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Septic ShockPhase 2NCT01000649

Effects of the V1a Agonist FE 202158 in Patients With Septic Shock

A Phase 2 study testing FE 202158 1.25, FE 202158 2.5 and FE 202158 3.75 in people with Septic Shock, run by Ferring Pharmaceuticals at 16 sites in 4 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this trial was to examine the safety and tolerability, pharmacokinetics of FE 202158 and to assess whether it can stabilize blood pressure and reduce vascular (blood vessel) leakage. FE 202158 had previously been tested in healthy volunteers. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Septic Shock
What is being tested?
FE 202158 1.25, FE 202158 2.5 and FE 202158 3.75
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
53 participants
Where
16 sitesin 4 countries
Study dates
Nov 2009to Sep 2011
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Signed informed consent form by the patient or a legal representative according to local regulations
  • Man or woman 18 years of age or older
  • Proven or suspected infection
  • Low blood pressure
  • Signs of decreased circulation in the tissues
  • Willing to use an adequate barrier method or hormonal method of contraception, if not abstinent, from the day of informed consent to one week after the end of infusion of study medication.

Who cannot join

  • Present or a history (within the last 5 years) of acute coronary syndrome (myocardial infarction or unstable angina). Patients who have been asymptomatic for 6 months after coronary revascularisation are eligible.
  • Hypovolaemia suspected on clinical grounds, e.g. cold extremities with delayed capillary filling, low cardiac filling pressure, marked systolic or pulse pressure variation or positive leg raising test.
  • Known or suspected cardiac failure
  • Pregnancy or breastfeeding
  • Any cause of hypotension other than early septic shock
  • Use of vasopressin or terlipressin for blood pressure support during the current hospital admission
Show all 16Show fewer
  • Proven or suspected acute mesenteric ischemia, as judged by the investigator
  • Known episode of septic shock within 1 month prior to randomisation
  • Underlying chronic heart disease
  • Traumatic brain injury
  • Present hospitalisation with burn injury
  • Symptomatic peripheral vascular disease including Raynaud's syndrome
  • Previously randomized in this trial
  • Intake of an investigational drug within the last 3 months (or longer if judged by the Investigator to possibly influence the outcome of the current study)
  • Known participation in another clinical trial
  • Considered by the investigator to be unsuitable to participate in the trial for any other reason

Trial locations and contacts

16 sites in 4 countries.

16 sites in 4 countries

United States6 sites
  • Cooper University Hospital

    Camden, New Jersey

  • Division of Education and Research SMDC Health System

    Duluth, Minnesota

  • Baylor College of Medicine

    Houston, Texas

  • Mount Sinai School of Medicine

    New York, New York

  • Christiana Care Health System

    Newark, Delaware

  • Baystate Medical Center

    Springfield, Massachusetts

Other trials in United States

Belgium4 sites
  • Clinique Universitaire St-Luc

    Brussels

  • Erasme Hospital (Free University of Brussels)

    Brussels

  • University Hospital Vrije Universiteit

    Brussels

  • Service des Soins Intensits

    Dinant

Other trials in Belgium

Denmark4 sites
  • Bispebjerg Hospital

    Bispebjerg

  • Rigshospitalet

    Copenhagen

  • Hillerød Hospital

    Hillerød

  • Hvidovre Hospital

    Hvidovre

Other trials in Denmark

Canada2 sites
  • Royal Columbian Hospital

    Vancouver

  • St. Paul´s Hospital

    Vancouver

Other trials in Canada

About this study

Official title: Infusion Proof-of-concept Trial Investigating the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Ascending Doses of FE 202158 in Patients With Vasodilatory Hypotension in Early Septic Shock

The purpose of this trial was to examine the safety and tolerability, pharmacokinetics of FE 202158 and to assess whether it can stabilize blood pressure and reduce vascular (blood vessel) leakage. FE 202158 had previously been tested in healthy volunteers.

Read the detailed description

This was a multi-centre, double-blind, randomized, placebo-controlled, parallel group trial investigating the safety, tolerability, pharmacokinetics, and pharmacodynamics of FE 202158 (using three ascending doses) in patients with vasodilatory hypotension in early septic shock, when given as continuous infusion for up to 7 days.

The trial comprised of three treatment arms where FE 202158 was administered in 1.25 ng, 2.5 ng and 3.75 ng dose, respectively. A placebo arm was also included in the trial where patients received isotonic saline.

Efficacy of FE 202158 was determined by evaluating its ability to maintain mean arterial pressure (MAP) >60 mmHg and its modulating effect on inflammatory markers. Effects of FE 202158 on other variables like vital signs, morbidity, mortality and pulmonary function were also determined.

