Hypotension Clinical Trial
Official title:
A Phase IIa Study of Safety and Efficacy of NOX-100 for Preventing Hypotension in Patients During Hemodialysis Sessions
This study is designed to evaluate the safety, tolerability and efficacy profile of NOX-100 to reduce intradialytic hypotension (IDH) in patients undergoing chronic hemodialysis (HD).
This is a 2-stage, prospective, randomized, double-blind, multi-dose, placebo-controlled,
cross-over, phase IIa study to evaluate the safety, tolerability and efficacy profiles of
NOX-100 to reduce the number of intradialytic hypotension episodes. At single-blind stage I,
the eligible subject will receive a 1-week run-in period followed by a 1-week NOX-100
treatment in a dose of 0.4mg/kg/hr. To evaluate the clearance of NOX-100, plasma levels of
NOX-100 at the end of the 1st dialysis and prior to the 2nd dialysis will be measured. An
interim analysis will be undertaken after the completion of first stage. The following
process should be conducted only if the plasma level of NOX-100 decreases by 90% or more in
these patients and all safety data have been reviewed by the medical monitor.
At double blind stage II, patients will be randomized to one of the following treatment
sequences in a 1:1 ratio.
- Sequence A: NOX-100 treatment phase followed by Placebo treatment phase
- Sequence B: Placebo treatment phase followed by NOX-100 treatment phase
After a 1-week placebo, the subjects will receive the two 4-week treatment (sequence A or
sequence B)which are separated by 1-week wash-out. In the NOX-100 treatment phase, subjects
will subsequently receive NOX-100 in doses of 1.2, 2.5, 5, and 10 mg/kg/hr at the first three
dialysis sessions over each week. In the placebo treatment phase, subjects will receive
comparative placebo for four weeks. For the first 20 subjects, the treatment dose could be
escalated only after the individual safety data have been reviewed by an unblinded medical
monitor.
To confirm if there is hepatic metabolism of NOX-100 between dialysis sessions, a
pre-dialysis plasma level will be tested at the 2nd dialysis of Week 2, 5, 7 and 10 in the
second stage.
In both stages, the blood pressure will be measured pre-HD, every 30 minutes during HD and
post-HD for monitoring the hypotension episode. For safety assessment, all AE(s), SAE(s) and
any signs/symptoms during HD will be recorded. The safety of study drug will be followed
until 4 weeks after last treatment.
A Data and Safety Monitoring Board (DSMB) will be established prior to start of the trial and
the DSMB meeting will be hold every 6~12 months during study period. Both medical monitor and
DSMB will be responsible for safeguarding the interests of trial participants.
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