search
Back to results

Comparison of Captisol-Enabled™ Iohexol and Omnipaque™ in Patients With Impaired Renal Function Undergoing Coronary Angiography

Primary Purpose

Contrast-induced Nephropathy

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
CE-Iohexol
Iohexol
Sponsored by
Ligand Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Contrast-induced Nephropathy

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female aged ≥18 years
  2. Referred for a coronary angiography (with or without percutaneous coronary intervention) and must meet either 1 of the following criteria:

    1. Estimated glomerular filtration rate (eGFR) <45 and ≥15 mL/min/1.73 m2 as determined by the Chronic Kidney Disease Epidemiology Collaboration (CKD- EPI) equation; or
    2. eGFR <60 and ≥45 mL/min/1.73 m2 as determined by the CKD-EPI equation and at least 1 of the following conditions:

      • Age >75 years
      • Diabetes mellitus with glycosylated hemoglobin (HbA1c) ≤10%
      • New York Heart Association (NYHA) class II or III heart failure
      • Albuminuria with urine albumin-to-creatinine ratio (UACR) or urine protein-to- creatinine ratio (UPCR) ≥300 and ≤4000 mg/g; or
      • Anemia, with hemoglobin levels ≥8 g/dL but <12.0 g/dL in women and <13.0 g/dL in men, as defined by the World Health Organization
  3. If female, must also meet any 1 of the following criteria:

    1. Surgically sterile with bilateral tubal ligation, bilateral salpingectomy, bilateral oophorectomy, or hysterectomy
    2. Postmenopausal with amenorrhea for at least 1 year and follicle-stimulating hormone in the postmenopausal range; or
    3. Is a woman of childbearing potential, non-pregnant and non-lactating at Screening, and must agree to use a protocol-recommended method of birth control or abstain from heterosexual intercourse, beginning at least 30 days prior to and until 30 days following investigational contrast agent administration
  4. If a male who can father a child, must also meet all of the following criteria:

    1. Willing to use a protocol-recommended method of birth control, ie, a double barrier approach (eg, condoms with spermicide) or abstain from heterosexual intercourse with women of childbearing potential, from Day 1 until at least 90 days after investigational contrast agent administration; and
    2. Willing to refrain from sperm donation from Day 1 until at least 90 days after investigational contrast agent administration
  5. Willing to undergo protocol-recommended blood and urine collections, physical examinations, and laboratory investigations; and
  6. Willing and able to provide written informed consent

Exclusion criteria

  1. eGFR <15 mL/min/1.73 m2
  2. Reduction in eGFR by approximately 25% that is considered to be acute per the Investigator's judgment
  3. Body weight >125 kg
  4. Uncorrected clinically significant abnormalities of clinical laboratory assessments which, in the Investigator's opinion, will interfere with the study conduct, including but not limited to the following:

    1. HbA1c >10%
    2. Blood glucose >270 mg/dL
    3. Hemoglobin <8 g/dL
    4. Albuminuria with UACR or UPCR >4000 mg/g; or
    5. Aspartate aminotransferase or alanine aminotransferase >3 x upper limit of reference range
  5. Positive test for severe acute respiratory syndrome coronavirus 2 RNA at Screening;
  6. Positive test for human immunodeficiency virus antibody, hepatitis B surface antigen, or hepatitis C virus RNA at Screening
  7. Uncontrolled hypertension, with systolic blood pressure (BP) >180 mmHg or diastolic BP >110 mmHg at Screening, based on the average of 3 BP measurements obtained from the patient's dominant arm
  8. Hypotension, that is considered to be of recent occurrence per the Investigator's judgment, and required resuscitation with intravenous fluids
  9. Non-cardiac acute illness or injuries that, in the opinion of the Investigator, could put the patient at risk or obscure the interpretation of the results of the study
  10. Known allergy or sensitivity to iodinated contrast agents, Captisol, or any of the excipients in the study contrast agent that cannot be adequately managed with prophylactic treatment per the Investigator's judgment and Good Clinical Practice
  11. Known allergy to heparin, history of heparin-induced thrombocytopenia, or history of heparin induced thrombocytopenia with thrombosis
  12. Chronic disease(s) that, in the opinion of the Investigator, could interfere with (or for which the treatment might interfere with) the conduct of the study or interpretation of the study results or would place the patient at undue risk by participating in the study, including but not limited to the following:

