search
Back to results

Study of APX-115 in Contrast Induced Acute Kidney Injury in Subjects Undergoing PCI

Primary Purpose

Contrast Induced Acute Kidney Injury

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Isuzinaxib (APX-115)
Placebo
Sponsored by
Aptabio Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Contrast Induced Acute Kidney Injury focused on measuring Isuzinaxib, APX-115, Contrast media, ROS, Acute Kidney Injury, Percutaneous Coronary Intervention

Eligibility Criteria

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

Inclusion Criteria: Willing and able to provide informed consent. Male or female, of any race or ethnicity, 18 years of age or older, inclusive, on the day of informed consent. Racial and ethnic minorities should be included in the study population to the greatest extent possible. Diagnosed with coronary artery disease. Planned to undergo coronary angiography within 4 weeks of being consented. Risk of CKD evidenced by 30 mL/min/1.73m2 ≤ eGFR (Glomerular filtration rate) < 90 mL/min/1.73 m2 confirmed by local or central laboratory. Women of childbearing potential or males willing and able to use at least one protocol-specified method of contraception for the duration of their enrolment. Subject is aware of the investigational nature of this study and willing to comply with protocol treatments, blood tests, and other evaluations listed in the ICF. Exclusion Criteria: Females who are pregnant or who are planning to become pregnant before the end of planned enrolment or who are breastfeeding. Subjects who are not expected to go through PCI at the discretion of investigator or cardiologist Subjects who have a history of hypersensitivity to contrast media or who cannot be administered contrast media according to investigator's discretion Acute myocardial infarction within 1 month prior to Screening ESRD confirmed by eGFR < 15 mL/min/1.73 m2 at Screening. Clinically significant heart disease as determined by the Investigator within 2 months prior to Screening including but not limited to any of following; cardiogenic shock, treatment requiring intra-aortic balloon pump (IABP) support, treatment with extra corporeal membrane oxygenation (ECMO), or NYHA class IV heart failure. Uncontrolled treated/untreated hypertension (defined as systolic blood pressure > 180 mmHg and/or diastolic blood pressure > 100 mmHg, mean of measured 2 times at Screening will be permitted). Known or suspected hypersensitivity to any component of the APX-115 formulation. History of acute kidney injury or renal dialysis within 1 month prior to Screening and/or plan to undergo a renal dialysis during enrolment. Clinically apparent liver disease as determined by the Investigator (e.g., jaundice, cholestasis, hepatic synthetic impairment, or active hepatitis) or moderate or severe hepatic impairment as determined by Child-Pugh score (Class B or C) at Screening. Impaired liver function, defined as alanine aminotransferase (ALT) ≥ 2.5 times UNL or Total bilirubin >1.5 × ULN, unless the subject has known Gilbert's syndrome. Any sign or symptom of acute or chronic infection at Screening. Receipt of any investigational drug within 4 weeks prior to Screening. Confirmed or suspected abuse of alcohol or controlled substances within 1 year prior to Screening. Clinically significant hematology abnormalities; hemoglobin <9 g/dL for females or <11 g/dL for males, absolute neutrophil count <1500/mm3, platelet count <100 × 109/L) at Screening. If any parameter is below the specified threshold, one hematology retest analyzed at the central or local laboratory within a week prior to randomization is permitted with the result of the last sample being conclusive. Any other clinically significant medical condition or laboratory abnormality as determined by the Investigator that might jeopardize the safety of the subject, impair subject compliance, or impede safety/efficacy observations during enrolment. Mental incapacity, unwillingness, or language barrier precluding adequate understanding or cooperation with protocol requirements Use of CYP1A2, CYP2B6 and CYP3A4 substrates or UGT inhibitors and inducers or OAT3 substrates prior to enrollment or concurrently. It will be only accepted to be eligible to screening if the subjects' concomitant medications will be reviewed and approved by the medical monitor and/or sponsor prior to the initial study dose

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    Isuzinaxib (APX-115)

    Placebo

    Arm Description

    4 x Isuzinaxib 88 mg calculated as free base (4 x 100mg APX-115(Isuzinaxib hydrocloride) capsules as salt form) administered QD, orally, for 5 consecutive days

