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Safety and Efficacy of Conivaptan in Hyponatremic Patients With Symptomatic Acute Decompensated Heart Failure (ADHF) (CONVERT-H)

Primary Purpose

Hyponatremia, Acute Decompensated Heart Failure

Status
Terminated
Phase
Phase 3
Locations
India
Study Type
Interventional
Intervention
conivaptan
placebo
Sponsored by
Cumberland Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hyponatremia focused on measuring hyponatremia, euvolemic hyponatremia, hypervolemic hyponatremia, acute decompensated heart failure, conivaptan, Vaprisol

Eligibility Criteria

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

Inclusion Criteria:

  • Presents to emergency department with documented history of CHF and symptomatic ADHF, will be treated for ADHF, and primary reason for admission to the hospital is ADHF
  • Dyspnea at rest or with minimal exertion and must have moderate shortness of breath (SOB) in any of the first three Provocative Dyspnea Assessment positions
  • Severe pulmonary congestion as evidenced by jugular venous distention or lower extremity/sacral edema or rales upon chest auscultation or chest x-ray.
  • BNP > 400 or NT-pro BNP > 1500 drawn during Screening
  • Systolic blood pressure >= 100 mmHg to < 180 mmHg at time of start of study drug
  • Serum sodium value >= 115 mEq/L (115 mmol/L) and < 135 mEq/L (135 mmol/L) during Screening

Exclusion Criteria:

  • Clinical evidence of volume depletion
  • Active ongoing acute coronary syndrome or acute ST segment elevation myocardial infarction (or has experienced a myocardial infarction within 30 days of Screening)
  • In cardiogenic shock
  • Calculated creatinine clearance < 30 mL/min/1.73 m2 as estimated by the Modification of Diet in Renal Disease (MDRD) equation, has received intravenous (IV) contrast agent within 72 hours prior to randomization or is expected to receive IV contrast agent within the first 72 hours of study participation
  • Ultrafiltration within the past 72 hours.
  • Currently using or expected to use inotropic therapy
  • Cardiac bypass grafts in the past 60 days
  • Cerebrovascular accident in the past 30 days
  • Uncontrolled brady- or ventricular tachyarrhythmias requiring emergent pacemaker placement or treatment
  • Hemodynamically significant uncorrected primary cardiac valvular disease or hypertrophic cardiomyopathy
  • Untreated severe hypothyroidism, hyperthyroidism or adrenal insufficiency based on medical history
  • ALT or AST elevations > 5 times upper limit of normal
  • Biliary liver cirrhosis, history or presence of severe hepatic encephalopathy, ascites, esophageal variceal bleeding within the past three months, severe portal hypertension or surgical portosystemic shunt.
  • Received any organ transplant, clinical diagnosis of pneumonia, symptomatic hyponatremia requiring urgent intervention or any concurrent illness which, in the opinion of the investigator, may interfere with treatment or evaluation of safety
  • Pregnant or lactating
  • Currently using vasopressin, oxytocin or desmopressin

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Conivaptan

Arm Description

Matching loading dose and continuous intravenous infusion for 48 hours

20mg loading dose followed by a 20mg/ day continuous intravenous infusion for 48 hours

Outcomes

Primary Outcome Measures

Change in Renal Function From Baseline at 72 Hours Assessed by Calculated Creatinine Clearance (MDRD Equation)
MDRD = Modification of Diet in Renal Disease The MDRD equation is a standard calculation for estimated glomerular filtration rate. Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Assessment of Dyspnea at 24 Hours as Determined by a 7-point Likert Scale
Dyspnea is defined as the sensation of uncomfortable or difficult breathing. Changes in Dyspnea were assessed using the following 7-point scale: 1-Markedly worse; 2-Moderately worse; 3-Mildly worse; 4-No change; 5-Mildly improved; 6-Moderately improved; 7-Markedly better/improved. Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.

