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Evaluation of Safety and Efficacy of Lumason/SonoVue in Subjects Undergoing Pharmacologic Stress BR1-142

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ClinicalTrials.gov Identifier: NCT02552238
Recruitment Status : Completed
First Posted : September 17, 2015
Results First Posted : August 5, 2020
Last Update Posted : July 7, 2021
Sponsor:
Information provided by (Responsible Party):
Bracco Diagnostics, Inc

Brief Summary:
The purpose of this study was to assess the safety and efficacy of Lumason-enhanced dobutamine stress echo (DSE) in subjects having a suboptimal left ventricular endocardial border delineation (LV EBD) at rest and who were scheduled for coronary angiography.

Condition or disease Intervention/treatment Phase
Coronary Artery Disease Drug: Lumason Phase 3

Detailed Description:
The study was designed to assess the safety and efficacy of Lumason at improving the visualization of the LV EBD during pharmacologic stress echocardiography examinations and for detection or exclusion of the coronary artery disease (CAD). The study population consisted of adult subjects referred for pharmacological stress echocardiography and with suboptimal image quality during unenhanced ultrasound imaging at rest who had known or suspected CAD. Subjects enrolled in the study represented subjects who could benefit most from CEUS stress echocardiography.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 174 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: A Prospective Multicenter Phase III Clinical Evaluation of the Safety and Efficacy of Lumason™/SonoVue® in Subjects Undergoing Pharmacologic Stress Echocardiography With Dobutamine for the Diagnosis of Coronary Artery Disease
Actual Study Start Date : October 12, 2015
Actual Primary Completion Date : June 22, 2017
Actual Study Completion Date : February 25, 2018

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Lumason
Lumason (sulfur hexafluoride lipid-type A microspheres) 2 mL IV injection
Drug: Lumason
Lumason (sulfur hexafluoride-type A microspheres) an ultrasound contrast agent was administered as 2 single 2-mL IV injections during rest and stress echocardiography
Other Name: SonoVue




Primary Outcome Measures :
  1. Sensitivity and Specificity of Lumason Enhanced Dobutamine Stress Echo (DSE) for Detection or Exclusion of Coronary Artery Disease (CAD) [ Time Frame: Participants were followed until they had coronary angiography or up to 6 months post dose to collect clinical information on cardiac events if no coronary angiography were performed ]

    The diagnostic performance of the echocardiographic images was compared to the truth standard to determine sensitivity and specificity. A diagnosis of CAD was determined for both the echo images and truth standard (positive diagnosis for CAD is defined as >/= 50% stenosis of any vessel on coronary angiography or if no coronary angiography was performed the occurence of a cardiac event based on clinical information for up to 6 months post dose; otherwise the diagnosis was negative).

    Results for sensitivity and specificity are reflected based on difference between contrast enhanced stress echo and unenhanced stress echo. Results for analysis of data based on majority assessment from the three off-site blinded readers are presented.

    Sensitivity and specificity are the percentages of correctly diagnosed subjects by stress echo over the total positive and negative subjects according to the truth standard respectively.


  2. Reader-Specific Percentages of Participants Identified as Having a Critical Shift From Suboptimal to Optimal Echocardiographic Images [ Time Frame: Participants were followed until they had coronary angiography or up to 6 months post dose to collect clinical information on cardiac events if no coronary angiography was performed ]
    The percentage of subjects with suboptimal images (defined as >= 2 adjacent segments with inadequate LV EBD in any of the 3 apical views) at unenhanced stress echo converted to adequate (reduction of suboptimal segments in any of the 3 apical views) at contrast-enhanced stress echo


Secondary Outcome Measures :
  1. Change in Total LV EBD [ Time Frame: Participants were followed until they had coronary angiography or up to 6 months post dose to collect clinical information on cardiac events if no coronary angiography was performed ]
    Measured as the change in the total LV EBD score based on the 17 segments, from peak stress unenhanced vs. peak stress contrast-enhanced. Total LV EBD score ranges from 0 to 34 and higher score is better outcome.

  2. Number of Participants With Adverse Events [ Time Frame: 72 hours post dose ]
    To obtain safety data in subjects administered Lumason during echocardiography



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

Inclusion Criteria:

  • Provided written Informed Consent and comply with protocol requirements;
  • Was at least 18 years of age;
  • Had suspected of having CAD and undergoing coronary angiography within 6 months after the LUMASON DSE.
  • Had undergone a previous echocardiography prior to enrollment; resulting in suboptimal unenhanced images at rest, defined as ≥ 2 suboptimal adjacent segments in any apical view.

