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Study to Evaluate IV CR845 in Hemodialysis Patients With Moderate-to-Severe Pruritus

Primary Purpose

Uremic Pruritus

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
CR845 0.5 mcg/kg
CR845 1 mcg/kg
CR845 1.5mcg/kg
Placebo
Sponsored by
Cara Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Uremic Pruritus focused on measuring Hemodialysis, CR845, Kappa opioid, Anti-itch, difelikefalin

Eligibility Criteria

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

Inclusion Criteria:

  1. Willing and able to provide written informed consent prior to participating in this study;
  2. Able to communicate clearly with the Investigator and staff, able to read, complete questionnaires, and understand the study procedures;
  3. Males or females 18 years of age or older;
  4. ESRD patients who have been on hemodialysis 3 times per week for at least 3 months prior to the start of Screening;
  5. Women of child-bearing potential must have a negative serum pregnancy test and agree to practice an acceptable form of birth control for the duration of the study
  6. Male patients that are not biologically or surgically sterile must agree to practice an acceptable from of birth control for the duration of the study
  7. Weigh between 88.2 lb (40.0 kg) and 297.6 lb (135.0 kg).
  8. Patient must self-report pruritus in the month prior to screening.
  9. If patient is receiving treatment for itch, this treatment must be stable prior to screening and during treatment period.
  10. At least 2 single-pool Kt/V measurements ≥ 1.2, or at least 2 urea reduction ratio measurements ≥ 65%, or 1 single-pool Kt/V measurement ≥ 1.2 and 1 urea reduction ratio measurement ≥ 65% on different dialysis days during the 3 months period prior to Screening;
  11. Patient who self-categorize as moderate-to-severe itch.

Exclusion Criteria:

  1. Known to be non-compliant with dialysis treatment (i.e., has missed more than 2 dialysis sessions in the past 2 months because of non-compliance);
  2. Anticipated to receive a kidney transplant during the study;
  3. Known history of allergic reaction to opiates, such as hives
  4. Known or suspected history of alcohol, narcotic, or other drug abuse or dependence within 12 months prior to Screening;
  5. Patient has any clinically relevant acute or chronic medical or neuropsychiatric condition which, in the opinion of the Investigator, would pose undue risk to the patient, would impede completion of the study procedures, or would compromise the validity of the study measurements;
  6. Serum alanine aminotransferase or aspartate aminotransferase greater than 2.5 times the reference upper limit of normal (ULN), or total bilirubin greater than 2 times ULN at Screening;
  7. Received another investigational drug within 30 days prior to the start of Screening or has planned to participate in another clinical trial while enrolled in this study;
  8. Has pruritus probably or definitely attributed to a cause other than ESRD or its complications (e.g., patients with concomitant pruritic dermatological disease or cholestatic liver disease would be excluded). (Note: Patients whose pruritus is attributed to ESRD complications such as hyperparathyroidism, hyperphosphatemia, anemia, or the dialysis procedure or prescription may be enrolled);
  9. Has localized itch restricted to the palms of the hands;
  10. Has pruritus only during the dialysis session (by patient report);
  11. Anticipated to receive opioid antagonists (e.g., naloxone, naltrexone), or opioid mixed agonist-antagonist (e.g., buprenorphine, nalbuphine) from the start of Screening through the end of the Treatment Period;
  12. Used Salvia divinorum or Salvinorin A within 30 days prior to the start of Screening or is anticipated to use it during the study;
  13. Received ultraviolet B treatment within 30 days prior to the start of Screening or anticipated to receive such treatment during the study;
  14. Participated in a previous clinical trial with CR845.

