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Study of Dutogliptin in Combination With Filgrastim in Post-Myocardial Infarction

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: NCT03486080
Recruitment Status : Completed
First Posted : April 3, 2018
Last Update Posted : May 27, 2021
Information provided by (Responsible Party):
Recardio, Inc.

Brief Summary:
A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Safety and Efficacy Study of Dutogliptin in Combination with Filgrastim in Early Recovery Post-Myocardial Infarction

Condition or disease Intervention/treatment Phase
Acute Myocardial Infarction Acute Myocardial Ischemia STEMI - ST Elevation Myocardial Infarction Drug: Dutogliptin Tartrate Drug: Filgrastim Injectable Product Drug: Placebos Phase 2

Detailed Description:

Dutogliptin 60 mg administered by twice daily subcutaneous (SC) injection for 14 days in combination with a fixed standard dose of filgrastim (10 µg/kg) administered SC daily for 5 days. This study will be conducted in adults with ST-elevation myocardial infarction (STEMI) with successful revascularization following percutaneous coronary intervention (PCI) and stent implantation.

Primary Objective

• To evaluate the safety and tolerability of dutogliptin in combination with filgrastim in subjects with STEMI compared with placebo

Secondary Objectives

  • To assess preliminary efficacy of dutogliptin in combination with filgrastim in subjects with STEMI compared with placebo as determined by cardiac magnetic resonance imaging (cMRI)
  • To determine the pharmacokinetics (PK) of dutogliptin in a subset of the study population
  • To establish the pharmacodynamics (PD) of dutogliptin (plasma DPP4 activity) in a subset of the study population

Exploratory Objectives

  • To examine the effects of dutogliptin in combination with filgrastim on:
  • Change from baseline in plasma stromal cell-derived factor (SDF)-1a levels
  • Change from baseline in plasma biomarkers, including N-terminal pro-b-type natriuretic peptide (NT-proBNP) and high sensitivity troponin

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 49 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description: Blinded placebo controlled
Primary Purpose: Treatment
Official Title: A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Safety and Efficacy Study of Dutogliptin in Combination With Filgrastim in Early Recovery Post-Myocardial Infarction
Actual Study Start Date : December 7, 2018
Actual Primary Completion Date : February 26, 2021
Actual Study Completion Date : February 26, 2021

Arm Intervention/treatment
Active Comparator: Dutogliptin/filgrastim combination
Twice daily SC injections of 60 mg dutogliptin tartrate for 14 days in combination with 10 µg/kg filgrastim injectable product for 5 days
Drug: Dutogliptin Tartrate
Active treatment
Other Name: dutogliptin

Drug: Filgrastim Injectable Product
Active treatment
Other Name: filgrastim

Placebo Comparator: Placebo control
Twice daily dutogliptin SC placebos for 14 days in combination with matching filgrastim SC placebos for 5 days
Drug: Placebos
placebo control
Other Name: placebo

Primary Outcome Measures :
  1. Safety assessment of the number of Grade 3 and 4 treatment emergent AEs or serious AEs (SAEs) as assessed by CTCAE v4.0.AEs (SAEs) as assessed by CTCAE v4.0. [ Time Frame: 90 days ]
    Assess the tolerability of a combination of dutogliptin and filgrastim

Secondary Outcome Measures :
  1. Cardiovascular efficacy LVEF [ Time Frame: 90 days ]
    Left ventricular ejection fraction (%) by MRI

  2. Cardiovascular efficacy LVESV [ Time Frame: 90 days ]
    Left ventricular end systolic volume (mL) by MRI

  3. Cardiovascular efficacy LVEDV [ Time Frame: 90 days ]
    Left ventricular end diastolic volume (mL) by MRI

  4. Cardiovascular tissue damage reduction [ Time Frame: 90 days ]
    Infarct size (mm2)

  5. Cardiovascular LFM [ Time Frame: 90 days ]
    Left ventricular mass (mm2)

  6. Cardiovascular motion [ Time Frame: 90 days ]
    Regional wall motion (mm)

  7. Pharmacokinetics (PK) [ Time Frame: 14 days ]
    Assess the systemic exposure (dutogliptin AUC) of s.c. administered dutogliptin

  8. Pharmacodynamics (PD) [ Time Frame: 14 days ]
    Assess the PD effects (plasma DPP4 activity) of s.c. administered dutogliptin

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years to 85 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. 1. Male or female born between 1933 and 2000.
  2. Body weight <96 kg (212 lb).
  3. Able to provide written informed consent, including signing and dating the informed consent form (ICF).
  4. Diagnosis of STEMI (defined as new ST-segment elevation at the J point of at least 2 continuous leads of >2 mm [0.2 mV] in men or >1.5 mm [0.1 mV] in women in leads V2 and V3 OR >1 mm in any other contiguous precordial leads or the limb leads [for both men and women]) with PCI (bare metal or drug-eluting stent) and Thrombolysis in Myocardial Infarction flow grade 2 or 3 occurring >2 hours and <24 hours after symptom onset.
  5. LVEF ≤45% obtained by cECHO performed within 36 hours post-stent placement.
  6. Receiving standard medical therapy for post-MI treatment, according to local procedures and Principal Investigator discretion
  7. Female subjects of childbearing potential must have a negative serum pregnancy test at Screening and an additional negative urine pregnancy test prior to the first dose of IMP unless regulated differently by national legislation.
  8. Sexually active female subjects of childbearing potential (i.e., women who are not postmenopausal or who have not had a bilateral oophorectomy, hysterectomy, or tubal ligation) and all male subjects (who have not been surgically sterilized by vasectomy) must agree to use effective contraception during the study.

