A Study of Safety, PK, & PD of ISIS 416858 Administered Subcutaneously to Patients With End-Stage Renal Disease on Hemodialysis
- Registration Number
- NCT02553889
- Lead Sponsor
- Ionis Pharmaceuticals, Inc.
- Brief Summary
Evaluation of safety, tolerability, PK and PD of ISIS 416858 in patients with end-stage renal disease (ESRD) receiving chronic hemodialysis.
- Detailed Description
Evaluation of Safety, PK and PD of ISIS 416858 in patients with end-stage renal disease (ESRD) receiving chronic hemodialysis.
The overall objectives are to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of ISIS 416858 in ESRD patients on hemodialysis.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 49
- End stage renal disease maintained on outpatient hemodialysis at a healthcare center for > 3 months from screening with hemodialysis using heparin (unfractionated heparin or low-molecular weight heparin) 3 times per week for a minimum of 3 hours per dialysis session and plan to continue this throughout the study.
-
Documented thrombotic event (acute coronary syndrome, stroke or transient ischemic attack, venous thromboembolic event) in the past 3 months.
-
Active bleeding within the past 3 months from screening or documented bleeding diathesis (history of bleeding disorder) or Screening values of:
- Platelet count < 150,000 cells/mm3
- INR > 1.4
- aPTT > upper limit of normal (ULN)
-
Abnormal liver function at Screening:
- ALT or AST > 2 x ULN
- Total bilirubin > ULN
-
Concomitant medication restrictions: Concomitant use of anticoagulant/antiplatelet agents (e.g., dabigatran, rivaroxaban, clopidogrel) that may affect coagulation (except low dose aspirin (≤ 100 mg/day) during Treatment and Post-treatment Evaluation Periods is not allowed.
-
Uncontrolled hypertension as judged by the Investigator. Patients with a pre- or post-dialysis blood pressure (BP) that is > 160 mmHg on at least 3 of last 5 dialysis treatments.
-
Planned major surgery in the next 6 months (e.g. renal transplant surgery)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Cohort A Placebo Patients in Cohort A will be randomized to receive either 200 mg ISIS 416858 or placebo. A 2:1 ratio will be used. For Cohort A, the study will include a 4-week screening period and a 12-week treatment period followed by a 12-week post-treatment evaluation period. Cohort A will receive Study Drug (ISIS 416858 or placebo) twice a week during the first 2 weeks, followed by once weekly for the remaining 10 weeks of the treatment period. All doses of Study Drug will be administered subcutaneously (SC) 10 minutes after completion of the hemodialysis treatment. Cohort B ISIS 416858 Patients in Cohort B will be randomized to receive either 300 mg ISIS 416858 or placebo. A 2:1 ratio will be used. For Cohort B, the study will include a 4-week screening period and a 12-week treatment period followed by a 12-week post-treatment evaluation period. Cohort B will receive Study Drug (ISIS 416858 or placebo) twice a week during the first 2 weeks, followed by once weekly for the remaining 10 weeks of the treatment period. All doses of Study Drug will be administered subcutaneously (SC) 10 minutes after completion of the hemodialysis treatment. PK Cohort ISIS 416858 A 4-week screening period followed by a 4-week treatment period followed by a 6-week post-treatment evaluation period. Treatment period includes 1 dose of 300 mg ISIS 416858 on Day 1 and again on Day 29. Both doses of Study Drug will be administered subcutaneously (SC). Cohort B Placebo Patients in Cohort B will be randomized to receive either 300 mg ISIS 416858 or placebo. A 2:1 ratio will be used. For Cohort B, the study will include a 4-week screening period and a 12-week treatment period followed by a 12-week post-treatment evaluation period. Cohort B will receive Study Drug (ISIS 416858 or placebo) twice a week during the first 2 weeks, followed by once weekly for the remaining 10 weeks of the treatment period. All doses of Study Drug will be administered subcutaneously (SC) 10 minutes after completion of the hemodialysis treatment. Cohort A ISIS 416858 Patients in Cohort A will be randomized to receive either 200 mg ISIS 416858 or placebo. A 2:1 ratio will be used. For Cohort A, the study will include a 4-week screening period and a 12-week treatment period followed by a 12-week post-treatment evaluation period. Cohort A will receive Study Drug (ISIS 416858 or placebo) twice a week during the first 2 weeks, followed by once weekly for the remaining 10 weeks of the treatment period. All doses of Study Drug will be administered subcutaneously (SC) 10 minutes after completion of the hemodialysis treatment.
- Primary Outcome Measures
Name Time Method Safety and Tolerability - evaluated by reviewing frequency and severity of Adverse events (including bleeding events) and use of concomitant medications, changes in vital signs and laboratory evaluations for all patients For the PK Cohort: Patients will be followed for 72 days. For Cohorts A and B: Patients will be followed for 162 days. The safety and tolerability of ISIS 416858 will be evaluated by reviewing frequency and severity of Adverse events (including bleeding events) and use of concomitant medications, changes in vital signs and laboratory evaluations for all patients
- Secondary Outcome Measures
Name Time Method Pharmacodynamic Outcomes in FXI antigen and activity as measured by absolute change over time. For the PK Cohort: Patients will be followed for 72 days. For Cohorts A and B: Patients will be followed for 162 days. Pharmacodynamic Outcomes as measured by absolute change over time for FXI antigen and activity (units/milliliter)
Pharmacodynamic Outcomes in FXI antigen and activity as measured by percent change over time. For the PK Cohort: Patients will be followed for 72 days. For Cohorts A and B: Patients will be followed for 162 days. Pharmacodynamic Outcomes as measured by percent change over time for FXI antigen and activity (units/milliliter)
Pharmacodynamic Outcomes in aPTT as measured by absolute change over time. For the PK Cohort: Patients will be followed for 72 days. For Cohorts A and B: Patients will be followed for 162 days. Pharmacodynamic Outcomes as measured by absolute change over time for aPTT (seconds)
Pharmacodynamic Outcomes in aPTT as measured by percent change over time. For the PK Cohort: Patients will be followed for 72 days. For Cohorts A and B: Patients will be followed for 162 days. Pharmacodynamic Outcomes as measured by percent change over time for aPTT (seconds)
Pharmacodynamic Outcomes for PT and the PT derived INR as measured by absolute change over time. For the PK Cohort: Patients will be followed for 72 days. For Cohorts A and B: Patients will be followed for 162 days. Pharmacodynamic Outcomes as measured by absolute change over time for PT (seconds) and the PT derived INR (International Normalization Ratio)
Pharmacodynamic Outcomes for PT and the PT derived INR as measured by percent change over time. For the PK Cohort: Patients will be followed for 72 days. For Cohorts A and B: Patients will be followed for 162 days. Pharmacodynamic Outcomes as measured by percent change over time for PT (seconds) and the PT derived INR (International Normalization Ratio)
Trial Locations
- Locations (1)
Ionis Investigative Site
🇨🇦Montreal, Quebec, Canada