    1. NYHA class IV or decompensated heart failure; or
    2. Cirrhosis of the liver
  13. Inability to receive periprocedural intravenous volume expansion
  14. Received contrast media within 10 days prior to the scheduled coronary angiography
  15. Unable or not willing to come off non-steroidal anti-inflammatory drugs, including ibuprofen, for at least 24 hours before the scheduled procedure

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    CE-Iohexol

    Omnipaque™ (Iohexol)

    Arm Description

    Subject is randomized to receive CE-Iohexol Injection

    Subject is randomized to receive Omnipaque™ Iohexol Injection

    Outcomes

    Primary Outcome Measures

    Incidence of contrast-induced acute kidney injury (CI-AKI)
    Evaluate the incidence of CI-AKI in patients with impaired renal function undergoing coronary angiography, from baseline to any blood draw within 7 days following intravascular administration of CE-iohexol compared with Omnipaque (iohexol).

    Secondary Outcome Measures

    Image quality
    Compare image quality of coronary angiography in patients administered CE-iohexol versus iohexol.
    Change in serum creatinine (SCr)
    Evaluate the changes in SCr in patients administered CE-iohexol versus iohexol.
    Proportion of patients exhibiting an increase in SCr
    Evaluate the proportion of patients exhibiting an increase in SCr following intravascular administration of CE-iohexol compared with iohexol.
    Change in serum cystatin C
    Evaluate the changes in serum cystatin C in patients administered CE-iohexol versus iohexol.
    Incidence of Adverse Events
    The number of patients with adverse events (AE) and serious adverse events will be assessed and graded according to Common Terminology Criteria for Adverse Events (CTCAE) v 4.0. Monitoring for Major Adverse Cardiac and Renal Events (MARCEs) will be part of the AE assessment.

    Full Information

    First Posted
    October 27, 2020
    Last Updated
    April 1, 2022
    Sponsor
    Ligand Pharmaceuticals
    Collaborators
    CyDex Pharmaceuticals, Inc.
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT04627831
    Brief Title
    Comparison of Captisol-Enabled™ Iohexol and Omnipaque™ in Patients With Impaired Renal Function Undergoing Coronary Angiography
    Official Title
    Randomized Parallel Group Study Comparing the Renal Safety of CAPTISOL-Enabled™ Iohexol (CE-Iohexol) Injection and Omnipaque™ (Iohexol) Injection in Patients With Impaired Renal Function Undergoing Coronary Angiography
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Internal decision
    Study Start Date
    January 2022 (Anticipated)
    Primary Completion Date
    March 2023 (Anticipated)
    Study Completion Date
    April 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Ligand Pharmaceuticals
    Collaborators
    CyDex Pharmaceuticals, Inc.

    4. Oversight

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

    5. Study Description

    Brief Summary
    Randomized parallel group study comparing the renal safety of Captisol-Enabled™ Iohexol (CE-Iohexol) Injection and Omnipaque™ (Iohexol) Injection in patients with impaired renal function undergoing coronary angiography.
    Detailed Description
    The purpose of this trial is to demonstrate a reduction in the incidence of contrast-induced acute kidney injury (CI-AKI), also known as contrast-induced nephropathy (CIN), and the equivalence of image quality following administration of Captisol-Enabled™-Iohexol (CE-Iohexol) Injection compared to Omnipaque™(Iohexol) Injection in patients with impaired renal function undergoing invasive coronary angiography.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Contrast-induced Nephropathy

