E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
A life-threatening organ dysfunction due to dysregulated host response to a proven or suspected infection |
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E.1.1.2 | Therapeutic area | Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Therapeutic techniques [E02] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
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 |
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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 investigate the safety and tolerability of ADRECIZUMAB in patients with early septic shock and elevated bio-ADM (concentration of > 70 pg/ml) in treatment arm A (2 mg/kg) and in treatment arm B (4 mg/kg) over the 90 days study period.
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E.2.2 | Secondary objectives of the trial |
•To obtain first data on efficacy of ADRECIZUMAB in patients with early septic shock and a bio-ADM concentration of > 70 pg/ml in the treatment arms compared with placebo.
•To study the PK of free-ADRECIZUMAB
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Written informed consent by patient or legal representative
(according to country – specific regulations)
2. Male and female patient, age ≥ 18 years
3. Body weight 50 kg – 120 kg
4. Bio-ADM concentration > 70 pg/ml
5. Patient with early septic shock (start of vasopressor therapy
< 12 hours)
6. Women of childbearing potential must have a negative serum or urine pregnancy test before randomizatoin and have to use a highly effective method of contraception
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E.4 | Principal exclusion criteria |
1. Moribund and death is considered imminent 2-3 days
2. Pre-existing unstable condition (e.g. a recent cerebral hemorrhage or infarct, a recent acute unstable myocardial infarction (all < 3 months), congestive heart failure – NYHA Class IV)
3. Patients that required cardiopulmonary resuscitation in the last 4 weeks prior to evaluation for enrollment
4. Severe COPD with chronic oxygen need at home (GOLD IV)
5. Any organ or bone marrow transplant within the past 24 weeks
6. Uncontrolled serious hemorrhage (≥ 2 units of blood / platelets in the previous 24 hrs.). Patients may be considered for enrollment if bleeding has stopped and patient is otherwise qualified
7. Uncontrolled hematological / oncological malignancies
8. Immunosuppressed patients (known HIV, absolute neutropenia < 500 per µL)
9. Treatment with immunosuppressive drugs
10. Severe chronic liver disease (Child-Pugh C)
11. Systemic fungal infection or active tuberculosis
12. Neuromuscular disorders that impact breathing / spontaneous ventilation
13. Burns > 30% of body surface
14. Plasmapheresis
15. Breastfeeding women
16. Participation in a clinical trial involving another investigational drug within 4 weeks prior to inclusion
17. Unwilling or unable to be fully evaluated for all follow-up visits
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E.5 End points |
E.5.1 | Primary end point(s) |
• Mortality related to ADRECIZUMAB
• Interruption of infusion due to intolerability of ADRECIZUMAB
• New treatment-emergent adverse events related to ADRECIZUMAB
• Changes in severity and frequency of treatment-emergent adverse Events
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
•Primary efficacy endpoint:
Sepsis Support Index (SSI) defined as: days with organ support or dead within 14 days follow up.
More precisely: In the time frame of 14 day follow-up, each day on support with vasopressor, and/or mechanical ventilation, and/or renal dysfunction (defined as renal SOFA = 4), or not alive, is counted as 1. The sum over the follow-up period is defined as SSI.
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E.5.2 | Secondary end point(s) |
• Sepsis Support Index (SSI) defined as: days with organ support or dead within 14 day follow up
More precisely: In the time frame of 14 day follow-up, each day on support with vasopressor, and/or mechanical ventilation, and/or renal dysfunction (defined as renal SOFA = 4), or not alive, is counted as 1. The sum over the follow up period is defined as SSI
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
•Sepsis Support Index (SSI) at 28 day follow-up
• Penalized Sepsis Support Index (pSSI) at 14 and 28 day follow-up
•Persistent organ dysfunction or death at 14 and 28 day follow-up
•Day 28 and day 90 mortality rate
•SSI and pSSI excluding the renal component
•Individual Sepsis Support Index components with and without mortality
•Sequential Organ Failure Assessment (SOFA) Score
• Improvement in renal function as change in penKid and creatinine (day 3 – day 1,day 7 – day 1)
•Length of stay at ICU/ hospital
•Changes of functional parameters and other parameters during stay at ICU
•Vasopressor use (drug,highest/lowest dose, duration)
•APACHE II
•Quality of Life by Euro-QoL-5 (day 28 and day 90)
•Vital signs (heart rate, blood pressure)
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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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 30 |
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 | No |
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
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Last visit of the last subject (LVLS) |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 9 |