A Study of Ularitide in the Treatment of Subjects With Acute Decompensated Heart Failure

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. Identifier: NCT00487799
Recruitment Status : Withdrawn (Facet no longer has ownership of ularitide.)
First Posted : June 19, 2007
Last Update Posted : July 20, 2009
Information provided by:
Facet Biotech

Brief Summary:
To determine the maximum tolerated dose (MTD) of ularitide in the treatment of subjects hospitalized with symptomatic acute decompensated heart failure (ADHF).

Condition or disease Intervention/treatment Phase
Heart Failure, Congestive Drug: Ularitide Phase 1

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 32 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Treatment
Official Title: A Phase 1, Randomized, Double-Blind, Placebo-Controlled, Dose Escalation Study of Ularitide in the Treatment of Subjects With Acute Decompensated Heart Failure

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Failure

Primary Outcome Measures :
  1. The MTD of ularitide infused over 48 hours.

Secondary Outcome Measures :
  1. Frequency, severity, and relationship of AEs and serious adverse events (SAEs) to study drug through Day 32 (ie, 30 days following the end of study drug infusion).
  2. Physical examinations, vital signs, electrocardiography, and clinical laboratory values through 48 hours.
  3. Decline in renal function defined as a >25% rise or a 0.3 mg/dL increase in serum creatinine from pre-dose at baseline to 48 hours post the end of infusion and through Day 32.
  4. Pharmacokinetic profile including Css, AUC, CL, V, and t½ up to 2 hours post end of infusion.
  5. Incidence of ularitide-specific anti-drug antibodies (ADAb) through Day 32.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

To be considered eligible for inclusion, subjects must meet all of the following criteria:

  • Males and females who are 18 years or older.
  • Unplanned hospitalization for ADHF.
  • Randomization should occur as soon as possible from presentation to emergency department or hospital for ADHF up to 24 hours from admission.
  • Dyspnea at rest as assessed by the subject not more than 1 hour prior to randomization. Subjects must have the ability to interpret and report self-assessed dyspnea.
  • At least 1 of the following 2 criteria:

    1. Prior medical history of CHF (eg, prior hospitalization for CHF or left ventricular ejection fraction <40%, as determined by transthoracic echocardiography at the time of screening or previously determined and documented in the patient's chart as follows):

      • Within the previous 6 months in subjects with unstable symptoms, or
      • Within the previous 12 months in subjects with stable symptoms.
    2. Clinical evidence (at screening) of heart failure, including abnormal jugular venous pressure (JVP) (eg, >8 cm above the clavicle, assessed at 45°angle), rales or crackles more than a third above bases, or 2+ lower extremity edema.
  • On optimal background therapy for ADHF (as determined by the investigator); subjects are required to have received, at a minimum, at least 1 hour of oxygen supplementation and at least one dose of IV furosemide at a minimum dose of 40 mg with the last bolus being delivered >2 hours before study drug administration is initiated (or another diuretic at a comparable dose; eg, 2 mg bumetanide or 20 mg torsemide, with the last bolus being delivered >4 hours before study drug administration is initiated.
  • If subject received IV opiate, the last dose must have been >3 hours before administration of study drug.
  • Women of childbearing potential must have a negative pregnancy test prior to being randomized in the study. Women and men of reproductive potential will agree to utilize effective contraception during the entire treatment period and for 1 month after receiving the last dose of ularitide or placebo.
  • Ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information (in accordance with national and local subject privacy regulations).

Exclusion Criteria:

Any subject will be ineligible for this study if any one of the following criteria is met:

