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Efficacy and Safety of CUSA-081 in the Restoration of Central Venous Access Device (CVAD) Functionality (READY 1)

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ClinicalTrials.gov Identifier: NCT03594175
Recruitment Status : Recruiting
First Posted : July 20, 2018
Last Update Posted : April 19, 2021
Sponsor:
Information provided by (Responsible Party):
Chiesi Farmaceutici S.p.A.

Brief Summary:
Study to evaluate the efficacy and safety of CUSA-081 in the restoration of central venous access device (CVAD) functionality in participants 18 years and older.

Condition or disease Intervention/treatment Phase
Catheter Occlusion Thrombosis Drug: CUSA-081 Drug: Placebo Drug: Alteplase Phase 3

Detailed Description:

This is a phase III, multinational, multicenter, randomized, double-blind, parallel-group, active and placebo-controlled study to examine CUSA-081 versus placebo or alteplase in subjects with dysfunctional non-hemodialysis Central Venous Access Devices (CVADs).

During the study, the treatment period will consist of one visit which may take place on the same day as screening or on the following day. After meeting all inclusion criteria, subjects will be randomized in a 9:1:6 ratio of CUSA-081: placebo: alteplase. There will be a follow-up assessment performed on Day 30 (±2 days) after treatment with study drug.

Routine blood pressure measurement, heart rate and urine pregnancy test will be performed before enrollment in the study. Safety, including Treatment Emergent AEs (TEAEs), Adverse Drug Reactions (ADRs) and Adverse Events of Special Interest (AESI), will be recorded throughout the study. The end of the trial is defined as the last follow-up contact of the last subject to receive study drug in the trial.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 800 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Phase 3, Randomized, Double-Blind, Active and Placebo-Controlled Study on the Use of CUSA-081 for Dysfunctional Central Venous Access Devices (CVADs)
Actual Study Start Date : February 12, 2020
Estimated Primary Completion Date : August 2022
Estimated Study Completion Date : September 2022

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: CUSA-081
Participants will receive 1 or 2 doses of CUSA-081, 0.7 milligrams (mg) (0.4 units) per 2 milliliter (mL) directly into the catheter lumen. Participants will receive the first dose at minute (min) 0, and the second dose, if needed, at min 90.
Drug: CUSA-081
Participants will receive 1 or 2 doses of CUSA-081 0.7 mg/2 mL directly into the catheter lumen
Other Name: reteplase

Placebo Comparator: Placebo
Participants will receive 1 or 2 doses of placebo (normal saline) directly into the catheter lumen. Participants will receive the first dose at min 0, and the second dose, if needed, at min 90.
Drug: Placebo
Participants will receive 1 or 2 doses of placebo (normal saline) directly into the catheter lumen

Active Comparator: Alteplase
Participants will receive 1 or 2 doses of alteplase, 2 mg/mL, directly into the catheter lumen. Participants will receive the first dose at min 0, and the second dose, if needed, at min 90.
Drug: Alteplase
Participants will receive 1 or 2 doses of alteplase, 2 mg/2 mL, directly into the catheter lumen




Primary Outcome Measures :
  1. Percentage Of Participants With Treatment Success Following A Single Instillation Of Study Drug With A Dwell Time Up To 90 Mins [ Time Frame: Day 1 (up to 90 mins postdose) ]
    Treatment success is defined as the restoration of CVAD functionality, measured as the ability to withdraw 3 mL of blood and infuse 5 mL of saline. For this assessment, dwell time is up to 90 mins. The percentage will be calculated as the number of participants with treatment success divided by the total number of participants in the group, multiplied by 100%.


Secondary Outcome Measures :
  1. Percentage Of Participants With Treatment Success Following A Single Instillation Of Study Drug With A Total Dwell Time Up To 30 And 60 Mins [ Time Frame: Day 1 (up to 30 and 60 mins postdose) ]
    Treatment success is defined as the restoration of CVAD functionality, measured as the ability to withdraw 3 mL of blood and infuse 5 mL of saline. For this assessment, dwell time is up to 60 mins. The percentage will be calculated as the number of participants with treatment success divided by the total number of participants in the group, multiplied by 100%.

