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Safety and Efficacy of CMX-2043 for Protection of the Heart and Kidneys in Subjects Undergoing Coronary Angiography (CARIN)

Primary Purpose

Non STEMI, Unstable Angina

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
CMX-2043
Placebo comparator
Sponsored by
Ischemix, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Non STEMI

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female subjects at least 18 years of age.
  2. Subjects with acute coronary syndrome (excluding STEMI).
  3. Subjects undergoing coronary angiography with the possibility of going on to PCI. However, if it is known that the patient is unlikely to undergo PCI, the patient should not be enrolled.
  4. Subjects must meet either one of the following criteria:

    1. An eGFR < 45 mL/min as determined by the MDRD equation
    2. An eGFR < 60 mL/min as determined by the MDRD equation and at least one of the following:

    i. Over 75 years of age ii. Diabetes mellitus iii. Ejection fraction less than 40% iv. Hypotension v. Congestive heart failure (NYHA stage II or higher) vi. Anemia (hemoglobin below 10 g/dL at screening)

  5. Female subjects must also meet any one of the following criteria:

    1. Surgically sterile with bilateral tubal ligation or hysterectomy
    2. Post-menopausal for at least one year
    3. If of child-bearing potential, practicing an acceptable method of birth control for the duration of the study as judged by the investigator, such as condoms, foams, jellies, diaphragm, intrauterine device or abstinence.
  6. Subjects free of non-cardiac acute injuries or illnesses that, in the opinion of the investigator, could put the subject at risk or obscure the interpretation of results.
  7. Subjects willing to undergo pre-and post-study blood and urine collection, physical exams and laboratory investigations.
  8. Subjects willing to provide signed written informed consent form.

Exclusion Criteria:

  1. Subjects undergoing elective coronary angiography (i.e., stable angina).
  2. Subjects with end-stage renal disease (i.e., eGFR < 15).
  3. Subjects with ST-elevation myocardial infarction (STEMI)
  4. Subjects who experienced cardiac arrest associated with the current admission which required chest compressions or cardiopulmonary resuscitation.
  5. Subjects who experienced a life threatening arrhythmia associated with the current admission such as ventricular fibrillation or ventricular tachycardia.
  6. Subjects who weigh over 125 kg.
  7. Subjects with an active history of psychiatric disorders likely to limit the validity of consent to participate in the study or limit the ability to comply with the protocol requirements.
  8. Subjects with a history of alcohol or drug abuse within one year of screening.
  9. Subjects with uncorrected clinically significant abnormalities of clinical laboratory tests which in the investigators opinion will interfere with the study conduct.
  10. Subjects with non-cardiac acute illness or injuries in which the investigator considers will increase the risk to the subject or to the study's success or which will obscure the interpretation of the results.
  11. Subject with chronic diseases considered by the investigator unfit for the procedure or which will increase the risk to the subject or to the study's success or which will obscure the interpretation of results.
  12. Subjects who are currently enrolled or who have participated in a clinical study within 30 days of screening or within 5 half-lives of another study drug, whichever is longer.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Experimental

    Experimental

    Placebo Comparator

    Arm Label

    CMX-2043 2.4 mg/Kg

    CMX-2043 3.6 mg/kg

    CMX-2043 2.4 mg/kg given twice

    Placebo comparator

    Arm Description

    Bolus injection of investigational product given prior to the cardiac catheterization and placebo given 24 hours after the first dose.

    Bolus injection of investigational product given prior to the cardiac catheterization and placebo given 24 hours after the first dose.

    Bolus injection of investigational product given prior to the cardiac catheterization and again 24 hours after the first dose.

    Placebo comparator (PBS) given prior to cardiac catheterization and again 24 hours after the first dose.

    Outcomes

    Primary Outcome Measures

    Prevention of acute kidney injury (AKI).
    Reduction in the incidence of AKI as determined by the KDIGO definition of AKI compared to placebo.

    Secondary Outcome Measures

    Reduction in biomarkers of AKI
    Reduction in renal injury as determined by renal biomarkers in the treatment groups compared to placebo.
    Trends in clinical outcomes
    Incidence of major adverse cardiac events (MACE) or major adverse kidney events (MAKE) or other clinical complications in the treatment groups compared to placebo.
    Prevention of cardiac injury in unstable angina (UA) subjects who go on to PCI.
    Reduction in cardiac injury as determined by cardiac biomarkers in the treatment groups compared to placebo
    Safety monitoring
    Assessments of treatment emergent adverse events.

    Full Information

    First Posted
    April 1, 2014
    Last Updated
    February 22, 2016
    Sponsor
    Ischemix, LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02103959
    Brief Title
    Safety and Efficacy of CMX-2043 for Protection of the Heart and Kidneys in Subjects Undergoing Coronary Angiography
    Acronym
    CARIN
    Official Title
    A Prospective, Comparative, Randomized, Multi-Center, Double-Blinded, Placebo-Controlled, Phase 2a Study of the Safety and Efficacy of CMX-2043 for Periprocedural Injury Protection in Subjects Undergoing Coronary Angiography at Risk of Radio-contrast Induced Nephropathy (CARIN)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2014
    Overall Recruitment Status
    Completed
    Study Start Date
    June 2014 (undefined)
    Primary Completion Date
    September 2015 (Actual)
    Study Completion Date
    December 2015 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Ischemix, LLC