Secondary Outcome Measures

Change in Renal Function From Baseline at Hours 24, 48 and 72 as Assessed by Urine Creatinine Clearance
Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Change in Renal Function From Baseline at Hours 24, 48 and Day 9 (or Day of Discharge) as Assessed by Serum Creatinine Concentration and Calculated Creatinine Clearance
Calculated creatinine clearance is only calculated through hour 72 using the MDRD equation. MDRD = Modification of Diet in Renal Disease The MDRD equation is a standard calculation for estimated glomerular filtration rate. Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Incidence of Use of Rescue Therapy or Other Intervention (Including Dialysis) Because of Worsening Renal Function
Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Termination of Study Drug Due to an Adverse Event or Intolerability
Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Assessment of Dyspnea at Baseline, Hours 6, 12, 24 and 48 Using a Relative Dyspnea Assessment
Dyspnea is defined as the sensation of uncomfortable or difficult breathing. Changes in Dyspnea were assessed using the following 7-point Likert scale: 1-Markedly worse; 2-Moderately worse; 3-Mildly worse; 4-No change; 5-Mildly improved; 6-Moderately improved; 7-Markedly better/improved. Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Assessment of Dyspnea at Baseline, Hours 6, 12, 24 and 48 Using a Provocative Dyspnea Assessment
Dyspnea is defined as the sensation of uncomfortable or difficult breathing. The Provocative Dyspnea Assessment assesses dyspnea and changes in dyspnea from Baseline on a 5-point Likert scale at 5 different positions and assigns a Dyspnea Severity Score that ranges from 1 (worst severity) to 25 (least severity). Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Change From Baseline in Body Weight at Hours 24, 48 and 72 and Days 6 and 9 (or Day of Discharge)
Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Total Loop Diuretic Use Through 48 Hours
Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Total Urine Output at Hours 6, 12, 24, 48 and 72
Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.

Full Information

First Posted
February 11, 2009
Last Updated
April 30, 2014
Sponsor
Cumberland Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00843986
Brief Title
Safety and Efficacy of Conivaptan in Hyponatremic Patients With Symptomatic Acute Decompensated Heart Failure (ADHF)
Acronym
CONVERT-H
Official Title
A Phase-3b, Randomized, Double-Blind, Placebo-Controlled, Multi-Center Study to Assess the Safety and Efficacy of Conivaptan in Symptomatic Acute Decompensated Heart Failure (ADHF) Subjects With Hyponatremia
Study Type
Interventional

2. Study Status

Record Verification Date
April 2014
Overall Recruitment Status
Terminated
Why Stopped
The clinical study has been terminated based on difficulties to enroll eligible subjects per protocol inclusion and exclusion criteria.
Study Start Date
April 2009 (undefined)
Primary Completion Date
August 2009 (Actual)
Study Completion Date
August 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cumberland Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will evaluate the safety and effectiveness of Conivaptan, a vasopressin antagonist, in the treatment of hyponatremic subjects having symptomatic acute decompensated heart failure (ADHF).
Detailed Description
Subjects will be recruited from the Emergency Department. It is expected that subjects will be treated according to the institution's accepted conventional therapy protocol for the treatment of ADHF. Therapy may also include the use of loop diuretics for the relief of pulmonary congestion and maintenance of adequate urine output.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hyponatremia, Acute Decompensated Heart Failure
Keywords
hyponatremia, euvolemic hyponatremia, hypervolemic hyponatremia, acute decompensated heart failure, conivaptan, Vaprisol

