Acute Myocardial InfarctionPhase 2NCT02742103
A Study of CSL112 in Adults With Moderate Renal Impairment and Acute Myocardial Infarction
A Phase 2 study testing CSL_112 in people with Acute Myocardial Infarction and Moderate Renal Impairment, run by CSL Behring at 31 sites in 5 countries.
Trial summary
This study is a phase 2, multicenter, double-blind, randomized, placebo controlled, parallel-group study to investigate the renal safety and tolerability of multiple dose intravenous (IV) administration of CSL112 compared with placebo in subjects with moderate renal impairment (RI) and acute myocardial infarction… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Acute Myocardial Infarction, Moderate Renal Impairment
- What is being tested?
- CSL_112
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 83 participants
- Where
- 31 sitesin 5 countries
- Study dates
- Aug 2016to Jun 2017
- 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
- Men or women, at least 18 years of age, with evidence of moderate renal impairment (an eGFR ≥ 30 and <60 mL/min/1.73 m2) and myocardial necrosis in a clinical setting consistent with a type I (spontaneous) acute myocardial infarction (AMI).
Who cannot join
- Symptoms, biomarker elevation or electrocardiogram (ECG) changes other than those of the index event that are consistent with a diagnosis of AMI but are likely not due to primary myocardial ischemia
- Ongoing hemodynamic instability
- Planned coronary artery bypass surgery
- Evidence of hepatobiliary disease
- History of acute kidney injury (AKI) after previous exposure to an intravenous contrast agent.
- History of nephrotic range proteinuria.
- Known history of allergy to soy beans or peanuts, immunoglobulin A (IgA) deficiency, antibodies to IgA , or hypersensitivity to CSL112 or any of its components.
- Other severe comorbid condition, concurrent medication, or other issue that renders the subject unsuitable for participation in the study.
Trial locations and contacts
31 sites in 5 countries.
31 sites in 5 countries
United States13 sites
Study Site 16208
Alexandria, Louisiana, 71301
Study Site 16101
Birmingham, Alabama, 35211
Study Site 16112
Boise, Idaho, 83712
Study Site 16168
Concord, California, 94520
Study Site 16135
Danbury, Connecticut, 06810
Study Site 16056
Durham, North Carolina, 27705
Study Site 16014
High Point, North Carolina, 27762
Study Site 16078
Huntsville, Alabama, 35801
Study Site 16003
Jacksonville, Florida, 32209
Study Site 16130
Littleton, Colorado, 80120
Study Site 16061
Petoskey, Michigan, 49770
Study Site 16018
Rapid City, South Dakota, 57701
Study Site 16241
Wichita Falls, Texas, 76301
Germany6 sites
Study Site 17005
Berlin, 10249
Study Site 17009
Berlin, 10967
Study Site 17003
Berlin, 13353
Study Site 17014
Frankfurt am Main, Hesse, 65929
Study Site 17001
Freiburg im Breisgau, Baden-Wurttemberg, 79106
Study Site 17006
Hamburg, 20246
Hungary5 sites
Study Site 18001
Budapest, 1122
Study Site 18005
Budapest, 1134
Study Site 18007
Nyíregyháza, 4400
Study Site 18003
Pécs, 7624
Study Site 18009
Szeged, 6720
Netherlands4 sites
Study Site 21001
Alkmaar, 1815 JD
Study Site 21006
Amsterdam, 1091 AC
Study Site 21017
Amsterfoort, 3818 TZ
Study Site 21008
Nijmegen, 6525 EC
Israel3 sites
Study Site 19005
Haifa, 3109601
Study Site 19002
Nahariya, 22100
Study Site 19008
Safed, 13100
About this study
Official title: A Phase 2, Multicenter, Double-blind, Randomized, Placebo-controlled, Parallel-group, Study to Investigate the Safety and Tolerability of Multiple Dose Administration of CSL112 in Subjects With Moderate Renal Impairment and Acute Myocardial Infarction
This study is a phase 2, multicenter, double-blind, randomized, placebo controlled, parallel-group study to investigate the renal safety and tolerability of multiple dose intravenous (IV) administration of CSL112 compared with placebo in subjects with moderate renal impairment (RI) and acute myocardial infarction (AMI).