    4 x Placebo capsules administered QD, orally, for 5 consecutive days

    Outcomes

    Primary Outcome Measures

    Safety endpoints: adverse event
    Number of adverse events
    Safety endpoints: vital sign
    Number of subjects with abnormal Vital Signs
    Safety endpoints: physical exam
    Abnormal physical examination
    Safety endpoints: ECG
    Abnormal Electrocardiogram (ECG)
    Safety endpoints: labs
    Number of abnormal results of Hematology, Biochemistry and Urinalysis

    Secondary Outcome Measures

    Incidence rate of Acute kidney injury
    definition of CI-AKI: Serum Creatinine absolute variation ≥ 0.5mg/dL or Serum creatinine relative variation increasing 25% from baseline up to 72 hours after CAG with the exposure of contrast medium and PCI
    Long term kidney function: Serum creatinine
    Serum creatinine level
    Long term kidney function: eGFR
    eGFR level
    Kidney function parameters: creatinine, BUN
    Serum creatinine and BUN level
    Kidney function parameters: eGFR
    eGFR using CKD-EPI
    pharmacokinetics parameters: the area under the plasma concentration-time curve (AUC0-last, AUCtau)
    to be assessed from plasma and urine samples (subset of subjects only)
    pharmacokinetics parameters: peak concentration (Cmax, Tmax)
    to be assessed from plasma and urine samples (subset of subjects only)
    pharmacokinetics parameters: steady state peak plasma concentration (Css,max)
    to be assessed from plasma and urine samples (subset of subjects only)
    pharmacokinetics parameters: steady state trough plasma concentration (Css,min)
    to be assessed from plasma and urine samples (subset of subjects only)
    pharmacokinetics parameters: steady state after 5 consecutive days of drug administration
    to be assessed from plasma and urine samples (subset of subjects only)
    pharmacokinetics parameters: apparent total clearance (CL/F)
    to be assessed from plasma and urine samples (subset of subjects only)
    pharmacokinetics parameters: renal clearance (CLR)
    to be assessed from plasma and urine samples (subset of subjects only)
    pharmacokinetics parameters: apparent nonrenal clearance (CLNR/F)
    to be assessed from plasma and urine samples (subset of subjects only)
    pharmacokinetics parameters: apparent volume of distribution (V/F)
    to be assessed from plasma and urine samples (subset of subjects only)
    pharmacokinetics parameters: terminal half-life (t1/2)
    to be assessed from plasma and urine samples (subset of subjects only)
    pharmacokinetics parameters: fraction/cumulated fraction of excreted in urine
    to be assessed from plasma and urine samples (subset of subjects only)

    Full Information

    First Posted
    May 27, 2022
    Last Updated
    May 10, 2023
    Sponsor
    Aptabio Therapeutics, Inc.
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT05758896
    Brief Title
    Study of APX-115 in Contrast Induced Acute Kidney Injury in Subjects Undergoing PCI
    Official Title
    Effect on Contrast Induced Acute Kidney Injury of APX-115 in Subjects Undergoing Percutaneous Coronary Intervention A Randomized, Double-blind, Parallel Group, Multicenter, Multi-national Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    July 31, 2023 (Anticipated)
    Primary Completion Date
    September 30, 2024 (Anticipated)
    Study Completion Date
    December 31, 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Aptabio Therapeutics, Inc.

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    Brief Summary
    This phase 2 study is to assess the safety and efficacy of APX-115 active doses in Contrast Induced Acute Kidney Disease compared to placebo following multiple oral dosing in patients with undergoing percutaneous coronary intervention. It is anticipated that approximately 280 patients will be randomized into the study in a 1:1 ratio to 400 mg APX-115 (Isuzinaxib hydrochloride) or placebo arm.
    Detailed Description
    Patients with chronic kidney disease undergoing percutaneous coronary intervention deserve careful consideration of various clinical options to minimize the risk of contrast-induced acute kidney injury and to optimize clinical outcomes. Contrast-induced acute kidney injury (CI-AKI) is a leading cause of a hospital-acquired renal failure and has been reported to affect both the mortality and morbidity of patients receiving contrast media. Contrast-induced acute kidney injury is the third leading cause of hospital-acquired acute kidney injury and has been recognized as a serious complication of percutaneous coronary intervention (PCI), which may be associated with increased morbidity and mortality. APX-115 is a potent small molecule inhibitor of NADPH-oxidase (NOX) isozymes developed by AptaBio Therapeutics, Inc. In-vivo study results suggest that multiple NOX isoforms may contribute to renal injury in CI-AKI model, and pan-NOX inhibition may be a new therapeutic approach for prevention of CI-AKI.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Contrast Induced Acute Kidney Injury
    Keywords
    Isuzinaxib, APX-115, Contrast media, ROS, Acute Kidney Injury, Percutaneous Coronary Intervention

