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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT01906307
Other study ID # LJPC-501-CS-5001
Secondary ID
Status Terminated
Phase Phase 1
First received July 17, 2013
Last updated March 1, 2016
Start date March 2014
Est. completion date December 2015

Study information

Verified date March 2016
Source La Jolla Pharmaceutical Company
Contact n/a
Is FDA regulated No
Health authority United States: Food and Drug Administration
Study type Interventional

Clinical Trial Summary

Hepatorenal syndrome (HRS) is a life-threatening condition marked by rapid decline in kidney function in patients with liver cirrhosis or fulminant liver failure. Vasodilation in the gastrointestinal region is largely thought to contribute to the disease. LJPC-501 is a vasoconstrictor that may restore proper circulation and kidney function in patients with HRS.


Description:

Vasoconstrictors are considered a promising approach to treat HRS due to the significant vasodilation of the splanchnic circulation that contributes to systemic arterial underfilling and leads to functional decline of the kidney in these patients. Vasoconstrictors currently in use are associated with reduced organ perfusion and have marginal effect on sodium excretion. The vasoconstrictor angiotensin II has been shown to produce significant sodium excretion and urine output in patients with cirrhosis and ascites, supporting its potential utility in the treatment of HRS.


Recruitment information / eligibility

Status Terminated
Enrollment 6
Est. completion date December 2015
Est. primary completion date November 2015
Accepts healthy volunteers No
Gender Both
Age group 18 Years and older
Eligibility Inclusion Criteria:

1. Patients with HRS, as defined by the International Ascites Club [1]:

- Cirrhosis with ascites

- Serum creatinine > 1.5 mg/dL

- No improvement of serum creatinine (decrease to a level of = 1.5 mg/dL) after at least 2 days with diuretic withdrawal and volume expansion with albumin

- Absence of shock

- No current or recent treatment with nephrotoxic drugs

- Absence of parenchymal kidney disease, as indicated by proteinuria > 500 mg/day, microhematuria (> 50 red blood cells per high power field) and/or abnormal renal ultrasonography

Or patients with HRS due to acute alcoholic hepatitis

2. Patient is able to undergo a reliable neurologic exam, as determined by the investigator

3. Patient or legal surrogate is willing and able to provide written informed consent

4. Patient is willing and able to comply with all protocol requirements

Exclusion Criteria:

1. Evidence of shock

2. Current or recent treatment with nephrotoxic drugs

3. Use of midodrine, octreotide, or other vasopressors within 48 hours of screening

4. Current treatment with dialysis

5. Serum creatinine > 7 mg/dL

6. Active cardiovascular disease within 3 months of screening

7. History of transient ischemic attacks or prior stroke

8. History of organ transplant

9. Ongoing infection requiring intravenous administration of antibiotics (patients with documented infections considered by the Investigator to be controlled within 48 hours of screening may be permitted in the study upon consultation with the Sponsor's Medical Monitor)

10. Participation in a clinical trial within 30 days of screening

11. Patient unlikely to survive more than 72 hours in the opinion of the investigator

12. Patient is pregnant or planning to become pregnant during study

Study Design

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment


Related Conditions & MeSH terms


Intervention

Drug:
LJPC-501
Patients will receive LJPC-501 at titrated doses, with a starting range from 1 to 100 ng/kg/min, by continuous infusion on Days 1 through 5. In Group 1, drug doses will be titrated to 5, 15, and 25 ng/kg/min, after which doses will be titrated in multiples of 25 ng/kg/min. In Groups 2-5, drug doses will be titrated by 25 ng/kg/min. Dose titrations will occur every 2 hours until a MAP of 110 mmHg is reached, maximum urine output is achieved, or a dose of 250 ng/kg/min is achieved. Dosing will then continue at the maximum dose achieved through Day 5.

Locations

Country Name City State
United States Annette C. & Harold C. Simmons Transplant Institute @ Baylor University Medical Center Dallas Texas

Sponsors (1)

Lead Sponsor Collaborator
La Jolla Pharmaceutical Company

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Other Change in biomarkers of disease activity from baseline on Day 5 baseline and Day 5 No
Primary Adverse events through 5 days of treatment 5 days Yes
Secondary Maximum Tolerated Dose 5 days Yes
Secondary Effects on serum creatinine through 5 days of treatment 5 days No
Secondary Effects on ascites through 5 days of treatment 5 days No
Secondary Effects on urine output through 5 days of treatment 5 days No
Secondary Effects on sodium excretion through 5 days of treatment 5 days No