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    Clinical Trial Results:
    Ciclosporin to Protect Renal function In Cardiac Surgery. CiPRICS. A Phase II Double Blind Randomized Placebo Controlled Study.

    Summary
    EudraCT number
    2014-004610-29
    Trial protocol
    SE  
    Global end of trial date
    06 Oct 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    22 Dec 2018
    First version publication date
    22 Dec 2018
    Other versions
    Summary report(s)
    Clinical_study_report

    Trial information

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    Trial identification
    Sponsor protocol code
    2014.001
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02397213
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Skanes University Hospital
    Sponsor organisation address
    Getingevägen 4, Lund, Sweden, 22185
    Public contact
    Dept of Cardiothoracic Surgery, Skanes University Hospital, 46 461753495349, henrik.bjursten@skane.se
    Scientific contact
    Dept of Cardiothoracic Surgery, Skanes University Hospital, 46 461753495349, henrik.bjursten@skane.se
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    12 May 2017
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    30 Jun 2016
    Global end of trial reached?
    Yes
    Global end of trial date
    06 Oct 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To study the efficacy of ciclosporin, with brand name CicloMulsion®, given preoperatively in CABG study patients to reduce the degree of AKI after CABG surgery. A number of biological markers for kidney function will be evaluated as mentioned in 4.4.
    Protection of trial subjects
    Treated in routine care.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    07 Apr 2015
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety
    Long term follow-up duration
    1 Months
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Sweden: 154
    Worldwide total number of subjects
    154
    EEA total number of subjects
    154
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    37
    From 65 to 84 years
    115
    85 years and over
    2

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    446 patients planned for non-emergent CABG with high risk of developing acute kidney injury where assessed for eligibility. 292 patients were excluded, 154 included: - 30 did not meet inclusion criteria. - 140 met exclusion criteria - 44 declined to participate - 77 where excluded for other reasons - 1 included in safety analysis only.

    Period 1
    Period 1 title
    Baseline (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Carer, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Ciclosporin
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    CicloMulsion
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Emulsion for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    bolus...

    Arm title
    Placebo
    Arm description
    -
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Emulsion for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    llll

    Number of subjects in period 1
    Ciclosporin Placebo
    Started
    75
    79
    Completed
    75
    79

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Ciclosporin
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Reporting group values
    Ciclosporin Placebo Total
    Number of subjects
    75 79 154
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
        Newborns (0-27 days)
    0
        Infants and toddlers (28 days-23 months)
    0
        Children (2-11 years)
    0
        Adolescents (12-17 years)
    0
        Adults (18-64 years)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    69.7 ± 8.1 69.1 ± 8.3 -
    Gender categorical
    Units: Subjects
        Female
    13 11 24
        Male
    62 68 130

    End points

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    End points reporting groups
    Reporting group title
    Ciclosporin
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Primary: Relative change in P-Cystatin C from Baseline to postoperative Day 3

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    End point title
    Relative change in P-Cystatin C from Baseline to postoperative Day 3
    End point description
    End point type
    Primary
    End point timeframe
    From Day -1 to Day 3.
    End point values
    Ciclosporin Placebo
    Number of subjects analysed
    75
    78
    Units: mmol/L
        arithmetic mean (standard deviation)
    136.38 ± 35.64
    115.87 ± 30.82
    Statistical analysis title
    Mixed linear model
    Comparison groups
    Placebo v Ciclosporin
    Number of subjects included in analysis
    153
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.05
    Method
    Mixed models analysis
    Confidence interval

