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Hypoxic-Ischemic EncephalopathyPhase 2STARNCT05778188

A Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Preliminary Efficacy of RLS-0071 in Newborns With Moderate or Severe Hypoxic-Ischemic Encephalopathy Undergoing Therapeutic Hypothermia

A Phase 2 study testing RLS-0071 in people with Hypoxic-Ischemic Encephalopathy, run by ReAlta Life Sciences, Inc. at 15 sites in United States.

Recruiting

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

Sites and contacts
Official record
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Trial summary

Hypoxic-ischemic encephalopathy (HIE) affects approximately 4,000 to 12,000 persons annually in the United States. Mortality from HIE has been reported up to 60%, with at least 25% of survivors left with significant neurocognitive disability. Read more about this study

Who is it for?
Ages Up to 10 hours
Conditions the study is for
Hypoxic-Ischemic Encephalopathy
What is being tested?
RLS-0071
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
70 participants
Where
15 sitesUnited States
Study dates
27 Jul 2023to Dec 2028
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 Up to 10 hours
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • ≥ 36 weeks gestation.
  • Sentinel event prior to delivery such as abruption, tight nuchal cord, uterine rupture, profound bradycardia, shoulder dystocia, or cord prolapse or other acute event likely attributable for newborn depression at delivery or an acute change in the fetal status with a clinical presentation consistent with an acute sentinel event with no clearly defined etiology.
  • Moderate or severe encephalopathy based on at least one risk of encephalopathy criterion (a) and one clinical signs of encephalopathy criterion (b):
  • Risk of encephalopathy (either):
  • Blood gas drawn within 1 hour of birth, either arterial blood gas (ABG) or venous blood gas (VBG) (cord or infant) with pH ≤ 7.0 OR base deficit ≥ 16 mmol/L.
  • OR
Show all 15Show fewer
  • appearance, pulse, grimace, activity, and respiration (APGAR) score ≤ 5 at 10 minutes OR
  • The infant required assisted ventilation ≥ 10 minutes after birth (ie, endotracheal, mask ventilation, or continuous positive airway pressure [CPAP]).
  • Clinical signs of encephalopathy (either/both):
  • Moderate/Severe encephalopathy on National Institute of Child Health and Human Development assessment.
  • Evidence of seizures (clinical and/or electroencephalogram).
  • Be eligible to receive therapeutic hypothermia.
  • Active whole-body cooling to be started prior to 6 hours of age (passive cooling is permitted prior to active whole body cooling).
  • Product of a singleton pregnancy.
  • Written informed consent obtained from parent or legal guardian.

Who cannot join

  • Inability to enroll in the study and initiate the first dose of RLS-0071 within 10 hours of life.
  • Known major congenital and/or chromosomal abnormality(ies).
  • Severe growth restriction (birth weight ≤ 1800 g).
  • Prenatal diagnosis of brain abnormality or hydrocephalus.
  • Patient's head circumference is < 30 cm.
  • 10-minute APGAR score < 2, if available.
Show all 14Show fewer
  • Infants suspected of overwhelming sepsis or congenital infection based on the Investigator's clinical consideration at the time of enrollment.
  • Persistent severe hypotension unresponsive to inotropic support (requiring >2 inotropes, not inclusive of hydrocortisone).
  • Persistent severe hypoxia in the setting of 100% fraction of inspired oxygen (FiO₂) and unresponsive to nitric oxide or requiring extracorporeal membrane oxygenation (ECMO).
  • Severe disseminated intravascular coagulation with clinical bleeding.
  • Neonatal encephalopathy believed to be due to a cause other than perinatal hypoxia (ie, other than HIE).
  • Moribund infants for whom withdrawal of care being considered.
  • Suspected or confirmed fetal alcohol syndrome or suspected substance withdraw seizures.
  • Any other condition that the investigator may consider would make the patient ineligible for the study or place the patient at an unacceptable risk (Note: this criterion would include a clinically significant [eg, Grade 3 or 4] intracranial hemorrhage).

Trial locations and contacts

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

15 sites in 1 country

United States15 sites, 14 recruiting
  • Study Site 002

    Boston, Massachusetts, 02115

    Recruiting
  • Study Site 021

    Cleveland, Ohio, 44195

    Recruiting
  • Study Site 003

    Durham, North Carolina, 27710

    Recruiting
  • Study Site 022

    Fort Worth, Texas, 76104

    Recruiting
  • Study Site 001

    Gainesville, Florida, 32608

    Recruiting
  • Study Site 014

    Indianapolis, Indiana, 46202

    Recruiting
  • Study Site 012

    Lexington, Kentucky, 40536

    Withdrawn
  • Study Site 016

    Little Rock, Arkansas, 72202

    Recruiting
  • Study Site 018

    Miami, Florida, 33143

    Recruiting
  • Study Site 005

    Morgantown, West Virginia, 26506

    Recruiting
  • Study Site 013

    Orange, California, 92868

    Recruiting
  • Study Site 010

    Orlando, Florida, 32803

    Recruiting
  • Study Site 020

    San Diego, California, 92037

    Recruiting
  • Study Site 019

    San Diego, California, 92123

    Recruiting
  • Study Site 006

    St Louis, Missouri, 63110

    Recruiting

Other trials in United States

About this study

Official title: A Phase 2, Two-Stage, Randomized, Double-Blind, Placebo-Controlled, Multiple-Ascending Dose Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Preliminary Efficacy of RLS-0071 in Newborns With Moderate or Severe Hypoxic-Ischemic Encephalopathy Undergoing Therapeutic Hypothermia With Long-Term Follow-Up

