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Study of Efficacy and Safety of GNR-060 vs Metalyse in Patients With ST Elevation Myocardial Infarction

Primary Purpose

ST Elevation Myocardial Infarction

Status
Recruiting
Phase
Phase 3
Locations
Russian Federation
Study Type
Interventional
Intervention
GNR-060
Metalyse
Sponsored by
AO GENERIUM
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for ST Elevation Myocardial Infarction focused on measuring Myocardial Infarction, ST Elevation, ECG, STEMI, Myocardial Ischemia, Coronary Thrombosis, Thrombolysis, Thrombolytic, Thrombolytic therapy, Fibrinolytic therapy, Fibrinolysis, Bleeding, Hemorrhagic syndrome, Haemorrhage, Hemorrhagic stroke, Coronary angiography, Revascularization, Reperfusion, Tenecteplase, Metalyse, Metalise, TNK-tPA, Fibrin-specific plasminogen activator, Recombinant DNA technology, AMI

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Myocardial infarction with elevation of the ST segment of the ECG (at point J) in 2 adjacent leads after no more than 6 hours from the onset of pain (lasting at least 20 minutes) in the chest (at the time of screening): ≥ 2.5 mm in male ˂ 40 years, ≥ 2 mm in male ≥ 40 years, or ≥ 1.5 mm in female in leads V2-V3 and/or ≥ 1 mm in other leads in the absence of left ventricular hypertrophy or left bundle branch block. Exclusion Criteria: Diseases accompanied by significant bleeding, currently or within the last 6 months, hemorrhagic diathesis. Current oral anticoagulant therapy with INR > 1.3. Diseases of the central nervous system at present or in history (neoplasm, aneurysm, surgery on the brain or spinal cord). Severe uncontrolled arterial hypertension. Major surgical interventions, biopsy of a parenchymal organ or significant trauma within the last 2 months (including trauma in combination with AMI at the present time), recent (within the last 3 months) traumatic brain injury. Prolonged or traumatic cardiopulmonary resuscitation (> 2 minutes) within the last 2 weeks. Severe liver dysfunction, including liver failure, cirrhosis, portal hypertension (including esophageal varicose veins), active hepatitis. Peptic ulcer of the stomach or duodenum in the acute stage. Chronic kidney disease or other significant kidney disease with a decrease in glomerular filtration rate ≤30 ml / min / 1.73 m2. Arterial aneurysm or presence of arterial/venous vascular malformation. Neoplasm with an increased risk of bleeding. Acute pericarditis and/or subacute bacterial endocarditis. Acute pancreatitis. Hypersensitivity to the active substance (tenecteplase), gentamicin (residual traces of the manufacturing process) or any excipient. Hemorrhagic stroke or stroke of unknown etiology at present or in history. Intracranial (including subarachnoid) hemorrhage at present or in history. Ischemic stroke or transient ischemic attack (TIA) within the last 6 months. Recent bleeding from the gastrointestinal or genitourinary tract or childbirth (within the last 10 days). A recent (before 24 hours) puncture of an incompressible blood vessel (eg, subclavian or jugular vein). Congenital and hereditary hemorrhagic coagulopathy (hemophilia, etc.) in history. Pregnancy or breastfeeding. Body mass index (BMI) less than 18.5 or more than 40 kg/m2. Participation in another clinical trial currently or within 30 days prior to screening; use of any investigational drug within 30 days or 5 half-lives prior to screening.

Sites / Locations

  • Regional State Budgetary Health Institution "Regional Clinical Emergency Hospital"
  • Regional State Budgetary Institution of Health Care "Altai Territorial Cardiology Dispensary"Recruiting
  • State Budgetary Institution of Health Care of the Arkhangelsk Region "First City Clinical Hospital named after E.E. Volosevich"Recruiting
  • Regional State Budgetary Health Institution "Belgorod Regional Clinical Hospital of St. Joasaph"Recruiting
  • State Autonomous Healthcare Institution of the Perm Territory "City Clinical Hospital No. 4"Recruiting
  • State Autonomous Healthcare Institution "Interregional Clinical and Diagnostic Center"
  • Municipal budgetary health care institution "City emergency hospital of the city of Rostov-on-Don"Recruiting
  • State Budgetary Institution of the Ryazan Region "Regional Clinical Hospital"
  • State budgetary health care institution of the Sverdlovsk region "Scientific and practical center for specialized types of medical care" Ural Institute of Cardiology "Recruiting
  • State Health Institution "City Clinical Emergency Hospital No. 25"
  • State Budgetary Health Institution of the Yaroslavl Region "Regional Clinical Hospital"

