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Biorest Liposomal Alendronate With Stenting sTudy (BLAST) (BLAST)

Primary Purpose

Coronary Artery Stenosis

Status
Completed
Phase
Phase 2
Locations
Israel
Study Type
Interventional
Intervention
Liposomal Alendronate
Liposomal Alendronate
Saline infusion (placebo)
Sponsored by
BIOrest Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Stenosis focused on measuring Liposomal Alendronate, Percutaneous coronary intervention, Coronary stenting, de novo stenotic lesions, Native coronary arteries, Restenosis, Bare metal stent, Presillion CoCr coronary stent

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject is eligible for percutaneous coronary intervention .
  2. Subject is an acceptable candidate for coronary artery bypass graft surgery.
  3. Subject has stable angina pectoris
  4. Subject is a candidate for elective stenting of up to 2 lesions.

Exclusion Criteria:

General

  1. Any planned elective surgery or percutaneous intervention within 6 months post-procedure.
  2. A previous coronary interventional procedure of any kind within 30 days prior to the procedure.
  3. Subject requires a staged procedure of either the target or any non-target vessel within 9 months post-procedure.
  4. Any drug eluting stent (DES) deployment within the past 12 months.
  5. Any planned drug eluting stent (DES) deployment during the procedure associated with this study or within 3 months following the index procedure.
  6. Known hypersensitivity or contraindication to aspirin or clopidogrel or a sensitivity to contrast media, which cannot be adequately pre-medicated
  7. Concurrent medical condition with a life expectancy of less than 12 months.
  8. Documented left ventricular ejection fraction (LVEF) < 25% at the most recent evaluation.
  9. Evidence of ST elevated myocardial infarction (STEMI) or non-STEMI with troponin (cTn) levels greater than or equal to 3 times the normal limit at any time within 72 hours of the intended trial procedure.
  10. History of cerebrovascular accident or transient ischemic attack in the last 6 months.
  11. Leukopenia .
  12. Neutropenia
  13. Thrombocytopenia
  14. Serum creatinine level >2.5 mg/dl within 7 days prior to index procedure.
  15. History of bleeding diathesis or coagulopathy or inability to accept blood transfusions.
  16. Known hypersensitivity or contraindication to aspirin, heparin or bivalirudin, clopidogrel and ticlopidine, cobalt, nickel, L-605 Cobalt chromium alloy, Alendronate or sensitivity to contrast media, which cannot be adequately pre-medicated.
  17. History of severe:Gastrointestinal disease,Immunodeficiency,Bone diseases

Angiographic Exclusion Criteria

  1. Unprotected left main coronary artery disease (obstruction greater than 50% in the left main coronary artery that is not protected by at least one non-obstructed bypass graft to the LAD or Circumflex artery or a branch thereof).
  2. Any previous stent placement within 15 mm (proximal or distal) of the target lesion(s).
  3. Target vessel exhibiting lesions with greater than 60% diameter stenosis outside of a range of 5 mm proximal and distal to the target lesion(s) based on visual estimate or on-line QCA.
  4. Target lesion(s) exhibiting an intraluminal thrombus (occupying >50% of the true lumen diameter) at any time.
  5. Lesion location that is aorto-ostial or within 5 mm of the origin of the left anterior descending (LAD) or left circumflex (LCX).
  6. The target lesion(s) requires treatment with a device other than PTCA prior to stent placement (such as, but not limited to, directional coronary atherectomy, excimer laser, rotational atherectomy, etc.).
  7. Target lesion(s) with side branches > 2.0mm in diameter.
  8. Target lesion(s) involving a bifurcation (either stenosis of both main vessel and major branch or stenosis of just major branch).
  9. Target lesion(s) with severe calcification.
  10. Target vessel exhibiting excessive tortuosity that may impede stent delivery and deployment at target lesion(s).
  11. Target lesion(s) located in a native vessel distal to an anastomosis with a saphenous vein graft or a left/right internal mammary artery (LIMA/RIMA) bypass.

Sites / Locations

  • Hillel Yaffe Medical Center
  • Bnei Zion Medical Center
  • Rambam Health Care Campus
  • Lady Davis Carmel Medical Center
  • Shaare Zedek Medical Center
  • Meir Medical Center
  • Western Galilee Hospital, Nahariya
  • Rabin Medical Center
  • The Baruch Padeh Medical Center, Poriya
  • Sheba Medical Center, Tel Hashomer
  • Kaplan Medical Center
  • The Tel Aviv Sourasky Medical Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

low dose

high dose

placebo

Arm Description

Liposomal Alendronate dose of 0.001 mg

Liposomal Alendronate dose of 0.01 mg

IV saline infusion

Outcomes

Primary Outcome Measures

In-stent late loss: measured at 6 months post-procedure as determined by quantitative coronary angiography (QCA).

