Clinical Trial Results:
Parallel-Group, Placebo-Controlled Randomized Study Investigating the Effect of Intravenous Iso-osmolar Iodinated Contrast Material Iodixanol (Visipaque™ Injection 320 mgI/mL) on Renal Function in Adults with Chronic Kidney Disease (CKD) Stage III or Stage IV Who Have Undergone Endovascular Aneurysm Repair (EVAR)
Summary
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EudraCT number |
2016-001668-13 |
Trial protocol |
ES GB BE HU PL NL |
Global end of trial date |
19 Oct 2018
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Results information
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Results version number |
v1(current) |
This version publication date |
02 Nov 2019
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First version publication date |
02 Nov 2019
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
GE-012-106
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT03119662 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
GE Healthcare Ltd.
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Sponsor organisation address |
The Grove Centre, White Lion Road, Amersham, Buckinghamshire, United Kingdom, HP7 9LL
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Public contact |
Medical Director - Nuclear Medicine, GE Healthcare Ltd., info@ge.com
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Scientific contact |
Medical Director - Nuclear Medicine, GE Healthcare Ltd., info@ge.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
07 Dec 2018
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
19 Oct 2018
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Was the trial ended prematurely? |
Yes
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General information about the trial
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Main objective of the trial |
To demonstrate the safety of intravenous (i.v.) iodinated iso-osmolar iodixanol (Visipaque™ Injection 320 mgI/mL) usage in contrast-enhanced computed tomography (CECT) for CKD stage III/IV patients by evaluating the incidence of acute kidney injury (AKI) stage >=1, per acute kidney injury network (AKIN) serum creatinine (SCr) criteria [AKIN 2015] [Mehta et al. 2007], in patients undergoing CECT with iodixanol vs subjects receiving placebo and undergoing nonenhanced computed tomography (NECT) and an additional non–contrast-enhanced ultrasound imaging modality.
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Protection of trial subjects |
A Steering Committee oversaw the study from conceptual protocol development, throughout study conduct and termination. In addition to the Steering Committee, a Critical Event Adjudication Committee (CEAC) was established to review all morbidity and mortality events (i.e., critical events, including Endovascular Aneurysm Repair (EVAR)-related post-baseline events). A Data Safety Monitoring Board (DSMB) was established to periodically review acute kidney injury (AKI) rates and make recommendations on the continuation of the study or potential requirement to amend the protocol. The Steering Committee and CEAC were not provided access to any treatment allocation information during the conduct of the study.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
08 Feb 2018
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Spain: 2
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Country: Number of subjects enrolled |
United States: 2
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Worldwide total number of subjects |
4
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EEA total number of subjects |
2
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
0
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From 65 to 84 years |
4
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85 years and over |
0
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Recruitment
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Recruitment details |
The Study was conducted at 29 sites in United States of America & Europe from 8 February 2018 to 19 October 2018. A total of 8 subjects with Chronic Kidney Disease (CKD) stage III/IV were enrolled at 4 sites. Of which, 4 of these subjects failed screening due to not meeting one or more inclusion/exclusion criteria. | |||||||||||||||
Pre-assignment
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Screening details |
A total of 4 subjects were randomized in 1:1 ratio to undergo either contrast-enhanced computed tomography (CECT) or non-enhanced computed tomography (NECT), of which 1 subject withdrew from study. | |||||||||||||||
Period 1
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Period 1 title |
Overall Study (overall period)
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Is this the baseline period? |
Yes | |||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Not blinded | |||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Visipaque™: Contrast-Enhanced Computed Tomography (CECT) | |||||||||||||||
Arm description |
Subjects received 1 intravenous injection of Visipaque™ 320 mg I/ml injection (100 mL iodixanol) and underwent computed tomography (CT) examination. | |||||||||||||||
Arm type |
Experimental | |||||||||||||||
Investigational medicinal product name |
Visipaque
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
100 mL iodixanol (Visipaque Injection 320 mg I/mL), followed by a 10 mL saline flush to ensure delivery of the full dose of Visipaque.
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Arm title
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Saline: Non-Enhanced Computed Tomography (NECT) | |||||||||||||||
Arm description |
Subjects received 1 intravenous injection of saline placebo (matched to Visipaque™ 320 mg I/ml injection) and underwent computed tomography (CT) examination and supplemental non-contrast duplex ultrasonography imaging examination. | |||||||||||||||
Arm type |
Placebo | |||||||||||||||
Investigational medicinal product name |
Saline
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
100 mL saline, followed by a 10 mL saline flush.