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

GNR-060

Metalyse

Arm Description

Main group (122 patients) - GNR-060

Control group (122 patients) - Metalyse

Outcomes

Primary Outcome Measures

Frequency of the complete myocardial reperfusion based on the independent assessment of coronary angiography
TIMI Grade 3 coronary blood flow after the trombolisis

Secondary Outcome Measures

Frequency of the complete+partial myocardial reperfusion based on the independent assessment of coronary angiography
TIMI Grade 2 or 3 coronary blood flow after the trombolisis
Frequency of myocardial reperfusion based on ECG data
Resolution of the ST segment by 30%, 50%, 70% or more
Changes in troponin T and creatine kinase MB levels
90-Day mortality
Mortality within 90 days after myocardial infarction
30-Day and 90-Day cardiovascular mortality
Cardiovascular mortality up to 30 and 90 days after myocardial infarction
Frequency of the postinfarction complications
Frequency of any postifarction complication except for arrythmias
Frequency of the combined events "cardiovascular death + recurrent myocardial infarction + stroke" and "cardiovascular death + recurrent myocardial infarction + stroke + heart failure"

Full Information

First Posted
October 26, 2022
Last Updated
October 31, 2022
Sponsor
AO GENERIUM
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1. Study Identification

Unique Protocol Identification Number
NCT05601999
Brief Title
Study of Efficacy and Safety of GNR-060 vs Metalyse in Patients With ST Elevation Myocardial Infarction
Official Title
Multicenter Randomized Single Blind Study of the Clinical Efficacy and Safety of GNR-060 (JSC "GENERIUM", Russia) Compared to Metalyse (Boehringer Ingelheim Pharma GmbH & Co.KG, Germany) in Patients With ST Elevation Myocardial Infarction
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
September 3, 2021 (Actual)
Primary Completion Date
September 29, 2023 (Anticipated)
Study Completion Date
December 13, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AO GENERIUM

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
GNR-060(JSC "GENERIUM", Russia) is a proposed biosimilar to the referent product Metalyse. This study is to compare the clinical efficacy and safety of GNR-060 vs Metalyse as a thrombolitic agent in patients with with ST Elevation Myocardial Infarction (STEMI).
Detailed Description
The trial is designed as a multicenter randomized single blinded study with the centralized blinded outcome assessment. The patients with diagnosed STEMI will be randomly assigned with one of the treatment options within 4 hours after the symptoms onset. The effectiveness of the tested product GNR-060 or reference product Metalyze will be assessed by the coronarography within 24 hours after the thrombolysis with the following PCI in case of ineffectiveness. The patients will then be followed up for survival and cardiac events for 90 days. The safety assessment will also include any related hemorrhagic complication. The pharmacokinetic parameters and immunogenicity will be also assessed.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
ST Elevation Myocardial Infarction
Keywords
Myocardial Infarction, ST Elevation, ECG, STEMI, Myocardial Ischemia, Coronary Thrombosis, Thrombolysis, Thrombolytic, Thrombolytic therapy, Fibrinolytic therapy, Fibrinolysis, Bleeding, Hemorrhagic syndrome, Haemorrhage, Hemorrhagic stroke, Coronary angiography, Revascularization, Reperfusion, Tenecteplase, Metalyse, Metalise, TNK-tPA, Fibrin-specific plasminogen activator, Recombinant DNA technology, AMI