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    280 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Isuzinaxib (APX-115)
    Arm Type
    Experimental
    Arm Description
    4 x Isuzinaxib 88 mg calculated as free base (4 x 100mg APX-115(Isuzinaxib hydrocloride) capsules as salt form) administered QD, orally, for 5 consecutive days
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    4 x Placebo capsules administered QD, orally, for 5 consecutive days
    Intervention Type
    Drug
    Intervention Name(s)
    Isuzinaxib (APX-115)
    Other Intervention Name(s)
    Isuzinaxib Hydrochloride
    Intervention Description
    Treatment allocation in 1:1 ratio to Isuzinaxib or Placebo
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Treatment allocation in 1:1 ratio to Isuzinaxib or Placebo
    Primary Outcome Measure Information:
    Title
    Safety endpoints: adverse event
    Description
    Number of adverse events
    Time Frame
    Day -2 to day 84
    Title
    Safety endpoints: vital sign
    Description
    Number of subjects with abnormal Vital Signs
    Time Frame
    Day 0 to day 84
    Title
    Safety endpoints: physical exam
    Description
    Abnormal physical examination
    Time Frame
    Day 0 to day 84
    Title
    Safety endpoints: ECG
    Description
    Abnormal Electrocardiogram (ECG)
    Time Frame
    Day 0 to day 84
    Title
    Safety endpoints: labs
    Description
    Number of abnormal results of Hematology, Biochemistry and Urinalysis
    Time Frame
    Day 0 to day 84
    Secondary Outcome Measure Information:
    Title
    Incidence rate of Acute kidney injury
    Description
    definition of CI-AKI: Serum Creatinine absolute variation ≥ 0.5mg/dL or Serum creatinine relative variation increasing 25% from baseline up to 72 hours after CAG with the exposure of contrast medium and PCI
    Time Frame
    from baseline up to 72 hours after PCI procedure
    Title
    Long term kidney function: Serum creatinine
    Description
    Serum creatinine level
    Time Frame
    week 4 and week 12
    Title
    Long term kidney function: eGFR
    Description
    eGFR level
    Time Frame
    week 4 and week 12
    Title
    Kidney function parameters: creatinine, BUN
    Description
    Serum creatinine and BUN level
    Time Frame
    over 12-week period
    Title
    Kidney function parameters: eGFR
    Description
    eGFR using CKD-EPI
    Time Frame
    over 12-week period
    Title
    pharmacokinetics parameters: the area under the plasma concentration-time curve (AUC0-last, AUCtau)
    Description
    to be assessed from plasma and urine samples (subset of subjects only)
    Time Frame
    Day -2~2
    Title
    pharmacokinetics parameters: peak concentration (Cmax, Tmax)
    Description
    to be assessed from plasma and urine samples (subset of subjects only)
    Time Frame
    Day -2~2
    Title
    pharmacokinetics parameters: steady state peak plasma concentration (Css,max)
    Description
    to be assessed from plasma and urine samples (subset of subjects only)
    Time Frame
    Day -2~2
    Title
    pharmacokinetics parameters: steady state trough plasma concentration (Css,min)
    Description
    to be assessed from plasma and urine samples (subset of subjects only)
    Time Frame
    Day -2~2
    Title
    pharmacokinetics parameters: steady state after 5 consecutive days of drug administration
    Description
    to be assessed from plasma and urine samples (subset of subjects only)
    Time Frame
    Day -2~2
    Title
    pharmacokinetics parameters: apparent total clearance (CL/F)
    Description
    to be assessed from plasma and urine samples (subset of subjects only)
    Time Frame
    Day -2~2
    Title
    pharmacokinetics parameters: renal clearance (CLR)
    Description
    to be assessed from plasma and urine samples (subset of subjects only)
    Time Frame
    Day -2~2
    Title
    pharmacokinetics parameters: apparent nonrenal clearance (CLNR/F)
    Description
    to be assessed from plasma and urine samples (subset of subjects only)
    Time Frame
    Day -2~2
    Title
    pharmacokinetics parameters: apparent volume of distribution (V/F)
    Description
    to be assessed from plasma and urine samples (subset of subjects only)
    Time Frame
    Day -2~2
    Title
    pharmacokinetics parameters: terminal half-life (t1/2)
    Description
    to be assessed from plasma and urine samples (subset of subjects only)
    Time Frame
    Day -2~2
    Title
    pharmacokinetics parameters: fraction/cumulated fraction of excreted in urine
    Description
    to be assessed from plasma and urine samples (subset of subjects only)
    Time Frame
    Day -2~2
    Other Pre-specified Outcome Measures:
    Title
    Biomarkers assessment
    Description
    NGAL, KIM-1, Cystatin-C and NT-proBNP
    Time Frame
    72 hours
    Title
    Composite PCI outcome
    Description
    death, myocardial infarction (MI) and stent thrombosis (ST)
    Time Frame
    over 12-week period

