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A Study to Explore the Renal Safety of Visipaque Injection 320 mgI/mL in Patients With Chronic Kidney Disease

Primary Purpose

Chronic Kidney Diseases

Status
Terminated
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Visipaque
Placebos
Sponsored by
GE Healthcare
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Chronic Kidney Diseases focused on measuring Acute kidney injury (AKI), Acute kidney injury network (AKIN), Chronic kidney disease (CKD), Contrast-enhanced computed tomography (CECT), Endovascular Aneurysm Repair (EVAR), Iodixanol, Non-enhanced computed tomography (NECT), Serum creatinine (SCr)

Eligibility Criteria

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

Inclusion Criteria:

  • Was ≥18 years of age at the time that written informed consent is obtained.
  • Was male or is a nonpregnant, nonlactating female who is either surgically sterile or is postmenopausal. Women of childbearing potential must use adequate contraception from Screening until 30 days after the Baseline Visit and must have a negative pregnancy test at the Baseline Visit.
  • Was an outpatient who has undergone successful EVAR and is scheduled for his/her next post-procedural imaging follow-up examination.
  • Had previously completed one or more of his or her post-EVAR surveillance imaging examination(s) that provided evidence on stable post-EVAR status.
  • Had a documented diagnosis of stage III or IV CKD and stable renal function.
  • Was able to provide written informed consent.
  • Was able and willing to comply with all study procedures as described in the protocol.

Exclusion Criteria:

  • Was pregnant, lactating, is possibly pregnant, or is actively trying to conceive during the study period.
  • Was a patient for whom an endoleak or other clinically meaningful EVAR-related complication (as judged by the investigator) has already been discovered.
  • Was undergoing surveillance following a Thoracic Endovascular Repair (TEVAR).
  • Had a known or suspected history of immediate or delayed hypersensitivity to iodine or any iodinated contrast medium.
  • Was using metformin (e.g., Glucophage®) that cannot be discontinued for the period of 24 hours prior to the Baseline Visit and for at least 48 hours after the imaging procedure.
  • Had been exposed to any intravascular iodinated contrast medium in the 7 days prior to the Baseline Visit.
  • Had congestive heart failure (New York Heart Association [NYHA] Class IV) or hepatic failure/liver cirrhosis.
  • Had Stage V CKD.
  • Had a pre-existing requirement for renal dialysis.
  • Had undergone percutaneous transluminal renal angioplasty (PTRA) within 12 months before the index EVAR procedure or is scheduled to undergo PTRA during the study period.
  • Had any clinically active, serious, life-threatening disease, medical, or significant psychiatric condition; has a life expectancy of less than 6 months; or is, in the Investigator's opinion, unsuitable for participation in the study for any reason.
  • Had been enrolled in another clinical study within the 30 days prior to the Screening Visit or is planned to enroll in another clinical study within the duration of this study.
  • Had been previously enrolled in this study.
  • Was using i.v. vasopressor or inotropic medications.
  • Had used nonsteroidal anti-inflammatory drugs (NSAIDs) or any nephrotoxic medication within 48 hours of the Baseline Visit or will do so within 72 hours after the CT procedure-with the exception of acetylsalicylic acid (Aspirin) at a dose of ≤100 mg daily (QD).
  • Had been hospitalized within 30 days prior to Screening Visit for any reason other than practical purposes for management of tests or diagnostic assessments.