  • Breathing rate <18 breaths per minute (measured during 60 seconds).
  • A systolic blood pressure (SBP) <110 mmHg or >180 mmHg within an hour before randomization, or SBP <120 mmHg for subjects receiving IV inotropics or vasodilators. A SBP <90 mmHg in two successive measurements within 30 minutes before randomization. (Subjects on baseline IV inotropes or vasodilators must be on a stable dose for ³3 hours prior to randomization.)
  • BNP <400 pg/mL or NT?pro-BNP <1200 pg/mL anytime from initial presentation to hospital to time of randomization.
  • Use of IV contrast material within 48 hours before infusion of study drug.
  • History of central or peripheral neurological ischemic disorder (stroke, etc.).
  • Active myocarditis, obstructive hypertrophic cardiomyopathy, congenital heart disease, restrictive cardiomyopathy, constrictive pericarditis, severe aortic stenosis, uncorrected primary valvular disease, or significant obstructive valve disease.
  • Acute decompensated heart failure associated with endocrine (eg, thyroid storm), metabolic, or drug-related toxicity.
  • Elevation of serum creatinine?kinase myocardial band (CK?MB) or cardiac troponin (Troponin I) >2 times the upper limit of normal within 6 hours prior to randomization.
  • Active, ongoing myocardial ischemia, hospitalization for acute myocardial infarction, or administration of thrombolytic therapy in the last 30 days prior to randomization, or, any ECG abnormalities in the opinion of the investigator, suggestive of active ischemic changes.
  • Percutaneous coronary intervention, coronary artery bypass graft surgery, other cardiac surgery, or major noncardiac surgery within 90 days prior to randomization.
  • Any cardiogenic shock (SBP <90 mmHg with signs or symptoms of organ hypoperfusion) from initial presentation to randomization.
  • Any significant volume depletion or severe electrolyte imbalance.
  • Renal disorder with a creatinine clearance <30 mL/min, as calculated by the Cockcroft-Gault equation at screening.
  • Use of a phosphodiesterase type 5 (PDE 5) inhibitor such as sildenafil within 72 hours prior to randomization.
  • Planned coronary revascularization procedure (percutaneous coronary intervention or coronary artery bypass grafting) during current hospital admission.
  • Use or anticipated need for invasive or noninvasive mechanical circulatory or ventilatory support.
  • Anemia (hemoglobin <10 mg/dL or a hematocrit <30%).
  • Vasculitis, active infective endocarditis, or suspected infections including pneumonia or sepsis.
  • Body temperature ≥ 38º C.
  • Significant acute or chronic respiratory disorder (eg, severe chronic obstructive pulmonary disease) or primary pulmonary hypertension with baseline dyspnea that may interfere with the ability to interpret dyspnea assessments or hemodynamic measurements.
  • Terminal illness other than CHF with expected survival <180 days.
  • Previous exposure to ularitide.
  • Nesiritide treatment in the last 30 days prior to randomization.
  • Allergy to natriuretic peptides.
  • Participation in a clinical drug trial or investigational device trial within 30 days prior to randomization.
  • Current drug abuse or chronic alcoholism (at the Investigator's determination).
  • Women who are pregnant or breast-feeding. Women of childbearing age will have a urine pregnancy test to determine pregnancy status within 24 hours prior to randomization.
  • Any condition that, in the investigator's opinion, makes the subject unsuitable for study participation, including a history of repeated admission related to non-adherence to prescribed medication.
  • For subjects with concomitant invasive hemodynamic monitoring (ie, pulmonary artery catheter monitoring): Baseline PCWP ≤ 20 mmHg.

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 identifier (NCT number): NCT00487799

United States, California
UCSD Medical Center
San Diego, California, United States, 92103
United States, Georgia
The Atlanta Cardiology Group, PC
Atlanta, Georgia, United States, 30342
United States, Illinois
Feinberg School of Medicine, Northwestern Univ.
Chicago, Illinois, United States, 60611
United States, Michigan
Henry Ford Health System
Detroit, Michigan, United States, 48202
United States, Missouri
Washington University School of Medicine
St. Louis, Missouri, United States, 63110
United States, New York
Cardiovascular Specialists PC dba New York Heart Ctr.
Syracuse, New York, United States, 13210
United States, Pennsylvania
Albert Einstein Medical Center
Philadelphia, Pennsylvania, United States, 19141
United States, Tennessee
Kore Cardiovascular Research Institute
Lexington, Tennessee, United States, 38351
Sponsors and Collaborators
Facet Biotech
Principal Investigator: William Cotts, MD Feinberg School of Medicine, Northwestern Univ.
Principal Investigator: Gregory Ewald, MD Washington University School of Medicine
Principal Investigator: Daniel Fuleihan, MD Cardiovascular Specialists PC dba New York Heart Ctr
Principal Investigator: Barry Greenberg, MD UCSD Medical Center
Principal Investigator: Darshak Karia, MD Albert Einstein Medical Center
Principal Investigator: Elie Korban, MD Kore Cardiovascular Research Institute
Principal Investigator: Richard Nowak, MD Henry Ford Health System
Principal Investigator: Nirav Y. Raval, MD The Atlanta Cardiology Group, PC

Additional Information: Identifier: NCT00487799     History of Changes
Other Study ID Numbers: Ularitide-1503
First Posted: June 19, 2007    Key Record Dates
Last Update Posted: July 20, 2009
Last Verified: July 2009

Keywords provided by Facet Biotech:
Acute Decompensated Heart Failure
Heart Failure

Additional relevant MeSH terms:
Heart Failure
Heart Diseases
Cardiovascular Diseases
Bronchodilator Agents
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Asthmatic Agents
Respiratory System Agents
Natriuretic Agents