A Study of OCE-205 in Participants With Cirrhosis With Ascites Who Developed Hepatorenal Syndrome-Acute Kidney Injury
Primary Purpose
Cirrhosis, Ascites, Hepatorenal Syndrome
Status
Active
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
OCE-205
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Cirrhosis focused on measuring HRS-AKI
Eligibility Criteria
Inclusion Criteria:
- Signed informed consent form (ICF) by participant or their legal/authorized representatives.
- Diagnosed with decompensated cirrhosis with ascites.
- Receiving albumin and has had appropriate diuretic withdrawal for at least 2 days prior to randomization into the study.
- Beta-blockers should be discontinued 48 hours prior to randomization, unless doctor deems necessary for appropriate medical treatment.
- No sustained improvement in renal function after both diuretic withdrawal and plasma volume expansion with albumin.
- Female participants must have a negative pregnancy test prior to randomization and agree to avoid becoming pregnant during the study and for 30 days after the end of treatment. Male participants must agree to use 2 effective contraceptive methods during the study and up to 30 days after the end of treatment.
Exclusion Criteria:
- Serum Creatinine >3.8 mg/dL.
- Large volume paracentesis (LVP ≥6L) within 4 days of randomization.
- Pulse oximeter reading of <90% on 2L or less.
- Sepsis and/or uncontrolled bacterial infection.
- Experienced shock within 72 hrs prior to screening.
- Model for End-Stage Liver Disease (MELD) score >35.
- Hypertension with a Systolic BP > 140 mmHg and/ or a Diastolic BP >100 mmHg.
- Treated with or exposed to nephrotoxic agents or has had exposure to radiographic contrast agents within 72 hrs prior to screening.
- Has superimposed acute liver injury due to drugs, or toxins except for acute alcoholic hepatitis.
- Proteinuria greater than 500 mg/dL.
- Impaired cardiac function as evidenced by symptoms consistent with New York Heart Association Classification Class 2 or worse.
- Received Renal Replacement Therapy (RRT) within 4 weeks of randomization.
- Has had a Trans Jugular Intrahepatic Porto-systemic shunt (TIPS).
- Pregnant or breastfeeding.
- Diagnosed with a malignancy within the past 5 years.
- History or current evidence of any condition (COVID-19 positive with respiratory/cardiac complications), therapy or laboratory abnormality that might confound the results of the study, interfere with the participation for the full duration of the study, or is not in the best interest to participate in the opinion of the investigator.
- Participated in a study of an investigational medical product or device within the last 8 weeks preceding screening.
- Experienced a major blood loss (≥500 mL) within the last 4 weeks prior to screening.
- Is stuporous or comatose at screening (West Haven scores III and IV). exhibiting bradycardia.
Sites / Locations
- Mayo Clinic - Phoenix
- Keck Medical Center of USC
- University of California, San Francisco Liver Clinic
- Stanford Hospital
- MedStar Georgetown University Hospital
- Tampa General Medical Group
- Piedmont Atlanta Hospital
- Northwestern Medicine
- Indiana University Hospital
- University of Maryland Medical Center
- Massachusetts General Hospital
- M Health Fairview University of Minnesota Medical Center
- Mayo Clinic
- University of Missouri
- Rutgers New Jersey Medical School
- New York-Presbyterian Hospital
- University of Cincinnati Medical Center
- Medical University of South Carolina
- Baylor University
- CHI St Luke's Health Baylor College of Medicine Medical Center
- McGuire VA Medical Center
- Virginia Commonwealth University Health System
- Toronto General Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm Type
Placebo Comparator
Experimental
Experimental
Experimental
Experimental
Arm Label
OCE-205 Cohort 1
OCE-205 Cohort 2
OCE-205 Cohort 3
OCE-205 Cohort 4
OCE-205 Cohort 5
Arm Description
Placebo, intravenous infusion
OCE-205, 8 µg/hr, intravenous infusion
OCE-205, 15 µg/hr, intravenous infusion
OCE-205, 30 µg/hr, intravenous infusion
OCE-205, 50 µg/hr, intravenous infusion
Outcomes
Primary Outcome Measures
Time to measurement of concentration serum creatinine (sCr) value of less than 1.5 mg/dL on 2 consecutive days
Secondary Outcome Measures
Mean Concentration of OCE-205 at Steady State Concentration (Css)
Rate of Total Body Clearance (CL) of OCE-205
Time to Elimination Half-Life (t1/2) of OCE-205
Volume of Steady-State Volume of Distribution (Vss) of OCE-205
Change in Mean Arterial Pressure (MAP) rate
Percentage Change in rate of Mean Arterial Pressure (MAP)
Change in Pulse Rate
Percentage Change in Pulse Rate
Change in concentration of Serum Creatinine (sCr)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05309200
Brief Title
A Study of OCE-205 in Participants With Cirrhosis With Ascites Who Developed Hepatorenal Syndrome-Acute Kidney Injury
Official Title
A Multi-Center, Randomized, Placebo-Controlled, Double-Blind, Adaptive Dose-Ranging Study to Assess Safety and Efficacy of Intravenous OCE-205 in Adults Diagnosed With Cirrhosis With Ascites Who Have Developed Hepatorenal Syndrome-Acute Kidney Injury (HRS-AKI)
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 28, 2022 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ocelot Bio, 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
OCE-205 is being tested to treat participants who have developed Hepatorenal Syndrome-Acute Kidney Injury as a complication of cirrhosis with ascites.