Sites / Locations

  • University Hospital
  • : Aventiv Research Inc.
  • Central Arkansas Veteran's Healthcare System
  • Alliance Research Centers
  • Universal Axon Clinical Research, LLC
  • Jacksonville Center for Clinical Research
  • University of South Florida - South Tampa Campus
  • University of Iowa Hospitals and Clinics
  • Norton Hospital
  • Boston University Medical Center/Boston Medical Center
  • The Duluth Clinic, Ltd.
  • Mount Sinai West
  • University of North Carolina at Chapel Hill Clinical Translational Research Center
  • Wake Forest Baptist Health
  • Rhode Island Hospital
  • UT Southwestern Medical Center
  • University of Vermont Medical Center
  • UZ Leuven
  • CRCHUM- CHUM Research Center
  • St. Boniface General Hospital
  • Oddzial Chirurgii Naczyniowej i Ogolnej, Wojewodzki Szpital Specjalistyczny Nr 4 w Bytomiu
  • Klinika Kardiochirurgii i Chirurgii Naczyniowej, Uniwersyteckie Centrum Kliniczne
  • Klinika Chirurgii Naczyniowej i Angiologii, Samodzielny Publiczny Szpital Kliniczny nr 1
  • Oddzial Chirurgii Ogolnej i Naczyn, Szpital Kliniczny Przemienienia Panskiego Uniwersytetu Medycznego
  • Hospital Clinic de Barcelona
  • Hospital Universitario Puerta del Mar
  • Hospital Universitario Son Espases
  • St. George's Healthcare NHS Trust, St. George's Hospital
  • Royal Stoke University Hospital, Radiology Department

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Visipaque™: Contrast-Enhanced Computed Tomography (CECT)

Saline: Non-Enhanced Computed Tomography (NECT)

Arm Description

Participants received 1 intravenous injection of Visipaque™ 320 mg I/ml injection (100 mL iodixanol) and underwent computed tomography (CT) examination.

Participants received 1 intravenous injection of saline placebo (matched to Visipaque™ 320 mg I/ml injection) and underwent computed tomography (CT) examination and supplemental non-contrast duplex ultrasonography imaging examination.

Outcomes

Primary Outcome Measures

Assessment of the Incidence of Acute Kidney Injury (AKI) Stage >=1 Per Acute Kidney Injury Network (AKIN) Serum Creatinine (SCr) Criteria
AKIN Serum Creatinine Criteria for AKI- Stage 1: a SCr increase of >=0.3 mg/dL (>=26.4 μmol/L) or increase to >=150% to 200% (>=1.5- to 2.0-fold) from baseline within 48 hours. Stage 2: a SCr increase to >200% to 300% (>2.0- to 3-fold) from baseline within 48 hours. Stage 3: a SCr increase to >300% (>3.0-fold) from baseline or SCr >=4.0 mg/dL (>=354 μmol/L) with an acute increase of >=0.5 mg/dL (>=44 μmol/L) within 48 hours.

Secondary Outcome Measures

Assessment of the Incidence of Acute Kidney Injury (AKI) Stage >=2 Per Acute Kidney Injury Network (AKIN) Serum Creatinine (SCr) Criteria
AKIN Serum Creatinine Criteria for AKI- Stage 1: a SCr increase of >=0.3 mg/dL (>=26.4 μmol/L) or increase to >=150% to 200% (>=1.5- to 2.0-fold) from baseline within 48 hours. Stage 2: a SCr increase to >200% to 300% (>2.0- to 3-fold) from baseline within 48 hours. Stage 3: a SCr increase to >300% (>3.0-fold) from baseline or SCr >=4.0 mg/dL (>=354 μmol/L) with an acute increase of >=0.5 mg/dL (>=44 μmol/L) within 48 hours.
Assessment of the Incidence of Acute Kidney Injury (AKI) by Contrast Induced Nephropathy (CIN)
Standard definition of CIN: Increase in SCr of 0.5 mg/dL or more in the 24 to 72 hours after the CT scan.
Assessment of the Incidence of Acute Kidney Injury (AKI) Stage >=2 By Waikar Criteria
Waikar's definitions of AKI: Stage 1: 0.3 mg/dL increase in SCr over 24 hours or a 0.5 mg/dL increase in SCr over 48 hours. Stage 2: 0.5 mg/dL increase in SCr over 24 hours or a 1.0 mg/dL increase in SCr over 48 hours. Stage 3: 1.0 mg/dL increase in SCr over 24 hours or a 1.5 mg/dL increase in SCr over 48 hours.
All Cause Mortality and Morbidity
Mortality (all cause death) and morbidity i.e. critical events.
Blinded Independent Assessment of Image Quality/Diagnostic Confidence Using a 5-Point Scale
Blinded independent assessment of image quality/diagnostic confidence using a 5-point scale. Image quality/diagnostic confidence for all imaging studies was rated on a 5-point scale from 1 (poor) to 5 (excellent).

