| E.1 Medical condition or disease under investigation |
| E.1.1 | Medical condition(s) being investigated |
| Severe sepsis or septic shock |
|
| MedDRA Classification |
| E.1.2 Medical condition or disease under investigation |
| E.1.2 | Version | 13.1 |
| E.1.2 | Level | PT |
| E.1.2 | Classification code | 10040070 |
| E.1.2 | Term | Septic shock |
| E.1.2 | System Organ Class | 10021881 - Infections and infestations |
|
| E.1.2 Medical condition or disease under investigation |
| E.1.2 | Version | 13.1 |
| E.1.2 | Level | PT |
| E.1.2 | Classification code | 10053879 |
| E.1.2 | Term | Sepsis syndrome |
| E.1.2 | System Organ Class | 10021881 - Infections and infestations |
|
| E.1.3 | Condition being studied is a rare disease | No |
| E.2 Objective of the trial |
| E.2.1 | Main objective of the trial |
| To assess the effects of HES 130/0.4 compared with a balanced crystalloid solution on mortality and end-stage kidney failure in patients with severe sepsis. |
|
| E.2.2 | Secondary objectives of the trial |
To assess the effects of HES 130/0.4 compared with a balanced crystalloid solution on · Sepsis-related organ failure assessment (SOFA, modified from (19), see Appendix 5) score (excluding Glasgow Coma Score) at day 5 after randomisation ·Kidney failure (SOFA score > 2 in the kidney component) at any time during the ICU stay after randomisation ·Development of kidney failure (doubling of p-creatinine values) during the ICU stay after randomisation ·Development of acidosis as the lowest recorded pHa during the ICU stay after randomisation ·Need of dialysis/haemofiltration ·Need of ventilation ·Days alive without dialysis/haemofiltration ·Days alive without ventilation ·Hospital length of stay for survivors |
|
| E.2.3 | Trial contains a sub-study | No |
| E.3 | Principal inclusion criteria |
All adult patients who ·Undergo resuscitation in the ICU
·AND fulfilment within the previous 24 hours of the criteria for severe sepsis according to the Society of Critical Care Medicine/American College of Chest Physicians (SCCM/ACCP), see Appendix 1
·AND consent is obtainable either from the patient or by proxy (physician and/or next of kin)
|
|
| E.4 | Principal exclusion criteria |
·Age < 18 years ·Previously randomised in the 6S trial ·Allergy towards hydroxyethyl starch or malic acid ·Treatment with > 1000 ml’s of any synthetic colloid within the last 24 hours prior to randomisation ·Any form of renal replacement therapy ·Acute burn injury > 10% body surface area ·Severe hyperkalaemia, p-K > 6.0 mM ·Liver or kidney transplantation during current hospital admission ·Intracranial bleeding within current hospitalisation ·Enrolment into another ICU trial of drugs with potential action on circulation, renal function or coagulation ·Withdrawal of active therapy |
|
| E.5 End points |
| E.5.1 | Primary end point(s) |
| The composite outcome measure of 90-day mortality or end-stage kidney disease defined as dialysis-dependency 90 days after randomisation will be the primary outcome measure, and these two outcome measures will also be analysed separately |
|
| E.6 and E.7 Scope of the trial |
| E.6 | Scope of the trial |
| E.6.1 | Diagnosis | No |
| E.6.2 | Prophylaxis | No |
| E.6.3 | Therapy | Yes |
| E.6.4 | Safety | Yes |
| E.6.5 | Efficacy | Yes |
| E.6.6 | Pharmacokinetic | No |
| E.6.7 | Pharmacodynamic | No |
| E.6.8 | Bioequivalence | No |
| E.6.9 | Dose response | No |
| E.6.10 | Pharmacogenetic | No |
| E.6.11 | Pharmacogenomic | No |
| E.6.12 | Pharmacoeconomic | No |
| E.6.13 | Others | No |
| E.7 | Trial type and phase |
| E.7.1 | Human pharmacology (Phase I) | No |
| E.7.1.1 | First administration to humans | No |
| E.7.1.2 | Bioequivalence study | No |
| E.7.1.3 | Other | No |
| E.7.1.3.1 | Other trial type description | |
| E.7.2 | Therapeutic exploratory (Phase II) | No |
| E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
| E.7.4 | Therapeutic use (Phase IV) | No |
| E.8 Design of the trial |
| E.8.1 | Controlled | Yes |
| E.8.1.1 | Randomised | Yes |
| E.8.1.2 | Open | No |
| E.8.1.3 | Single blind | No |
| E.8.1.4 | Double blind | Yes |
| E.8.1.5 | Parallel group | Yes |
| E.8.1.6 | Cross over | No |
| E.8.1.7 | Other | No |
| E.8.2 | Comparator of controlled trial |
| E.8.2.1 | Other medicinal product(s) | Yes |
| E.8.2.2 | Placebo | No |
| E.8.2.3 | Other | No |
| E.8.3 |
The trial involves single site in the Member State concerned
| No |
| E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
| E.8.4.1 | Number of sites anticipated in Member State concerned | 14 |
| E.8.5 | The trial involves multiple Member States | Yes |
| E.8.5.1 | Number of sites anticipated in the EEA | 25 |
| E.8.6 Trial involving sites outside the EEA |
| E.8.6.1 | Trial being conducted both within and outside the EEA | No |
| E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
| E.8.7 | Trial has a data monitoring committee | Yes |
| E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
The independent Data Monitoring and Safety Committee - DMSC - will recommend pausing or stopping the trial if ·Group-difference in the primary outcome measure is found at the interim analysis ·Group-difference in 30- or 90-day mortality is found at the interim analysis ·Group-difference in SUSARs or SARs is found at the interim analysis ·Results from other trials show clear benefit or harm with one of the trial fluids
|
|
| E.8.9 Initial estimate of the duration of the trial |
| E.8.9.1 | In the Member State concerned years | 2 |
| E.8.9.1 | In the Member State concerned months | 0 |
| E.8.9.1 | In the Member State concerned days | 0 |
| E.8.9.2 | In all countries concerned by the trial years | 2 |
| E.8.9.2 | In all countries concerned by the trial months | 0 |
| E.8.9.2 | In all countries concerned by the trial days | 0 |