- Being tested
- CSL_112, Placebo
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CSL_112Biological
CSL112 is a novel formulation of apolipoprotein A-I (apoA-I) purified from human plasma and reconstituted to form high-density lipoprotein (HDL) particles.
PlaceboOther
0.9% weight/volume sodium chloride solution (ie, normal saline)
| Study group | Role | What they receive |
|---|---|---|
| CSL_112 | Experimental | CSL112 will be administered intravenously, once weekly for 4 consecutive weeks (4 infusions in total). Receives: Biological: CSL_112 |
| Placebo | Placebo comparator | Placebo will be administered at the same frequency, volume and duration as the CSL112 infusion. Receives: Other: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percent of Participants With at Least One Occurrence of Treatment-emergent Renal Serious Adverse Events (SAEs) (SAF)
A renal SAE is defined as any SAE with a MedDRA preferred term included in the Acute Renal Failure narrow Standard MedDRA Query or a preferred term of renal tubular necrosis, renal cortical necrosis, renal necrosis, or renal papillary necrosis.
Measured: Up to 9 weeks
Percent of Participants With Treatment-emergent Acute Kidney Injury (AKI )
Acute kidney injury is defined as an absolute increase in serum creatinine from baseline ≥ 0.3 mg/dL during the Active Treatment Period that is sustained upon repeat measurement by the central laboratory no earlier than 24 hours after the elevated value. If no repeat value is obtained, a single serum creatinine value that is increased from baseline ≥ 0.3 mg/dL (26.5 μmol/L) during the Active Treatment Period would also fulfil the definition of AKI.
Measured: Up to 4 weeks
Secondary outcomes (15)
Number of Participants With Treatment-emergent Adverse Events (TEAEs)
Measured: Up to 9 weeks
Percentage of Participants With TEAEs
Measured: Up to 9 weeks
Total Number of TEAEs
Measured: Up to 9 weeks
Number of Participants With Treatment-emergent Adverse Drug Reaction (ADR) or Suspected ADR
Adverse drug reactions or suspected adverse drug reactions are defined as:
- All TEAEs, including local tolerability events, that begin during or within 1 hour after the end of an infusion; or
- Those TEAEs that the investigator or sponsor indicate may be causally related to product administration; or
- All TEAEs for which the Investigator's causality assessment is missing or indeterminate; or
- All TEAEs for which the incidence in an active treatment arm exceeds the exposure-adjusted incidence rate in the placebo arm by 30% or more, provided the difference in incidence rates is 1% or more.
Measured: Up to 9 weeks
Percentage of Participants With Treatment-emergent Adverse Drug Reaction (ADR) or Suspected ADR
Adverse drug reactions or suspected adverse drug reactions are defined as:
- All TEAEs, including local tolerability events, that begin during or within 1 hour after the end of an infusion; or
- Those TEAEs that the investigator or sponsor indicate may be causally related to product administration; or
- All TEAEs for which the Investigator's causality assessment is missing or indeterminate; or
- All TEAEs for which the incidence in an active treatment arm exceeds the exposure-adjusted incidence rate in the placebo arm by 30% or more, provided the difference in incidence rates is 1% or more.