  2. Percentage Of Participants With Treatment Success After Up To 2 Instillations Of Study Drug With A Total Dwell Time Up To 120, 150, And 180 Mins [ Time Frame: Day 1 (up to 120, 150, and 180 mins postdose) ]
    Treatment success is defined as the restoration of CVAD functionality, measured as the ability to withdraw 3 mL of blood and infuse 5 mL of saline. For this assessment, dwell time is up to 180 mins. The percentage will be calculated as the number of participants with treatment success divided by the total number of participants in the group, multiplied by 100%.

  3. Rate Of Recurrent Catheter Dysfunction Within 30 Days Following Treatment With Study Drug [ Time Frame: Day 1 (postdose) up to Day 30 ]
    The rate of recurrent catheter dysfunction is defined as re-occlusion. The rate of recurrent catheter dysfunction will be analyzed using the Kaplan-Meier method. This analysis is based on all participants with treatment success following up to 2 administrations of study drug with a total dwell time up to 180 mins.



Information from the National Library of Medicine

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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:

  1. Inability to have 3mL of blood withdrawn from the selected study catheter;
  2. A single or multi-lumen CVAD, implanted ports or peripherally inserted central catheters (PICCs) in place for > 24 hours and documented as previously being patent and functional;
  3. Ability to designate one dysfunctional lumen of a multi-lumen catheter to be used throughout the study for both study drug instillation and assessment of CVAD function;
  4. Male and non-pregnant female subjects from all racial and ethnic groups 18 years of age and older;
  5. Able to have fluids infused at the volume necessary to instill study drug into the CVAD (i.e., up to 2 mL);
  6. Informed consent form (ICF) signed and dated indicating that the subject has been informed of and agreed with all pertinent aspects of the study and is willing to comply with all study requirements and procedures.

Exclusion Criteria:

  1. CVAD (any type) used for hemodialysis;
  2. CVAD known to be dysfunctional for more than 48 hours;
  3. Reasonable evidence of mechanical or non-thrombotic occlusion in the selected study catheter (e.g., catheter malposition or migration, sutures, kinks, or precipitates causing obstruction), radiographic assessment is not required;
  4. Known or suspected catheter related bloodstream infection (CRBSI);
  5. Use of any fibrinolytic agent or anticoagulant (e.g., alteplase, tenecteplase, reteplase, urokinase or heparin) within 24 hours prior to the treatment period (first instillation of study drug). Use of subcutaneous LMWH for prophylaxis of thromboembolic events is allowed;
  6. Known to be at high risk for bleeding events or embolic complications in the opinion of the Investigator, or has a known condition for which bleeding constitutes a significant hazard (e.g. recent stroke, recent intracranial or intraspinal surgery or serious head trauma, intracranial neoplasm, arteriovenous malformation or aneurysm, known bleeding diathesis);
  7. Uncontrolled hypertension (systolic BP ≥160 or diastolic BP ≥110 mmHg) at screening;
  8. Clinically unstable in the opinion of the site investigator;
  9. Known to be pregnant or breastfeeding at screening;
  10. Previously treated in this study (READY 1) or in study READY 2;
  11. History of allergic reaction to reteplase, alteplase or vial ingredients (excipients or diluents);
  12. Use of any investigational drug or experimental medical device within 28 days prior to treatment; non interventional observational studies participation is allowed.
  13. Not mentally, socially, or otherwise able to complete the trial assessment or not likely to survive beyond 30 days.

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): NCT03594175


Contacts
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Contact: Chiesi Clinical Trial Information +39 0521 279 715 clinicaltrials_info@chiesi.com

Locations
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Sponsors and Collaborators
Chiesi Farmaceutici S.p.A.
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Responsible Party: Chiesi Farmaceutici S.p.A.
ClinicalTrials.gov Identifier: NCT03594175    
Other Study ID Numbers: CUSA-081-HEM-01
2019-002124-32 ( EudraCT Number )
First Posted: July 20, 2018    Key Record Dates
Last Update Posted: April 19, 2021
Last Verified: April 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
Keywords provided by Chiesi Farmaceutici S.p.A.:
CVAD
CUSA-081
reteplase
alteplase
occluded catheters
catheter
occlusion
thrombosis
thrombotic occlusion
Additional relevant MeSH terms:
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Thrombosis
Embolism and Thrombosis
Vascular Diseases
Cardiovascular Diseases
Tissue Plasminogen Activator
Reteplase
Fibrinolytic Agents
Fibrin Modulating Agents
Molecular Mechanisms of Pharmacological Action