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Evaluation of Safety & Efficacy of BIO-11006 Inhalation Solution in Patients With ARDS

Primary Purpose

Respiratory Distress Syndrome, Adult

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
BIO-11006
Placebo
Sponsored by
BioMarck Pharmaceuticals, Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Respiratory Distress Syndrome, Adult focused on measuring intubation, aerosol, sepsis, edema

Eligibility Criteria

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

Inclusion Criteria:

  1. Has provided (or relative has) written informed consent and authorization for use and disclosure of protected health information
  2. Has a clinical diagnosis of sepsis or septic shock defined as:

    • Known or suspected infection
    • Systemic inflammatory response syndrome (SIRS), defined as meeting at least 2 of the following 3 criteria for a systemic inflammatory response:

      • White blood cell count >12,000 or <4,000 or >10% band forms
      • Body temperature >38°C (any route) or <36°C (by core temperatures only: indwelling catheter, esophageal, rectal)
      • Heart rate >90 beats/min or receiving medications that slow heart rate or pace rhythm
  3. Enrollment must occur within 48 hours of first meeting ARDS criteria per the Berlin definition of ARDS (ARDS Task Force 2012) and no more than 72 hours from the initiation of mechanical ventilation. (The bilateral opacities, respiratory failure, and decreased P/F ratio must all be present within a 24 hour time period of one another.):

    • Lung injury of acute onset, within 1 week of an apparent clinical insult, with progression of respiratory symptoms
    • Bilateral opacities on chest imaging not fully explained by effusions, lobar/lung collapse, or nodules.
    • Respiratory failure not fully explained by cardiac failure or fluid overload. (Need objective assessment (e.g. echocardiography) to exclude hydrostatic edema if no risk factor present.)
    • Decreased arterial partial pressure of oxygen (PaO2)/ fraction of inspired oxygen (FIO2) ratio while on a minimum Positive End Expiratory Pressure (PEEP) of 5 cm water (H2O):

      • Moderate ARDS: 101 to 200 mmHg (≤ 26.6 kPa)
      • Severe ARDS: ≤ 100 mmHg (≤ 13.3 kPa)

Exclusion Criteria:

  1. Age < 18 years or >75 years old
  2. Greater than 48 hours since first meeting ARDS criteria per the Berlin definition of ARDS
  3. Pregnant or breastfeeding (negative pregnancy test required prior to randomization for female patients of childbearing potential.)
  4. Prisoner
  5. Any other irreversible disease or condition for which 6 month mortality is estimated to be > 50%
  6. Moderate to severe liver failure (Child Pugh Score > 12)
  7. Severe chronic respiratory disease with a PaCO2 > 50 mmHg or the use of home oxygen
  8. Patient, surrogate, or physician not committed to full support (exception: a patient will not be excluded if he/she would receive all supportive care except for attempts at resuscitation from cardiac arrest).
  9. Major trauma in the prior 5 days
  10. Lung transplant patient
  11. No consent/inability to obtain consent
  12. Moribund patient not expected to survive 24 hours
  13. World Health Organization (WHO) Functional Class III or IV pulmonary hypertension
  14. No intent/unwillingness to follow lung protective ventilation strategy or fluid management protocol
  15. Currently receiving extracorporeal life support or high frequency oscillatory ventilation
  16. Known hypersensitivity to BIO 11006
  17. Burn victims >20% Total Body Surface Area (TBSA) or with known airway inhalation injury

Sites / Locations

  • University of Chicago Medicine
  • University of North Carolina School of Medicine
  • Wake Forest University
  • University of Pennsylvania
  • Vanderbilt University, Div of Allergy, Pulmonary, Critical Care

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Active intervention

Placebo intervention

Arm Description

Patients will be randomized in a 1:1 ratio to either aerosolized BIO-11006 (125mg in 3mL half normal saline) intervention twice daily plus ventilation for up to 28 days or placebo.

Patients will be randomized in a 1:1 ratio to either aerosolized placebo (3mL half normal saline) intervention twice daily plus ventilation for up to 28 days or active drug.