Measured: Up to 9 weeks
Number of Participants With Change in Renal Status
Number of participants with changes in renal status defined as:
- Absolute increases from baseline in serum creatinine as follows:
- ≤ baseline value ii. > 0 to < 0.3 mg/dL iii. ≥ 0.3 to ≤ 0.5 mg/dL iv. > 0.5 mg/dL
- Increases in serum creatinine that are sustained for ≥ 24 hours upon repeat measurement that are greater than or equal to 1.5 x, 2 x, or 3.0 x the baseline value, or serum creatinine ≥ 4.0 mg/dL
- Initiation of renal replacement therapy
- Decrease in eGFR ≥ 25% from baseline starting during the active treatment period and that is sustained at the final study visit
Measured: Baseline and up to 4 weeks
Percentage of Participants With Change in Renal Status
Percentage of participants with changes in renal status defined as:
- Absolute increases from baseline in serum creatinine as follows:
- ≤ baseline value ii. > 0 to < 0.3 mg/dL iii. ≥ 0.3 to ≤ 0.5 mg/dL iv. > 0.5 mg/dL
- Increases in serum creatinine that are sustained for ≥ 24 hours upon repeat measurement that are greater than or equal to 1.5 x, 2 x, or 3.0 x the baseline value, or serum creatinine ≥ 4.0 mg/dL
- Initiation of renal replacement therapy
- Decrease in eGFR ≥ 25% from baseline starting during the active treatment period and that is sustained at the final study visit
Measured: Baseline and up to 4 weeks
Number of Participants With Change in Hepatic Status
Number of participants with a change from baseline in hepatic status and that is sustained for ≥ 24 hours upon repeat measurement, defined as:
- Alanine aminotransferase (ALT) > 3 x upper limit of normal (ULN)
- ALT > 5 x ULN
- ALT > 10 x ULN
- Serum total bilirubin > 1.5 x ULN
- Serum total bilirubin > 2 x ULN
- Possible Hy's law cases, as defined in the FDA Guidance for Industry: Drug-Induced Liver Injury: Premarketing Clinical Evaluation (July 2009).
Measured: Baseline and up to 4 weeks
Percentage of Participants With Change in Hepatic Status
Percentage of participants with a change from baseline in hepatic status and that is sustained for ≥ 24 hours upon repeat measurement, defined as:
- Alanine aminotransferase (ALT) > 3 x upper limit of normal (ULN)
- ALT > 5 x ULN
- ALT > 10 x ULN
- Serum total bilirubin > 1.5 x ULN
- Serum total bilirubin > 2 x ULN
- Possible Hy's law cases, as defined in the FDA Guidance for Industry: Drug-Induced Liver Injury: Premarketing Clinical Evaluation (July 2009).
Measured: Baseline and up to 4 weeks
Number of Participants With Treatment-emergent Bleeding Events
Bleeding events are as defined by the Bleeding Academic Research Consortium (BARC) criteria (Mehran et al., 2011).
Measured: Up to 9 weeks
Percentage of Participants With Treatment-emergent Bleeding Events
Bleeding events are as defined by the Bleeding Academic Research Consortium (BARC) criteria (Mehran et al., 2011).
Measured: Up to 9 weeks
Percentage of Participants With Binding Antibodies Specific to Apolipoprotein A-I (Apo-A1) and CSL112
Measured: Up to 9 weeks
Baseline-corrected Plasma Concentration Maximum (Cmax) After Infusion 1 for apoA-I and PC
Measured: Immediately after end of infusion
Baseline-corrected Plasma Concentration Maximum (Cmax) After Infusion 4 for apoA-I and PC
Measured: Immediately after end of infusion
Plasma apoA-I and Phosphatidylcholine (PC) Accumulation Ratio After Infusion 4
The plasma apoA-I and PC accumulation ratio will be determined for CSL112-treated subjects.
Measured: Immediately after end of infusion
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Apr 2016 (estimated)
- Study startAug 2016
- Primary completionJun 2017
- Study completionJun 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Acute Myocardial InfarctionStudies of the same condition, open and under way.
- More trials run by CSL BehringThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 83 participants (actual)
Sponsor and investigators
- Lead sponsor
- CSL Behring
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Danielle Duffy, MD, Study director, CSL Behring
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02742103
- Sponsor's protocol ID
- CSL112_2001
- Other IDs
- 2015-003017-26, 2015
- Status last verified
- May 2020
- First submitted
- 30 Mar 2016
- Last updated
- 11 Jun 2020
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Zheng B, Duffy D, Tricoci P, Kastrissios H, Pfister M, Wright SD, Gille A, Tortorici MA. Pharmacometric analyses to characterize the effect of CSL112 on apolipoprotein A-I and cholesterol efflux capacity in acute myocardial infarction patients. Br J Clin Pharmacol. 2021 Jun;87(6):2558-2571. doi: 10.1111/bcp.14666. Epub 2020 Dec 23.