Secondary Outcome Measures

Major Adverse Cardiac Events (MACE)

Full Information

First Posted
August 20, 2008
Last Updated
January 17, 2016
Sponsor
BIOrest Ltd.
Collaborators
Baim Institute for Clinical Research, Cardiovascular Research Foundation, New York, Stanford University
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1. Study Identification

Unique Protocol Identification Number
NCT00739466
Brief Title
Biorest Liposomal Alendronate With Stenting sTudy (BLAST)
Acronym
BLAST
Official Title
Intravenous Liposomal Alendronate Infusion in Subjects Undergoing Bare Metal Coronary Stent Implantation
Study Type
Interventional

2. Study Status

Record Verification Date
January 2016
Overall Recruitment Status
Completed
Study Start Date
September 2008 (undefined)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
December 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BIOrest Ltd.
Collaborators
Baim Institute for Clinical Research, Cardiovascular Research Foundation, New York, Stanford University

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The main objective of this study is to assess the safety and efficacy of Liposomal Alendronate in the treatment of de novo stenotic lesions in native coronary arteries in a population undergoing PCI with implantation of a bare metal stent. Study hypothesis: Liposomal Alendronate will reduce in-stent restenosis as compared to placebo.
Detailed Description
This is a Phase II dose-finding, randomized, multi-center, prospective, double blind clinical study. Subjects undergoing percutaneous coronary intervention (PCI) with the Presillion™ CoCr bare metal stent will be randomized into three groups and administered (in a single dose intravenously (IV) through a peripheral venous catheter) either: low dose Liposomal Alendronate of 0.001 mg, high dose Liposomal Alendronate of 0.01 mg, or placebo (IV saline infusion) on a 1:1:1 basis. All subjects will undergo angiographic follow-up at 6 months and 110 subjects enrolled from pre-specified sites will undergo intravascular ultrasound (IVUS) at baseline and follow-up at 6 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Stenosis
Keywords
Liposomal Alendronate, Percutaneous coronary intervention, Coronary stenting, de novo stenotic lesions, Native coronary arteries, Restenosis, Bare metal stent, Presillion CoCr coronary stent

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
226 (Actual)

