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Acute Myocardial InfarctionPhase 2DOBERMANNNCT05350592

Low-Dose Dobutamine and Single-Dose Tocilizumab in Acute Myocardial Infarction With High Risk of Cardiogenic Shock

A Phase 2 study testing Tocilizumab, Dobutamine and NaCl 0.9% in people with Acute Myocardial Infarction and Cardiogenic Shock, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

In the present study, we aim to investigate the effects of dobutamine infusion and/or a single intravenous (IV) dose of the IL-6 antagonist Tocilizumab administered after percutaneous coronary intervention (PCI) to patients with acute myocardial infarction (AMI) presenting < 24 hours from onset of chest pain and an… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Tocilizumab, Dobutamine and NaCl 0.9%
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
100 participants
Where
1 siteDenmark
Study dates
13 Mar 2022to 30 Sep 2025
Phase
Phase 2
Are there results?
Not yet: the study is under way

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

  • Acute myocardial infarction
  • Revascularization with PCI
  • Presentation within 24 hours of chest pain
  • ORBI risk score ≥ 10
  • Age ≥ 18

Who cannot join

  • Unwilling to give informed consent to study participation
  • Unable to give consent due to language barrier
  • Comatose after cardiac arrest
  • Cardiogenic shock with systolic blood pressure < 100 mmHg for more than 30 minutes or need for vasopressor to maintain blood pressure and arterial lactate > 2,5 (2,0) mmol/L developed before leaving the cath. lab.
  • Other major clinical non-coronary condition (stroke, sepsis etc.), which can explain a high ORBI risk score
  • Referral for acute coronary artery bypass grafting (CABG) (< 24 hours) after the CAG
Show all 13Show fewer
  • Contraindications against dobutamine infusion (sustained ventricular tachycardia prior to admission or noted in the cath.lab., known pheochromocytoma, idiopathic hypertrophic subaortic stenosis)
  • Tocilizumab allergy
  • Pregnant- or breastfeeding women
  • Known liver disease/dysfunction
  • Ongoing uncontrollable infection
  • Immune deficiency/treatment with immunosuppressants
  • Known, uncontrolled gastrointestinal (GI) disease predisposing to GI perforation

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Rigshospitalet, Copenhagen University Hospital

    Copenhagen, 2100

Other trials in Denmark

About this study

Official title: Low-dose Dobutamine Infusion and Single-dose Tocilizumab in Acute Myocardial Infarction Patients With High Risk of Cardiogenic Shock Development - a 2x2 Multifactorial, Double-blinded, Randomized, Placebo Controlled Trial

In the present study, we aim to investigate the effects of dobutamine infusion and/or a single intravenous (IV) dose of the IL-6 antagonist Tocilizumab administered after percutaneous coronary intervention (PCI) to patients with acute myocardial infarction (AMI) presenting < 24 hours from onset of chest pain and an intermediate to high risk of cardiogenic shock (CS) by assessment with the ORBI risk score (≥10 - not in overt shock at hospital admission).

Plasma concentrations of pro-B-type natriuretic peptide (proBNP) as a proxy for development of cardiogenic shock (CS) and hemodynamic instability will be sampled for primary endpoint analysis.

Read more

Effects on clinical parameters, mortality, morbidity as well as specific indicators of inflammation, cardiac function, and infarct size will secondarily be assessed noninvasively.

The rationale behind the current study is that inflammatory and neurohormonal responses are associated with subclinical hemodynamic instability in patients with AMI with high risk of CS have worse outcomes. The potentially unstable condition may be targeted pharmacologically as an add-on to existing therapy. This is investigated in patients at elevated risk of CS by sampling biomarkers reflecting the inflammatory and neurohormonal responses, as well as determining effects on patient outcomes and infarct size.

Read the detailed description

The planned study is an investigator-initiated, randomized, double blinded clinical trial.

Consecutive patients at Copenhagen University Hospital, Rigshospitalet admitted with AMI < 24 hours from chest pain will be screened.