The study aims are to evaluate the safety and efficacy of OCE-205 at various doses.
Participants will receive treatment by intravenous infusion. Participants will continue with this treatment until participants meets primary endpoint or any discontinuation criteria.
Detailed Description
The study will include 5 treatment arms including 1 Placebo Arm and 4 active drug arms. Participants will be randomly selected to 1 of 5 arms.
Placebo
OCE-205 at 8 micrograms per hour (µg/hr)
OCE-205 at 15 micrograms per hour (µg/hr)
OCE-205 at 30 micrograms per hour (µg/hr)
OCE-205 at 50 micrograms per hour (µg/hr)
This multi-center trial will be conducted in the United States and Canada. If selected for the study, participants will be randomly assigned to 1 of the 5 treatment arms.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cirrhosis, Ascites, Hepatorenal Syndrome, Acute Kidney Injury
Keywords
HRS-AKI
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
100 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
OCE-205 Cohort 1
Arm Type
Placebo Comparator
Arm Description
Placebo, intravenous infusion
Arm Title
OCE-205 Cohort 2
Arm Type
Experimental
Arm Description
OCE-205, 8 µg/hr, intravenous infusion
Arm Title
OCE-205 Cohort 3
Arm Type
Experimental
Arm Description
OCE-205, 15 µg/hr, intravenous infusion
Arm Title
OCE-205 Cohort 4
Arm Type
Experimental
Arm Description
OCE-205, 30 µg/hr, intravenous infusion
Arm Title
OCE-205 Cohort 5
Arm Type
Experimental
Arm Description
OCE-205, 50 µg/hr, intravenous infusion
Intervention Type
Drug
Intervention Name(s)
OCE-205
Intervention Description
The drug product, OCE-205, is a sterile solution to be used for intravenous infusion.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo to match OCE-205 is a sterile solution to be used for intravenous infusion.
Primary Outcome Measure Information:
Title
Time to measurement of concentration serum creatinine (sCr) value of less than 1.5 mg/dL on 2 consecutive days
Time Frame
From Day 1 infusion start to Last Day of infusion end
Secondary Outcome Measure Information:
Title
Mean Concentration of OCE-205 at Steady State Concentration (Css)
Time Frame
From Day 1 infusion start to Last Day of infusion end
Title
Rate of Total Body Clearance (CL) of OCE-205
Time Frame
From Day 1 infusion start to Last Day of infusion end
Title
Time to Elimination Half-Life (t1/2) of OCE-205
Time Frame
From Day 1 infusion start to Last Day of infusion end
Title
Volume of Steady-State Volume of Distribution (Vss) of OCE-205
Time Frame
From Day 1 infusion start to Last Day of infusion end
Title
Change in Mean Arterial Pressure (MAP) rate
Time Frame
From Day 1 infusion start to Last Day of infusion end
Title
Percentage Change in rate of Mean Arterial Pressure (MAP)
Time Frame
From Day 1 infusion start to Last Day of infusion end
Title
Change in Pulse Rate
Time Frame
From Day 1 infusion start to Last Day of infusion end
Title
Percentage Change in Pulse Rate
Time Frame
From Day 1 infusion start to Last Day of infusion end
Title
Change in concentration of Serum Creatinine (sCr)
Time Frame
From Day 1 infusion start to Last Day of infusion end
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed informed consent form (ICF) by participant or their legal/authorized representatives.
Diagnosed with decompensated cirrhosis with ascites.