Hypoxic-ischemic encephalopathy (HIE) affects approximately 4,000 to 12,000 persons annually in the United States. Mortality from HIE has been reported up to 60%, with at least 25% of survivors left with significant neurocognitive disability. Despite this vital unmet medical need, no pharmacological adjunct or alternative therapy has proven beneficial in improving outcomes in neonatal HIE.

RLS-0071 is a novel peptide being developed for the treatment of neonatal HIE. This study is designed to evaluate the safety and tolerability of RLS-0071 in the treatment of newborns with moderate or severe HIE.

Read the detailed description

This is a Phase 2, two-stage, multisite, randomized, double-blind, placebo-controlled, multiple-ascending dose study of RLS-0071 to assess the safety, tolerability, pharmacokinetics (PK), and preliminary efficacy in newborns with moderate or severe HIE undergoing therapeutic hypothermia.

In Stage 1, participants will receive either ascending doses of RLS-0071 or a matched volume of placebo for 72 hours in addition to standard of care treatment, including therapeutic hypothermia. During and after the dosing period, participants will be monitored and assessed for safety evaluations through Day 14. After completion of Stage 1, participants will transition to Stage 2 of the study for long-term observation until participants reach 24 months of age.

The first cohort subsets, consisting of Cohort 1a (moderate HIE) and 1b (severe HIE), will receive a dose of 3 mg/kg RLS-0071 or a matched volume of placebo every 8 hours (q8h). A Data Safety Monitoring Board (DSMB) will review available clinical safety and PK data from Cohort 1 subsets with completed study intervention, and make a recommendation on whether to escalate the dose for moderate and severe HIE cohorts. The Sponsor will consider the DSMB recommendation to make their decision on dose escalation in addition to their own evaluation of all available safety and PK data. If the decision is made to escalate, Cohort 2 subsets (2a [moderate] and 2b [severe]) will be recruited to receive an escalated dose of RLS-0071 (10 mg/kg) or a matched volume of placebo. Following the completion of study intervention for each Cohort 2 subset (2a [moderate] or 2b [severe]), the DSMB will review available safety and PK data and make a recommendation whether to expand enrollment for Cohort 2+ (2a+ [moderate] or 2b+ [severe]) at 10 mg/kg RLS-0071 or a matched volume of placebo.

Being tested
RLS-0071, Placebo
Keywords
Birth Asphyxia, Anoxic brain injury
Medical subject headings
Hypoxia-Ischemia, Brain, Asphyxia Neonatorum

What participants receive

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

  • RLS-0071Drug

    RLS-0071 (unit strength 10 mg/mL) will be administered by infusion for a dose level of 3 or 10 mg/kg. Planned infusion duration is 10 minutes for all dose levels.

  • PlaceboDrug

    Placebo control (commercial sterile saline) will be administered by infusion at a volume matched to RLS-0071 (3 or 10 mg/kg). Planned infusion duration is 10 minutes for all matched dose levels.

Study groups in NCT05778188
Study groupRoleWhat they receive
RLS-0071ExperimentalDoses of RLS-0071 to be administered every 8 hours (q8h), for a total of 10 doses over 72 hours.
Receives: Drug: RLS-0071
PlaceboPlacebo comparatorDoses of sterile saline (sodium chloride, 0.9%) to be administered every 8 hours (q8h), for a total of 10 doses over 72 hours.
Receives: Drug: Placebo

What is being measured

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

  1. Frequency and severity of adverse events (AEs) and serious adverse events (SAEs) by treatment group at Day 14

    Number of participants with AEs and SAEs graded between Grade 1 (mild in severity) and Grade 5 (death related to AE).

    Measured: Day 1 to Day 14

  2. Frequency and severity of events of special interest and SAEs by treatment group at 24 months

    Number of participants with events of special interest and SAEs graded between Grade 1 (mild in severity) and Grade 5 (death related to AE).

    Events of special interest are: autoimmune disorder, persistent hypotension, persistent pulmonary hypertension, acute kidney injury, major venous thrombosis, severe intracranial hemorrhage, pulmonary hemorrhage, culture proven sepsis, necrotizing enterocolitis, severe thrombocytopenia, hepatic dysfunction, hyperbilirubinemia, coagulopathy, hypocalcemia, cerebral palsy, developmental or speech delay, learning disability, and visual or hearing impairment.