Outcomes

Primary Outcome Measures

Incidence of treatment-emergent adverse events
Assessment of frequency, type, severity, and duration of treatment-emergent Adverse Events (AE) daily during 28 day treatment period, including clinically significant laboratory abnormalities

Secondary Outcome Measures

Incidence of mortality
Mortality will be assessed daily during treatment for 28 days and at day 180 after enrollment.
Number of Intensive Care Unit (ICU)-free days
Number of days not in the ICU assessed daily during the 28 day treatment period.
Number of ventilator-free days
Number of days off the ventilator assessed daily during 28 day treatment
Change in oxygen saturation / fraction of inspired oxygen (S/F) ratio
Change in theS/F ratio assessed daily during the 28 day treatment period
Change in pro-inflammatory biomarkers from baseline to end of treatment
ARDS associated biomarkers will be measured in plasma

Full Information

First Posted
June 20, 2017
Last Updated
June 23, 2020
Sponsor
BioMarck Pharmaceuticals, Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03202394
Brief Title
Evaluation of Safety & Efficacy of BIO-11006 Inhalation Solution in Patients With ARDS
Official Title
A Phase IIa, Placebo Controlled, Multicenter Pilot Study to Evaluate the Safety and Efficacy of BIO-11006 Inhalation Solution in Patients With Acute Respiratory Distress Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
June 2020
Overall Recruitment Status
Completed
Study Start Date
August 5, 2017 (Actual)
Primary Completion Date
March 30, 2020 (Actual)
Study Completion Date
June 15, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioMarck Pharmaceuticals, Ltd.

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 Phase IIa pilot study is a placebo controlled, multicenter study to evaluate safety and efficacy of aerosolized BIO-11006 Inhalation Solution in ARDS patients. The subjects will be randomized 1:1 to either BIO-11006 125 mg twice daily plus standard of care or placebo plus standard of care. The treatment will continue for up to 28 days. The study will enroll up to 40 adult ARDS patients in up to eight sites within USA.
Detailed Description
This is a randomized, double blind, placebo controlled, parallel-group Phase IIa pilot study of aerosolized BIO 11006 in patients with sepsis-induced acute respiratory distress syndrome (ARDS). All patients enrolled in the study will be ventilated. To be eligible for enrollment, patients must be adults who have sepsis-induced ARDS within 48 hours prior to enrollment, require intubation, and exhibit bilateral infiltrates consistent with pulmonary edema on the frontal chest radiograph within 48 hours of enrollment. Patients will be randomized in a 1:1 ratio to either BIO-11006 125 mg twice daily (BID) plus standard of care ventilation or placebo (half normal saline [HNS]) BID plus standard of care ventilation. Patients randomized to receive BIO-11006 or placebo will start dosing at the time of ventilation and continue for up to 28 days or length of ventilation (if shorter). Patients in both groups will receive best available standard of care treatment, including low-volume mechanical ventilation as indicated by clinical judgment and patient response. The maximum duration of treatment will be 30 days. The primary objective of this study is to evaluate the safety and efficacy of aerosolized BIO-11006 at a dose of 125 mg BID in ventilated patients who have ARDS. Safety is the primary endpoint in this study and will be monitored by adverse event reporting, oxygenation, mortality, vital signs, ventilator-free days, and ICU-free days. This study will enroll up to 40 adult patients with ARDS induced by sepsis who first met the Berlin Criteria for ARDS within 48 hours of enrollment, and who require intubation and exhibit bilateral opacities consistent with pulmonary edema on frontal chest radiograph within 48 hours of enrollment. BIO 11006 Inhalation Solution drug product is formulated at a dosage strength of 41.67 mg/mL (125 mg/3 mL) as an aqueous solution containing sodium chloride and is intended for aerosol administration by the "Aeroneb Pro®" nebulizer to patients randomized to active treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Respiratory Distress Syndrome, Adult
Keywords
intubation, aerosol, sepsis, edema