Full Information

First Posted
March 21, 2017
Last Updated
November 28, 2019
Sponsor
GE Healthcare
Collaborators
Syneos Health
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1. Study Identification

Unique Protocol Identification Number
NCT03119662
Brief Title
A Study to Explore the Renal Safety of Visipaque Injection 320 mgI/mL in Patients With Chronic Kidney Disease
Official Title
Parallel-Group, Placebo-Controlled Randomized Study Investigating the Effect of Intravenous Iso-osmolar Iodinated Contrast Material Iodixanol (Visipaque™ Injection 320 mgI/mL) on Renal Function in Adults With Chronic Kidney Disease (CKD) Stage III or Stage IV Who Have Undergone Endovascular Aneurysm Repair (EVAR)
Study Type
Interventional

2. Study Status

Record Verification Date
November 2019
Overall Recruitment Status
Terminated
Why Stopped
The trial was discontinued due to a lower than anticipated recruitment rate. The decision has not been made due to any safety reasons.
Study Start Date
February 8, 2018 (Actual)
Primary Completion Date
September 13, 2018 (Actual)
Study Completion Date
October 19, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GE Healthcare
Collaborators
Syneos Health

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
This parallel-group, randomized, placebo-controlled study will examine the incidence and severity of acute kidney injury (AKI) in patients with chronic kidney disease (CKD) stage III/IV following an i.v. injection of iso-osmolar iodinated contrast material iodixanol (Visipaque™ Injection 320 mgI/mL), as compared with patients who received saline and underwent a non-enhanced CT (NECT) and duplex ultrasound (US) during their scheduled post-EVAR surveillance imaging.
Detailed Description
GEHC has decided not to provide this detail

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Kidney Diseases
Keywords
Acute kidney injury (AKI), Acute kidney injury network (AKIN), Chronic kidney disease (CKD), Contrast-enhanced computed tomography (CECT), Endovascular Aneurysm Repair (EVAR), Iodixanol, Non-enhanced computed tomography (NECT), Serum creatinine (SCr)

7. Study Design

Primary Purpose
Other
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Visipaque™: Contrast-Enhanced Computed Tomography (CECT)
Arm Type
Experimental
Arm Description
Participants received 1 intravenous injection of Visipaque™ 320 mg I/ml injection (100 mL iodixanol) and underwent computed tomography (CT) examination.
Arm Title
Saline: Non-Enhanced Computed Tomography (NECT)
Arm Type
Placebo Comparator
Arm Description
Participants received 1 intravenous injection of saline placebo (matched to Visipaque™ 320 mg I/ml injection) and underwent computed tomography (CT) examination and supplemental non-contrast duplex ultrasonography imaging examination.
Intervention Type
Drug
Intervention Name(s)
Visipaque
Intervention Description
100 mL iodixanol (Visipaque Injection 320 mg I/mL), followed by a 10 mL saline flush to ensure delivery of the full dose of Visipaque.
Intervention Type
Drug
Intervention Name(s)
Placebos
Intervention Description
100 mL saline, followed by a 10 mL saline flush.
Primary Outcome Measure Information:
Title
Assessment of the Incidence of Acute Kidney Injury (AKI) Stage >=1 Per Acute Kidney Injury Network (AKIN) Serum Creatinine (SCr) Criteria
Description
AKIN Serum Creatinine Criteria for AKI- Stage 1: a SCr increase of >=0.3 mg/dL (>=26.4 μmol/L) or increase to >=150% to 200% (>=1.5- to 2.0-fold) from baseline within 48 hours. Stage 2: a SCr increase to >200% to 300% (>2.0- to 3-fold) from baseline within 48 hours. Stage 3: a SCr increase to >300% (>3.0-fold) from baseline or SCr >=4.0 mg/dL (>=354 μmol/L) with an acute increase of >=0.5 mg/dL (>=44 μmol/L) within 48 hours.
Time Frame
48 hours post-baseline (Follow-up 1)
Secondary Outcome Measure Information:
Title
Assessment of the Incidence of Acute Kidney Injury (AKI) Stage >=2 Per Acute Kidney Injury Network (AKIN) Serum Creatinine (SCr) Criteria
Description
AKIN Serum Creatinine Criteria for AKI- Stage 1: a SCr increase of >=0.3 mg/dL (>=26.4 μmol/L) or increase to >=150% to 200% (>=1.5- to 2.0-fold) from baseline within 48 hours. Stage 2: a SCr increase to >200% to 300% (>2.0- to 3-fold) from baseline within 48 hours. Stage 3: a SCr increase to >300% (>3.0-fold) from baseline or SCr >=4.0 mg/dL (>=354 μmol/L) with an acute increase of >=0.5 mg/dL (>=44 μmol/L) within 48 hours.
Time Frame
48 hours post-baseline (Follow-up 1)
Title
Assessment of the Incidence of Acute Kidney Injury (AKI) by Contrast Induced Nephropathy (CIN)
Description
Standard definition of CIN: Increase in SCr of 0.5 mg/dL or more in the 24 to 72 hours after the CT scan.
Time Frame
48 hours post-baseline (Follow-up 1)
Title
Assessment of the Incidence of Acute Kidney Injury (AKI) Stage >=2 By Waikar Criteria
Description
Waikar's definitions of AKI: Stage 1: 0.3 mg/dL increase in SCr over 24 hours or a 0.5 mg/dL increase in SCr over 48 hours. Stage 2: 0.5 mg/dL increase in SCr over 24 hours or a 1.0 mg/dL increase in SCr over 48 hours. Stage 3: 1.0 mg/dL increase in SCr over 24 hours or a 1.5 mg/dL increase in SCr over 48 hours.
Time Frame
48 hours post-baseline (Follow-up 1)
Title
All Cause Mortality and Morbidity
Description
Mortality (all cause death) and morbidity i.e. critical events.
Time Frame
From Baseline to Month 6
Title
Blinded Independent Assessment of Image Quality/Diagnostic Confidence Using a 5-Point Scale
Description
Blinded independent assessment of image quality/diagnostic confidence using a 5-point scale. Image quality/diagnostic confidence for all imaging studies was rated on a 5-point scale from 1 (poor) to 5 (excellent).
Time Frame
Month 6