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Baseline characteristics reporting groups
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Reporting group title |
Visipaque™: Contrast-Enhanced Computed Tomography (CECT)
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Reporting group description |
Subjects received 1 intravenous injection of Visipaque™ 320 mg I/ml injection (100 mL iodixanol) and underwent computed tomography (CT) examination. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Saline: Non-Enhanced Computed Tomography (NECT)
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Reporting group description |
Subjects received 1 intravenous injection of saline placebo (matched to Visipaque™ 320 mg I/ml injection) and underwent computed tomography (CT) examination and supplemental non-contrast duplex ultrasonography imaging examination. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Visipaque™: Contrast-Enhanced Computed Tomography (CECT)
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Reporting group description |
Subjects received 1 intravenous injection of Visipaque™ 320 mg I/ml injection (100 mL iodixanol) and underwent computed tomography (CT) examination. | ||
Reporting group title |
Saline: Non-Enhanced Computed Tomography (NECT)
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Reporting group description |
Subjects received 1 intravenous injection of saline placebo (matched to Visipaque™ 320 mg I/ml injection) and underwent computed tomography (CT) examination and supplemental non-contrast duplex ultrasonography imaging examination. |
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End point title |
Assessment of the Incidence of Acute Kidney Injury (AKI) Stage >=1 Per Acute Kidney Injury Network (AKIN) Serum Creatinine (SCr) Criteria [1] | ||||||||||||
End point description |
AKIN Serum Creatinine Criteria for AKI- Stage 1: a SCr increase of >=0.3 mg/dL (>=26.4 μmol/L) or increase to >=150% to 200% (>=1.5- to 2.0-fold) from baseline within 48 hours. Stage 2: a SCr increase to >200% to 300% (>2.0- to 3-fold) from baseline within 48 hours. Stage 3: a SCr increase to >300% (>3.0-fold) from baseline or SCr >=4.0 mg/dL (>=354 μmol/L) with an acute increase of >=0.5 mg/dL (>=44 μmol/L) within 48 hours. The study was early terminated as limited number of subjects enrolled (N=4 randomized subjects) hence, no statistical analyses were performed, and no tables and listings were produced.
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End point type |
Primary
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End point timeframe |
48 hours post-baseline (Follow-up 1)
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Notes [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: Due to early termination of study, no statistical analyses were performed, and no tables and listings were produced. |
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Notes [2] - Due to early termination of study, no tables & listings were produced to perform planned analysis. [3] - Due to early termination of study, no tables & listings were produced to perform planned analysis. |
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No statistical analyses for this end point |
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End point title |
Assessment of the Incidence of Acute Kidney Injury (AKI) Stage >=2 Per Acute Kidney Injury Network (AKIN) Serum Creatinine (SCr) Criteria | ||||||||||||
End point description |
AKIN Serum Creatinine Criteria for AKI- Stage 1: a SCr increase of >=0.3 mg/dL (>=26.4 μmol/L) or increase to >=150% to 200% (>=1.5- to 2.0-fold) from baseline within 48 hours. Stage 2: a SCr increase to >200% to 300% (>2.0- to 3-fold) from baseline within 48 hours. Stage 3: a SCr increase to >300% (>3.0-fold) from baseline or SCr >=4.0 mg/dL (>=354 μmol/L) with an acute increase of >=0.5 mg/dL (>=44 μmol/L) within 48 hours. The study was early terminated as limited number of subjects enrolled (N=4 randomized subjects) hence, no statistical analyses were performed, and no tables and listings were produced.
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End point type |
Secondary
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End point timeframe |
48 hours post-baseline (Follow-up 1)
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Notes [4] - Due to early termination of study, no tables and listings were produced to perform planned analysis. [5] - Due to early termination of study, no tables and listings were produced to perform planned analysis. |
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No statistical analyses for this end point |
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End point title |
Assessment of the Incidence of Acute Kidney Injury (AKI) by Contrast Induced Nephropathy (CIN) | ||||||||||||
End point description |
Standard definition of CIN: Increase in SCr of 0.5 mg/dL or more in the 24 to 72 hours after the CT scan. The study was early terminated as limited number of subjects enrolled (N=4 randomized subjects) hence, no statistical analyses were performed, and no tables and listings were produced.
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End point type |
Secondary
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End point timeframe |
48 hours post-baseline (Follow-up 1)
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Notes [6] - Due to early termination of study, no tables and listings were produced to perform planned analyses. [7] - Due to early termination of study, no tables and listings were produced to perform planned analyses. |
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No statistical analyses for this end point |
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End point title |
Assessment of the Incidence of Acute Kidney Injury (AKI) Stage >=2 By Waikar Criteria | ||||||||||||
End point description |
Waikar’s definitions of AKI: Stage 1: 0.3 mg/dL increase in SCr over 24 hours or a 0.5 mg/dL increase in SCr over 48 hours. Stage 2: 0.5 mg/dL increase in SCr over 24 hours or a 1.0 mg/dL increase in SCr over 48 hours. Stage 3: 1.0 mg/dL increase in SCr over 24 hours or a 1.5 mg/dL increase in SCr over 48 hours. The study was early terminated as limited number of subjects enrolled (N=4 randomized subjects) hence, no statistical analyses were performed, and no tables and listings were produced.
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End point type |
Secondary
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End point timeframe |
48 hours post-baseline (Follow-up 1)
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Notes [8] - Due to early termination of study, no tables and listings were produced to perform planned analyses. [9] - Due to early termination of study, no tables and listings were produced to perform planned analyses. |
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No statistical analyses for this end point |
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End point title |
All Cause Mortality and Morbidity | |||||||||
End point description |
Mortality (all cause death) and morbidity i.e. critical events. The study was early terminated as limited number of subjects enrolled (N=4 randomized subjects) hence, no statistical analyses were performed, and no tables and listings were produced.