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Patients will be randomized in a 1:1 ratio to either BIO 11006 125 mg twice daily (intervention) plus standard of care ventilation or placebo BID plus standard of care ventilation. Patients randomized to receive BIO 11006 or placebo will start dosing at the time of ventilation and continue for up to 30 days or length of ventilation (if shorter).
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
38 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Active intervention
Arm Type
Active Comparator
Arm Description
Patients will be randomized in a 1:1 ratio to either aerosolized BIO-11006 (125mg in 3mL half normal saline) intervention twice daily plus ventilation for up to 28 days or placebo.
Arm Title
Placebo intervention
Arm Type
Placebo Comparator
Arm Description
Patients will be randomized in a 1:1 ratio to either aerosolized placebo (3mL half normal saline) intervention twice daily plus ventilation for up to 28 days or active drug.
Intervention Type
Drug
Intervention Name(s)
BIO-11006
Intervention Description
Intervention involves aerosolized delivery of either the active drug or placebo by the "Aeroneb Pro nebulizer".
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Half Normal saline
Intervention Description
Intervention involves aerosolized delivery of either the active drug or placebo by the "Aeroneb Pro nebulizer".
Primary Outcome Measure Information:
Title
Incidence of treatment-emergent adverse events
Description
Assessment of frequency, type, severity, and duration of treatment-emergent Adverse Events (AE) daily during 28 day treatment period, including clinically significant laboratory abnormalities
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Incidence of mortality
Description
Mortality will be assessed daily during treatment for 28 days and at day 180 after enrollment.
Time Frame
End of treatment period (28 days) and end of follow up period (180 days)
Title
Number of Intensive Care Unit (ICU)-free days
Description
Number of days not in the ICU assessed daily during the 28 day treatment period.
Time Frame
28 days
Title
Number of ventilator-free days
Description
Number of days off the ventilator assessed daily during 28 day treatment
Time Frame
28 days
Title
Change in oxygen saturation / fraction of inspired oxygen (S/F) ratio
Description
Change in theS/F ratio assessed daily during the 28 day treatment period
Time Frame
28 days
Title
Change in pro-inflammatory biomarkers from baseline to end of treatment
Description
ARDS associated biomarkers will be measured in plasma
Time Frame
pretreatment and end of treatment period (28 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: Has provided (or relative has) written informed consent and authorization for use and disclosure of protected health information Has a clinical diagnosis of sepsis or septic shock defined as: Known or suspected infection Systemic inflammatory response syndrome (SIRS), defined as meeting at least 2 of the following 3 criteria for a systemic inflammatory response: White blood cell count >12,000 or <4,000 or >10% band forms Body temperature >38°C (any route) or <36°C (by core temperatures only: indwelling catheter, esophageal, rectal) Heart rate >90 beats/min or receiving medications that slow heart rate or pace rhythm Enrollment must occur within 48 hours of first meeting ARDS criteria per the Berlin definition of ARDS (ARDS Task Force 2012) and no more than 72 hours from the initiation of mechanical ventilation. (The bilateral opacities, respiratory failure, and decreased P/F ratio must all be present within a 24 hour time period of one another.): Lung injury of acute onset, within 1 week of an apparent clinical insult, with progression of respiratory symptoms Bilateral opacities on chest imaging not fully explained by effusions, lobar/lung collapse, or nodules. Respiratory failure not fully explained by cardiac failure or fluid overload. (Need objective assessment (e.g. echocardiography) to exclude hydrostatic edema if no risk factor present.) Decreased arterial partial pressure of oxygen (PaO2)/ fraction of inspired oxygen (FIO2) ratio while on a minimum Positive End Expiratory Pressure (PEEP) of 5 cm water (H2O): Moderate ARDS: 101 to 200 mmHg (≤ 26.6 kPa) Severe ARDS: ≤ 100 mmHg (≤ 13.3 kPa) Exclusion Criteria: Age < 18 years or >75 years old Greater than 48 hours since first meeting ARDS criteria per the Berlin definition of ARDS Pregnant or breastfeeding (negative pregnancy test required prior to randomization for female patients of childbearing potential.) Prisoner Any other irreversible disease or condition for which 6 month mortality is estimated to be > 50% Moderate to severe liver failure (Child Pugh Score > 12) Severe chronic respiratory disease with a PaCO2 > 50 mmHg or the use of home oxygen Patient, surrogate, or physician not committed to full support (exception: a patient will not be excluded if he/she would receive all supportive care except for attempts at resuscitation from cardiac arrest). Major trauma in the prior 5 days Lung transplant patient No consent/inability to obtain consent Moribund patient not expected to survive 24 hours World Health Organization (WHO) Functional Class III or IV pulmonary hypertension No intent/unwillingness to follow lung protective ventilation strategy or fluid management protocol Currently receiving extracorporeal life support or high frequency oscillatory ventilation Known hypersensitivity to BIO 11006 Burn victims >20% Total Body Surface Area (TBSA) or with known airway inhalation injury
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Brian Dickson, MD
Organizational Affiliation
Biomarck Pharmaceuticals
Official's Role
Study Chair
Facility Information:
Facility Name
University of Chicago Medicine
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
University of North Carolina School of Medicine
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Wake Forest University
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Vanderbilt University, Div of Allergy, Pulmonary, Critical Care
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Evaluation of Safety & Efficacy of BIO-11006 Inhalation Solution in Patients With ARDS

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