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Microvascular ObstructionPhase 2NCT04848220

A Study Evaluating the Safety, Tolerability, and Effect on Microvascular Obstruction of Intravenous Temanogrel in Adult Participants Undergoing Percutaneous Coronary Intervention

A Phase 2 study testing Temanogrel in people with Microvascular Obstruction, run by Pfizer at 12 sites in 5 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this study is to determine whether intravenous temanogrel is a safe and effective treatment for microvascular obstruction (MVO) in adult participants undergoing percutaneous coronary intervention (PCI). Read more about this study

Who is it for?
Ages 30 to 80 years
Conditions the study is for
Microvascular Obstruction
What is being tested?
Temanogrel
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
29 participants
Where
12 sitesin 5 countries
Study dates
20 May 2021to 31 Aug 2022
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 30 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Stable angina participants suitable for elective PCI, or participants suitable for PCI for diagnosis of non-ST-elevation myocardial infarction or unstable angina (NSTEMI/UA) who are consistently hemodynamically stable until the time of PCI and have a thrombolysis in myocardial infarction (TIMI) Flow Grade 2 or 3 on the diagnostic angiography
  • Target lesions for PCI must appear suitable for stenting as confirmed on the diagnostic angiography and must satisfy the study criteria regarding lesion size and vessel diameter/type.
  • Females must not be of childbearing potential
  • Males with pregnant or non-pregnant female partners of childbearing potential must agree to using a condom during treatment and for 90 days following treatment

Who cannot join

  • Planned or anticipated use of rotational atherectomy/ablation or shockwave therapies during the PCI procedure
  • Any history of stroke, seizure, intracranial bleeding, or intracranial aneurysm
  • Transient ischemic attack within the 6 months prior to Screening
  • History of major trauma, major surgery, and/or clinically significant head injury or hemorrhage within the last 6 months of Screening
  • Any ST-elevation myocardial infarction (STEMI) within 10 days of Screening or STEMI within the target vessel territory within the last 4 months of Screening

Trial locations and contacts

12 sites in 5 countries.

12 sites in 5 countries

Australia4 sites
  • Royal Prince Alfred Hospital

    Camperdown, New South Wales, 2050

  • Concord Repatriation General Hospital

    Concord, New South Wales, 2139

  • Alfred Health - The Alfred Hospital

    Melbourne, Victoria, 3004

  • Royal Perth Hospital

    Perth, Western Australia, 6000

Other trials in Australia

United States3 sites
  • University of Chicago Medical Center

    Chicago, Illinois, 60637

  • Tibor Rubin VA Medical Center

    Long Beach, California, 90822-5201

  • VA Palo Alto - Cardiac Catheterization Laboratory

    Palo Alto, California, 94304

Other trials in United States

Netherlands3 sites
  • Catharina Ziekenhuis

    Eindhoven, 5623 EJ

  • Radboud University Medical Center

    Nijmegen, Gelderland, 6525 GA

  • Maasstad Hospital

    Rotterdam, South Holland, 3079 DZ

Other trials in Netherlands

Sweden1 site
  • Skåne University Hospital

    Lund, 221 85

Other trials in Sweden

United Kingdom1 site
  • East and North Hertfordshire NHS Trust Lister Hospital

    Stevenage, SG1 4AB

Other trials in United Kingdom

About this study

Official title: A Phase 2, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Assess the Safety, Tolerability, and Effect on Microvascular Obstruction of Temanogrel in Subjects Undergoing Percutaneous Coronary Intervention

The purpose of this study is to determine whether intravenous temanogrel is a safe and effective treatment for microvascular obstruction (MVO) in adult participants undergoing percutaneous coronary intervention (PCI).

Read the detailed description

This is a Phase 2, multicenter, randomized, double-blind, placebo-controlled study to be conducted in 2 stages (Stage A and Stage B). Stage A is an ascending single-dose placebo-controlled study planned to consist of 2 cohorts. Stage B is a parallel-treatment group study planned to consist of a placebo group and 2 active treatment groups of temanogrel doses selected based on safety and tolerability data in Stage A.

