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Evaluation of Safety & Efficacy of BIO-11006 Inhalation Solution in Patients With ARDS

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ClinicalTrials.gov Identifier: NCT03202394
Recruitment Status : Recruiting
First Posted : June 28, 2017
Last Update Posted : December 6, 2018
Sponsor:
Information provided by (Responsible Party):
BioMarck Pharmaceuticals, Ltd.

Brief Summary:
This Phase IIa pilot study is a placebo controlled, multicenter study to evaluate safety and efficacy of aerosolized BIO-11006 Inhalation Solution in ARDS patients. The subjects will be randomized 1:1 to either BIO-11006 125 mg twice daily plus standard of care or placebo plus standard of care. The treatment will continue for up to 28 days. The study will enroll up to 40 adult ARDS patients in up to eight sites within USA.

Condition or disease Intervention/treatment Phase
Respiratory Distress Syndrome, Adult Drug: BIO-11006 Drug: Placebo Phase 2

Detailed Description:

This is a randomized, double blind, placebo controlled, parallel-group Phase IIa pilot study of aerosolized BIO 11006 in patients with sepsis-induced acute respiratory distress syndrome (ARDS). All patients enrolled in the study will be ventilated. To be eligible for enrollment, patients must be adults who have sepsis-induced ARDS within 48 hours prior to enrollment, require intubation, and exhibit bilateral infiltrates consistent with pulmonary edema on the frontal chest radiograph within 48 hours of enrollment. Patients will be randomized in a 1:1 ratio to either BIO-11006 125 mg twice daily (BID) plus standard of care ventilation or placebo (half normal saline [HNS]) BID plus standard of care ventilation. Patients randomized to receive BIO-11006 or placebo will start dosing at the time of ventilation and continue for up to 28 days or length of ventilation (if shorter). Patients in both groups will receive best available standard of care treatment, including low-volume mechanical ventilation as indicated by clinical judgment and patient response. The maximum duration of treatment will be 30 days.

The primary objective of this study is to evaluate the safety and efficacy of aerosolized BIO-11006 at a dose of 125 mg BID in ventilated patients who have ARDS. Safety is the primary endpoint in this study and will be monitored by adverse event reporting, oxygenation, mortality, vital signs, ventilator-free days, and ICU-free days.

This study will enroll up to 40 adult patients with ARDS induced by sepsis who first met the Berlin Criteria for ARDS within 48 hours of enrollment, and who require intubation and exhibit bilateral opacities consistent with pulmonary edema on frontal chest radiograph within 48 hours of enrollment.

BIO 11006 Inhalation Solution drug product is formulated at a dosage strength of 41.67 mg/mL (125 mg/3 mL) as an aqueous solution containing sodium chloride and is intended for aerosol administration by the "Aeroneb Pro®" nebulizer to patients randomized to active treatment.


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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 60 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Patients will be randomized in a 1:1 ratio to either BIO 11006 125 mg twice daily (intervention) plus standard of care ventilation or placebo BID plus standard of care ventilation. Patients randomized to receive BIO 11006 or placebo will start dosing at the time of ventilation and continue for up to 30 days or length of ventilation (if shorter).
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase IIa, Placebo Controlled, Multicenter Pilot Study to Evaluate the Safety and Efficacy of BIO-11006 Inhalation Solution in Patients With Acute Respiratory Distress Syndrome
Actual Study Start Date : August 5, 2017
Estimated Primary Completion Date : August 31, 2019
Estimated Study Completion Date : December 1, 2019


Arm Intervention/treatment
Active Comparator: Active intervention
Patients will be randomized in a 1:1 ratio to either aerosolized BIO-11006 (125mg in 3mL half normal saline) intervention twice daily plus ventilation for up to 28 days or placebo.
Drug: BIO-11006
Intervention involves aerosolized delivery of either the active drug or placebo by the "Aeroneb Pro nebulizer".

Placebo Comparator: Placebo intervention
Patients will be randomized in a 1:1 ratio to either aerosolized placebo (3mL half normal saline) intervention twice daily plus ventilation for up to 28 days or active drug.
Drug: Placebo
Intervention involves aerosolized delivery of either the active drug or placebo by the "Aeroneb Pro nebulizer".
Other Name: Half Normal saline




Primary Outcome Measures :
  1. Incidence of treatment-emergent adverse events [ Time Frame: 28 days ]
    Assessment of frequency, type, severity, and duration of treatment-emergent Adverse Events (AE) daily during 28 day treatment period, including clinically significant laboratory abnormalities


Secondary Outcome Measures :
  1. Incidence of mortality [ Time Frame: End of treatment period (28 days) and end of follow up period (180 days) ]
    Mortality will be assessed daily during treatment for 28 days and at day 180 after enrollment.

  2. Number of Intensive Care Unit (ICU)-free days [ Time Frame: 28 days ]
    Number of days not in the ICU assessed daily during the 28 day treatment period.