Conditions
Septic Shock
Being tested
FE 202158 1.25, FE 202158 2.5, FE 202158 3.75, Placebo
Keywords
V1a agonist
Medical subject headings
Shock, Septic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • FE 202158 1.25Drug

    FE 202158 at dose 1.25 ng/kg/min infused.

  • FE 202158 2.5Drug

    FE 202158 at dose 2.5 ng/kg/min infused.

  • FE 202158 3.75Drug

    FE 202158 at dose 3.75 ng/kg/min infused.

  • PlaceboOther

    Isotonic saline infused.

Study groups in NCT01000649
Study groupRoleWhat they receive
FE 202158 1.25ExperimentalPatients in the arm received an intravenous infusion for up to 7 days of FE 202158 at an initial rate of 1.25 ng/kg/min. FE 202158 was provided as an isotonic acetate buffered stock solution of pH 4.0 in vials appropriately diluted with isotonic saline prior to use.
Receives: Drug: FE 202158 1.25
FE 202158 2.5ExperimentalPatients in the arm received an intravenous infusion for up to 7 days of FE 202158 at an initial rate of 2.5 ng/kg/min. FE 202158 was provided as an isotonic acetate buffered stock solution of pH 4.0 in vials appropriately diluted with isotonic saline prior to use.
Receives: Drug: FE 202158 2.5
FE 202158 3.75ExperimentalPatients in the arm received an intravenous infusion for up to 7 days of FE 202158 at an initial rate of 3.75 ng/kg/min. FE 202158 was provided as an isotonic acetate buffered stock solution of pH 4.0 in vials appropriately diluted with isotonic saline prior to use.
Receives: Drug: FE 202158 3.75
PLCBOPlacebo comparatorPatients in the arm received an intravenous infusion for up to 7 days of placebo.
Receives: Other: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of Patients Maintaining Target Mean Arterial Pressure (MAP) (>60 mmHg) With no Open Label NE (Norepinephrine)

    Data were evaluated for target MAP of ≥ 60 mmHg. A 95% confidence interval (CI) was calculated and presented using Clopper-Pearson method.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  2. Proportion of Patients Maintaining Target MAP (>60) Irrespective of Open Label NE

    Data were evaluated for target MAP of ≥ 60 mmHg. A 95% confidence interval (CI) was calculated and presented using Clopper-Pearson method.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  3. Cumulative Dose of Open Label NE.

    Cumulative Dose of Open Label NE over 7 days.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  4. Infusion Rates of Open Label NE.

    Mean open label NE infusion rate within each predefined time period.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

Secondary outcomes (23)
  1. Pharmacokinetic (PK) Parameter in Patients : Steady State Concentration

    PK parameters were calculated using nonlinear 2-compartment population PK model with random patient effects on clearance and volume of distribution.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  2. PK Parameter in Patients : Time to Steady State

    PK parameters were calculated using nonlinear 2-compartment population PK model with random patient effects on clearance and volume of distribution.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  3. PK Parameter in Patients : Clearance

    PK parameters were calculated using nonlinear 2-compartment population PK model with random patient effects on clearance and volume of distribution.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  4. PK Parameter in Patients : Steady State Volume of Distribution

    PK parameters were calculated using nonlinear 2-compartment population PK model with random patient effects on clearance and volume of distribution.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  5. PK Parameter in Patients : Initial Elimination Half-life

    PK parameters were calculated using nonlinear 2-compartment population PK model with random patient effects on clearance and volume of distribution.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  6. PK Parameter in Patients : Terminal Elimination Half-life

    PK parameters were calculated using nonlinear 2-compartment population PK model with random patient effects on clearance and volume of distribution.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  7. Change From Baseline in C-reactive Protein (CRP)

    The change from Baseline in CRP levels were analysed and presented as per the planned time points.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  8. Change From Baseline in Tumor Necrosis Factor (TNF)-Alpha

    The change from Baseline in TNF-alpha levels were analysed and presented as per the planned time points.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: At Day 1, Day 2, Day 4, and Day 7

  9. Change From Baseline in Interleukin-6 (IL-6)

    The change from Baseline in IL-6 levels were analysed and presented as per the planned time points.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: At Day 1, Day 2, Day 4, and Day 7

  10. Change From Baseline in Interleukin-10 (IL-10)

    The change from Baseline in IL-10 levels were analysed and presented as per the planned time points.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: At Day 1, Day 2, Day 4, and Day 7