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    The reporting of AE began after administration of study medication and lasted until the follow-up phone call was made 1 month after the operation day.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.0
    Reporting groups
    Reporting group title
    Ciclosporin
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Serious adverse events
    Ciclosporin Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    10 / 76 (13.16%)
    11 / 79 (13.92%)
         number of deaths (all causes)
    0
    1
         number of deaths resulting from adverse events
    0
    1
    Investigations
    Liver function test abnormal
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Postpericardiotomy syndrome
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular graft occlusion
    Additional description: Vascular Graft Occlusion and Myocardial infarction.
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Pericardial effusion
         subjects affected / exposed
    1 / 76 (1.32%)
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorder
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac failure
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac arrest
    Additional description: Cardiac arrest, Myocardial Infarction and Pulmonary Oedema.
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Cerebrovascular accident
         subjects affected / exposed
    0 / 76 (0.00%)
    2 / 79 (2.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    General disorders and administration site conditions
    Non-cardiac chest pain
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest pain
    Additional description: Chest pain, Nausea and Vomiting.
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Gastrointestinal haemorrhage
    Additional description: Gastrointestinal haemorrhage was reported for one patient in the Placebo group. Gastrointestinal Haemorrhage and Cardiac Arrest was reported for one patient in the Ciclosporin Group.
         subjects affected / exposed
    1 / 76 (1.32%)
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pleural effusion
         subjects affected / exposed
    3 / 76 (3.95%)
    0 / 79 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Hydronephrosis
    Additional description: Hydronephrosis and Ureteral Stenosis
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    1 / 76 (1.32%)
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colon gangrene
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mediastinitis
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Postoperative wound infection
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Ciclosporin Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    21 / 76 (27.63%)
    20 / 79 (25.32%)
    Investigations
    Liver function test abnormal
         subjects affected / exposed
    1 / 76 (1.32%)
    1 / 79 (1.27%)
         occurrences all number
    1
    1
    Hepatic enzyme increased
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Injury, poisoning and procedural complications
    Postpericardiotomy syndrome
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Vascular graft occlusion
    Additional description: Vascular graft occlusion, myocardial infarction
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences all number
    1
    0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Hypertension
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences all number
    1
    0
    Cardiac disorders
    Pericardial effusion
         subjects affected / exposed
    1 / 76 (1.32%)
    1 / 79 (1.27%)
         occurrences all number
    1
    1
    Angina pectoris
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Atrial fibrillation
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences all number
    1
    0
    Cardiac disorder
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Cardiac failure
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences all number
    1
    0
    Ventricular arrhythmia
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Cardiac arrest
    Additional description: Cardiac arrest, myocardial infarction, pulmonary oedema
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Nervous system disorders
    Cerebrovascular accident
         subjects affected / exposed
    0 / 76 (0.00%)
    2 / 79 (2.53%)
         occurrences all number
    0
    2
    Syncope
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences all number
    1
    0
    General disorders and administration site conditions
    Non-cardiac chest pain
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Chest pain
    Additional description: Chest pain was reported for one patient in the Ciclosporin group. Chest pain, nausea, and vomiting was reported for one patient in the Placebo group.
         subjects affected / exposed
    1 / 76 (1.32%)
    1 / 79 (1.27%)
         occurrences all number
    1
    1
    Pyrexia
    Additional description: Pyrexia, C-reactive protein increased
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Gastrointestinal haemorrhage
    Additional description: Gastrointestinal haemorrhage was reported for one patient in the Placebo group. Gastrointestinal haemorrhage and cardiac arrest was reported for one patient in the Ciclosporin group.
         subjects affected / exposed
    1 / 76 (1.32%)
    1 / 79 (1.27%)
         occurrences all number
    1
    1
    Respiratory, thoracic and mediastinal disorders
    Pleural effusion
         subjects affected / exposed
    6 / 76 (7.89%)
    2 / 79 (2.53%)
         occurrences all number
    6
    2
    Pneumothorax
         subjects affected / exposed
    2 / 76 (2.63%)
    0 / 79 (0.00%)
         occurrences all number
    2
    0
    Cough
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Dyspnoea
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences all number
    1
    0
    Psychiatric disorders
    Delirium
         subjects affected / exposed
    0 / 76 (0.00%)
    2 / 79 (2.53%)
         occurrences all number
    0
    2
    Sleep disorder
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences all number
    1
    0
    Renal and urinary disorders
    Renal failure
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences all number
    1
    0
    Urinary retention
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Hydronephrosis
    Additional description: Hydronephrosis, ureteral stenosis
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Infections and infestations
    Pneumonia
    alternative assessment type: Non-systematic
         subjects affected / exposed
    4 / 76 (5.26%)
    1 / 79 (1.27%)
         occurrences all number
    4
    1
    Postoperative wound infection
    alternative assessment type: Non-systematic
         subjects affected / exposed
    1 / 76 (1.32%)
    2 / 79 (2.53%)
         occurrences all number
    1
    2
    Urinary tract infection
    alternative assessment type: Non-systematic
         subjects affected / exposed
    1 / 76 (1.32%)
    1 / 79 (1.27%)
         occurrences all number
    1
    1
    Colon gangrene
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences all number
    1
    0
    Infection
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Mediastinitis
         subjects affected / exposed
    0 / 76 (0.00%)
    1 / 79 (1.27%)
         occurrences all number
    0
    1
    Respiratory infection
         subjects affected / exposed
    1 / 76 (1.32%)
    0 / 79 (0.00%)
         occurrences all number
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    02 May 2016
    - Based on the patient population available at the site, the size of the stratum was changed from "at least 60" to "approximately 50" patients from the group with an ...

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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