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Was ≥18 years of age at the time that written informed consent is obtained. Was male or is a nonpregnant, nonlactating female who is either surgically sterile or is postmenopausal. Women of childbearing potential must use adequate contraception from Screening until 30 days after the Baseline Visit and must have a negative pregnancy test at the Baseline Visit. Was an outpatient who has undergone successful EVAR and is scheduled for his/her next post-procedural imaging follow-up examination. Had previously completed one or more of his or her post-EVAR surveillance imaging examination(s) that provided evidence on stable post-EVAR status. Had a documented diagnosis of stage III or IV CKD and stable renal function. Was able to provide written informed consent. Was able and willing to comply with all study procedures as described in the protocol. Exclusion Criteria: Was pregnant, lactating, is possibly pregnant, or is actively trying to conceive during the study period. Was a patient for whom an endoleak or other clinically meaningful EVAR-related complication (as judged by the investigator) has already been discovered. Was undergoing surveillance following a Thoracic Endovascular Repair (TEVAR). Had a known or suspected history of immediate or delayed hypersensitivity to iodine or any iodinated contrast medium. Was using metformin (e.g., Glucophage®) that cannot be discontinued for the period of 24 hours prior to the Baseline Visit and for at least 48 hours after the imaging procedure. Had been exposed to any intravascular iodinated contrast medium in the 7 days prior to the Baseline Visit. Had congestive heart failure (New York Heart Association [NYHA] Class IV) or hepatic failure/liver cirrhosis. Had Stage V CKD. Had a pre-existing requirement for renal dialysis. Had undergone percutaneous transluminal renal angioplasty (PTRA) within 12 months before the index EVAR procedure or is scheduled to undergo PTRA during the study period. Had any clinically active, serious, life-threatening disease, medical, or significant psychiatric condition; has a life expectancy of less than 6 months; or is, in the Investigator's opinion, unsuitable for participation in the study for any reason. Had been enrolled in another clinical study within the 30 days prior to the Screening Visit or is planned to enroll in another clinical study within the duration of this study. Had been previously enrolled in this study. Was using i.v. vasopressor or inotropic medications. Had used nonsteroidal anti-inflammatory drugs (NSAIDs) or any nephrotoxic medication within 48 hours of the Baseline Visit or will do so within 72 hours after the CT procedure-with the exception of acetylsalicylic acid (Aspirin) at a dose of ≤100 mg daily (QD). Had been hospitalized within 30 days prior to Screening Visit for any reason other than practical purposes for management of tests or diagnostic assessments.
Facility Information:
Facility Name
University Hospital
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
Facility Name
: Aventiv Research Inc.
City
Mesa
State/Province
Arizona
ZIP/Postal Code
85210
Country
United States
Facility Name
Central Arkansas Veteran's Healthcare System
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72205
Country
United States
Facility Name
Alliance Research Centers
City
Laguna Hills
State/Province
California
ZIP/Postal Code