Exclusion Criteria:

• Was a pregnant or lactating female. Exclude the possibility of pregnancy: by testing on site at the institution (serum or urine βHCG) within 24 hours prior to the start of LUMASON administration(s), by surgical history (e.g., tubal ligation or hysterectomy), post menopausal with a minimum 1 year without menses;

  • Had any known hypersensitivity to 1 or more ingredients of LUMASON (sulfur hexafluoride or to any components of LUMASON);
  • Had any known hypersensitivity to dobutamine;
  • Had an ongoing or recent (within the last 30 days) acute myocardial infarction;
  • Had known right-to-left, bidirectional or transient cardiac shunt (ruled out with agitated saline study performed before administration of LUMASON);
  • Had electrolyte (especially potassium and magnesium) abnormalities;
  • Had unstable pulmonary and/or systemic hemodynamic conditions e.g.:

decompensated or inadequately controlled congestive heart failure (NYHA Class IV);

  • hypovolemia;
  • uncontrolled hypertension, i.e. resting systolic blood pressure >200 mmHg or diastolic blood pressure >110 mmHg;
  • unstable angina;
  • acute coronary syndrome;
  • aortic dissection;
  • acute pericarditis,
  • myocarditis, or endocarditis;
  • stenosis of the main left coronary artery;
  • hemodynamically significant outflow obstruction of the left ventricle, including hypertrophic obstructive cardiomyopathy;
  • hemodynamically significant cardiac valvular defect;
  • acute pulmonary embolism;
  • Had uncontrolled cardiac arrhythmias;
  • Had significant disturbance in conduction;
  • Had hypertrophic subaortic stenosis;
  • Had an acute illness (e.g., infections, hyperthyroidism, or severe anemia);
  • Was previously entered into this study or received an investigational compound within 30 days before admission into this study;
  • Had been treated with any other contrast agent either intravascularly or orally within 48 hours of the first LUMASON administration;
  • Had any medical condition or other circumstances which would significantly decrease the chances of obtaining reliable data, achieving study objectives, or completing the study and/or postdose follow-up examinations;

In addition, due to the use of Atropine in subjects who had not reached targeted heart rate with peak dobutamine infusion, subjects with the following were excluded:

  • Glaucoma;
  • Pyloric stenosis;
  • Prostatic hypertrophy.

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): NCT02552238


Locations
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United States, California
Coastal Multi-Specialty Research, Coastal Heart Medical Group
Santa Ana, California, United States, 92704
United States, Delaware
Alfieri Cardiology
Wilmington, Delaware, United States, 19803
United States, Florida
Homestead Cardiac and Vein Center
Homestead, Florida, United States, 33030
United States, Louisiana
Ochsner Clinic Foundation
New Orleans, Louisiana, United States, 70121
United States, Missouri
St. Louis University Hospital
Saint Louis, Missouri, United States, 63110
United States, Nebraska
University of Nebraska Medical Center
Omaha, Nebraska, United States, 68198
United States, North Carolina
Duke University Medical Center Cardiac Diagnostic Unit
Durham, North Carolina, United States, 27710
United States, Texas
University of Texas Medical Branch at Galveston
Galveston, Texas, United States, 77555
Belgium
Cliniques Universitaires Saint-Luc Unité de Pathologie Cardio-Vasculaire / Cardiologie
Bruxelles, Belgium, 1200
Antwerp University Hospital
Edegem, Belgium, 2650
Canada, Ontario
St. Michael's Hospital
Toronto, Ontario, Canada, M5B 1W8
United Kingdom
Northwick Park Hospital
Harrow, Middlesex, United Kingdom, HA1 3UJ
Hammersmith Hospital
London, United Kingdom, W12 0HS
Sponsors and Collaborators
Bracco Diagnostics, Inc
Investigators
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Study Director: Melda Dolan, MD Bracco Diagnostics, Inc
  Study Documents (Full-Text)

Documents provided by Bracco Diagnostics, Inc:
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Responsible Party: Bracco Diagnostics, Inc
ClinicalTrials.gov Identifier: NCT02552238    
Other Study ID Numbers: BR1-142
First Posted: September 17, 2015    Key Record Dates
Results First Posted: August 5, 2020
Last Update Posted: July 7, 2021
Last Verified: August 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by Bracco Diagnostics, Inc:
Lumason
Dobutamine stress echo
stress echo
coronary artery disease
Additional relevant MeSH terms:
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Coronary Artery Disease
Myocardial Ischemia
Coronary Disease
Heart Diseases
Cardiovascular Diseases
Arteriosclerosis
Arterial Occlusive Diseases
Vascular Diseases