Patients eligible for trial inclusion will be randomized 2:2 to receive a continuous IV dobutamine infusion of 5 mcg/kg/minute versus placebo for 24 hours and to receive a single IV dose of tocilizumab (1-hour infusion) versus placebo administered after PCI.

Treatment with the investigational drug will be initiated as soon as possible but no later than 2 hours after transfer to the coronary care unit (CCU) and after informed consent. All included patients will follow usual treatment according to current guidelines.

The biomarker proBNP will be measured in blood samples drawn upon hospital admission in patients with ORBI risk score ≥10, and after 12, 24, 36 and 48 hours from admission.

After treatment termination, 2D-echocardiography will be performed acutely and within 2 days to evaluate left ventricular ejection fraction (LVEF), and cardiac magnetic resonance imaging (cMRi) with late gadolinium enhancement technique prior to hospital discharge as close to 48 hours post-MI and after 3 months after discharge will be performed to calculate area at risk and salvage index after AMI.Blood samples (40 mL) will be obtained and stored in a biobank for subsequent measurement of biomarkers reflecting inflammation, neurohormonal activation, neuronal injury, connective tissue function and other relevant pathophysiological processes.

These biomarkers will solely have research interest and no clinical implications. Furthermore, no genetic biomarkers and markers associated with malignancy development will be measured. Any leftover blood from the research biobank will be transferred to a biobank for future research and stored for up to 10 years solely for research purposes. After this period blood samples will be destroyed.

Being tested
Tocilizumab, Dobutamine, NaCl 0.9%
Keywords
acute myocardial infarction, cardiogenic shock, AMI, inflammation, proBNP, AMI-CS, infarct size, STEMI
Medical subject headings
Shock, Cardiogenic, Inflammation, ST Elevation Myocardial Infarction

What participants receive

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

  • TocilizumabDrug

    Also called RoActemra (Actemra)

    Single bolus

  • DobutamineDrug

    Also called Dobutrex

    Continous weight-adjusted infusion

  • NaCl 0.9%Drug

    Also called Saline isotonic

    Placebo comparator and diluent

Study groups in NCT05350592
Study groupRoleWhat they receive
Tocilizumab + DobutamineActive comparatorTocilizumab IV 280 mg (100mL/hour, 1 hour) Dobutamine IV 5 micrograms/kg/minute (5mL/hour, 24 hours)
Receives: Drug: Tocilizumab; Drug: Dobutamine
Tocilizumab + PlaceboActive comparatorTocilizumab IV 280 mg (100mL/hour, 1 hour) NaCl 0,9% IV (5mL/hour, 24 hours)
Receives: Drug: Tocilizumab; Drug: NaCl 0.9%
Placebo + DobutamineActive comparatorNaCl 0,9% IV (100mL/hour, 1 hour) Dobutamine IV 5 micrograms/kg/minute (5mL/hour, 24 hours)
Receives: Drug: Dobutamine; Drug: NaCl 0.9%
Placebo + PlaceboPlacebo comparatorNaCl 0,9% IV (100mL/hour, 1 hour) NaCl 0,9% IV (5mL/hour, 24 hours)
Receives: Drug: NaCl 0.9%

What is being measured

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

  1. ProBNP

    ProBNP plasma concentration being assessed at multiple time points (including the primary endpoint) will be analyzed by application of a linear mixed model of covariance. As the biomarker will be measured prior to initiation of the study drug, the models will be baseline corrected (i.e., constrained linear mixed models, CLMM). The main result of these analyses will be the treatment-by-time interaction as a marker of whether the proBNP levels change differently over time in the treatment versus the placebo arm.

