Acute Lung Injury Clinical Trials Incubator Unit
Overview
- Phase
- Phase 2
- Intervention
- Not specified
- Conditions
- Respiratory Distress Syndrome, Adult
- Sponsor
- University of Washington
- Enrollment
- 13
- Locations
- 1
- Primary Endpoint
- Alveolar lavage concentrations of interleukin-8 (measured post-treatment at Days 2, 3, 6, 7, and 8)
- Status
- Terminated
- Last Updated
- 8 years ago
Overview
Brief Summary
This is a phase II, randomized, double-blind, placebo-controlled, safety and efficacy study of a recombinant chimeric monoclonal antibody against CD14 (IC14) in hospitalized patients with acute lung injury (ALI).
Detailed Description
BACKGROUND: This study will use IC14, a recombinant chimeric monoclonal antibody (mAb) recognizing CD14, to block CD14 medicated cellular activation in patients with sepsis-induced ALI. Research results of antibody interaction with CD14 suggest that CD14 has a central role in the recognition of bacterial products and the induction of innate immune responses. Although beneficial, when this response is combined with a component of alveolar stretch it may induce an exaggerated response that can be harmful. This study will implement strategies to block CD14-mediated cellular activation and will evaluate whether this strategy has a beneficial effect in reducing alveolar inflammatory response, mechanical ventilation days, multiple organ failure, and severity of organ dysfunction in patients with sepsis-induced ALI. DESIGN NARRATIVE: The primary outcome of this study will be alveolar lavage concentrations of interleukin-8 that will be measured post-treatment at Days 2 and 3, and Days 6 to 8. The key secondary outcomes of this study will be: 1) Worst Murray Lung Injury Score (measured at Days 1 through 7, and Day 28); 2) Worst Multiple Organ Dysfunction (MOD) Score (Marshall) (measured at Days 1 through 7, and Day 28); 3) Infections-nosocomial and/or surgical site infections (measured at Day 28); 4) Ventilator-free days (measured at Day 28); and 5) Mortality (measured at Day 28).
Investigators
Eligibility Criteria
Inclusion Criteria
- •Presence of ALI, defined as the following:
- •Acute onset (less than 28 days from study entry)
- •PaO2/FiO2 of less than 300
- •Bilateral infiltrates consistent with pulmonary edema on frontal chest radiograph (infiltrates may be patchy, diffuse, homogeneous, or asymmetric)
- •Requirement for positive pressure ventilation via endotracheal tube
- •No clinical evidence of left atrial hypertension
- •Clinical indication for antimicrobial therapy at the time of randomization
- •Anticipated duration of mechanical ventilation greater than 48 hours
Exclusion Criteria
- •Treatment with a drug or device within 30 days prior to study entry that has not received regulatory approval at the time of study entry
- •Does not meet safety criteria for bronchoscopic alveolar lavage either at baseline or is anticipated to be too high a risk for lavage on Day 1 of the study
- •Intubation for cardiopulmonary arrest
- •Intubation for status asthmaticus, pulmonary embolus, or myocardia infarction
- •Anticipated survival less than 48 hours from intubation
- •Anticipated survival less than 28 days due to pre-existing medical condition
Outcomes
Primary Outcomes
Alveolar lavage concentrations of interleukin-8 (measured post-treatment at Days 2, 3, 6, 7, and 8)
Secondary Outcomes
- Worst Murray Lung Injury Score
- Worst Multiple Organ Dysfunction (MOD) Score (Marshall) (measured at Days 1 through 7, and Day 28)
- Infections-nosocomial and/or surgical site infections
- Ventilator-free days
- Mortality (measured at Day 28)