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CirrhosisPhase 3CIBERbBECHONCT05769868

Efficacy of Esmolol in the Identification of Cardiovascular Disorders by Cirrhosis, Diabetes Mellitus and Cardiotoxic Treatments

A Phase 3 study testing Esmolol Injection [Brevibloc] in people with Cirrhosis and Diabetes Mellitus, run by Consorcio Centro de Investigación Biomédica en Red (CIBER) at 6 sites in Spain.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The purpose of this study is to assess the superiority of esmolol echocardiography over conventional echocardiography in the diagnosis of subclinical myocardial involvement associated with diabetes mellitus 2, cirrhosis and antineoplastic treatments. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Cirrhosis, Diabetes Mellitus, Oncologic Disorders
What is being tested?
Esmolol Injection [Brevibloc]
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,000 participants
Where
6 sitesSpain
Study dates
18 Apr 2023to Sep 2027
Phase
Phase 3
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
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years.
  • Absence of previous heart disease, defined as the absence of relevant cardiac structural alterations such as moderate or severe hypertrophy, alteration of segmental contraction, Moderate or severe valvular disease, intraventricular obstructive gradient, or old myocardial infarction.
  • Existence of an at least acceptable ultrasonic window, which allows the visualization of at least 14 of the 17 segments of the LV myocardium.
  • Sinus rhythm, with a basal heart rate greater than 50 bpm.
  • Diabetic patients with a diagnosis of Diabetes Mellitus 2 (DM2) with or without Heart Failure with Normal Ejection Fraction (HFNEF) (n = 300) will be included. Previous diagnosis of HFNEF with clinical stability at the time of inclusion (n = 200). No previous diagnosis of HFNEF (n = 100).
  • 200 patients with cirrhosis stratified by the following additional criteria will be included: Child-Pugh A class (n = 25); Child-Pugh B class (n = 75); Child-Pugh C class (with and without ascites n = 50 and n = 50, respectively).
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  • 300 cancer patients will be included, divided into 3 therapeutic groups: 125 patients diagnosed with Lymphoma or Sarcoma receiving chemotherapy based on anthracyclines at high doses (≥ 240 mg / m2); 125 patients with Human Epidermal growth factor Receptor 2 (HER2) positive breast cancer receiving chemotherapy regimen that includes trastuzumab without anthracyclines; 50 patients with hepatocarcinoma receiving treatment with Sorafenib.
  • Expected survival> 6 months, first-diagnosis of cancer, and receiving treatment with chemotherapy that includes any of the previous schemes.
  • A control group (n = 200) without heart disease and without any of the study conditions will be included: diabetes from any cause, cancer or active cancer treatment or some degree of liver disease.

Who cannot join

  • Contraindication for the administration of esmolol (according to technical data sheet): Hypersensitivity to esmolol hydrochloride; Severe sinus bradycardia (HR <50 bpm); 2nd or 3rd degree atrioventricular block without pacemaker; Cardiogenic shock, severe hypotension, or decompensated heart failure; Untreated pheochromocytoma; Acute asthmatic attack; Concomitant intravenous administration or within the first 48 hours after verapamil.
  • Treatment with beta-blocker drugs (oral, topical or intravenous) in the last 7 days before the study.
  • History of ventricular or supraventricular arrhythmias that prevent the safe withdrawal of antiarrhythmic or braking treatment before the administration of esmolol.
  • History of previous high-grade atrioventricular (AV) conduction disorder in non-pacemaker patients.
  • Severe asthma with bronchial hyperresponsiveness.
  • Patients with acute infection.
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  • Participants in other clinical trials in the 30 days prior to the start of the study.
  • Pregnant women, or who plan to be, and women during breastfeeding.
  • Patients with limitation to follow the protocol for any reason.
  • Diagnosis of Diabetes Mellitus (DM) of any type other than type 2 [type 1, Latent Autoimmune Diabetes in Adults (LADA), Maturity-Onset Diabetes of the Young (MODY), New Onset Diabetes After Transplant (NODAT), etc.]
  • Patients in New York Heart Association (NYHA) functional class IV or with advanced heart failure.
  • Treatment with an oral beta-blocker at the time of the examination that cannot be safely temporarily suspended 72 hours before the test.
  • Active evidence of Hepatitis B Virus (HBV) or Hepatitis B Virus (HCV) infection.
  • Personal history of previous cancer requiring systemic treatment (excludes skin or localized cancers treated locally surgically).
  • Previous exposure to systemic antitumor treatment or radiotherapy on the thoracic region.

