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SC IL-1Ra in SAH - Phase III Trial (SCIL) (SCIL)

Primary Purpose

Subarachnoid Hemorrhage

Status
Active
Phase
Phase 3
Locations
United Kingdom
Study Type
Interventional
Intervention
IL-1Ra
IL-1Ra Placebo
Sponsored by
University of Manchester
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Subarachnoid Hemorrhage focused on measuring Aneurysmal

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients with CT positive spontaneous SAH admitted to a participating neurosurgical centre where written informed consent can be obtained and study drug can be administered within 72 hours of ictus.
  2. No concomitant health problems that, in the opinion of the PI or designee, would interfere with participation, administration of study drug or assessment of outcomes including safety.
  3. Willing and able to give informed consent or consent available from a patient representative for trial inclusion including agreement in principle to receive study drug and undergo all study assessments.
  4. Male or female aged 18 years or above.

Exclusion Criteria:

  1. Unconfirmed or uncertain diagnosis of spontaneous SAH.
  2. Known active tuberculosis or active hepatitis.
  3. Known active malignancy.
  4. Known Still's Disease
  5. Neutropenia (ANC <1.5 x 109/L ).
  6. Abnormal renal function (creatinine clearance or estimated Glomerular Filtration Rate (eGFR) < 30 ml/minute) documented in the last 3 months prior to this SAH.
  7. Live vaccinations within the last 10 days of this SAH.
  8. Previous or concurrent treatment with IL-1Ra known at the time of trial entry or previous participation in this trial.
  9. Current treatment with TNF antagonists.
  10. Known to have participated in a clinical trial of an investigational agent or device in the 30 days prior to ictus.
  11. Known to have participated in a clinical trial of an investigational agent or device within 5 half-lives (of the previous agent or device) prior to ictus.
  12. Known to be pregnant or breast feeding or inability to reliably confirm that the patient is not pregnant
  13. Clinically significant serious concurrent medical condition, pre morbid illnesses, or concurrent serious infection, at the PI's (or designee's) discretion, which could affect the safety or tolerability of the intervention.
  14. Known allergy to IL-1Ra or any of the excipients listed in the drug SmPC
  15. Known allergy to other products that are produced by DNA technology using the micro-organism E. coli (e.g. E.coli derived protein).
  16. Current treatment with IL-6 or IL-1 inhibitors or drugs affecting the IL-1 axis.

Sites / Locations

  • Derriford Hospital
  • Royal Hallamshire Hospital
  • University Hospital of Wales
  • Leeds General Infirmary
  • Royal Sussex County Hospital
  • Southmead Hospital
  • Addenbrookes Hospital
  • The Walton Centre
  • Royal London Hospital
  • St George's Hospital
  • Charing Cross Hospital
  • National Hospital for Neurology and Neurosurgery, Queen Square
  • Northern Care Alliance NHS Foundation Trust
  • Queens Medical Centre
  • Royal Preston Hospital
  • Southampton General Hospital
  • Royal Stoke University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

IL-1Ra twice daily

Placebo twice daily

Arm Description

Outcomes

Primary Outcome Measures

Ordinal shift in modified Rankin Score (mRS)

Secondary Outcome Measures

Measurement of mood using HADS
Measurement of fatigue using Fatigue score
Measurement of quality of life using EQ-5D-5L score

Full Information

First Posted
August 9, 2017
Last Updated
October 9, 2023
Sponsor
University of Manchester
Collaborators
National Institute for Health Research, United Kingdom, Clinical Trials Unit, Manchester, Northern Care Alliance NHS Foundation Trust
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1. Study Identification

Unique Protocol Identification Number
NCT03249207
Brief Title
SC IL-1Ra in SAH - Phase III Trial (SCIL)
Acronym
SCIL
Official Title
Does Interleukin-1 Receptor Antagonist Improve Outcome Following Aneurysmal Subarachnoid Haemorrhage (aSAH)? A Phase III Trial
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 11, 2018 (Actual)
Primary Completion Date
April 2024 (Anticipated)
Study Completion Date
September 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Manchester
Collaborators
National Institute for Health Research, United Kingdom, Clinical Trials Unit, Manchester, Northern Care Alliance NHS Foundation Trust

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase III trial will establish whether IL-1Ra, with sub-cutaneous (SC) administration twice daily for up to 21 days post aneurysmal subarachnoid haemorrhage (aSAH), improves clinical outcome as measured by ordinal shift in mRS at 6 months. Patients with SAH transferred to a neurosurgical centre will be identified and approached for study participation. Following consent, patients will be randomised to receive either IL-1Ra or placebo for a maximum of 21 days from onset of symptoms. Patients who are found to be non-aneurysmal following randomisation will be withdrawn from the study treatment. Blood samples for plasma IL-6 will be obtained prior to randomisation and at day 3-5 post randomisation for IL-6 & IL-1 measurement. Safety will be measured at 30 days post randomisation and outcome assessed at 6 months post randomisation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Subarachnoid Hemorrhage
Keywords
Aneurysmal