8. Arms, Groups, and Interventions

Arm Title
low dose
Arm Type
Experimental
Arm Description
Liposomal Alendronate dose of 0.001 mg
Arm Title
high dose
Arm Type
Experimental
Arm Description
Liposomal Alendronate dose of 0.01 mg
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
IV saline infusion
Intervention Type
Drug
Intervention Name(s)
Liposomal Alendronate
Other Intervention Name(s)
LA
Intervention Description
IV in a single low dose during the index procedure (coronary stent implantation) over 2 hours
Intervention Type
Drug
Intervention Name(s)
Liposomal Alendronate
Other Intervention Name(s)
LA
Intervention Description
IV in a single high dose during the index procedure (coronary stent implantation) over 2 hours
Intervention Type
Drug
Intervention Name(s)
Saline infusion (placebo)
Other Intervention Name(s)
Saline
Intervention Description
IV saline infusion during the index procedure (coronary stent implantation) over 2 hours
Primary Outcome Measure Information:
Title
In-stent late loss: measured at 6 months post-procedure as determined by quantitative coronary angiography (QCA).
Time Frame
6 months post-procedure
Secondary Outcome Measure Information:
Title
Major Adverse Cardiac Events (MACE)
Time Frame
at 30, 180 and 360 days as well as yearly through 5 years post-procedure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is eligible for percutaneous coronary intervention . Subject is an acceptable candidate for coronary artery bypass graft surgery. Subject has stable angina pectoris Subject is a candidate for elective stenting of up to 2 lesions. Exclusion Criteria: General Any planned elective surgery or percutaneous intervention within 6 months post-procedure. A previous coronary interventional procedure of any kind within 30 days prior to the procedure. Subject requires a staged procedure of either the target or any non-target vessel within 9 months post-procedure. Any drug eluting stent (DES) deployment within the past 12 months. Any planned drug eluting stent (DES) deployment during the procedure associated with this study or within 3 months following the index procedure. Known hypersensitivity or contraindication to aspirin or clopidogrel or a sensitivity to contrast media, which cannot be adequately pre-medicated Concurrent medical condition with a life expectancy of less than 12 months. Documented left ventricular ejection fraction (LVEF) < 25% at the most recent evaluation. Evidence of ST elevated myocardial infarction (STEMI) or non-STEMI with troponin (cTn) levels greater than or equal to 3 times the normal limit at any time within 72 hours of the intended trial procedure. History of cerebrovascular accident or transient ischemic attack in the last 6 months. Leukopenia . Neutropenia Thrombocytopenia Serum creatinine level >2.5 mg/dl within 7 days prior to index procedure. History of bleeding diathesis or coagulopathy or inability to accept blood transfusions. Known hypersensitivity or contraindication to aspirin, heparin or bivalirudin, clopidogrel and ticlopidine, cobalt, nickel, L-605 Cobalt chromium alloy, Alendronate or sensitivity to contrast media, which cannot be adequately pre-medicated. History of severe:Gastrointestinal disease,Immunodeficiency,Bone diseases Angiographic Exclusion Criteria Unprotected left main coronary artery disease (obstruction greater than 50% in the left main coronary artery that is not protected by at least one non-obstructed bypass graft to the LAD or Circumflex artery or a branch thereof). Any previous stent placement within 15 mm (proximal or distal) of the target lesion(s). Target vessel exhibiting lesions with greater than 60% diameter stenosis outside of a range of 5 mm proximal and distal to the target lesion(s) based on visual estimate or on-line QCA. Target lesion(s) exhibiting an intraluminal thrombus (occupying >50% of the true lumen diameter) at any time. Lesion location that is aorto-ostial or within 5 mm of the origin of the left anterior descending (LAD) or left circumflex (LCX). The target lesion(s) requires treatment with a device other than PTCA prior to stent placement (such as, but not limited to, directional coronary atherectomy, excimer laser, rotational atherectomy, etc.). Target lesion(s) with side branches > 2.0mm in diameter. Target lesion(s) involving a bifurcation (either stenosis of both main vessel and major branch or stenosis of just major branch). Target lesion(s) with severe calcification. Target vessel exhibiting excessive tortuosity that may impede stent delivery and deployment at target lesion(s). Target lesion(s) located in a native vessel distal to an anastomosis with a saphenous vein graft or a left/right internal mammary artery (LIMA/RIMA) bypass.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Prof Shmuel Banai, MD
Organizational Affiliation
The Tel Aviv Sourasky Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hillel Yaffe Medical Center
City
Hadera
ZIP/Postal Code
38100
Country
Israel
Facility Name
Bnei Zion Medical Center
City
Haifa
ZIP/Postal Code
31048
Country
Israel
Facility Name
Rambam Health Care Campus
City
Haifa
ZIP/Postal Code
31096
Country
Israel
Facility Name
Lady Davis Carmel Medical Center
City
Haifa
ZIP/Postal Code
34362
Country
Israel
Facility Name
Shaare Zedek Medical Center
City
Jerusalem
ZIP/Postal Code
91031
Country
Israel
Facility Name
Meir Medical Center
City
Kfar Saba
ZIP/Postal Code
44281
Country
Israel
Facility Name
Western Galilee Hospital, Nahariya
City
Nahariya
ZIP/Postal Code
22100
Country
Israel
Facility Name
Rabin Medical Center
City
Petah Tikva
ZIP/Postal Code
49100
Country
Israel
Facility Name
The Baruch Padeh Medical Center, Poriya
City
Poriya
ZIP/Postal Code
15218
Country
Israel
Facility Name
Sheba Medical Center, Tel Hashomer
City
Ramat Gan
ZIP/Postal Code
52521
Country
Israel
Facility Name
Kaplan Medical Center
City
Rehovot
ZIP/Postal Code
76100
Country
Israel
Facility Name
The Tel Aviv Sourasky Medical Center
City
Tel Aviv
ZIP/Postal Code
64239
Country
Israel

12. IPD Sharing Statement

Citations:
PubMed Identifier
23351827
Citation
Banai S, Finkelstein A, Almagor Y, Assali A, Hasin Y, Rosenschein U, Apruzzese P, Lansky AJ, Kume T, Edelman ER. Targeted anti-inflammatory systemic therapy for restenosis: the Biorest Liposomal Alendronate with Stenting sTudy (BLAST)-a double blind, randomized clinical trial. Am Heart J. 2013 Feb;165(2):234-40.e1. doi: 10.1016/j.ahj.2012.10.023. Epub 2012 Dec 11.
Results Reference
derived

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Biorest Liposomal Alendronate With Stenting sTudy (BLAST)

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