  11. Change From Baseline in Interleukin-1 Receptor (IL-1R) Antagonist

    The change from Baseline in IL-1R levels were analysed and presented as per the planned time points.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: At Day 1, Day 2, Day 4, and Day 7

  12. Change From Baseline in Heart Rate

    The change from Baseline in heart rate was analysed and presented as per the planned time points.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  13. Change From Baseline in Fluid Balance

    The change from Baseline in fluid balance were analysed and presented as per the planned time points. The fluid balance was adjusted for length of time interval and weight.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  14. SOFA Score

    The SOFA score, is used to track a patient's status during the stay in an intensive care unit. This scoring system is used to determine the extent of a person's organ function or rate of failure. The scoring system comprise of scores for six different system: Respiratory System; Nervous System; Cardiovascular System; Liver; Coagulation; and Renal System. Score for each system ranges from 0-4 (0=normal, 4=worst).

    Total SOFA score is a sum of the individual system score and range from 0 to 24, 0 being the better and 24 being the worst patient status.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7, Day 14 and Day 29

  15. Pulmonary Function : Change From Baseline in PaO2/FiO2

    Change from Baseline in PaO2/FiO2 was observed at each time-point.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  16. Pulmonary Function : Change From Baseline in Tidal Volume

    Change from Baseline in tidal volume was observed at each time-point.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  17. Change From Baseline in Arterial Blood Gas (Lactate)

    Change from Baseline in arterial blood gas (lactate) was observed at each time-point.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

  18. Days Alive and Free of Any Organ Dysfunction at Day 7

    Percentage of days alive and free of any organ dysfunction (i.e. no. of days divided by 7).

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: At Day 7

  19. Percentage of Patients Alive and Free of All Vasopressors

    Percentage of patients alive and free of all vasopressors was assessed on Days 7, 14, and 28.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: At Day 7, Day 14 and Day 28

  20. Percentage of Days Alive and Free of Dialysis

    Percentage of days alive and free of dialysis was assessed on Days 7, 14, and 28.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: At Day 7, Day 14 and Day 28

  21. Percentage of Days Alive and Free of Ventilation

    Percentage of days alive and free of ventilation was assessed on Days 7, 14, and 28.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: At Day 7

  22. Mortality

    Mortality was assessed as percentage of patients dead at pre-specified time points.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: At Day 1, 7, 14, and 28

  23. Incidence of Abnormal Changes in ECG

    The number of patients having abnormal changes in ECG variables during the trial period was presented.

    The patients (n=2) in the FE 202158 3.75 ng/kg/min dose group were both discontinued within 5 hours after start of infusion. Therefore, no adequate data was available to perform the analysis for the outcome.

    Measured: Day 1 up to Day 7

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Oct 2009 (estimated)
  2. Study startNov 2009
  3. Primary completionAug 2011
  4. Study completionSep 2011

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
53 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01000649
Sponsor's protocol ID
FE 202158 CS02
Other IDs
EudraCT: 2009-010798-19
Status last verified
Aug 2017
First submitted
30 Sep 2009
Last updated
25 Sep 2017
Data monitoring committee
Yes

Publications

  • Russell JA, Vincent JL, Kjolbye AL, Olsson H, Blemings A, Spapen H, Carl P, Laterre PF, Grundemar L. Selepressin, a novel selective vasopressin V1A agonist, is an effective substitute for norepinephrine in a phase IIa randomized, placebo-controlled trial in septic shock patients. Crit Care. 2017 Aug 15;21(1):213. doi: 10.1186/s13054-017-1798-7.

    PubMed 28807037
  • Rehberg S, Yamamoto Y, Sousse L, Bartha E, Jonkam C, Hasselbach AK, Traber LD, Cox RA, Westphal M, Enkhbaatar P, Traber DL. Selective V(1a) agonism attenuates vascular dysfunction and fluid accumulation in ovine severe sepsis. Am J Physiol Heart Circ Physiol. 2012 Nov 15;303(10):H1245-54. doi: 10.1152/ajpheart.00390.2012. Epub 2012 Sep 7.

    PubMed 22961865

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing FE 202158 1.25, FE 202158 2.5 and FE 202158 3.75 in people with Septic Shock, run by Ferring Pharmaceuticals at 16 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 25 Sep 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 16 sites in United States, Belgium, Denmark, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 Jun 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of Patients Maintaining Target Mean Arterial Pressure (MAP) (>60 mmHg) With no Open Label NE (Norepinephrine) (time frame: Day 1 up to Day 7). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01000649, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Sep 2017.

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