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Masking Description
Single-blinded
Allocation
Randomized
Enrollment
244 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
GNR-060
Arm Type
Experimental
Arm Description
Main group (122 patients) - GNR-060
Arm Title
Metalyse
Arm Type
Active Comparator
Arm Description
Control group (122 patients) - Metalyse
Intervention Type
Biological
Intervention Name(s)
GNR-060
Other Intervention Name(s)
Tenecteplase
Intervention Description
GNR-060 will be administered in an individual dose depending on body weight as a single intravenous bolus
Intervention Type
Biological
Intervention Name(s)
Metalyse
Other Intervention Name(s)
Tenecteplase
Intervention Description
Metalyse will be administered in an individual dose depending on body weight as a single intravenous bolus
Primary Outcome Measure Information:
Title
Frequency of the complete myocardial reperfusion based on the independent assessment of coronary angiography
Description
TIMI Grade 3 coronary blood flow after the trombolisis
Time Frame
up to 24 hours
Secondary Outcome Measure Information:
Title
Frequency of the complete+partial myocardial reperfusion based on the independent assessment of coronary angiography
Description
TIMI Grade 2 or 3 coronary blood flow after the trombolisis
Time Frame
up to 24 hours
Title
Frequency of myocardial reperfusion based on ECG data
Description
Resolution of the ST segment by 30%, 50%, 70% or more
Time Frame
after 90 minutes
Title
Changes in troponin T and creatine kinase MB levels
Time Frame
7 days
Title
90-Day mortality
Description
Mortality within 90 days after myocardial infarction
Time Frame
90 days
Title
30-Day and 90-Day cardiovascular mortality
Description
Cardiovascular mortality up to 30 and 90 days after myocardial infarction
Time Frame
30 and 90 days
Title
Frequency of the postinfarction complications
Description
Frequency of any postifarction complication except for arrythmias
Time Frame
up to 30 days
Title
Frequency of the combined events "cardiovascular death + recurrent myocardial infarction + stroke" and "cardiovascular death + recurrent myocardial infarction + stroke + heart failure"
Time Frame
30 days
Other Pre-specified Outcome Measures:
Title
Frequency and severity of hemorrhagic complications
Description
Hemorragies will be classified based on BARC, ISTH and TIMI definitions
Time Frame
up to 30 days
Title
Incidence of the hemorrhagic stroke
Description
Any case of treatment-related hemorrhagic stroke
Time Frame
up to 30 days
Title
Frequency and severity of the adverse drug reactions
Description
Any adverse events related to the trombolisis
Time Frame
up to 30 days
Title
Proportion of patients with the antidrug antibodies
Description
Anti-tenecteplaze antibody will be measured before trombolisis and 7 days after.
Time Frame
7 days

