Safety and Efficacy of Inhaled Pegylated Adrenomedullin (PEG-ADM) in Patients Suffering From Acute Respiratory Distress Syndrome (ARDS): a Double-blind, Randomized, Placebo-controlled, Multicenter Phase 2a/b Clinical Trial
试验速览
- 阶段
- 2 期
- 状态
- 终止
- 发起方
- Bayer
- 入组人数
- 90
- 试验地点
- 22
- 主要终点
- VFS in Part B participants
研究概览
简要总结
The study is composed of two parts. In part A of the study two active doses of inhaled pegylated adrenomedullin (PEG-ADM) will be compared regarding safety and efficacy to a substance that has no therapeutic effect (placebo) in order to find an optimal and safe of the study drug. In part B of the study the highest dose that is considered safe and has demonstrated efficacy will be taken forward to collect information how well patients suffering from Acute Respiratory Distress Syndrome (ARDS) respond to treatment with inhaled pegylated adrenomedullin (PEG-ADM) compared to treatment with placebo. ARDS is a type of lung failure that cause fluid to build up in the lungs making breathing difficult or impossible.
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
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •≥18 years of age at the time of inclusion into study.
- •Invasively mechanically ventilated acute respiratory distress syndrome [ARDS] patients (diagnosed according to Berlin definition of ARDS, including positive end-expiratory pressure [PEEP] of ≥5 cm H2O, X-ray (or CT scan) indicative of ARDS: bilateral opacities not fully explained by cardiac failure, fluid overload, lobar/lung collapse, effusions or nodules).
- •Initial diagnosis of mild, moderate or severe ARDS prior to study inclusion, with acute onset of ARDS within 1 week after suspected trigger factor of
- •Pneumonia
- •Aspiration
- •Pancreatitis
- •Prior to randomization, hypoxemia with PaO2:FiO2 ≤300 mmHg continuously observed for a period of ≥4 hours (with values of ≥2 arterial blood gas [ABG] analyses during that time, with the last value obtained timely (generally ≤3 hours) prior to randomization), under ventilation with minimum PEEP ≥8 cm H2O.
- •Time from first meeting the last diagnostic ARDS criterion (Berlin criteria) to randomization must be ≤48 hours.
- •For Study Part A: ARDS patients for whom measurements of extra-vascular lung water are regarded as medically indicated by the treating physician, and these measurements are planned as part of their clinical care, from Study Day 1 up to Study Day 7 (if then still intubated).
排除标准
- •Any value of a PaO2:FiO2 ratio >300 mmHg within a time interval of 4 hours before randomization
- •Rescue therapy (e.g. inhalation of nitric oxide gas and/or inhalation of prostacyclin analogues, or extra corporeal membrane oxygenation [ECMO] / extra corporeal CO2 removal [ECCO2R]) already initiated at screening and/or Study Day 1 (prior to first dose of the study intervention)
- •Moribund participants not expected to survive 24 hours (clinical decision)
- •Expected duration of invasive mechanical ventilation less than 48 hours (clinical decision)
- •History of co-morbidities requiring long-term/home oxygen use (e.g. severe chronic obstructive pulmonary disease [COPD], pulmonary fibrosis) or non-invasive ventilation (except for sleep apnea management), or making weaning per se improbable (e.g. ALS, muscular dystrophy)
- •Smoke inhalation injury, extensive burns or trauma/head injury as concomitant condition
- •History of pneumectomy, lung lobectomy or lung transplant
- •Diffuse alveolar hemorrhage from vasculitis
- •Current lung malignancy (incl. lung metastasis), or other malignancy requiring chemotherapy or radiation within the last month
- •Chronic kidney disease with a history of renal replacement therapy (e.g. dialysis)
- •Chronic liver disease Child-Pugh Class C
- •Chronic heart failure NYHA IV
- •Known hypersensitivity to polyethyleneglycol (PEG, Macrogol)
- •Participation in other interventional studies involving pharmacological interventions, or biological or cell therapy interventions
- •Diagnosis of COVID-19 pneumonia within 6 weeks prior to study inclusion. History of SARS-CoV-2 infection (positive test based on nucleic acid amplification technology or positive antigen test) without COVID-19 pneumonia does not exclude patients
研究组 & 干预措施
Part A - Active Drug Dose 1
Participants will receive Active Drug Dose 1 for a maximum of 14 days in study phase Part A
干预措施: BAY1097761 Active Dose 1 (Drug)
Part A - Active Drug Dose 2
Participants will receive Active Drug Dose 2 for a maximum of 14 days in study phase Part A
干预措施: BAY1097761 Active Dose 2 (Drug)
Part A - Placebo
Participants will receive Placebo for a maximum of 14 days in study phase Part A
干预措施: Placebo to BAY1097761 (Other)
Part B - Active Drug Dose
Participants will receive Active Drug 1 or 2 for a maximum of 14 days in study phase Part B
干预措施: BAY1097761 Active Dose 1 (Drug)
Part B - Active Drug Dose
Participants will receive Active Drug 1 or 2 for a maximum of 14 days in study phase Part B
干预措施: BAY1097761 Active Dose 2 (Drug)
Part B - Placebo
Participants will receive Placebo for a maximum of 14 days in study phase Part B
干预措施: Placebo to BAY1097761 (Other)
结局指标
主要结局
VFS in Part B participants
时间窗: At Day 28
Ventilator-free survival (VFS, participants alive and not on invasive mechanical ventilation)
次要结局
- Proportion of participants who still require invasive mechanical ventilation support in Part A and Part B participants(At Day 28 and Day 60)
- Ventilator-free days (VFDs) in Part A and Part B participants(Within Day 28 and Day 60)
- VFS in Part A and Part B participants(At Day 60)
- All-cause mortality in Part A and Part B participants(At Day 28, Day 60 and Day 90)
- VFS in Part A participants(At Day 28)
- CUI in Part A participants(Up to 7 days)
- Integrated analysis on VFS invoving all participants from Part A and Part B(At Day 28 and Day 60)