Trial locations and contacts

6 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Projects Department (CIBER) contact

+34 918222874

proyectos@ciberisciii.es

6 sites in 1 country

Spain6 sites, 6 recruiting
  • Hospital Universitari Vall d&#39;Hebron

    Barcelona, Barcelona, 08035

    José F Rodríguez Palomares, MD, PhD, +34 932746134, jfrodriguezpalomares@gmail.com

    Recruiting
  • Hospital Clínic de Barcelona

    Barcelona, Barcelona, 08036

    Marta Sitges Carreño, MD, PhD, +34 932275722, msitges@clinic.cat

    Not yet recruiting
  • Hospital General Universitario Gregorio Marañón

    Madrid, Madrid, 28007

    Javier Bermejo Thomas, MD, PhD, +34 915868279, javier.bermejo@salud.madrid.org

    Recruiting
  • Hospital Universitario La Paz

    Madrid, Madrid, 28046

    Esther Pérez David, MD, PhD, +34 639607988, eperezdavid@gmail.com

    Recruiting
  • Hospital Clínico Universitario de Salamanca

    Salamanca, Salamanca, 37007

    Candelas Pérez del Villar Moro, MD, +34 620778540, cperezdelvillar@gmail.com

    Recruiting
  • Hospital Universitari i Politècnic La Fe

    Valencia, Valencia, 46026

    Jaume Agüero Ramón-Llin, MD, PhD, +34 629378483, jaimeaguero30@hotmail.com

    Not yet recruiting

Other trials in Spain

About this study

Official title: Prospective, Multicenter and Open Study to Evaluate the Efficacy of Esmolol in the Early Identification of Cardiovascular Disorders Induced by Cirrhosis, Diabetes Mellitus and Cardiotoxic Treatments

The purpose of this study is to assess the superiority of esmolol echocardiography over conventional echocardiography in the diagnosis of subclinical myocardial involvement associated with diabetes mellitus 2, cirrhosis and antineoplastic treatments.

Read the detailed description

After being informed about the study and potential risks, all patients giving written informed consent will undergo a 10 days screening period to determine eligibility for study entry. At Baseline, patients who meet the eligibility requirements will be allocate in one of the 4 cohorts according to their medical conditions.

Trial design consists in a Screening period, Baseline, and 6 additional visits until Month-36.

All patients will undergo to a conventional echocardiography and echocardiography with esmolol administration at Baseline. This procedure will be performed at the following visits according their cohort.

Other complementary procedures will be the collection of blood samples to determine biomarkers, as well as hematology and biochemistry, vital signs and another explorations.

Being tested
Esmolol Injection [Brevibloc]
Keywords
beta blockers, echocardiography, esmolol, systolic function, cardiovascular diagnosis, biomarkers, diagnostic techniques, medical imaging
Medical subject headings
Fibrosis, Diabetes Mellitus

What participants receive

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

  • Esmolol Injection [Brevibloc]Drug

    Also called Anatomical Therapeutic Chemical (ATC) code: C07AB09, Esmolol Hydrochloride

    Brevibloc® will be administered intravenously by infusion pump following the administration schedule:

    Loading dose of 500 μg/kg for 1 minute, followed by a maintenance infusion of 50 μg/kg/minute over 5 minutes.

    If the target response is not obtained, the loading dose is repeated and the 50 dose is increased by 50 μg/kg/minute to a maximum of 200 μg/kg/minute.

    The objective response to esmolol beta-blockade is defined as a 15-20% reduction in heart rate, with lower limits of 55 bpm and a systolic blood pressure not less than 90 mmHg and diastolic blood pressure not less than 50 mmHg.

    The perfusion is kept active while the echocardiography image acquisition is completed (approx. 15-30 min).

Study groups in NCT05769868
Study groupRoleWhat they receive
Single ArmExperimental1 conventional echocardiography without esmolol administration followed by 1 echocardiography with esmolol administration at Baseline and other study visits.
Receives: Drug: Esmolol Injection [Brevibloc]

What is being measured

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

  1. Left Ventricle (LV) ejection fraction

    Estimated with 3D echocardiography (Both: convectional and with esmolol administration)

    Measured: At Baseline (Day 1) until Month-24 according to cohort

  2. Peak measurement of global LV systolic longitudinal strain

    Estimated with 3D echocardiography (Both: convectional and with esmolol administration)

    Measured: At Baseline (Day 1) until Month-24 according to cohort

  3. Ejection Intraventricular Pressure Difference (EIVPD) measure

    Estimated with M-mode echocardiography (Both: convectional and with esmolol administration)