Exclusion criteria

  1. Previous MI prior to Screening.
  2. Complex peri/post-MI clinical course, including arrhythmias, cardiogenic shock, pulmonary edema requiring mechanical ventilation, or requirement for vasopressor medications.
  3. Significant pre-existing cardiomyopathy with known LVEF ≤45% or moderate to severe mitral or aortic valvular disease.
  4. Amyloidosis, hypertrophic obstructive cardiomyopathy, restrictive cardiomyopathy, or constrictive pericarditis.
  5. Existing heart transplant.
  6. Ventricular tachycardia or fibrillation not associated with an acute ischemic episode.
  7. Uncontrolled hypertension (systolic >180 mmHg or diastolic >120 mmHg).
  8. Treatment with any DPP4 inhibitors (e.g., alogliptin, linagliptin, vildagliptin, saxagliptin, sitagliptin) or G-CSF medication (e.g., filgrastim, lenograstim, pegfilgrastim, lipegfilgrastim) within 4 months prior to Randomization.
  9. Contraindication to treatment with filgrastim, including known allergy to filgrastim or other G-CSF medication.
  10. Anemia defined as hemoglobin <9 g/dL prior to Randomization.
  11. Thrombocytosis (platelets >500 k/µL).
  12. Known positive serology for hepatitis B, hepatitis C, or human immunodeficiency virus (HIV).
  13. Alanine aminotransferase (ALT) concentrations >3 times the upper limit of normal (ULN) or bilirubin >2 x ULN prior to Randomization, according to local laboratory assessments.
  14. History of cirrhosis and Child-Pugh score B or C.
  15. Current fever greater than 101.4 °F (38.6 °C) or recent systemic infection within 2 weeks prior to Randomization.
  16. Contraindication to cMRI procedure, including prior implantable cardioverter defibrillator placement, known reaction to gadolinium, claustrophobia, non-MRI-compatible, cochlear implant, morbid obesity, or presence of ferromagnetic material including shunts, shrapnel, penile prostheses, or blood vessel coil.
  17. Pregnant, planning to become pregnant, or nursing female subjects.
  18. Autoimmune disease requiring immunosuppressive therapy or chronic steroid treatment >5 mg/day prednisolone or equivalent.
  19. Significant renal impairment defined as estimated glomerular filtration rate <45 mL/min/1.73 m2, using the Chronic Kidney Disease Epidemiology Collaboration equation.
  20. Active neoplasm requiring surgery, chemotherapy, or radiation within the prior 12 months (subjects with a history of malignancy who have undergone curative resection or otherwise not requiring treatment for at least 12 months prior to Screening with no detectable recurrence are allowed).
  21. Malignant hematological disease, i.e., chronic myeloid leukemia or myelodysplastic syndrome.
  22. History of cerebrovascular accident or transient ischemic attack in the past 6 months.
  23. History of pneumonia in the last 4 weeks.
  24. History of any significant medical or psychiatric disorder that in the opinion of the investigator would make the subject unsuitable for participation in the study.
  25. Treatment with an investigational drug within 30 days or 5 half-lives (whichever is longer) or treatment with an investigational biologic drug within 6 weeks prior to randomization.
  26. Participation in another concurrent clinical trial involving a therapeutic intervention (participation in observational studies and/or registry studies is permitted).
  27. Unable or unwilling to comply with the requirements of the study.
  28. Subject and/or an immediate family member is an employee of the investigational site directly affiliated with this study, the sponsor or the contract research organization.
  29. Considered by the investigator to be unsuitable to participate in the study for any other reason.
  30. Persons who are in an institution as a result of an administrative or judicial order, or soldiers.
  31. History of alcohol or drug abuse.

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): NCT03486080

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Clinical department of Cardiology
Graz, Austria
Klinikum Klagenfurt am Wörthersee
Klagenfurt, Austria, 9020
Algemeen Stedelijk Ziekenhuis Aalst
Aalst, Belgium
Military Hospital
Budapest, Hungary
Semmelweis Egyetem Városmajori Szív- és Érgyógyászati Klinika
Budapest, Hungary
Debreceni Egyetem Kardiológiai és Szívsebészeti Klinika
Debrecen, Hungary
Borsod-Abaúj-Zemplén Megyei Központi Kórház és Egyetemi Oktatókórház
Miskolc, Hungary
Maasstad Ziekenhuis
Rotterdam, Netherlands
Nicolaus Copernicus University
Bydgoszcz, Poland
SPS Szpital Zachodni
Grodzisk Mazowiecki, Poland, 05-825
Samodzielny Publiczny Szpital Wojewódzki im. Papieża Jana Pawła II
Zamość, Poland
Centralny Szpital Kliniczny Uniwersytetu Medycznego w Lodzi ul. Pomorska 251
Łódź, Poland, 92-213
Sponsors and Collaborators
Recardio, Inc.
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Study Chair: Roman Schenk, MD Recardio, Inc.
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Responsible Party: Recardio, Inc. Identifier: NCT03486080    
Other Study ID Numbers: REC-DUT-002
First Posted: April 3, 2018    Key Record Dates
Last Update Posted: May 27, 2021
Last Verified: May 2021
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
Additional relevant MeSH terms:
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Myocardial Infarction
Myocardial Ischemia
ST Elevation Myocardial Infarction
Pathologic Processes
Heart Diseases
Cardiovascular Diseases
Vascular Diseases
Adjuvants, Immunologic
Immunologic Factors
Physiological Effects of Drugs