Sites / Locations

  • Cara Therapeutics Investigator Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Investigator Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapetics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapetics Investigator Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Investigator Site
  • Cara Therapeutics Investigator Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Investigator Site
  • Cara Therapeutics Study Site
  • Cara Therapetics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site
  • Cara Therapeutics Study Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

CR845 0.5mcg/kg

CR845 1 mcg/kg

CR845 1.5mcg/kg

Placebo

Arm Description

Part A of study: IV CR845 0.5 mcg/kg administered after each dialysis session (3 times/week)

Part A of study: IV CR845 1 mcg/kg administered after each dialysis session (3 times/week)

Part A of study: IV CR845 1.5 mcg/kg administered after each dialysis session (3 times/week)

Part A of study: IV Placebo administered after each dialysis session (3 times/week)

Outcomes

Primary Outcome Measures

Change From Baseline in the Weekly Mean of the Daily 24-hour Worst Itching Intensity NRS Score During Week 8
Intensity of itch was measured using a numerical rating scale (NRS) used to indicate the intensity of the worst itching over the past 24 hours using a 0 to 10 numeric rating scale, where "0" represents "no itching" and "10" represents "worst itching imaginable". Higher scores meant worse itch intensity.

Secondary Outcome Measures

Improvement in Itch-related Quality of Life as Assessed by the Change From Baseline in Total Skindex-10 Scale Score at the End of Week 8
The Skindex-10 Scale is a multidimensional questionnaire which assesses itch-related quality of life over the past week. The questions cover 3 domains: disease, mood/emotional distress, and social functioning domain. A lower total score represents better quality of life. The minimum score is 0 and the maximum score is 60 (or total score can range from 0 to 60) with a higher score meaning a worse quality of life.

Full Information

First Posted
July 29, 2016
Last Updated
July 15, 2020
Sponsor
Cara Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02858726
Brief Title
Study to Evaluate IV CR845 in Hemodialysis Patients With Moderate-to-Severe Pruritus
Official Title
A Two-Part, Multicenter, Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Safety and Efficacy of Intravenous CR845 in Hemodialysis Patients With Moderate-to-Severe Pruritus
Study Type
Interventional