PubMed 33217027Gibson CM, Kerneis M, Yee MK, Daaboul Y, Korjian S, Mehr AP, Tricoci P, Alexander JH, Kastelein JJP, Mehran R, Bode C, Lewis BS, Mehta R, Duffy D, Feaster J, Halabi M, Angiolillo DJ, Duerschmied D, Ophuis TO, Merkely B. The CSL112-2001 trial: Safety and tolerability of multiple doses of CSL112 (apolipoprotein A-I [human]), an intravenous formulation of plasma-derived apolipoprotein A-I, among subjects with moderate renal impairment after acute myocardial infarction. Am Heart J. 2019 Feb;208:81-90. doi: 10.1016/j.ahj.2018.11.008. Epub 2018 Nov 22.
PubMed 30580130
Study at a glance
From the registry record, last updated by the sponsor on 11 Jun 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 2, Multicenter, Double-blind, Randomized, Placebo-controlled, Parallel-group, Study to Investigate the Safety and Tolerability of Multiple Dose Administration of CSL112 in Subjects With Moderate Renal Impairment and Acute Myocardial Infarction
- ClinicalTrials.gov ID
- NCT02742103
- Acronym / sponsor ID
- CSL112_2001
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 83 participants (actual)
- Lead sponsor
- CSL BehringIndustry (pharma, biotech, devices)
- Study start
- Aug 2016
- Primary completion
- Jun 2017 (actual)
- Study completion
- Jun 2017 (actual)
- First posted
- 18 Apr 2016 (estimated)
- Results
- Posted 11 Jun 2020
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study is a phase 2, multicenter, double-blind, randomized, placebo controlled, parallel-group study to investigate the renal safety and tolerability of multiple dose intravenous (IV) administration of CSL112 compared with placebo in subjects with moderate renal impairment (RI) and acute myocardial infarction (AMI).
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| CSL_112 | Experimental | Biological: CSL_112CSL112 will be administered intravenously, once weekly for 4 consecutive weeks (4 infusions in total). |
| Placebo | Placebo comparator | Other: PlaceboPlacebo will be administered at the same frequency, volume and duration as the CSL112 infusion. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Men or women, at least 18 years of age, with evidence of moderate renal impairment (an eGFR ≥ 30 and <60 mL/min/1.73 m2) and myocardial necrosis in a clinical setting consistent with a type I (spontaneous) acute myocardial infarction (AMI).
Key exclusion criteria (8 listed)
- Symptoms, biomarker elevation or electrocardiogram (ECG) changes other than those of the index event that are consistent with a diagnosis of AMI but are likely not due to primary myocardial ischemia
- Ongoing hemodynamic instability
- Planned coronary artery bypass surgery
- Evidence of hepatobiliary disease
- History of acute kidney injury (AKI) after previous exposure to an intravenous contrast agent.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| CSL_112CSL112 is a novel formulation of apolipoprotein A-I (apoA-I) purified from human plasma and reconstituted to form high-density lipoprotein (HDL) particles. | Biological | CSL_112 |
| Placebo0.9% weight/volume sodium chloride solution (ie, normal saline) | Other | Placebo |
Primary outcome
Percent of Participants With at Least One Occurrence of Treatment-emergent Renal Serious Adverse Events (SAEs) (SAF)
Time frame: Up to 9 weeks
A renal SAE is defined as any SAE with a MedDRA preferred term included in the Acute Renal Failure narrow Standard MedDRA Query or a preferred term of renal tubular necrosis, renal cortical necrosis, renal necrosis, or renal papillary necrosis.