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The objective of this study is to evaluate CMX-2043 for prevention of renal and cardiac injury associated with coronary angiography in patients with acute coronary syndrome (ACS), but excluding ST-elevation myocardial infarction (STEMI) patients. This study will specifically examine the ability of CMX-2043 to prevent acute renal injury following coronary angiography. The study will also examine the ability of CMX 2043 for prevention of periprocedural cardiac injury. Information will be obtained relating to the ability of CMX 2043 for prevention of major adverse cardiac and renal events following the procedure. Additional information will be obtained in this study to evaluate safety of the drug. Dose and regimen information will also be obtained for future clinical studies of CMX-2043.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Non STEMI, Unstable Angina

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Phase 2
    Interventional Study Model
    Single Group Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    361 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    CMX-2043 2.4 mg/Kg
    Arm Type
    Experimental
    Arm Description
    Bolus injection of investigational product given prior to the cardiac catheterization and placebo given 24 hours after the first dose.
    Arm Title
    CMX-2043 3.6 mg/kg
    Arm Type
    Experimental
    Arm Description
    Bolus injection of investigational product given prior to the cardiac catheterization and placebo given 24 hours after the first dose.
    Arm Title
    CMX-2043 2.4 mg/kg given twice
    Arm Type
    Experimental
    Arm Description
    Bolus injection of investigational product given prior to the cardiac catheterization and again 24 hours after the first dose.
    Arm Title
    Placebo comparator
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo comparator (PBS) given prior to cardiac catheterization and again 24 hours after the first dose.
    Intervention Type
    Drug
    Intervention Name(s)
    CMX-2043
    Intervention Description
    Slow bolus IV administration of CMX-2043
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo comparator
    Intervention Description
    Slow bolus IV administration of PBS
    Primary Outcome Measure Information:
    Title
    Prevention of acute kidney injury (AKI).
    Description
    Reduction in the incidence of AKI as determined by the KDIGO definition of AKI compared to placebo.
    Time Frame
    Three days
    Secondary Outcome Measure Information:
    Title
    Reduction in biomarkers of AKI
    Description
    Reduction in renal injury as determined by renal biomarkers in the treatment groups compared to placebo.
    Time Frame
    Three days
    Title
    Trends in clinical outcomes
    Description
    Incidence of major adverse cardiac events (MACE) or major adverse kidney events (MAKE) or other clinical complications in the treatment groups compared to placebo.
    Time Frame
    90 days
    Title
    Prevention of cardiac injury in unstable angina (UA) subjects who go on to PCI.
    Description
    Reduction in cardiac injury as determined by cardiac biomarkers in the treatment groups compared to placebo
    Time Frame
    Three days
    Title
    Safety monitoring
    Description
    Assessments of treatment emergent adverse events.
    Time Frame
    90 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male or female subjects at least 18 years of age. Subjects with acute coronary syndrome (excluding STEMI). Subjects undergoing coronary angiography with the possibility of going on to PCI. However, if it is known that the patient is unlikely to undergo PCI, the patient should not be enrolled. Subjects must meet either one of the following criteria: An eGFR < 45 mL/min as determined by the MDRD equation An eGFR < 60 mL/min as determined by the MDRD equation and at least one of the following: i. Over 75 years of age ii. Diabetes mellitus iii. Ejection fraction less than 40% iv. Hypotension v. Congestive heart failure (NYHA stage II or higher) vi. Anemia (hemoglobin below 10 g/dL at screening) Female subjects must also meet any one of the following criteria: Surgically sterile with bilateral tubal ligation or hysterectomy Post-menopausal for at least one year If of child-bearing potential, practicing an acceptable method of birth control for the duration of the study as judged by the investigator, such as condoms, foams, jellies, diaphragm, intrauterine device or abstinence. Subjects free of non-cardiac acute injuries or illnesses that, in the opinion of the investigator, could put the subject at risk or obscure the interpretation of results. Subjects willing to undergo pre-and post-study blood and urine collection, physical exams and laboratory investigations. Subjects willing to provide signed written informed consent form. Exclusion Criteria: Subjects undergoing elective coronary angiography (i.e., stable angina). Subjects with end-stage renal disease (i.e., eGFR < 15). Subjects with ST-elevation myocardial infarction (STEMI) Subjects who experienced cardiac arrest associated with the current admission which required chest compressions or cardiopulmonary resuscitation. Subjects who experienced a life threatening arrhythmia associated with the current admission such as ventricular fibrillation or ventricular tachycardia. Subjects who weigh over 125 kg. Subjects with an active history of psychiatric disorders likely to limit the validity of consent to participate in the study or limit the ability to comply with the protocol requirements. Subjects with a history of alcohol or drug abuse within one year of screening. Subjects with uncorrected clinically significant abnormalities of clinical laboratory tests which in the investigators opinion will interfere with the study conduct. Subjects with non-cardiac acute illness or injuries in which the investigator considers will increase the risk to the subject or to the study's success or which will obscure the interpretation of the results. Subject with chronic diseases considered by the investigator unfit for the procedure or which will increase the risk to the subject or to the study's success or which will obscure the interpretation of results. Subjects who are currently enrolled or who have participated in a clinical study within 30 days of screening or within 5 half-lives of another study drug, whichever is longer.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Alan S Lader, PhD
    Organizational Affiliation
    Ischemix, LLC
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    Safety and Efficacy of CMX-2043 for Protection of the Heart and Kidneys in Subjects Undergoing Coronary Angiography

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