Being tested
Temanogrel, Placebo
Keywords
Temanogrel, Microvascular obstruction, APD791, Percutaneous coronary intervention, MVO, PCI

What participants receive

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

  • TemanogrelDrug

    Participants will receive a single intravenous dose of temanogrel on Day 1 (Day 1 of PCI procedure)

  • PlaceboDrug

    Participants will receive a single intravenous dose of temanogrel matching placebo on Day 1

Study groups in NCT04848220
Study groupRoleWhat they receive
Stage A (Dose Cohort 1) and Stage B (Dose Group 1)ExperimentalNot described
Receives: Drug: Temanogrel
Stage A (Dose Cohort 2) and Stage B (Dose Group 2)ExperimentalNot described
Receives: Drug: Temanogrel
Stage A (Dose Cohort 1 and Dose Cohort 2) and Stage B (Dose Group 1 and Dose Group 2)Placebo comparatorNot described
Receives: Drug: Placebo

What is being measured

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

  1. Change in Index of Microcirculatory Resistance (IMR) From Baseline to Post Percutaneous Coronary Intervention (PCI)

    IMR was defined as the mean distal pressure at maximum hyperemia multiplied by the mean hyperemic transit time. IMRcorr (IMR corrected for the influence from collateral supply) was calculated using the following equation, to account for the presence of significant epicardial stenosis without the need for balloon dilation to measure the coronary wedge pressure (Pw), IMRcorr = mean aortic pressure at maximum hyperemia (Pa)*mean transit time at maximal hyperemia (Tmn) * [1.34 * mean distal coronary pressure at maximum hyperemia (Pd)/Pa minus 0.32].

    Measured: From Baseline (prior to administration of study treatment) to 15 minutes post-PCI on Day 1

Secondary outcomes (15)
  1. Change From Baseline to Post-PCI for Coronary Flow Reserve (CFR)

    The coronary flow reserve (CFR) was calculated from the ratio of baseline (i.e., resting transit time) to hyperemic mean transit time.

    Measured: From Baseline (prior to administration of study treatment) to 15 minutes post-PCI on Day 1

  2. Change From Baseline to Post-PCI for Fractional Flow Reserve (FFR)

    The FFR was calculated from the ratio of distal to proximal mean pressures at maximal hyperemia (FFR = [distal coronary pressure/aortic pressure at maximum hyperemia]).

    Measured: From Baseline (prior to administration of study treatment) to 15 minutes post-PCI on Day 1

  3. Change From Baseline to Post-PCI for Corrected Thrombolysis in Myocardial Infarction Frame Count (cTFC)

    The cTFC is a quantitative index of coronary flow and was calculated based upon the number of cine-frames that the intracoronary dye required to reach distal coronary landmarks.

    Measured: From Baseline (prior to administration of study treatment) to 15 minutes post-PCI on Day 1

  4. Number of Participants According to Change From Baseline to Post-PCI for Thrombolysis in Myocardial Infarction (TIMI) Flow Grade (TFG) Post-PCI

    The TFG is a measure of epicardial perfusion and was graded on a standard scale from 0 to 3, where Grade 0=no perfusion, grade 1=penetration without perfusion, grade 2=partial perfusion and grade 3= complete perfusion.

    Measured: Baseline (prior to administration of study treatment) and anytime between 0 to 15 minutes post-PCI on Day 1

  5. Number of Participants According to Change From Baseline to Post-PCI in Thrombolysis in Myocardial Infarction Myocardial Perfusion Grade (TMPG) Post-PCI

    The TMPG (also known as myocardial blush grade [MBG]), is a measure of myocardial perfusion in the capillary bed at the tissues level following contrast injection into the coronary artery. TMPG was graded on a scale from 0 to 3, where grade 0 = failure of dye to enter the microvasculature; grade 1 = dye slowly enters but fails to exit the microvasculature; grade 2 = delayed entry and exit of dye from the microvasculature; grade 3= normal entry and exit of dye from the microvasculature.

    Measured: Baseline (prior to administration of study treatment) and anytime between 0 to 15 minutes post-PCI on Day 1

  6. Change From Baseline to Post-PCI for Creatine Kinase (CK)

    Measured: Baseline (prior to administration of study treatment), anytime between 0 to 15 minutes, 6 hours post-PCI, and 24 hours post-PCI/discharge

  7. Change From Baseline to Post-PCI for Creatine Kinase-Myocardial Band (CK-MB)

    Measured: Baseline (prior to administration of study treatment), anytime between 0 to 15 minutes, 6 hours post-PCI and 24 hours post-PCI/discharge

  8. Change From Baseline to Post-PCI for Cardiac Troponin I

    Measured: Baseline (prior to administration of study treatment), anytime between 0 to 15 minutes, 6 hours post-PCI and 24 hours post-PCI/discharge

  9. Number of Participants With Procedural Myocardial Injury

    Procedural myocardial injury was defined as elevation of cardiac troponin (cTn) values greater than (>) 99th percentile upper reference limit (URL) in participants with normal baseline values (<= 99th percentile URL) or elevation of cTn by > 20% of the baseline value in participants with elevated cTn levels (>99th percentile URL).