    Measured: 48 hours

Secondary outcomes (13)
  1. CS and/or cardiac arrest

    Number of patients developing in-hospital CS and/or in-hospital cardiac arrest

    Measured: Index admission

  2. Acute Infarct Size

    Magnetic-resonance imaging-estimated infarct size

    Measured: Admission

  3. Post-infarction Salvaged Myocardium

    Magnetic-resonance imaging-estimated infarct size

    Measured: 3 months

  4. Additional biomarkers

    Reflecting neurohormonal activation, endothelial function/damage, inflammation (pro- and anti-inflammatory processes - including IL-6 and C-reactive peptide (CRP)), connective tissue damage, organ dysfunction, and other relevant physiological processes

    Measured: Index admission

  5. Post-procedure assessment

    Survey of PCI operator's post-procedure clinical assessment of the patient's survival at discharge (yes/no)

    Measured: Index admission

  6. Development of non-cardiac arrest arrythmia

    Number of patients and number of per-patient episodes of sustained ventricular tachycardia or atrial fibrillation with a frequency above 120 for more than 30 minutes

    Measured: Index admission

  7. 2D echocardiographic measurements of hemodynamics

    VTI and left ventricular function including strain measurements according to protocol

    Measured: Admisson, 3 months

  8. Re-admission

    Number of all cause and cardiovascular admissions during the first year after index hospitalization

    Measured: One year

  9. Heart Quality of Life (HeartQoL)

    Heart-specific Quality of Life Questionnaire

    Measured: Admission, 3 months

  10. EuroQol Group EQ-5D Quality of Life (EQ-5D-5L)

    Quality of Life Questionnaire

    Measured: Admission, 3 months

  11. HADS (Hospital Anxiety and Depression Scale)

    In-patient Anxiety and Depression Questionnaire

    Measured: Admission, 3 months

  12. The Montreal Cognitive Assessment (MOCA)

    Clinician-administered Cognitive Test

    Measured: Admission, 3 months

  13. Clinical Frailty Scale (CFS)

    Clinician-administered Assessment

    Measured: Admission, 3 months

Timeline

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

  1. First posted28 Apr 2022
  2. Study start13 Mar 2022
  3. Primary completion30 Jun 2025
  4. Study completion30 Sep 2025 (estimated)

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
Factorial
Model description
2x2
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
100 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05350592
Sponsor's protocol ID
RH-CARD-Pharma001
Other IDs
2021-002028-19, H-21045751, U1111-1277-8523
Acronym
DOBERMANN
Status last verified
Jul 2025
First submitted
8 Mar 2022
Last updated
17 Jul 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Data is planned to be available upon reasonable request via the Principal Investigator pending final, complete publication of the study.

Publications

  • Holle SLD, Kunkel JB, Hassager C, Pecini R, Wiberg S, Palm P, Holmvang L, Bang LE, Kjaergaard J, Thomsen JH, Engstrom T, Moller JE, Lonborg JT, Soholm H, Frydland M. Low-dose dobutamine in acute myocardial infarction with intermediate to high risk of cardiogenic shock development (the DOBERMANN-D trial): study protocol for a double-blinded, placebo-controlled, single-center, randomized clinical trial. Trials. 2024 Oct 30;25(1):731. doi: 10.1186/s13063-024-08567-y.

    PubMed 39478521
  • Kunkel JB, Holle SLD, Hassager C, Pecini R, Wiberg S, Palm P, Holmvang L, Bang LE, Kjaergaard J, Thomsen JH, Engstrom T, Moller JE, Lonborg JT, Frydland M, Soholm H. Interleukin-6 receptor antibodies (tocilizumab) in acute myocardial infarction with intermediate to high risk of cardiogenic shock development (DOBERMANN-T): study protocol for a double-blinded, placebo-controlled, single-center, randomized clinical trial. Trials. 2024 Nov 5;25(1):739. doi: 10.1186/s13063-024-08573-0.

    PubMed 39501388

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Tocilizumab, Dobutamine and NaCl 0.9% in people with Acute Myocardial Infarction and Cardiogenic Shock, run by Copenhagen University Hospital, Rigshospitalet at 1 site in Denmark.

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 5 inclusion and 13 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: under way, not looking for participants, as of the sponsor's last update on 17 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. 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?

This study is still under way. Results are not available in the source record yet.

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?

ProBNP (time frame: 48 hours). 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 NCT05350592, 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 17 Jul 2025.

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