Acute Kidney Injury Clinical Trial
Official title:
A Multi-Center, Parallel-Group, Randomized, Double Blind, Adaptive Study Investigating the Safety and Efficacy of THR-184 in Patients at Increased Risk of Developing Cardiac Surgery Associated-Acute Kidney Injury (CSA-AKI)
The purpose of this study is to determine whether THR-184 when administered around the time of cardiac surgery that requires cardiopulmonary bypass can prevent or ameliorate the development of acute kidney injury.
The study has been designed to include patients scheduled for cardiac surgery who are
considered at increased risk for developing CSA-AKI. The eligibility criteria are intended
to enrich the study population with such patients.
Stage 1 consisted of 140 patients randomized in a 1:1:1:1 ratio (approximately 35 patients
per treatment arm) to Placebo or to one of three (3) THR-184 dose arms:
- initial pre-surgery low dose of THR-184 by three (3) post-surgery doses at the low
dose, or
- initial pre-surgery middle dose of THR-184 followed by three (3) post-surgery doses at
the low dose, or
- initial pre-surgery high dose of THR-184 followed by three (3) post-surgery doses at
the low dose
An interim analysis (IA) was performed by the Independent Statistical Center (ISC) and
presented to the Independent Data Monitoring Committee (IDMC). The IDMC indicated no safety
concerns and recommended that the study continue with the placebo arm and the initial
pre-surgery high dose arm. Additionally, another dosing arm will be added, which will
increase the dose post-surgery.
Stage 2 will consist of approximately 270 patients randomized in a 1:1:2 ratio to Placebo or
to a dose selected from one of the two (2) THR-184 dose arms:
- initial pre-surgery high dose of THR-184, followed by (3) post-surgery doses at the
original low dose;
- initial pre-surgery high dose of THR-184, followed by (3) post-surgery doses at ~80% of
the pre-surgery dose
Study treatment (THR-184 or placebo) will consist of one 60-minute IV infusion administered
prior to surgery, followed by a 60-minute IV infusion administered, beginning in the early
post-operative period, and followed by two (2) additional 60-minute IV infusions
administered, on consecutive days post-cardiac surgery.
The primary endpoint for the evaluation of efficacy in patients receiving THR-184, as
compared to patients receiving Placebo, will be the proportion of patients developing
CSA-AKI as measured by the Kidney Disease Improving Global Outcomes (KDIGO) criteria, as
follows:
- Increase in Serum creatinine (SCr) by ≥0.3 mg/dl (>26.5 µmol/l) within 48 hours
post-surgery; or
- Increase in SCr to ≥1.5 times a baseline which has been measured in the previous 7
days; or
- Urine volume <0.5 ml/kg/h for 6 hours post-operatively
If at least one of these measures is present by the 7 day assessment, a patient will be
considered to have developed CSA-AKI.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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