  3. Number of ventilator-free days [ Time Frame: 28 days ]
    Number of days off the ventilator assessed daily during 28 day treatment

  4. Change in oxygen saturation / fraction of inspired oxygen (S/F) ratio [ Time Frame: 28 days ]
    Change in theS/F ratio assessed daily during the 28 day treatment period

  5. Change in pro-inflammatory biomarkers from baseline to end of treatment [ Time Frame: pretreatment and end of treatment period (28 days) ]
    ARDS associated biomarkers will be measured in plasma



Information from the National Library of Medicine

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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:

  1. Has provided (or relative has) written informed consent and authorization for use and disclosure of protected health information
  2. Has a clinical diagnosis of sepsis or septic shock defined as:

    • Known or suspected infection
    • Systemic inflammatory response syndrome (SIRS), defined as meeting at least 2 of the following 3 criteria for a systemic inflammatory response:

      • White blood cell count >12,000 or <4,000 or >10% band forms
      • Body temperature >38°C (any route) or <36°C (by core temperatures only: indwelling catheter, esophageal, rectal)
      • Heart rate >90 beats/min or receiving medications that slow heart rate or pace rhythm
  3. Enrollment must occur within 48 hours of first meeting ARDS criteria per the Berlin definition of ARDS (ARDS Task Force 2012) and no more than 72 hours from the initiation of mechanical ventilation. (The bilateral opacities, respiratory failure, and decreased P/F ratio must all be present within a 24 hour time period of one another.):

    • Lung injury of acute onset, within 1 week of an apparent clinical insult, with progression of respiratory symptoms
    • Bilateral opacities on chest imaging not fully explained by effusions, lobar/lung collapse, or nodules.
    • Respiratory failure not fully explained by cardiac failure or fluid overload. (Need objective assessment (e.g. echocardiography) to exclude hydrostatic edema if no risk factor present.)
    • Decreased arterial partial pressure of oxygen (PaO2)/ fraction of inspired oxygen (FIO2) ratio while on a minimum Positive End Expiratory Pressure (PEEP) of 5 cm water (H2O):

      • Moderate ARDS: 101 to 200 mmHg (≤ 26.6 kPa)
      • Severe ARDS: ≤ 100 mmHg (≤ 13.3 kPa)

Exclusion Criteria:

  1. Age < 18 years or >75 years old
  2. Greater than 48 hours since first meeting ARDS criteria per the Berlin definition of ARDS
  3. Pregnant or breastfeeding (negative pregnancy test required prior to randomization for female patients of childbearing potential.)
  4. Prisoner
  5. Any other irreversible disease or condition for which 6 month mortality is estimated to be > 50%
  6. Moderate to severe liver failure (Child Pugh Score > 12)
  7. Severe chronic respiratory disease with a PaCO2 > 50 mmHg or the use of home oxygen
  8. Patient, surrogate, or physician not committed to full support (exception: a patient will not be excluded if he/she would receive all supportive care except for attempts at resuscitation from cardiac arrest).
  9. Major trauma in the prior 5 days
  10. Lung transplant patient
  11. No consent/inability to obtain consent
  12. Moribund patient not expected to survive 24 hours
  13. World Health Organization (WHO) Functional Class III or IV pulmonary hypertension
  14. No intent/unwillingness to follow lung protective ventilation strategy or fluid management protocol
  15. Currently receiving extracorporeal life support or high frequency oscillatory ventilation
  16. Known hypersensitivity to BIO 11006
  17. Burn victims >20% Total Body Surface Area (TBSA) or with known airway inhalation injury

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): NCT03202394


Contacts
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Contact: Shannon S Carson, MD 919-966-2531 scarson@med.unc.edu
Contact: Brian Dickson, MD 919-607-8490 bdickson@biomarck.com

Locations
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United States, Illinois
University of Chicago Medicine Recruiting
Chicago, Illinois, United States, 60637
Contact: John Kress, MD    773-702-6790    jkress@medicine.bsd.uchicago.edu   
Contact: Anne Pohlmann, MSN    773-702-3804    apohlman@medicine.bsd.uchicago.edu   
United States, North Carolina
University of North Carolina School of Medicine Recruiting
Chapel Hill, North Carolina, United States, 27599
Contact: Shannon S Carson, MD    919-966-2531    scarson@med.unc.edu   
Contact: Wayne Anderson, PhD    919-445-0351    wayne_anderson@med.unc.edu   
Wake Forest University Recruiting
Winston-Salem, North Carolina, United States, 27157
Contact: Kevin Gibbs, MD    336-716-1210    kgibbs@wakehealth.edu   
Contact: Lori Flores, RN    336-713-0008    lflores@wakehealth.edu   
United States, Pennsylvania
University of Pennsylvania Recruiting
Philadelphia, Pennsylvania, United States, 19104
Contact: Nuala Meyer, MD    215-662-7049    Nuala.Meyer@uphs.upenn.edu   
Contact: Caroline Ittner    215-662-7056    Caroline.Ittner@uphs.upenn.edu   
United States, Tennessee
Vanderbilt University, Div of Allergy, Pulmonary, Critical Care Recruiting
Nashville, Tennessee, United States, 37232
Contact: Todd Rice, MD    615-322-3412    todd.rice@vanderbilt.edu   
Contact: Margaret A Hays, RN,MSN    615-343-8013    margaret.hays@vanderbilt.edu   
Sponsors and Collaborators
BioMarck Pharmaceuticals, Ltd.
Investigators
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Study Chair: Brian Dickson, MD Biomarck Pharmaceuticals

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Responsible Party: BioMarck Pharmaceuticals, Ltd.
ClinicalTrials.gov Identifier: NCT03202394     History of Changes
Other Study ID Numbers: BIM-CL-005
First Posted: June 28, 2017    Key Record Dates
Last Update Posted: December 6, 2018
Last Verified: December 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by BioMarck Pharmaceuticals, Ltd.:
intubation
aerosol
sepsis
edema
Additional relevant MeSH terms:
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Respiratory Distress Syndrome, Newborn
Respiratory Distress Syndrome, Adult
Syndrome
Respiratory Tract Diseases
Infant, Newborn, Diseases
Acute Lung Injury
Disease
Pathologic Processes
Respiration Disorders
Lung Diseases
Infant, Premature, Diseases
Lung Injury