    Measured: Day 1 to 24 months

  3. Frequency of premature discontinuation by treatment group due to AEs at Day 14

    Number of participants who prematurely discontinue from the study due to AEs

    Measured: Day 1 to Day 14

  4. Acute brain injury at Day 4, assessed through magnetic resonance imaging (MRI), using a standardized scoring system

    Brain injury MRI score includes scoring extent of injury across 4 domains (Grey matter, White matter/cortex, Cerebellum, and Additional). A score of 0 indicates a normal brain MRI, whereas the maximum score of 57 indicates extensive bilateral injury.

    Measured: Day 4

  5. Acute brain injury at Day 12, assessed through magnetic resonance imaging (MRI), using a standardized scoring system

    Brain injury MRI score includes scoring extent of injury across 4 domains (Grey matter, White matter/cortex, Cerebellum, and Additional). A score of 0 indicates a normal brain MRI, whereas the maximum score of 57 indicates extensive bilateral injury.

    Measured: Day 12

Secondary outcomes (14)
  1. Composite of mortality and neurodevelopmental impairment (NDI) at 24 months

    Measured: Day 1 to 24 months

  2. Mortality at 3, 6, 12, 18, and 24 months

    Number of participants alive at each timepoint

    Measured: Day 1 to 3, 6, 12, 18, and 24 months

  3. Number of participants with clinically significant laboratory abnormalities, events of special interest, and SAEs at 3, 6, 12, and 18 months

    Measured: Day 1 to 3, 6, 12, and 18 months

  4. Neurocognitive developmental outcome assessed by Bayley-4 at 24 months of age

    The Bayley Scales of Infant and Toddler Development (4th Edition) consists of 5 subdomains: the Cognitive, Language, Motor, Social-Emotional, and Adaptive Behavior scales. Cognitive, Language, and Motor domains include a total of 264 items, each ranked between 0-2 (where 0 is not present and 2 is mastery); the Social-Emotional and Adaptive Behavior domains are assessed through caregiver questionnaires.

    Measured: 24 months

  5. Neurodevelopmental growth impact: Diagnosis of cerebral palsy at 24 months of age

    Number of participants diagnosed with cerebral palsy

    Measured: 24 months

  6. Neurodevelopmental growth impact: Grading of cerebral palsy by using the Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R) at 24 months of age

    The GMFCS is a 5-level classification system for children and young people with cerebral palsy, where Level 1 indicates ability to walk without limitations and Level 5 indicates reliance on a manual wheelchair.

    Measured: 24 months

  7. Number of participants diagnosed with mild, moderate, or severe visual impairment and hearing impairment

    Measured: Day 1 to 24 months

  8. Number of days of supplemental nutritional support required

    Measured: Day 1 to 24 months

  9. Seizure occurrence

    Discrete number of seizures recorded

    Measured: Day 1 to Day 14

  10. Total seizure burden (total number of minutes seizing as measured by continuous electroencephalogram [EEG]) during hospitalization

    Measured: Day 1 to Day 14

  11. Electrical activity abnormality scoring as measured by EEG

    Measured: Day 1 to Day 14

  12. Impact on infant and family wellness, assessed by the Mother-to-Infant Bonding Scale (MIBS)

    The MIBS is a 9-item questionnaire, with total scores ranging from 0 to 27. A high score indicates weaker mother-to-infant bonding.

    Measured: 3 and 12 months

  13. Impact on infant and family wellness, assessed by the Parenting Stress Index, 4th Edition Short Form (PSI-4-SF)

    The PSI-4 is a 36-item questionnaire focusing on three domains: Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child, which combine to form a Total Stress scale. Scores are assessed following conversion into percentile ranks. Scores falling in the 90th or higher percentile indicate clinically significant parenting stress.

    Measured: 3, 12, and 24 months

  14. Quality of life assessment over the first 24 months of life

    A quality of life questionnaire will be used to collect information regarding the care of the aging child over the first 24 months of life.

    Measured: Day 4 to 24 months

Timeline

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

  1. First posted21 Mar 2023
  2. Study start27 Jul 2023
  3. Primary completionDec 2026 (estimated)
  4. Study completionDec 2028 (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
Parallel groups
Model description
Two-Stage, Randomized, Double-Blind, Placebo-Controlled, Multiple-Ascending Dose Study
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
70 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05778188
Sponsor's protocol ID
RLS-0071-202
Acronym
STAR
Status last verified
Apr 2026
First submitted
3 Mar 2023
Last updated
13 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing RLS-0071 in people with Hypoxic-Ischemic Encephalopathy, run by ReAlta Life Sciences, Inc. at 15 sites in United States.

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 15 inclusion and 14 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 13 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 15 sites in United States. 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?

Contact Lori Upham (757-901-0331, Lupham@realtals.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Frequency and severity of adverse events (AEs) and serious adverse events (SAEs) by treatment group at Day 14 (time frame: Day 1 to Day 14). The study lists 5 primary outcomes in all. 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 13 Apr 2026.

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