Trial to Evaluate Reduction in Inflammation in Patients With Advanced Chronic Renal Disease Utilizing Antibody Mediated IL-6 Inhibition (RESCUE)
A Phase 2b, Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate Reduction in Inflammation in Patients With Advanced Chronic Renal Disease Utilizing Antibody Mediated IL-6 Inhibition
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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Alabama
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Birmingham, Alabama, United States, 35205
- Central Alabama Research
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Arizona
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Mesa, Arizona, United States, 85210
- Aventiv Research
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Phoenix, Arizona, United States, 85018
- Elite Clinical Studies
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Phoenix, Arizona, United States, 85016
- Arizona Kidney Disease and Hypertension Center
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California
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Lynwood, California, United States, 90262
- North America Research Institute
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Riverside, California, United States, 92505
- Apex Research of Riverside
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Riverside, California, United States, 92503
- North America Research Institute
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San Dimas, California, United States, 91773
- North America Research Institute
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Colorado
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Arvada, Colorado, United States, 80002
- Western Nephrology and Metabolic Bone Disease, PC
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Florida
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Miami, Florida, United States, 33169
- AMPM Research Clinic
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Ocala, Florida, United States, 34474
- Ocala Cardiovascular Research
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Winter Park, Florida, United States, 32789
- Florida Premier Research Institue, LLC
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Georgia
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Augusta, Georgia, United States, 30901
- Southeastern Clinical Research Institute, LLC
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Columbus, Georgia, United States, 31904
- Columbus Regional Research Institute
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Illinois
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Chicago, Illinois, United States, 60643
- Investigator Research by Design, LLC
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Iowa
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Iowa City, Iowa, United States, 52242
- University of Iowa
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Louisiana
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Monroe, Louisiana, United States, 71201
- Clinical Trials of America, LLC - West Monroe
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Maryland
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Greenbelt, Maryland, United States, 20770
- Capital Nephrology
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Michigan
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Caro, Michigan, United States, 48723
- Onyx Clinical Research
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Detroit, Michigan, United States, 48202
- Henry Ford Health System
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Roseville, Michigan, United States, 48066
- St. Clair Nephrology Research
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Saint Clair Shores, Michigan, United States, 48081
- Nephrology Research of Michigan
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Minnesota
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Minneapolis, Minnesota, United States, 55404
- DaVita Clinical Research
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New York
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Great Neck, New York, United States, 11021
- Julia and Israel Waldbaum Dialysis Center
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Northport, New York, United States, 11768
- Northport VAMC
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The Bronx, New York, United States, 10461
- DaVita Clinical Research
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North Carolina
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Asheville, North Carolina, United States, 28801
- Mountain Kidney and Hypertension Associates
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Charlotte, North Carolina, United States, 28207
- Metrolina Nephrology Associates, PA
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Charlotte, North Carolina, United States, 28277
- Metrolina Nephrology Associates
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Whiteville, North Carolina, United States, 28472
- Southeastern Nephrology - Whiteville
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Wilmington, North Carolina, United States, 28401
- Southeastern Nephrology Associates - Wilmington
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Ohio
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Stow, Ohio, United States, 44224
- Summit Research Group, LLC
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Pennsylvania
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Allentown, Pennsylvania, United States, 18104
- Northeast Clinical Research Center
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Rhode Island
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Providence, Rhode Island, United States, 02903
- Rhode Island Hospital
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South Carolina
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Fort Mill, South Carolina, United States, 29707
- Piedmont Research Partners, LLC
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Greer, South Carolina, United States, 29651
- Mountain View CLinical Research - Greer
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Tennessee
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Knoxville, Tennessee, United States, 37923
- Knoxville Kidney Center, PLLC
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Nashville, Tennessee, United States, 37205
- Nephrology Associates, PC
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Texas
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Dallas, Texas, United States, 75246
- Renal Disease Research Institute
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Houston, Texas, United States, 77017
- Vilo Research Group, Inc
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Houston, Texas, United States, 77043
- Biopharma Informatick Inc. Research Center
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Houston, Texas, United States, 77070
- Juno Research, LLC - Northwest
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North Richland Hills, Texas, United States, 76180