Receiving albumin and has had appropriate diuretic withdrawal for at least 2 days prior to randomization into the study.
Beta-blockers should be discontinued 48 hours prior to randomization, unless doctor deems necessary for appropriate medical treatment.
No sustained improvement in renal function after both diuretic withdrawal and plasma volume expansion with albumin.
Female participants must have a negative pregnancy test prior to randomization and agree to avoid becoming pregnant during the study and for 30 days after the end of treatment. Male participants must agree to use 2 effective contraceptive methods during the study and up to 30 days after the end of treatment.
Exclusion Criteria:
Serum Creatinine >3.8 mg/dL.
Large volume paracentesis (LVP ≥6L) within 4 days of randomization.
Pulse oximeter reading of <90% on 2L or less.
Sepsis and/or uncontrolled bacterial infection.
Experienced shock within 72 hrs prior to screening.
Model for End-Stage Liver Disease (MELD) score >35.
Hypertension with a Systolic BP > 140 mmHg and/ or a Diastolic BP >100 mmHg.
Treated with or exposed to nephrotoxic agents or has had exposure to radiographic contrast agents within 72 hrs prior to screening.
Has superimposed acute liver injury due to drugs, or toxins except for acute alcoholic hepatitis.
Proteinuria greater than 500 mg/dL.
Impaired cardiac function as evidenced by symptoms consistent with New York Heart Association Classification Class 2 or worse.
Received Renal Replacement Therapy (RRT) within 4 weeks of randomization.
Has had a Trans Jugular Intrahepatic Porto-systemic shunt (TIPS).
Pregnant or breastfeeding.
Diagnosed with a malignancy within the past 5 years.
History or current evidence of any condition (COVID-19 positive with respiratory/cardiac complications), therapy or laboratory abnormality that might confound the results of the study, interfere with the participation for the full duration of the study, or is not in the best interest to participate in the opinion of the investigator.
Participated in a study of an investigational medical product or device within the last 8 weeks preceding screening.
Experienced a major blood loss (≥500 mL) within the last 4 weeks prior to screening.
Is stuporous or comatose at screening (West Haven scores III and IV). exhibiting bradycardia.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chief Medical Officer
Organizational Affiliation
Ocelot Bio
Official's Role
Study Chair
Facility Information:
Facility Name
Mayo Clinic - Phoenix
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85054
Country
United States
Facility Name
Keck Medical Center of USC
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
University of California, San Francisco Liver Clinic
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Stanford Hospital
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
MedStar Georgetown University Hospital
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
Tampa General Medical Group
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
Piedmont Atlanta Hospital
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30309
Country
United States
Facility Name
Northwestern Medicine
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Indiana University Hospital
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
University of Maryland Medical Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02144
Country
United States
Facility Name
M Health Fairview University of Minnesota Medical Center
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
University of Missouri
City
Columbia
State/Province
Missouri
ZIP/Postal Code
65212
Country
United States
Facility Name
Rutgers New Jersey Medical School
City
Newark
State/Province
New Jersey
ZIP/Postal Code
07103
Country
United States
Facility Name
New York-Presbyterian Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
University of Cincinnati Medical Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Baylor University
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
Facility Name
CHI St Luke's Health Baylor College of Medicine Medical Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
McGuire VA Medical Center
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23249
Country
United States
Facility Name
Virginia Commonwealth University Health System
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298
Country
United States
Facility Name
Toronto General Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2C4
Country
Canada
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
25638527
Citation
Angeli P, Gines P, Wong F, Bernardi M, Boyer TD, Gerbes A, Moreau R, Jalan R, Sarin SK, Piano S, Moore K, Lee SS, Durand F, Salerno F, Caraceni P, Kim WR, Arroyo V, Garcia-Tsao G. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. J Hepatol. 2015 Apr;62(4):968-74. doi: 10.1016/j.jhep.2014.12.029. Epub 2015 Jan 28. No abstract available. Erratum In: J Hepatol. 2015 Jul;63(1):290.
Results Reference
background
PubMed Identifier
26896734
Citation
Boyer TD, Sanyal AJ, Wong F, Frederick RT, Lake JR, O'Leary JG, Ganger D, Jamil K, Pappas SC; REVERSE Study Investigators. Terlipressin Plus Albumin Is More Effective Than Albumin Alone in Improving Renal Function in Patients With Cirrhosis and Hepatorenal Syndrome Type 1. Gastroenterology. 2016 Jun;150(7):1579-1589.e2. doi: 10.1053/j.gastro.2016.02.026. Epub 2016 Feb 16.