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: Myocardial infarction with elevation of the ST segment of the ECG (at point J) in 2 adjacent leads after no more than 6 hours from the onset of pain (lasting at least 20 minutes) in the chest (at the time of screening): ≥ 2.5 mm in male ˂ 40 years, ≥ 2 mm in male ≥ 40 years, or ≥ 1.5 mm in female in leads V2-V3 and/or ≥ 1 mm in other leads in the absence of left ventricular hypertrophy or left bundle branch block. Exclusion Criteria: Diseases accompanied by significant bleeding, currently or within the last 6 months, hemorrhagic diathesis. Current oral anticoagulant therapy with INR > 1.3. Diseases of the central nervous system at present or in history (neoplasm, aneurysm, surgery on the brain or spinal cord). Severe uncontrolled arterial hypertension. Major surgical interventions, biopsy of a parenchymal organ or significant trauma within the last 2 months (including trauma in combination with AMI at the present time), recent (within the last 3 months) traumatic brain injury. Prolonged or traumatic cardiopulmonary resuscitation (> 2 minutes) within the last 2 weeks. Severe liver dysfunction, including liver failure, cirrhosis, portal hypertension (including esophageal varicose veins), active hepatitis. Peptic ulcer of the stomach or duodenum in the acute stage. Chronic kidney disease or other significant kidney disease with a decrease in glomerular filtration rate ≤30 ml / min / 1.73 m2. Arterial aneurysm or presence of arterial/venous vascular malformation. Neoplasm with an increased risk of bleeding. Acute pericarditis and/or subacute bacterial endocarditis. Acute pancreatitis. Hypersensitivity to the active substance (tenecteplase), gentamicin (residual traces of the manufacturing process) or any excipient. Hemorrhagic stroke or stroke of unknown etiology at present or in history. Intracranial (including subarachnoid) hemorrhage at present or in history. Ischemic stroke or transient ischemic attack (TIA) within the last 6 months. Recent bleeding from the gastrointestinal or genitourinary tract or childbirth (within the last 10 days). A recent (before 24 hours) puncture of an incompressible blood vessel (eg, subclavian or jugular vein). Congenital and hereditary hemorrhagic coagulopathy (hemophilia, etc.) in history. Pregnancy or breastfeeding. Body mass index (BMI) less than 18.5 or more than 40 kg/m2. Participation in another clinical trial currently or within 30 days prior to screening; use of any investigational drug within 30 days or 5 half-lives prior to screening.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Rusava O. Matyushina, MD, PhD
Phone
+7 (495) 988-47-94
Ext
7109
Email
romatyushina@generium.ru
First Name & Middle Initial & Last Name or Official Title & Degree
Oksana A. Markova, MD, MSc
Phone
+7 (495) 988-47-94
Ext
7077
Email
oamarkova@generium.ru
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Oksana A. Markova, MD, MSc
Organizational Affiliation
AO GENERIUM
Official's Role
Study Chair
Facility Information:
Facility Name
Regional State Budgetary Health Institution "Regional Clinical Emergency Hospital"
City
Barnaul
State/Province
Altai Territory
ZIP/Postal Code
656038
Country
Russian Federation
Individual Site Status
Not yet recruiting
Facility Name
Regional State Budgetary Institution of Health Care "Altai Territorial Cardiology Dispensary"
City
Barnaul
State/Province
Altai Territory
ZIP/Postal Code
656055
Country
Russian Federation
Individual Site Status
Recruiting
Facility Name
State Budgetary Institution of Health Care of the Arkhangelsk Region "First City Clinical Hospital named after E.E. Volosevich"
City
Arkhangel'sk
State/Province
Arkhangelsk Region
ZIP/Postal Code
163001
Country
Russian Federation
Individual Site Status
Recruiting
Facility Name
Regional State Budgetary Health Institution "Belgorod Regional Clinical Hospital of St. Joasaph"
City
Belgorod
State/Province
Belgorod Region
ZIP/Postal Code
308007
Country
Russian Federation
Individual Site Status
Recruiting
Facility Name
State Autonomous Healthcare Institution of the Perm Territory "City Clinical Hospital No. 4"
City
Perm
State/Province
Perm Territory
ZIP/Postal Code
614107
Country
Russian Federation
Individual Site Status
Recruiting
Facility Name
State Autonomous Healthcare Institution "Interregional Clinical and Diagnostic Center"
City
Kazan
State/Province
Republic Of Tatarstan
ZIP/Postal Code
420101
Country
Russian Federation
Individual Site Status
Not yet recruiting
Facility Name
Municipal budgetary health care institution "City emergency hospital of the city of Rostov-on-Don"
City
Rostov-on-Don
State/Province
Rostov Region
ZIP/Postal Code
344068
Country
Russian Federation
Individual Site Status
Recruiting
Facility Name
State Budgetary Institution of the Ryazan Region "Regional Clinical Hospital"
City
Ryazan'
State/Province
Ryazan Region
ZIP/Postal Code
390039
Country
Russian Federation
Individual Site Status
Not yet recruiting
Facility Name
State budgetary health care institution of the Sverdlovsk region "Scientific and practical center for specialized types of medical care" Ural Institute of Cardiology "
City
Ekaterinburg
State/Province
Sverdlovsk Region
ZIP/Postal Code
620144
Country
Russian Federation
Individual Site Status
Recruiting
Facility Name
State Health Institution "City Clinical Emergency Hospital No. 25"
City
Volgograd
State/Province
Volgograd Region
ZIP/Postal Code
400138
Country
Russian Federation
Individual Site Status
Not yet recruiting
Facility Name
State Budgetary Health Institution of the Yaroslavl Region "Regional Clinical Hospital"
City
Yaroslavl
State/Province
Yaroslavl Region
ZIP/Postal Code
150062
Country
Russian Federation
Individual Site Status
Not yet recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

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Study of Efficacy and Safety of GNR-060 vs Metalyse in Patients With ST Elevation Myocardial Infarction

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