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End point type |
Secondary
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End point timeframe |
From Baseline to Month 6
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Notes [10] - Due to early termination of study, no tables and listings were produced to perform planned analyses. [11] - Due to early termination of study, no tables and listings were produced to perform planned analyses. |
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No statistical analyses for this end point |
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End point title |
Blinded Independent Assessment of Image Quality/Diagnostic Confidence Using a 5-Point Scale | |||||||||
End point description |
Blinded independent assessment of image quality/diagnostic confidence using a 5-point scale. Image quality/diagnostic confidence for all imaging studies was rated on a 5-point scale from 1 (poor) to 5 (excellent).
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End point type |
Secondary
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End point timeframe |
Month 6
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Notes [12] - Due to early termination of study, no tables and listings were produced to perform planned analyses. [13] - Due to early termination of study, no tables and listings were produced to perform planned analyses. |
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No statistical analyses for this end point |
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Adverse events information [1]
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Timeframe for reporting adverse events |
All Adverse Events (AEs) were collected from randomization until the end of the follow-up period (Month 6) regardless of seriousness or relationship to investigational product.
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Adverse event reporting additional description |
Reported AEs are study-emergent AEs that is AEs that developed/worsened during any time after randomization until end of the follow-up period (Month 6). Analysis was performed on safety population which included all participants who were randomized to receive Visipaque™ or saline placebo and had post-randomization observations.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||
Dictionary version |
19.0
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Reporting groups
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Reporting group title |
Visipaque™: Contrast-Enhanced Computed Tomography (CECT)
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Reporting group description |
Subjects received 1 intravenous injection of Visipaque™ 320 mg I/ml injection (100 mL iodixanol) and underwent CT examination. | ||||||||||||||||||||||||||||||
Reporting group title |
Saline: Non-Enhanced Computed Tomography (NECT)
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Reporting group description |
Subjects received 1 intravenous injection of saline placebo (matched to Visipaque™ 320 mg I/ml injection) and underwent CT examination and supplemental non-contrast duplex ultrasonography imaging examination. | ||||||||||||||||||||||||||||||
Notes [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported. Justification: There were no non- serious adverse events reported in this study. |
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Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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12 Apr 2017 |
Following amendments were made: Information on the recent European Society of Cardiology (ESC) 2014 guidelines was added.
•Clarification that the subset of subjects who might receive MB-102 and
monitored by ORFM would be from selected sites in the USA.
•Clarification on use of NSAIDs and excluded medication.
•Clarification of SAE reporting, laboratory AE evaluation, and blood sampling at Follow-up 1.
•Critical study events were more fully defined.
•Clarification of hydration requirements and the use of intravenous (i.v.) hydration.
•Clarification of procedures at screening and baseline, including timing of visits and signing of informed consent.
•Definition of the per-protocol set was updated.
•Minor typographical errors were corrected.
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25 Jan 2018 |
•Acceptable methods of contraception were further clarified to include acceptable, but not highly effective, birth control methods in line with guidelines and informed consent.
•Period of metformin discontinuation prior to the Baseline Visit was increased from 24 hours to 48 hours in line with core safety information.
•Thyroid-stimulating hormone (TSH) was added to the Screening laboratory evaluation.
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28 Mar 2018 |
•Potentially eligible subjects could enter this study any time during their post-Endovascular Aneurysm Repair (EVAR) follow-up, once they had passed the first imaging examination (commonly scheduled 1 month after the index EVAR), and if no complications, such as endoleaks, had been detected. Consequently, assessment for eligibility could happen years after the index EVAR, when documentation of the first imaging exam might not be available, despite subsequent follow-up examination(s) providing sufficient assurance on the stable post- EVAR status of such subjects. The changes in inclusion criteria and exclusion criterion aim to allow enrolment of otherwise eligible post-EVAR subjects in cases where documentation and evidence on the first month imaging examination were not available. The requirement for stable post-EVAR conditions (no endoleak, no clinically meaningful EVAR-related complication) was unchanged, so the characteristics of the subject population remained unchanged.
•The screening period was increased from 7 days to 14 days for logistical reasons.
•Recent literature reference was added.
•A definition of the end of the study was added.
•Clarification that randomization was in a 1:1 ratio.
•Text added to clarify that the use of N-acetylcysteine was discouraged for the purpose of preventing AKI.
•The period of time after which the Sponsor reserves the right to discontinue
participation of a study center at which no subjects had been enrolled wasincreased from within 3 months to within 6 months of initiation.
•Clarification that ‘personnel who were trained in the acute management of anaphylaxis and other emergencies and who have access to appropriate clinical supplies must be immediately available for 30 minutes after dosing’ was added.
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
Study was early terminated after enrollment of 4 subjects due to very slow recruitment rates. Sample size was 4 participants instead of planned 1164 participants, hence no statistical analyses were performed, no tables and listings were produced. |