A Phase IIIB Double Blind, Randomized, Placebo-Controlled, Dose-Comparison Study of Subcutaneous Hydration With and Without Human Recombinant Hyaluronidase (HYLENEX) in Volunteer Subjects
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 入组人数
- 50
- 试验地点
- 2
- 主要终点
- Average infusion flow rate (mL/hr) derived from the time to infuse 400 mL of lactated ringers
研究概览
简要总结
The purpose of this research study to test the effectiveness of a study medication to increase how fast a solution called lactated Ringer's is absorbed when put under the skin subcutaneously. The medication to be studied is an enzyme called hyaluronidase, and is a human recombinant form of the enzyme. The drug company name for this medication is Hylenex. Hylenex was currently an investigational medication at the initiation of the study, but received FDA approval during the study. An investigational medication is a medication or formulation of a medication that is not approved by the United States Food and Drug Administration for use in this country but may be used in studies such as this one.
详细描述
The study will be conducted in two sequential stages:
Stage 1: Preliminary assessment of mean flow rate and its inter-subject variability, and a comparison to IV infusion. Each subject will receive a SC infusion of 400 mL (from a 0.5 L bag) of Ringer's lactate solution in each upper arm, followed by one IV infusion of 400 mL of Ringer's lactate solution (from a 0.5 L bag). The SC injection sites will be randomized in a double-blinded fashion to receive either 150 units Hylenex or an equal volume of saline placebo injected into a Y-port in the tubing just above the catheter immediately prior to infusion. 24-gauge angiocatheters will be placed symmetrically in the SC space in both proximal upper extremities at the lateral aspect, midline halfway between the olecranon process and the inferoposterior aspect of the acromion, introduced at a 30-degree angle. A 24-gauge angiocatheter will also be placed in a vein in either the left or right forearm (per randomization). In each upper arm, Ringer's lactate solution will be infused SC by gravity (wide open) by placing the top of the fluid in a 0.5 liter bag at a height of 100 cm above the respective angiocatheter sites. After completion of both SC infusions, Ringer's lactate solution will be infused IV by gravity (wide open) by placing the top of the fluid in a 0.5 liter bag at a height of 100 cm above the angiocatheter sites. The flow rate observations in Stage 1 will be used to either confirm or adjust the proposed sample size for Stage 2, if such adjustment is necessary.
Stage 2: Dose-comparison assessment of rate of flow over the range of 150 to 1,500 units of Hylenex. Each subject will receive a SC infusion of 400 mL (from a 0.5 L bag) of Ringer's lactate solution in each upper arm. The SC injection sites will be randomized in a double-blinded fashion to either Hylenex or an equal volume of saline solution injected into a Y-port in the tubing just above the catheter immediately prior to infusion. 24-gauge angiocatheters will be placed symmetrically in the SC space in both proximal upper extremities at the lateral aspect, midline halfway between the olecranon process and the inferoposterior aspect of the acromion, introduced at a 30-degree angle. In each arm, Ringer's lactate solution will be infused SC by gravity (wide open) by placing the top of the fluid in a 0.5 liter bag at a height of 100 cm above the respective catheter sites. Subjects will be dosed in either two or three sequential cohorts.
Cohort 3, at 750 U, to be conducted ONLY if flow rate for Cohort 2 is at least 20% faster than for Cohort 1 without unacceptable toxicity in Cohort 1, or unacceptable toxicity observed in Cohort 2 and not Cohort
In each stage, safety and tolerability will be assessed through physical examination targeted at infusion sites and volume status assessment, vital signs, and adverse events.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Males or females aged 18 to 60 years, inclusive
- •Agreement that there will be no fluid intake for 12 hours prior to the start of the study infusion (except sips of water to take necessary medications)
- •Vital signs (BP, HR, RR) within normal range
- •Metabolic panel (e.g., sodium, potassium, chloride, bicarbonate, BUN, creatinine, glucose, calcium, AST, ALT, alkaline phosphatase, total bilirubin, albumin, and total protein) within normal range within 7 days of infusion
- •Adequate venous access in at least one forearm
- •A negative pregnancy test (if female of child-bearing potential) within 7 days of infusion
- •Decision-making capacity
- •Signed, written IRB-approved informed consent
排除标准
- •Extremity edema
- •Upper extremity pathology that could interfere with study outcome (e.g., cellulitis, lymphatic disorder or prior surgery, pre-existing pain syndrome, previous mastectomy and/or axillary lymph node dissection, etc.)
- •History of cardiovascular disease
- •Rales on lung auscultation
- •Known allergy to hyaluronidase or any other ingredient in the formulation of HYLENEX
- •Known allergy to bee or vespid venom
- •Known coagulopathy
结局指标
主要结局
Average infusion flow rate (mL/hr) derived from the time to infuse 400 mL of lactated ringers
次要结局
- Photographic images of the SC infusion sites
- Average SC infusion rate of flow (mL/hr) derived from time required to drain 400 mL from the 500 mL infusate bag, fluid and tubing AND for the arm circumference to return to baseline
- Flow rate determined by weight of infusate bag, fluid and tubing at specified timepoints
- For SC infusions, change in arm circumference in three locations in the vicinity of the site of infusion
- For SC infusions, time from the beginning of infusion until arm circumference returns to baseline
- Subject assessment of local discomfort by placing a mark on a 0 100 mm visual analogue scale (VAS) anchored by no discomfort and worst possible discomfort
- Local edema assessed by the Investigator on a 0-4 scale
- Leakage of fluid at angiocatheter site assessed by the Investigator on a 0-4 scale, prior to infusion, at mid-infusion, at end of infusion, and (for SC infusions), when arm circumference returns to baseline
- Subject's global rank-ordered preference for infusion
- Investigator's global rank-ordered preference for infusion
- Safety and tolerability, based on adverse events and PE including vital signs