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Matching loading dose and continuous intravenous infusion for 48 hours
Arm Title
Conivaptan
Arm Type
Experimental
Arm Description
20mg loading dose followed by a 20mg/ day continuous intravenous infusion for 48 hours
Intervention Type
Drug
Intervention Name(s)
conivaptan
Other Intervention Name(s)
Vaprisol; YM087
Intervention Description
Premix bag
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
Premix bag
Primary Outcome Measure Information:
Title
Change in Renal Function From Baseline at 72 Hours Assessed by Calculated Creatinine Clearance (MDRD Equation)
Description
MDRD = Modification of Diet in Renal Disease The MDRD equation is a standard calculation for estimated glomerular filtration rate. Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Time Frame
Baseline and 72 Hours
Title
Assessment of Dyspnea at 24 Hours as Determined by a 7-point Likert Scale
Description
Dyspnea is defined as the sensation of uncomfortable or difficult breathing. Changes in Dyspnea were assessed using the following 7-point scale: 1-Markedly worse; 2-Moderately worse; 3-Mildly worse; 4-No change; 5-Mildly improved; 6-Moderately improved; 7-Markedly better/improved. Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Time Frame
24 Hours
Secondary Outcome Measure Information:
Title
Change in Renal Function From Baseline at Hours 24, 48 and 72 as Assessed by Urine Creatinine Clearance
Description
Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Time Frame
Baseline, 24 Hours, 48 Hours and 72 Hours
Title
Change in Renal Function From Baseline at Hours 24, 48 and Day 9 (or Day of Discharge) as Assessed by Serum Creatinine Concentration and Calculated Creatinine Clearance
Description
Calculated creatinine clearance is only calculated through hour 72 using the MDRD equation. MDRD = Modification of Diet in Renal Disease The MDRD equation is a standard calculation for estimated glomerular filtration rate. Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Time Frame
Baseline, 24 Hours, 48 Hours and Day 9
Title
Incidence of Use of Rescue Therapy or Other Intervention (Including Dialysis) Because of Worsening Renal Function
Description
Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Time Frame
Day 9
Title
Termination of Study Drug Due to an Adverse Event or Intolerability
Description
Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Time Frame
48.5 Hours
Title
Assessment of Dyspnea at Baseline, Hours 6, 12, 24 and 48 Using a Relative Dyspnea Assessment
Description
Dyspnea is defined as the sensation of uncomfortable or difficult breathing. Changes in Dyspnea were assessed using the following 7-point Likert scale: 1-Markedly worse; 2-Moderately worse; 3-Mildly worse; 4-No change; 5-Mildly improved; 6-Moderately improved; 7-Markedly better/improved. Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Time Frame
Baseline, 6 Hours, 12 Hours, 24 Hours and 48 Hours
Title
Assessment of Dyspnea at Baseline, Hours 6, 12, 24 and 48 Using a Provocative Dyspnea Assessment
Description
Dyspnea is defined as the sensation of uncomfortable or difficult breathing. The Provocative Dyspnea Assessment assesses dyspnea and changes in dyspnea from Baseline on a 5-point Likert scale at 5 different positions and assigns a Dyspnea Severity Score that ranges from 1 (worst severity) to 25 (least severity). Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Time Frame
Baseline, 6 Hours, 12 Hours, 24 Hours and 48 Hours
Title
Change From Baseline in Body Weight at Hours 24, 48 and 72 and Days 6 and 9 (or Day of Discharge)
Description
Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Time Frame
Baseline, 24 Hours, 48 Hours, 72 Hours, Day 6 and Day 9
Title
Total Loop Diuretic Use Through 48 Hours
Description
Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Time Frame
48 Hours
Title
Total Urine Output at Hours 6, 12, 24, 48 and 72
Description
Outcome Measures were not analyzed due to the abbreviated enrollment at early study termination.
Time Frame
6 Hours, 12 Hours, 24 Hours, 48 Hours and 72 Hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Presents to emergency department with documented history of CHF and symptomatic ADHF, will be treated for ADHF, and primary reason for admission to the hospital is ADHF Dyspnea at rest or with minimal exertion and must have moderate shortness of breath (SOB) in any of the first three Provocative Dyspnea Assessment positions Severe pulmonary congestion as evidenced by jugular venous distention or lower extremity/sacral edema or rales upon chest auscultation or chest x-ray. BNP > 400 or NT-pro BNP > 1500 drawn during Screening Systolic blood pressure >= 100 mmHg to < 180 mmHg at time of start of study drug Serum sodium value >= 115 mEq/L (115 mmol/L) and < 135 mEq/L (135 mmol/L) during Screening Exclusion Criteria: Clinical evidence of volume depletion Active ongoing acute coronary syndrome or acute ST segment elevation myocardial infarction (or has experienced a myocardial infarction within 30 days of Screening) In cardiogenic shock Calculated creatinine clearance < 30 mL/min/1.73 m2 as estimated by the Modification of Diet in Renal Disease (MDRD) equation, has received intravenous (IV) contrast agent within 72 hours prior to randomization or is expected to receive IV contrast agent within the first 72 hours of study participation Ultrafiltration within the past 72 hours. Currently using or expected to use inotropic therapy Cardiac bypass grafts in the past 60 days Cerebrovascular accident in the past 30 days Uncontrolled brady- or ventricular tachyarrhythmias requiring emergent pacemaker placement or treatment Hemodynamically significant uncorrected primary cardiac valvular disease or hypertrophic cardiomyopathy Untreated severe hypothyroidism, hyperthyroidism or adrenal insufficiency based on medical history ALT or AST elevations > 5 times upper limit of normal Biliary liver cirrhosis, history or presence of severe hepatic encephalopathy, ascites, esophageal variceal bleeding within the past three months, severe portal hypertension or surgical portosystemic shunt. Received any organ transplant, clinical diagnosis of pneumonia, symptomatic hyponatremia requiring urgent intervention or any concurrent illness which, in the opinion of the investigator, may interfere with treatment or evaluation of safety Pregnant or lactating Currently using vasopressin, oxytocin or desmopressin
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Art Wheeler, MD
Organizational Affiliation
Cumberland Pharmaceuticals, Inc.
Official's Role
Study Director
Facility Information:
City
Hyderabaad
ZIP/Postal Code
500063
Country
India
City
Karnal
ZIP/Postal Code
132001
Country
India
City
New Delhi
ZIP/Postal Code
110025
Country
India
City
New Delhi
ZIP/Postal Code
110060
Country
India

12. IPD Sharing Statement

Links:
URL
http://www.astellas.us/docs/vaprisol.pdf
Description
Link to Prescribing Information

Learn more about this trial

Safety and Efficacy of Conivaptan in Hyponatremic Patients With Symptomatic Acute Decompensated Heart Failure (ADHF)

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