    Measured: At 6 hours and 24 hours post-PCI/discharge on Day 1

  10. Concentration of Temanogrel

    Observed plasma concentration of temanogrel. Lower limit of quantification (LLOQ) of temanogrel was 0.500 nanograms/milliliter (ng/mL).

    Measured: Pre-PCI, anytime between 0 to 15 minutes,1 hour, 3 hours, 6 hours post-PCI and 24 hours post PCI/discharge

  11. Concentration of AR295980

    Observed plasma concentration of AR295980.

    Measured: Pre-PCI, anytime between 0 to 15 minutes,1 hour, 3 hours, 6 hours post-PCI and 24 hours post PCI/discharge

  12. Concentration of AR295981

    Observed plasma concentration of AR295981.

    Measured: Pre-PCI, anytime between 0 to 15 minutes,1 hour, 3 hours, 6 hours post-PCI and 24 hours post PCI/discharge

  13. Number of Participants With Treatment-Emergent Adverse Events (TEAEs) by Severity

    An adverse event (AE) was any untoward medical occurrence that did not necessarily have a causal relationship with study treatment. TEAE was an AE that occurred after initiation of study treatment that was not present at the time of treatment start or an AE that increased in severity after the initiation of medication, if the event was present at the time of treatment start emerges. AEs were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 as grade 1: mild; grade 2: moderate; grade 3: severe, grade 4: life threatening, grade 5: death related to AE. Number of participants with any TEAE and grade 3 or higher TEAE have been reported.

    Measured: From start of study treatment on day 1 to up to maximum of 10 days

  14. Number of Participants With Serious Adverse Events (SAEs), Adverse Events Leading to Discontinuation of Study Treatment and Treatment-Related TEAEs

    An AE was any untoward medical occurrence that did not necessarily have a causal relationship with study treatment. TEAE was an AE that occurred after initiation of study treatment that was not present at the time of treatment start or an AE that increased in severity after the initiation of medication, if the event was present at the time of treatment start emerges. SAE was an AE resulting in any of the following outcomes or considered medically significant: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly or birth defect. Relatedness was based on investigator's assessment.

    Measured: From start of study treatment on day 1 to up to maximum of 10 days

  15. Number of Participants With Treatment-Related TEAEs According to the Preferred Term

    An adverse event was any untoward medical occurrence that did not necessarily have a causal relationship with study treatment. TEAE was an AE that occurred after initiation of study treatment that was not present at the time of treatment start or an AE that increased in severity after the initiation of medication, if the event was present at the time of treatment start emerges. Relatedness was based on investigator's assessment.

    Measured: From start of study treatment on day 1 to up to maximum of 10 days

Timeline

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

  1. First posted19 Apr 2021
  2. Study start20 May 2021
  3. Primary completion23 Aug 2022
  4. Study completion31 Aug 2022

Why it stopped: Business decision

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
Double blind
Who is masked
Participant, Investigator
Enrolment
29 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04848220
Sponsor's protocol ID
APD791-202
Other IDs
C5071002
Status last verified
Nov 2023
First submitted
14 Apr 2021
Last updated
12 Dec 2023
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical\_trials/trial\_data\_and\_results/data\_requests.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Temanogrel in people with Microvascular Obstruction, run by Pfizer at 12 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 4 inclusion and 5 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: stopped early, as of the sponsor's last update on 12 Dec 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in Australia, United States, Netherlands, Sweden, United Kingdom. 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 12 Dec 2023). 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?

Change in Index of Microcirculatory Resistance (IMR) From Baseline to Post Percutaneous Coronary Intervention (PCI) (time frame: From Baseline (prior to administration of study treatment) to 15 minutes post-PCI on Day 1). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 12 Dec 2023.

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