92653
Country
United States
Facility Name
Universal Axon Clinical Research, LLC
City
Doral
State/Province
Florida
ZIP/Postal Code
33166
Country
United States
Facility Name
Jacksonville Center for Clinical Research
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32216
Country
United States
Facility Name
University of South Florida - South Tampa Campus
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
University of Iowa Hospitals and Clinics
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
Norton Hospital
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
Boston University Medical Center/Boston Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02118
Country
United States
Facility Name
The Duluth Clinic, Ltd.
City
Duluth
State/Province
Minnesota
ZIP/Postal Code
55805
Country
United States
Facility Name
Mount Sinai West
City
New York
State/Province
New York
ZIP/Postal Code
10019
Country
United States
Facility Name
University of North Carolina at Chapel Hill Clinical Translational Research Center
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Wake Forest Baptist Health
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
Rhode Island Hospital
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02903
Country
United States
Facility Name
UT Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
University of Vermont Medical Center
City
Burlington
State/Province
Vermont
ZIP/Postal Code
05401
Country
United States
Facility Name
UZ Leuven
City
Leuven
ZIP/Postal Code
3000
Country
Belgium
Facility Name
CRCHUM- CHUM Research Center
City
Montreal
ZIP/Postal Code
H2X 0A9
Country
Canada
Facility Name
St. Boniface General Hospital
City
Winnipeg
ZIP/Postal Code
R2H 2A6
Country
Canada
Facility Name
Oddzial Chirurgii Naczyniowej i Ogolnej, Wojewodzki Szpital Specjalistyczny Nr 4 w Bytomiu
City
Bytom
ZIP/Postal Code
41-902
Country
Poland
Facility Name
Klinika Kardiochirurgii i Chirurgii Naczyniowej, Uniwersyteckie Centrum Kliniczne
City
Gdansk
ZIP/Postal Code
80-952
Country
Poland
Facility Name
Klinika Chirurgii Naczyniowej i Angiologii, Samodzielny Publiczny Szpital Kliniczny nr 1
City
Lublin
ZIP/Postal Code
20-081
Country
Poland
Facility Name
Oddzial Chirurgii Ogolnej i Naczyn, Szpital Kliniczny Przemienienia Panskiego Uniwersytetu Medycznego
City
Poznan
ZIP/Postal Code
61-848
Country
Poland
Facility Name
Hospital Clinic de Barcelona
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Facility Name
Hospital Universitario Puerta del Mar
City
Cadiz
ZIP/Postal Code
11009
Country
Spain
Facility Name
Hospital Universitario Son Espases
City
Palma
ZIP/Postal Code
07120
Country
Spain
Facility Name
St. George's Healthcare NHS Trust, St. George's Hospital
City
London
ZIP/Postal Code
SW17 0QT
Country
United Kingdom
Facility Name
Royal Stoke University Hospital, Radiology Department
City
Stoke on Trent
ZIP/Postal Code
ST4 6QG
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
29751980
Citation
Solomon R. PRESERVE: The End or the Beginning of a New Era in Prevention of Contrast-Associated Acute Kidney Injury? Am J Kidney Dis. 2018 Sep;72(3):322-324. doi: 10.1053/j.ajkd.2018.03.013. Epub 2018 May 8. No abstract available.
Results Reference
derived

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A Study to Explore the Renal Safety of Visipaque Injection 320 mgI/mL in Patients With Chronic Kidney Disease

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