Percent of Participants With Treatment-emergent Acute Kidney Injury (AKI )
Time frame: Up to 4 weeks
Acute kidney injury is defined as an absolute increase in serum creatinine from baseline ≥ 0.3 mg/dL during the Active Treatment Period that is sustained upon repeat measurement by the central laboratory no earlier than 24 hours after the elevated value. If no repeat value is obtained, a single serum creatinine value that is increased from baseline ≥ 0.3 mg/dL (26.5 μmol/L) during the Active Treatment Period would also fulfil the definition of AKI.
15 secondary outcomes
Number of Participants With Treatment-emergent Adverse Events (TEAEs)
Time frame: Up to 9 weeks
Percentage of Participants With TEAEs
Time frame: Up to 9 weeks
Total Number of TEAEs
Time frame: Up to 9 weeks
Number of Participants With Treatment-emergent Adverse Drug Reaction (ADR) or Suspected ADR
Time frame: Up to 9 weeks
Percentage of Participants With Treatment-emergent Adverse Drug Reaction (ADR) or Suspected ADR
Time frame: Up to 9 weeks
Number of Participants With Change in Renal Status
Time frame: Baseline and up to 4 weeks
Percentage of Participants With Change in Renal Status
Time frame: Baseline and up to 4 weeks
Number of Participants With Change in Hepatic Status
Time frame: Baseline and up to 4 weeks
Percentage of Participants With Change in Hepatic Status
Time frame: Baseline and up to 4 weeks
Number of Participants With Treatment-emergent Bleeding Events
Time frame: Up to 9 weeks
Percentage of Participants With Treatment-emergent Bleeding Events
Time frame: Up to 9 weeks
Percentage of Participants With Binding Antibodies Specific to Apolipoprotein A-I (Apo-A1) and CSL112
Time frame: Up to 9 weeks
Baseline-corrected Plasma Concentration Maximum (Cmax) After Infusion 1 for apoA-I and PC
Time frame: Immediately after end of infusion
Baseline-corrected Plasma Concentration Maximum (Cmax) After Infusion 4 for apoA-I and PC
Time frame: Immediately after end of infusion
Plasma apoA-I and Phosphatidylcholine (PC) Accumulation Ratio After Infusion 4
Time frame: Immediately after end of infusion
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Jun 2020.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 33217027Zheng B, Duffy D, Tricoci P, Kastrissios H, Pfister M, Wright SD, Gille A, Tortorici MA. Pharmacometric analyses to characterize the effect of CSL112 on apolipoprotein A-I and cholesterol efflux capacity in acute myocardial infarction patients. Br J Clin Pharmacol. 2021 Jun;87(6):2558-2571. doi: 10.1111/bcp.14666. Epub 2020 Dec 23.
- Derived from this study: PubMed 30580130Gibson CM, Kerneis M, Yee MK, Daaboul Y, Korjian S, Mehr AP, Tricoci P, Alexander JH, Kastelein JJP, Mehran R, Bode C, Lewis BS, Mehta R, Duffy D, Feaster J, Halabi M, Angiolillo DJ, Duerschmied D, Ophuis TO, Merkely B. The CSL112-2001 trial: Safety and tolerability of multiple doses of CSL112 (apolipoprotein A-I [human]), an intravenous formulation of plasma-derived apolipoprotein A-I, among subjects with moderate renal impairment after acute myocardial infarction. Am Heart J. 2019 Feb;208:81-90. doi: 10.1016/j.ahj.2018.11.008. Epub 2018 Nov 22.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Danielle Duffy, MD study director
CSL Behring
31 sites in 5 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing CSL_112 in people with Acute Myocardial Infarction and Moderate Renal Impairment, run by CSL Behring at 31 sites in 5 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 1 inclusion and 8 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 11 Jun 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 31 sites in United States, Germany, Hungary, Netherlands, Israel. 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 11 Jun 2020). 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?
Percent of Participants With at Least One Occurrence of Treatment-emergent Renal Serious Adverse Events (SAEs) (SAF) (time frame: Up to 9 weeks). The study lists 2 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 NCT02742103, 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 11 Jun 2020.