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Model Description
    Patients with impaired renal function scheduled for coronary angiography will be assessed for study eligibility. Prior to the planned coronary angiography procedure on Day 1, eligible patients will be randomized 1:1 to receive either CE-Iohexol Injection or iohexol. Randomization will be stratified by the following 2 factors. Diabetes mellitus status: Diabetics; or Non-diabetics; and Baseline eGFR, defined as the eGFR obtained as part of eligibility screening: <45 mL/min/1.73 m2; or 45 mL/min/1.73 m2. Contrast volumes will be determined according to medical need. All subjects will be well hydrated before and after the examination, according to good clinical practice and institution's standard procedures.
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Masking Description
    Subjects, and site personnel evaluating the subjects, will be blinded to the contrast media administered.
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    CE-Iohexol
    Arm Type
    Experimental
    Arm Description
    Subject is randomized to receive CE-Iohexol Injection
    Arm Title
    Omnipaque™ (Iohexol)
    Arm Type
    Active Comparator
    Arm Description
    Subject is randomized to receive Omnipaque™ Iohexol Injection
    Intervention Type
    Drug
    Intervention Name(s)
    CE-Iohexol
    Other Intervention Name(s)
    Captisol-Enabled™ Iohexol
    Intervention Description
    Captisol-Enabled™ Iohexol as needed for the diagnostic procedure. Volume will be determined according to medical need.
    Intervention Type
    Drug
    Intervention Name(s)
    Iohexol
    Other Intervention Name(s)
    Omnipaque™ (Iohexol)
    Intervention Description
    Iohexol as needed for the diagnostic procedure. Volume will be determined according to medical need.
    Primary Outcome Measure Information:
    Title
    Incidence of contrast-induced acute kidney injury (CI-AKI)
    Description
    Evaluate the incidence of CI-AKI in patients with impaired renal function undergoing coronary angiography, from baseline to any blood draw within 7 days following intravascular administration of CE-iohexol compared with Omnipaque (iohexol).
    Time Frame
    7 days
    Secondary Outcome Measure Information:
    Title
    Image quality
    Description
    Compare image quality of coronary angiography in patients administered CE-iohexol versus iohexol.
    Time Frame
    Day 1
    Title
    Change in serum creatinine (SCr)
    Description
    Evaluate the changes in SCr in patients administered CE-iohexol versus iohexol.
    Time Frame
    7 days
    Title
    Proportion of patients exhibiting an increase in SCr
    Description
    Evaluate the proportion of patients exhibiting an increase in SCr following intravascular administration of CE-iohexol compared with iohexol.
    Time Frame
    7 days
    Title
    Change in serum cystatin C
    Description
    Evaluate the changes in serum cystatin C in patients administered CE-iohexol versus iohexol.
    Time Frame
    7 days
    Title
    Incidence of Adverse Events
    Description
    The number of patients with adverse events (AE) and serious adverse events will be assessed and graded according to Common Terminology Criteria for Adverse Events (CTCAE) v 4.0. Monitoring for Major Adverse Cardiac and Renal Events (MARCEs) will be part of the AE assessment.
    Time Frame
    30 days
    Other Pre-specified Outcome Measures:
    Title
    Change in novel biomarkers of renal injury
    Description
    Evaluate the change in blood and urine biomarkers of renal injury from baseline to peak at 48 hours in patients administered CE-iohexol versus iohexol. Biomarkers may include neutrophil gelatinase-associated lipocalin, liver-type fatty acid binding protein and kidney injury molecule-1.
    Time Frame