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
IL-1Ra twice daily
Arm Type
Active Comparator
Arm Title
Placebo twice daily
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
IL-1Ra
Intervention Description
Doses to be administered subcutaneously (SC) twice daily (12 hourly) starting within 72 hours of ictus (onset of symptoms) for a maximum of 21 days from ictus (or sooner if discharged from neurosurgical centre).
Intervention Type
Drug
Intervention Name(s)
IL-1Ra Placebo
Intervention Description
Doses to be administered subcutaneously (SC) twice daily (12 hourly) starting within 72 hours of ictus (onset of symptoms) for a maximum of 21 days from ictus (or sooner if discharged from neurosurgical centre).
Primary Outcome Measure Information:
Title
Ordinal shift in modified Rankin Score (mRS)
Time Frame
6 months post randomisation
Secondary Outcome Measure Information:
Title
Measurement of mood using HADS
Time Frame
6 months post randomisation
Title
Measurement of fatigue using Fatigue score
Time Frame
6 months post randomisation
Title
Measurement of quality of life using EQ-5D-5L score
Time Frame
6 months post randomisation

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with CT positive spontaneous SAH admitted to a participating neurosurgical centre where written informed consent can be obtained and study drug can be administered within 72 hours of ictus. No concomitant health problems that, in the opinion of the PI or designee, would interfere with participation, administration of study drug or assessment of outcomes including safety. Willing and able to give informed consent or consent available from a patient representative for trial inclusion including agreement in principle to receive study drug and undergo all study assessments. Male or female aged 18 years or above. Exclusion Criteria: Unconfirmed or uncertain diagnosis of spontaneous SAH. Known active tuberculosis or active hepatitis. Known active malignancy. Known Still's Disease Neutropenia (ANC <1.5 x 109/L ). Abnormal renal function (creatinine clearance or estimated Glomerular Filtration Rate (eGFR) < 30 ml/minute) documented in the last 3 months prior to this SAH. Live vaccinations within the last 10 days of this SAH. Previous or concurrent treatment with IL-1Ra known at the time of trial entry or previous participation in this trial. Current treatment with TNF antagonists. Known to have participated in a clinical trial of an investigational agent or device in the 30 days prior to ictus. Known to have participated in a clinical trial of an investigational agent or device within 5 half-lives (of the previous agent or device) prior to ictus. Known to be pregnant or breast feeding or inability to reliably confirm that the patient is not pregnant Clinically significant serious concurrent medical condition, pre morbid illnesses, or concurrent serious infection, at the PI's (or designee's) discretion, which could affect the safety or tolerability of the intervention. Known allergy to IL-1Ra or any of the excipients listed in the drug SmPC Known allergy to other products that are produced by DNA technology using the micro-organism E. coli (e.g. E.coli derived protein). Current treatment with IL-6 or IL-1 inhibitors or drugs affecting the IL-1 axis. History of DRESS syndrome.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Andrew King
Organizational Affiliation
University of Manchester
Official's Role
Principal Investigator
Facility Information:
Facility Name
Derriford Hospital
City
Plymouth
State/Province
Devon
ZIP/Postal Code
PL6 8DH
Country
United Kingdom
Facility Name
Royal Hallamshire Hospital
City
Sheffield
State/Province
South Yorkshire
ZIP/Postal Code
S10 2JF
Country
United Kingdom
Facility Name
University Hospital of Wales
City
Cardiff
State/Province
Wales
ZIP/Postal Code
CF14 4XW
Country
United Kingdom
Facility Name
Leeds General Infirmary
City
Leeds
State/Province
Yorkshire
ZIP/Postal Code
LS1 3EX
Country
United Kingdom
Facility Name
Royal Sussex County Hospital
City
Brighton
ZIP/Postal Code
BN2 5BE
Country
United Kingdom
Facility Name
Southmead Hospital
City
Bristol
ZIP/Postal Code
BS10 5NB
Country
United Kingdom
Facility Name
Addenbrookes Hospital
City
Cambridge
ZIP/Postal Code
CB2 0QQ
Country
United Kingdom
Facility Name
The Walton Centre
City
Liverpool
ZIP/Postal Code
L9 7LJ
Country
United Kingdom
Facility Name
Royal London Hospital
City
London
ZIP/Postal Code
E1 1FR
Country
United Kingdom
Facility Name
St George's Hospital
City
London
ZIP/Postal Code
SW17 0QT
Country
United Kingdom
Facility Name
Charing Cross Hospital
City
London
ZIP/Postal Code
W6 8RF
Country
United Kingdom
Facility Name
National Hospital for Neurology and Neurosurgery, Queen Square
City
London
ZIP/Postal Code
WC1N 3BG
Country
United Kingdom
Facility Name
Northern Care Alliance NHS Foundation Trust
City
Manchester
Country
United Kingdom
Facility Name
Queens Medical Centre
City
Nottingham
ZIP/Postal Code
NG7 2UH
Country
United Kingdom
Facility Name
Royal Preston Hospital
City
Preston
ZIP/Postal Code
PR2 9HT
Country
United Kingdom
Facility Name
Southampton General Hospital
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Facility Name
Royal Stoke University Hospital
City
Stoke-on-Trent
ZIP/Postal Code
ST4 6QG
Country
United Kingdom

12. IPD Sharing Statement

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SC IL-1Ra in SAH - Phase III Trial (SCIL)

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