Sepsis Clinical Trial
Official title:
Senolytics To slOw Progression of Sepsis (STOP-Sepsis) Trial
The long-term goal is to test the clinical efficacy of senolytic therapies to reduce progression to and severity of sepsis in older patients. The central hypothesis is that a threshold burden of SnCs predisposes to a SASP mediated dysfunctional response to PAMPs, contributing to a disproportionate burden of sepsis in older patients. The study hypothesizes timely treatment with fisetin will interrupt this pathway. A multicenter, randomized, adaptive allocation clinical trial to identify the most efficacious dose of the senolytic fisetin to reduce the composite cardiovascular, respiratory, and renal sequential organ failure assessment score at 1 week, and predict the probability of success of a definitive phase III clinical trial.
Status | Recruiting |
Enrollment | 220 |
Est. completion date | August 23, 2026 |
Est. primary completion date | August 23, 2026 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 65 Years and older |
Eligibility | Inclusion Criteria: - Age >=65 years - Primary diagnosis of acute infection (per investigator judgment) - SOFA >1 - Admission order to the hospital - Expected length of stay >=48 hours (per investigator judgment) Exclusion Criteria: - Admission to the ICU - Vasopressors, mechanical ventilation, or dialysis - Comfort care only - Total bilirubin >3X or AST/ALT >4x upper limit of normal - eGFR < 25 ml/ min/ 1.73 m2 - Hemoglobin <7 g/dL; white blood cell count = 2,000/mm3; absolute neutrophil count =1 x 10^9/;, or platelet count = 40,000/µL - Known HIV, Hepatitis B, or Hepatitis C - Invasive fungal infection (per investigator judgment) - Uncontrolled effusions or ascites (per investigator judgment) - New/active invasive cancer except non-melanoma skin cancers - Known hypersensitivity or allergy to Fisetin. - Active treatment with potential drug-drug interactions - Enrolled in another sepsis clinical trial |
Country | Name | City | State |
---|---|---|---|
United States | Ridges | Burnsville | Minnesota |
United States | Southdale | Edina | Minnesota |
United States | St. John's | Maplewood | Minnesota |
United States | HCMC | Minneapolis | Minnesota |
United States | UMMC | Minneapolis | Minnesota |
United States | University of Minnesota | Minneapolis | Minnesota |
Lead Sponsor | Collaborator |
---|---|
University of Minnesota |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Difference in the composite cardiovascular, respiratory, and renal sequential organ failure assessment (CRR-SOFA) | The Sequential Organ Failure Assessment (SOFA) score is a scoring system that assesses the performance of several organ systems in the body (neurologic, blood, liver, kidney, and blood pressure/hemodynamics) and assigns a score based on the data obtained in each category. This outcome assesses only the cardiovascular, respiratory, and renal categories of the total SOFA score, and calculates the change from day 0 to day 7. | day 7 | |
Secondary | Safety of 2 doses of fisetin in patients with mild sepsis | Outcome is the number of serious adverse event | day 28 | |
Secondary | Organ failure free days | Outcome is 28 days minus the last day the patient required any of the following: ventilator support, vasopressors, or dialysis / renal replacement therapy. Patients who die prior to day 28 are given a value of -1. | day 28 | |
Secondary | Total SOFA score | The Sequential Organ Failure Assessment (SOFA) score is a scoring system that assesses the performance of several organ systems in the body (neurologic, blood, liver, kidney, and blood pressure/hemodynamics) and assigns a score based on the data obtained in each category. | day 7 | |
Secondary | Zubrod performance status | A scale for indicating a patient's functional level: 0 asymptomatic - 1 Symptomatic, fully ambulatory - 2 Symptomatic, in bed - 50% of the day - 3 Symptomatic, in bed; 50% of the day but not bedridden - 4 Bedridden - 5 Dead. | day 7 | |
Secondary | SF-12 score | The SF-12 is a self-reported validated outcome measure assessing the impact of health on an individual 39;s everyday life. Patients fill out a 12 question survey which is then scored by a clinician or researcher. | day 7 | |
Secondary | SF-12 score | The SF-12 is a self-reported validated outcome measure assessing the impact of health on an individual 39;s everyday life. Patients fill out a 12 question survey which is then scored by a clinician or researcher. | day 28 | |
Secondary | Zubrod performance status | A scale for indicating a patient's functional level: 0 asymptomatic - 1 Symptomatic, fully ambulatory - 2 Symptomatic, in bed - 50% of the day - 3 Symptomatic, in bed; 50% of the day but not bedridden - 4 Bedridden - 5 Dead. | day 28 | |
Secondary | Days in the ICU | This outcome is the number of days the patient was admitted to the ICU. | day 28 | |
Secondary | All-cause mortality | This outcome is the proportion of patients suffering all-cause mortality prior to day 28. | Day 28 | |
Secondary | Peripheral CD3+ senescent (SnCs) immune cells | Outcome is the relative expression of p16Ink4a in CD3+ cells. | day 7 | |
Secondary | Outcome is the relative expression of p16Ink4a in CD3+ cells. | Outcome is the relative expression of p16Ink4a in CD3+ cells. | day 28 | |
Secondary | TNF-alpha | Outcome is the concentration of TNF-alpha by Luminex human discovery assay | day 7 |
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