda Dolan, MD
Organizational Affiliation
Bracco Diagnostics, Inc
Official's Role
Study Director
Facility Information:
Facility Name
Sarver Heart Center, University of Arizona
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85724
Country
United States
Facility Name
University of California San Diego
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
Interventional Cardiology Medical Group, Inc.
City
West Hills
State/Province
California
ZIP/Postal Code
91037
Country
United States
Facility Name
Cardiology Physicians, PA
City
Newark
State/Province
Delaware
ZIP/Postal Code
19713
Country
United States
Facility Name
Community Heart and Vascular Community Hospital East
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46250
Country
United States
Facility Name
St. Luke's Mid-America Heart Institute
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Facility Name
North Kansas City Hospital
City
North Kansas City
State/Province
Missouri
ZIP/Postal Code
64116
Country
United States
Facility Name
Morristown Medical Center
City
Morristown
State/Province
New Jersey
ZIP/Postal Code
07960
Country
United States
Facility Name
The Institute for Clinical Research Holy Name Medical Center
City
Teaneck
State/Province
New Jersey
ZIP/Postal Code
07666
Country
United States
Facility Name
Mount Sinai Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Mazankowski Alberta Heart Institute, University of Alberta Hospital
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G2B7
Country
Canada
Facility Name
Medizinische Klinik m.S. Kardiologie und Angiologie, Charité Universitätsmedizin Berlin
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
Klinikum Lünen, St. Marien-Hospital GmbH
City
Lünen
ZIP/Postal Code
44534
Country
Germany
Facility Name
Universitätsmedizin Mainz
City
Mainz
ZIP/Postal Code
55131
Country
Germany
Facility Name
Kardiologie Klinik Dr. Müller GmbH, Peter Osypka Heart Center
City
Munich
ZIP/Postal Code
81379
Country
Germany
Facility Name
Azienda Ospedaliera Universitaria Parma
City
Parma
ZIP/Postal Code
43126
Country
Italy
Facility Name
Azienda Policlinico Umberto I Università degli Studi di Roma La Sapienza
City
Rome
ZIP/Postal Code
00161
Country
Italy

12. IPD Sharing Statement

Plan to Share IPD
No

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Evaluation of Safety and Efficacy of Lumason/SonoVue in Subjects Undergoing Pharmacologic Stress BR1-141

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