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Pilot Study of Hemoglobin Based Oxygen Therapeutics in Elective Coronary Revascularization

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT00317512
Recruitment Status : Completed
First Posted : April 25, 2006
Last Update Posted : May 16, 2008
Sponsor:
Information provided by:
Biopure Corporation

Study Description
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Brief Summary:
The purpose of this study is to assess the safety and feasibility of a novel oxygen carrying solution, HBOC-201, in the setting of PCI for Acute Coronary Syndromes from randomization til hospital discharge.

Condition or disease Intervention/treatment Phase
Angina Pectoris Unstable Angina Myocardial Infarction Procedure: Percutaneous Coronary Revascularization Drug: Hemoglobin-Based Oxygen Carrier-201 (HBOC-201) Drug: Voluven Phase 2

Detailed Description:

Acute coronary syndromes are due to an acute or subacute primary reduction of myocardial oxygen supply provoked by disruption of an atherosclerotic plaque associated with inflammation, thrombosis, vasoconstriction and microembolization. Occlusive thrombosis superimposed on a ruptured atheroma in an epicardial coronary artery is firmly established as the immediate cause of an acute ST-segment Elevation Myocardial Infarction (STEMI). Rapid restoration of blood flow (oxygen supply) to jeopardized myocardium limits necrosis and reduces mortality. This can be accomplished medically with a thrombolytic agent, or mechanically, with so-called primary balloon angioplasty or stenting. Primary percutaneous coronary intervention (PCI) has become the preferred therapy for STEMI in most developed countries.

HBOC-201 is a solution belonging to a new class of biologic oxygen therapeutics, hemoglobin based oxygen carriers. HBOC-201 is a crosslinked and glutaraldehyde-polymerized hemoglobin (Hb) extracted from isolated bovine red blood cells. On a gram-for-gram basis, HBOC-201 was calculated to be approximately three times more potent than stored fresh red blood cell hemoglobin at restoring baseline tissue oxygenation following severe acute anemia. Evaluation of this Hemoglobin Based Oxygen Carrier has been undertaken in 57 preclinical studies and 21 human clinical trials. The compound is under review by the US FDA and has been approved in the Republic of South Africa. However, HBOC-201 has not yet been evaluated in the setting of this disease (narrowing of a coronary artery).

Biopure will be studying the safety and feasibility of HBOC-201 in patients with typical symptoms of Unstable Angina or Non ST-segment Elevation Myocardial Infarction eligible to undergo invasive revascularization through a PCI procedure.

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 45 participants
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Multi-Center,Randomized,Double-Blind,Placebo-Controlled,Dose Finding Pilot Study, to Evaluate Safety/Feasibility of HBOC-201 in Elective Percutaneous Coronary Revascularization of Subjects With Acute Coronary Syndromes
Study Start Date : December 2003
Actual Primary Completion Date : April 2005
Actual Study Completion Date : July 2007
Arms and Interventions
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Arm Intervention/treatment
Active Comparator: 1
Voluven will be administered at 7.7 ml/min over 15 minutes,followed by Voluven at 7.7 ml/min over 15 minutes
 Procedure: Percutaneous Coronary Revascularization
Drug: Voluven
Active Comparator: 2
HBOC-201 will be administered at 7.7 ml/min over 15 minutes,followed by Voluven at 7.7 ml/min over 15 minutes
 Procedure: Percutaneous Coronary Revascularization
Drug: Hemoglobin-Based Oxygen Carrier-201 (HBOC-201)
Drug: Voluven
Experimental: 3
HBOC-201 will be administered at 7.7 ml/min over 15 minutes,followed by HBOC-201 at 7.7 ml/min over 15 minutes
 Procedure: Percutaneous Coronary Revascularization
Drug: Hemoglobin-Based Oxygen Carrier-201 (HBOC-201)


Outcome Measures
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Primary Outcome Measures :
  1. Safety
  2. In hospital thrombotic events
  3. Anaphylactic reactions
  4. Inflammatory reactions
  5. Substantial changes to systemic & coronary hemodynamics
  6. Circulatory overload
  7. Renal dysfunction
  8. Untoward drug interaction effects
  9. substantial changes in laboratory parameters
  10. Life threatening cardiac arrhythmias
  11. Other adverse events
  12. Feasibility:
  13. Number of subjects requiring premature discontinuation of study drug for clinical or logistical reasons