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Willing and able to provide informed consent. Male or female, of any race or ethnicity, 18 years of age or older, inclusive, on the day of informed consent. Racial and ethnic minorities should be included in the study population to the greatest extent possible. Diagnosed with coronary artery disease. Planned to undergo coronary angiography within 4 weeks of being consented. Risk of CKD evidenced by 30 mL/min/1.73m2 ≤ eGFR (Glomerular filtration rate) < 90 mL/min/1.73 m2 confirmed by local or central laboratory. Women of childbearing potential or males willing and able to use at least one protocol-specified method of contraception for the duration of their enrolment. Subject is aware of the investigational nature of this study and willing to comply with protocol treatments, blood tests, and other evaluations listed in the ICF. Exclusion Criteria: Females who are pregnant or who are planning to become pregnant before the end of planned enrolment or who are breastfeeding. Subjects who are not expected to go through PCI at the discretion of investigator or cardiologist Subjects who have a history of hypersensitivity to contrast media or who cannot be administered contrast media according to investigator's discretion Acute myocardial infarction within 1 month prior to Screening ESRD confirmed by eGFR < 15 mL/min/1.73 m2 at Screening. Clinically significant heart disease as determined by the Investigator within 2 months prior to Screening including but not limited to any of following; cardiogenic shock, treatment requiring intra-aortic balloon pump (IABP) support, treatment with extra corporeal membrane oxygenation (ECMO), or NYHA class IV heart failure. Uncontrolled treated/untreated hypertension (defined as systolic blood pressure > 180 mmHg and/or diastolic blood pressure > 100 mmHg, mean of measured 2 times at Screening will be permitted). Known or suspected hypersensitivity to any component of the APX-115 formulation. History of acute kidney injury or renal dialysis within 1 month prior to Screening and/or plan to undergo a renal dialysis during enrolment. Clinically apparent liver disease as determined by the Investigator (e.g., jaundice, cholestasis, hepatic synthetic impairment, or active hepatitis) or moderate or severe hepatic impairment as determined by Child-Pugh score (Class B or C) at Screening. Impaired liver function, defined as alanine aminotransferase (ALT) ≥ 2.5 times UNL or Total bilirubin >1.5 × ULN, unless the subject has known Gilbert's syndrome. Any sign or symptom of acute or chronic infection at Screening. Receipt of any investigational drug within 4 weeks prior to Screening. Confirmed or suspected abuse of alcohol or controlled substances within 1 year prior to Screening. Clinically significant hematology abnormalities; hemoglobin <9 g/dL for females or <11 g/dL for males, absolute neutrophil count <1500/mm3, platelet count <100 × 109/L) at Screening. If any parameter is below the specified threshold, one hematology retest analyzed at the central or local laboratory within a week prior to randomization is permitted with the result of the last sample being conclusive. Any other clinically significant medical condition or laboratory abnormality as determined by the Investigator that might jeopardize the safety of the subject, impair subject compliance, or impede safety/efficacy observations during enrolment. Mental incapacity, unwillingness, or language barrier precluding adequate understanding or cooperation with protocol requirements Use of CYP1A2, CYP2B6 and CYP3A4 substrates or UGT inhibitors and inducers or OAT3 substrates prior to enrollment or concurrently. It will be only accepted to be eligible to screening if the subjects' concomitant medications will be reviewed and approved by the medical monitor and/or sponsor prior to the initial study dose
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Aptabio Therapeutics Inc.
    Phone
    +82313653693
    Email
    hjpark@aptabio.com

    12. IPD Sharing Statement

    Learn more about this trial

    Study of APX-115 in Contrast Induced Acute Kidney Injury in Subjects Undergoing PCI

    We'll reach out to this number within 24 hrs