    Measured: At Baseline (Day 1) until Month-24 according to cohort

Secondary outcomes (9)
  1. Ejection fraction

    Obtained with 2D echocardiography (Simpson's biplane method)

    Measured: At Baseline (Day 1) until Month-24 according to cohort

  2. Interleukin (IL)-1β

    Biochemical variables in blood in relation to the alteration of the different components of the myocardium

    Measured: At Baseline (Day 1) until Month-24 according to cohort

  3. High-sensitivity IL-6 (hsIL-6)

    Biochemical variables in blood in relation to the alteration of the different components of the myocardium

    Measured: At Baseline (Day 1) until Month-24 according to cohort

  4. Soluble Suppression of Tumorigenicity 2 (ST-2)

    Biochemical variables in blood in relation to the alteration of the different components of the myocardium

    Measured: At Baseline (Day 1) until Month-24 according to cohort

  5. N-terminal fragment of brain natriuretic peptide (NT-proBNP)

    Biochemical variables in blood in relation to the alteration of the different components of the myocardium

    Measured: At Baseline (Day 1) until Month-24 according to cohort

  6. Ultrasensitive troponin I (hsTnI)

    Biochemical variables in blood in relation to the alteration of the different components of the myocardium

    Measured: At Baseline (Day 1) until Month-24 according to cohort

  7. Procollagen type I terminal propeptide (PICP)

    Biochemical variables in blood in relation to the alteration of the different components of the myocardium

    Measured: At Baseline (Day 1) until Month-24 according to cohort

  8. C-terminal telopeptide collagen type I (CITP)

    Biochemical variables in blood in relation to the alteration of the different components of the myocardium

    Measured: At Baseline (Day 1) until Month-24 according to cohort

  9. Matrix metalloproteinase-1 (MMP-1)

    Biochemical variables in blood in relation to the alteration of the different components of the myocardium

    Measured: At Baseline (Day 1) until Month-24 according to cohort

Timeline

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

  1. First posted15 Mar 2023
  2. Study start18 Apr 2023
  3. Primary completionMar 2027 (estimated)
  4. Study completionSep 2027 (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 3
Primary purpose
Diagnosis
Allocation
Not applicable
Intervention model
Sequential
Masking
None (open label)
Enrolment
1,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05769868
Sponsor's protocol ID
ICI20/00011
Other IDs
2021-003889-12
Acronym
CIBERbBECHO
Status last verified
Sep 2024
First submitted
15 Feb 2023
Last updated
1 Oct 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Yotti R, Bermejo J, Benito Y, Sanz-Ruiz R, Ripoll C, Martinez-Legazpi P, del Villar CP, Elizaga J, Gonzalez-Mansilla A, Barrio A, Banares R, Fernandez-Aviles F. Validation of noninvasive indices of global systolic function in patients with normal and abnormal loading conditions: a simultaneous echocardiography pressure-volume catheterization study. Circ Cardiovasc Imaging. 2014 Jan;7(1):164-72. doi: 10.1161/CIRCIMAGING.113.000722. Epub 2013 Oct 30.

    PubMed 24173273
  • Yotti R, Bermejo J, Desco MM, Antoranz JC, Rojo-Alvarez JL, Cortina C, Allue C, Rodriguez-Abella H, Moreno M, Garcia-Fernandez MA. Doppler-derived ejection intraventricular pressure gradients provide a reliable assessment of left ventricular systolic chamber function. Circulation. 2005 Sep 20;112(12):1771-9. doi: 10.1161/CIRCULATIONAHA.104.485128.

    PubMed 16172285
  • Yotti R, Ripoll C, Benito Y, Catalina MV, Elizaga J, Rincon D, Fernandez-Aviles F, Bermejo J, Banares R. Left ventricular systolic function is associated with sympathetic nervous activity and markers of inflammation in cirrhosis. Hepatology. 2017 Jun;65(6):2019-2030. doi: 10.1002/hep.29104. Epub 2017 Apr 28.

    PubMed 28195341

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Esmolol Injection [Brevibloc] in people with Cirrhosis and Diabetes Mellitus, run by Consorcio Centro de Investigación Biomédica en Red (CIBER) at 6 sites in Spain.

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 9 inclusion and 15 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: looking for participants now, as of the sponsor's last update on 1 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in Spain. 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. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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?

Contact Tania Luis García, BS (+34 917996034 ext. 47304, tanialuisgarcia@cibercv.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Left Ventricle (LV) ejection fraction (time frame: At Baseline (Day 1) until Month-24 according to cohort). The study lists 3 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 NCT05769868, which also lists 3 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 1 Oct 2024.

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