Eligibility Criteria
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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Written informed consent provided before initiation of any study-related procedure, and before any pre-procedural sedation, and agreement to comply with all protocol-specified procedures
  • Acute Coronary Syndrome (Stable and unstable angina or non ST segment Elevation Myocardial Infarction (UA/non-STEMI) [Braunwald class I-III Class B], Appendix 1).
  • Single vessel disease of the Left Coronary Artery (LCA)
  • One vessel disease of the Right Coronary Artery (RCA)
  • Have a single de novo lesion
  • Older than 18 years and younger than 75 years of age
  • Eligible to undergo PCI on the target vessel

Exclusion Criteria:

  • Previous Q-wave myocardial infarction
  • Congestive heart failure with Left ventricular Ejection Fraction <35%
  • Confirmed pregnancy
  • Anemia to a hemoglobin level <8.5g/dl
  • Systemic mastocytosis
  • History of known haemorrhagic stroke at any time or any stroke less than or equal to 30 days prior to randomization
  • Severe hypertension (>180/110mmHG) not adequately controlled by antihypertensive therapy at time of study entry
  • Need for mechanical ventilation
  • Renal impairment: Creatinine > 1.6mg/dl
  • Known history of COPD with FEV 1s < 1.0 liter
  • Contra-indications to the use of adenosine, i.e.History of bronchospasm and/or ongoing therapy with theophylline derivatives, >1 degree atrioventricular block in the absence of a functioning electronic pacemaker and treatment with dipyridamole within the prior 24 hours
  • Patients with significant hemodynamic compromise and/or cardiogenic shock requiring inotropic or pressor support or pulmonary edema
  • History of or clinical documentation of severe aortic/mitral valve stenosis, significant aortic valve insufficiency
  • Participation in another trial with an investigational drug or device (of other investigations) including the follow-up period, within the last 30 days before enrollment
  • Inability or unwillingness to perform 30 day follow up
  • Concomitant disease that interferes with prognosis (life expectancy of less than or equal to 6 months
  • Contra-indications to standard drugs for coronary intervention and coronary heart disease: aspirin, heparin, low molecular weight heparin, clopidogrel, contrast dye
  • Patient weight > 110kg
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00317512


Locations
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Belgium
Site # 5 Onze Lieve Vrouw Ziekenhuis (OLVZ)
Aalst, Belgium
Site # 6 Antwerpen
Antwerpen, Belgium
Germany
Site # 2 Herzzentrum
Leipzig, Germany
Netherlands
Site # 3 OLVG Amsterdam
Amsterdam, Netherlands
Site # 4 Academisch Medisch Centrum (AMC)
Amsterdam, Netherlands
Site # 1 Erasmus Medical Center
Rotterdam, Netherlands
Sponsors and Collaborators
Biopure Corporation
Investigators
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Principal Investigator: P W Serruys, Professor University Medical Center Rotterdam
More Information
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Publications of Results:

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Responsible Party: Biopure Corporation
ClinicalTrials.gov Identifier: NCT00317512    
Other Study ID Numbers: COR-0001
First Posted: April 25, 2006    Key Record Dates
Last Update Posted: May 16, 2008
Last Verified: May 2008
Keywords provided by Biopure Corporation:
Hemoglobin Based Oxygen carrier
HBOC 201
Percutaneous Revascularization
Percutaneous Coronary Intervention
 Non ST-segment Elevation Myocardial Infarction
Tissue Oxygenation
Transluminal Percutaneous Coronary Angioplasty
Additional relevant MeSH terms:
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Myocardial Infarction
Angina Pectoris
Angina, Unstable
Infarction
Ischemia
Pathologic Processes
Necrosis
Myocardial Ischemia
 Heart Diseases
Cardiovascular Diseases
Vascular Diseases
Chest Pain
Pain
Neurologic Manifestations
HBOC 201
Blood Substitutes