    7 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male or female aged ≥18 years Referred for a coronary angiography (with or without percutaneous coronary intervention) and must meet either 1 of the following criteria: Estimated glomerular filtration rate (eGFR) <45 and ≥15 mL/min/1.73 m2 as determined by the Chronic Kidney Disease Epidemiology Collaboration (CKD- EPI) equation; or eGFR <60 and ≥45 mL/min/1.73 m2 as determined by the CKD-EPI equation and at least 1 of the following conditions: Age >75 years Diabetes mellitus with glycosylated hemoglobin (HbA1c) ≤10% New York Heart Association (NYHA) class II or III heart failure Albuminuria with urine albumin-to-creatinine ratio (UACR) or urine protein-to- creatinine ratio (UPCR) ≥300 and ≤4000 mg/g; or Anemia, with hemoglobin levels ≥8 g/dL but <12.0 g/dL in women and <13.0 g/dL in men, as defined by the World Health Organization If female, must also meet any 1 of the following criteria: Surgically sterile with bilateral tubal ligation, bilateral salpingectomy, bilateral oophorectomy, or hysterectomy Postmenopausal with amenorrhea for at least 1 year and follicle-stimulating hormone in the postmenopausal range; or Is a woman of childbearing potential, non-pregnant and non-lactating at Screening, and must agree to use a protocol-recommended method of birth control or abstain from heterosexual intercourse, beginning at least 30 days prior to and until 30 days following investigational contrast agent administration If a male who can father a child, must also meet all of the following criteria: Willing to use a protocol-recommended method of birth control, ie, a double barrier approach (eg, condoms with spermicide) or abstain from heterosexual intercourse with women of childbearing potential, from Day 1 until at least 90 days after investigational contrast agent administration; and Willing to refrain from sperm donation from Day 1 until at least 90 days after investigational contrast agent administration Willing to undergo protocol-recommended blood and urine collections, physical examinations, and laboratory investigations; and Willing and able to provide written informed consent Exclusion criteria eGFR <15 mL/min/1.73 m2 Reduction in eGFR by approximately 25% that is considered to be acute per the Investigator's judgment Body weight >125 kg Uncorrected clinically significant abnormalities of clinical laboratory assessments which, in the Investigator's opinion, will interfere with the study conduct, including but not limited to the following: HbA1c >10% Blood glucose >270 mg/dL Hemoglobin <8 g/dL Albuminuria with UACR or UPCR >4000 mg/g; or Aspartate aminotransferase or alanine aminotransferase >3 x upper limit of reference range Positive test for severe acute respiratory syndrome coronavirus 2 RNA at Screening; Positive test for human immunodeficiency virus antibody, hepatitis B surface antigen, or hepatitis C virus RNA at Screening Uncontrolled hypertension, with systolic blood pressure (BP) >180 mmHg or diastolic BP >110 mmHg at Screening, based on the average of 3 BP measurements obtained from the patient's dominant arm Hypotension, that is considered to be of recent occurrence per the Investigator's judgment, and required resuscitation with intravenous fluids Non-cardiac acute illness or injuries that, in the opinion of the Investigator, could put the patient at risk or obscure the interpretation of the results of the study Known allergy or sensitivity to iodinated contrast agents, Captisol, or any of the excipients in the study contrast agent that cannot be adequately managed with prophylactic treatment per the Investigator's judgment and Good Clinical Practice Known allergy to heparin, history of heparin-induced thrombocytopenia, or history of heparin induced thrombocytopenia with thrombosis Chronic disease(s) that, in the opinion of the Investigator, could interfere with (or for which the treatment might interfere with) the conduct of the study or interpretation of the study results or would place the patient at undue risk by participating in the study, including but not limited to the following: NYHA class IV or decompensated heart failure; or Cirrhosis of the liver Inability to receive periprocedural intravenous volume expansion Received contrast media within 10 days prior to the scheduled coronary angiography Unable or not willing to come off non-steroidal anti-inflammatory drugs, including ibuprofen, for at least 24 hours before the scheduled procedure
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Keith Marschke, PhD
    Organizational Affiliation
    Ligand Pharmaceuticals
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    Comparison of Captisol-Enabled™ Iohexol and Omnipaque™ in Patients With Impaired Renal Function Undergoing Coronary Angiography

    We'll reach out to this number within 24 hrs