2. Study Status

Record Verification Date
July 2020
Overall Recruitment Status
Completed
Study Start Date
June 2016 (undefined)
Primary Completion Date
March 14, 2017 (Actual)
Study Completion Date
March 14, 2017 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
2 Part Study: Part A will assess 3 different dosing levels of IV CR845 versus placebo in patient on hemodialysis who have moderate-to-severe itching due to uremic pruritus. Patients will receive either CR845 or placebo after each dialysis session for eight weeks. The safety and efficacy of CR845 will be monitored throughout the study. A sub-group of patients will also have pharmacokinetic assessments completed. Part B of the study will assess one dose of IVCR845 versus placebo for 12 weeks in patients on hemodialysis who have moderate-to-severe itching. The dose of CR845 used in Part B will be based on safety and efficacy found in Part A.
Detailed Description
This is a two-part study. Patients participating in Part A will be consented and trained on the completion of questionnaires about the severity of itching and overall health. Patients will be required to complete questionnaires during their visits to the dialysis center and also while at home on other days. Results of the screening questionnaires will assess eligibility for the study. Additional laboratory tests and measurements for safety will also be completed during the screening period. Patients meeting all criteria for entry into Part A of the study will be randomized to receive either one of three different doses of CR845 or a placebo. Patients will receive the study drug for eight weeks IV after each hemodialysis treatment (i.e. 3 times per week). Assessments for intensity of itch and safety will also be completed during the 8 week treatment period. When patients have completed treatment, a Follow-up visit will be completed 7 days later. Patients participating in Part B will be consented and trained on the completion of questionnaires about itching and overall health. Patients will be required to complete questionnaires during their visits to the dialysis center and also while at home on other days. Laboratory tests and measurements for safety will also be completed during the screening period to determine study eligibility. Patients meeting all criteria for entry into Part B of the study will be randomized to receive either CR845 or a placebo. The dose of CR845 used will have been determined based on the safety and efficacy from Part A. Patients will be dosed with either CR845 or placebo for twelve weeks after each hemodialysis treatment (i.e. 3 times per week). Assessments for intensity of itch and safety will be completed during the treatment period also. When patients have completed treatment, a Follow-up visit will be completed 7 days later.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Uremic Pruritus
Keywords
Hemodialysis, CR845, Kappa opioid, Anti-itch, difelikefalin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
226 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CR845 0.5mcg/kg
Arm Type
Experimental
Arm Description
Part A of study: IV CR845 0.5 mcg/kg administered after each dialysis session (3 times/week)
Arm Title
CR845 1 mcg/kg
Arm Type
Experimental
Arm Description
Part A of study: IV CR845 1 mcg/kg administered after each dialysis session (3 times/week)
Arm Title
CR845 1.5mcg/kg
Arm Type
Experimental
Arm Description
Part A of study: IV CR845 1.5 mcg/kg administered after each dialysis session (3 times/week)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Part A of study: IV Placebo administered after each dialysis session (3 times/week)
Intervention Type
Drug
Intervention Name(s)
CR845 0.5 mcg/kg
Other Intervention Name(s)
CR845
Intervention Description
IV medication delivered three times/week
Intervention Type
Drug
Intervention Name(s)
CR845 1 mcg/kg
Other Intervention Name(s)
CR845
Intervention Description
IV medication delivered three times/week
Intervention Type
Drug
Intervention Name(s)
CR845 1.5mcg/kg
Other Intervention Name(s)
CR845
Intervention Description
IV medication delivered three times/week
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
IV medication delivered three times/week
Primary Outcome Measure Information:
Title
Change From Baseline in the Weekly Mean of the Daily 24-hour Worst Itching Intensity NRS Score During Week 8
Description
Intensity of itch was measured using a numerical rating scale (NRS) used to indicate the intensity of the worst itching over the past 24 hours using a 0 to 10 numeric rating scale, where "0" represents "no itching" and "10" represents "worst itching imaginable". Higher scores meant worse itch intensity.
Time Frame
Baseline, Week 8
Secondary Outcome Measure Information:
Title
Improvement in Itch-related Quality of Life as Assessed by the Change From Baseline in Total Skindex-10 Scale Score at the End of Week 8
Description
The Skindex-10 Scale is a multidimensional questionnaire which assesses itch-related quality of life over the past week. The questions cover 3 domains: disease, mood/emotional distress, and social functioning domain. A lower total score represents better quality of life. The minimum score is 0 and the maximum score is 60 (or total score can range from 0 to 60) with a higher score meaning a worse quality of life.
Time Frame