Results Reference
background
PubMed Identifier
25644760
Citation
Cavallin M, Kamath PS, Merli M, Fasolato S, Toniutto P, Salerno F, Bernardi M, Romanelli RG, Colletta C, Salinas F, Di Giacomo A, Ridola L, Fornasiere E, Caraceni P, Morando F, Piano S, Gatta A, Angeli P; Italian Association for the Study of the Liver Study Group on Hepatorenal Syndrome. Terlipressin plus albumin versus midodrine and octreotide plus albumin in the treatment of hepatorenal syndrome: A randomized trial. Hepatology. 2015 Aug;62(2):567-74. doi: 10.1002/hep.27709. Epub 2015 Feb 13.
Results Reference
background
PubMed Identifier
30213943
Citation
Gines P, Sola E, Angeli P, Wong F, Nadim MK, Kamath PS. Hepatorenal syndrome. Nat Rev Dis Primers. 2018 Sep 13;4(1):23. doi: 10.1038/s41572-018-0022-7. Erratum In: Nat Rev Dis Primers. 2018 Oct 15;4(1):33.
Results Reference
background
PubMed Identifier
18471512
Citation
Martin-Llahi M, Pepin MN, Guevara M, Diaz F, Torre A, Monescillo A, Soriano G, Terra C, Fabrega E, Arroyo V, Rodes J, Gines P; TAHRS Investigators. Terlipressin and albumin vs albumin in patients with cirrhosis and hepatorenal syndrome: a randomized study. Gastroenterology. 2008 May;134(5):1352-9. doi: 10.1053/j.gastro.2008.02.024. Epub 2008 Feb 14.
Results Reference
background
PubMed Identifier
31700640
Citation
McClure T, Chapman B, Hey P, Testro A, Gow P. Long-term continuous terlipressin infusion in cirrhotic patients with hepatorenal syndrome or refractory ascites awaiting liver transplantation is associated with an increase in plasma sodium. United European Gastroenterol J. 2019 Nov;7(9):1271-1273. doi: 10.1177/2050640619878996. Epub 2019 Sep 19. No abstract available.
Results Reference
background
PubMed Identifier
24687396
Citation
Robertson M, Majumdar A, Garrett K, Rumler G, Gow P, Testro A. Continuous outpatient terlipressin infusion for hepatorenal syndrome as a bridge to successful liver transplantation. Hepatology. 2014 Dec;60(6):2125-6. doi: 10.1002/hep.27154. Epub 2014 May 19. No abstract available.
Results Reference
background
PubMed Identifier
19201943
Citation
Salerno F, Gerbes A, Gines P, Wong F, Arroyo V. Diagnosis, prevention and treatment of hepatorenal syndrome in cirrhosis. Postgrad Med J. 2008 Dec;84(998):662-70. doi: 10.1136/gut.2006.107789.
Results Reference
background
PubMed Identifier
18471513
Citation
Sanyal AJ, Boyer T, Garcia-Tsao G, Regenstein F, Rossaro L, Appenrodt B, Blei A, Gulberg V, Sigal S, Teuber P; Terlipressin Study Group. A randomized, prospective, double-blind, placebo-controlled trial of terlipressin for type 1 hepatorenal syndrome. Gastroenterology. 2008 May;134(5):1360-8. doi: 10.1053/j.gastro.2008.02.014. Epub 2008 Feb 13.
Results Reference
background
PubMed Identifier
33657294
Citation
Wong F, Pappas SC, Curry MP, Reddy KR, Rubin RA, Porayko MK, Gonzalez SA, Mumtaz K, Lim N, Simonetto DA, Sharma P, Sanyal AJ, Mayo MJ, Frederick RT, Escalante S, Jamil K; CONFIRM Study Investigators. Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome. N Engl J Med. 2021 Mar 4;384(9):818-828. doi: 10.1056/NEJMoa2008290.
Results Reference
background
PubMed Identifier
26524479
Citation
Vasudevan A, Ardalan Z, Gow P, Angus P, Testro A. Efficacy of outpatient continuous terlipressin infusions for hepatorenal syndrome. Hepatology. 2016 Jul;64(1):316-8. doi: 10.1002/hep.28325. Epub 2015 Dec 22. No abstract available.
Results Reference
background
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A Study of OCE-205 in Participants With Cirrhosis With Ascites Who Developed Hepatorenal Syndrome-Acute Kidney Injury
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