Baseline, Week 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willing and able to provide written informed consent prior to participating in this study; Able to communicate clearly with the Investigator and staff, able to read, complete questionnaires, and understand the study procedures; Males or females 18 years of age or older; ESRD patients who have been on hemodialysis 3 times per week for at least 3 months prior to the start of Screening; Women of child-bearing potential must have a negative serum pregnancy test and agree to practice an acceptable form of birth control for the duration of the study Male patients that are not biologically or surgically sterile must agree to practice an acceptable from of birth control for the duration of the study Weigh between 88.2 lb (40.0 kg) and 297.6 lb (135.0 kg). Patient must self-report pruritus in the month prior to screening. If patient is receiving treatment for itch, this treatment must be stable prior to screening and during treatment period. At least 2 single-pool Kt/V measurements ≥ 1.2, or at least 2 urea reduction ratio measurements ≥ 65%, or 1 single-pool Kt/V measurement ≥ 1.2 and 1 urea reduction ratio measurement ≥ 65% on different dialysis days during the 3 months period prior to Screening; Patient who self-categorize as moderate-to-severe itch. Exclusion Criteria: Known to be non-compliant with dialysis treatment (i.e., has missed more than 2 dialysis sessions in the past 2 months because of non-compliance); Anticipated to receive a kidney transplant during the study; Known history of allergic reaction to opiates, such as hives Known or suspected history of alcohol, narcotic, or other drug abuse or dependence within 12 months prior to Screening; Patient has any clinically relevant acute or chronic medical or neuropsychiatric condition which, in the opinion of the Investigator, would pose undue risk to the patient, would impede completion of the study procedures, or would compromise the validity of the study measurements; Serum alanine aminotransferase or aspartate aminotransferase greater than 2.5 times the reference upper limit of normal (ULN), or total bilirubin greater than 2 times ULN at Screening; Received another investigational drug within 30 days prior to the start of Screening or has planned to participate in another clinical trial while enrolled in this study; Has pruritus probably or definitely attributed to a cause other than ESRD or its complications (e.g., patients with concomitant pruritic dermatological disease or cholestatic liver disease would be excluded). (Note: Patients whose pruritus is attributed to ESRD complications such as hyperparathyroidism, hyperphosphatemia, anemia, or the dialysis procedure or prescription may be enrolled); Has localized itch restricted to the palms of the hands; Has pruritus only during the dialysis session (by patient report); Anticipated to receive opioid antagonists (e.g., naloxone, naltrexone), or opioid mixed agonist-antagonist (e.g., buprenorphine, nalbuphine) from the start of Screening through the end of the Treatment Period; Used Salvia divinorum or Salvinorin A within 30 days prior to the start of Screening or is anticipated to use it during the study; Received ultraviolet B treatment within 30 days prior to the start of Screening or anticipated to receive such treatment during the study; Participated in a previous clinical trial with CR845.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Frederique Menzaghi, PhD
Organizational Affiliation
Cara Therapeutics
Official's Role
Study Director
Facility Information:
Facility Name
Cara Therapeutics Investigator Site
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85035
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Pine Bluff
State/Province
Arkansas
ZIP/Postal Code
71603
Country
United States
Facility Name
Cara Therapeutics Investigator Site
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Northridge
State/Province
California
ZIP/Postal Code
91324
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Whittier
State/Province
California
ZIP/Postal Code
90603
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Denver
State/Province
Colorado
ZIP/Postal Code
80218
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Hollywood
State/Province
Florida
ZIP/Postal Code
33024
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Tampa
State/Province
Florida
ZIP/Postal Code
33614
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Winter Park
State/Province
Florida
ZIP/Postal Code
32789
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Augusta
State/Province
Georgia
ZIP/Postal Code
30909
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Meridian
State/Province
Idaho
ZIP/Postal Code
83642
Country
United States
Facility Name
Cara Therapetics Study Site
City
Creve Coeur
State/Province
Missouri
ZIP/Postal Code
63141
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64131
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68124
Country
United States
Facility Name
Cara Therapetics Investigator Site
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87109
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Gallup
State/Province
New Mexico
ZIP/Postal Code
87301
Country
United States
Facility Name
Cara Therapeutics Study Site
City
College Point
State/Province
New York
ZIP/Postal Code
11385
Country
United States
Facility Name
Cara Therapeutics Investigator Site
City
Mineola
State/Province
New York
ZIP/Postal Code
11501
Country
United States
Facility Name
Cara Therapeutics Investigator Site
City
Wilmington
State/Province
North Carolina
ZIP/Postal Code
28401
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Bethlehem
State/Province
Pennsylvania
ZIP/Postal Code
18017
Country
United States
Facility Name
Cara Therapeutics Investigator Site
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19140
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37408
Country
United States
Facility Name
Cara Therapetics Study Site
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37920
Country
United States
Facility Name
Cara Therapeutics Study Site
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78221
Country
United States
Facility Name
Cara Therapeutics Study Site
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Cara Therapeutics Study Site
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78251
Country
United States
Facility Name
Cara Therapeutics Study Site
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
33283264
Citation
Hercz D, Jiang SH, Webster AC. Interventions for itch in people with advanced chronic kidney disease. Cochrane Database Syst Rev. 2020 Dec 7;12(12):CD011393. doi: 10.1002/14651858.CD011393.pub2.
Results Reference
derived

Learn more about this trial

Study to Evaluate IV CR845 in Hemodialysis Patients With Moderate-to-Severe Pruritus

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