- North Hills Medical Research, Inc
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San Antonio, Texas, United States, 78212
- Clinical Advancement Center, PLLC
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San Antonio, Texas, United States, 78229
- San Antonio Kidney Disease Center Physicians Group, PLLC
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Vermont
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Burlington, Vermont, United States, 05401
- University of Vermont
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Virginia
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Danville, Virginia, United States, 25241
- Southside Urology and Nephrology
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Manassas, Virginia, United States, 20110
- Manassas Clinical Research Center
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Wisconsin
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Kenosha, Wisconsin, United States, 53142
- Clinical Investigation Specialist, Inc
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 18 years of age
- Stage 3-5 CKD
- hs-CRP > 2.0 mg/L
- Comply with contraception
Exclusion Criteria:
- Low neutrophil count
- Low platelet count
- Spot urine protein to creatinine ration > 4000 mg/g
- ALT/AST >2.5x ULN
- TSAT < 10%
- Positive TB test
- Evidence of HIV, hepatitis B
- Blind or illiterate
- Expected to require blood transfusion
- Thromboembolic event within 12-weeks
- Evidence of active infection
- Peptic ulcer disease, diverticulitis, inflammatory bowel disease
- Uncontrolled hypertension
- Planned coronary revascularization
- Major cardiac surgery, CHF
- Active malignancy, bone marrow or organ transplant
- Allergy to study drug
- Treatment with investigational drug, treatment with HIF stabilizer or ESA
- Use of immunosuppressive drugs, systemic antibiotics
- Breastfeeding, any other significant medical history
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Placebo Comparator: Placebo
Matching placebo
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human IgG1k anti-human IL-6 monoclonal antibody
Other Names:
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Experimental: Ziltivekimab 7.5 mg
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human IgG1k anti-human IL-6 monoclonal antibody
Other Names:
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Experimental: Ziltivekimab 15 mg
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human IgG1k anti-human IL-6 monoclonal antibody
Other Names:
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Experimental: Ziltivekimab 30 mg
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human IgG1k anti-human IL-6 monoclonal antibody
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Percent Change From Baseline in High-sensitivity C-reactive Protein (Hs-CRP) Levels
Time Frame: Baseline (average of the hs-CRP value prior to randomization and day 1), week 13
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Percent change from baseline in hs-CRP levels at week 13 are presented.
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Baseline (average of the hs-CRP value prior to randomization and day 1), week 13
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Percent Change From Baseline in Serum Amyloid A (SAA)
Time Frame: Baseline (average of the values at week -1 and day 1), week 13
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Percent change from baseline in SAA at week 13 are presented.
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Baseline (average of the values at week -1 and day 1), week 13
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Percent Change From Baseline in Fibrinogen
Time Frame: Baseline (day 1), week 13
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Percent change from baseline in fibrinogen at week 13 are presented.
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Baseline (day 1), week 13
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Percentage of Participants With Treatment Emergent Adverse Events (TEAEs), Treatment Emergent Serious AEs (TESAEs), Severe Hematologic AEs, Severe Non-hematologic AEs, and AEs Leading to Drug Discontinuation
Time Frame: From week 0 to week 32
|
An AE was defined as any unfavorable and unintended sign (including an abnormal laboratory finding), symptom or disease temporally associated with the use of a product, whether or not considered related to the product.
TEAEs are defined as AEs that initiated or worsened on or after the date of first dose of study drug up to the end of safety-follow-up.
A SAE was defined as any untoward medical occurrence that at any dose results in death, or is life-threatening, or requires inpatient hospitalization or causes prolongation of existing hospitalization results in persistent or significant disability/incapacity, or may have caused a congenital anomaly/birth defect, or requires intervention to prevent permanent impairment or damage.
TEAEs that met any of these criteria were considered severe hematologic AEs: grade 3 neutropenia, grade 3 anemia, grade 3 leukopenia, grade 3 lymphopenia, grade 3 eosinophilia, and grade 3 thrombocytopenia.
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From week 0 to week 32
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Percentage of Participants With Thrombolysis in Myocardial Infarction (TIMI) Major Bleeding Events
Time Frame: From week 0 to week 32
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Bleeding events were classified using the TIMI bleeding classification as follows: 1) major: intracranial hemorrhage or a >=5 g/dL decrease in the hemoglobin concentration or a >=15 percent (%) absolute decrease in the hematocrit; 2) minor: (a) observed blood loss: >=3 g/dL decrease in the hemoglobin concentration or >=10% decrease in the hematocrit.
(b) no observed blood loss: >=4 g/dL decrease in the hemoglobin concentration or >=12% decrease in the hematocrit; 3) minimal: any clinically overt sign of hemorrhage (including imaging) that was associated with a < 3 g/dL decrease in the hemoglobin concentration or <9% decrease in the hematocrit.
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From week 0 to week 32
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Percentage of Participants With Any Treatment-emergent Adverse Events of Special Interest (AESI)
Time Frame: From week 0 to week 32
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An AE was defined as any unfavourable and unintended sign (including an abnormal laboratory finding), symptom or disease temporally associated with the use of a product, whether or not considered related to the product.
AESI included serious infections, malignancies, anaphylaxis occurring at any time, even if considered unrelated to the study drug, gastrointestinal perforations, hypersensitivity reaction during investigational product (IP) administration, neutrophils per cubic millimeter (500/mm^3) (severe) or neutrophils <1000/mm^3 (severe) with evidence of concurrent infection, severe injection-related reactions, thrombocytopenia (platelet count <50,000/mm^3 (severe)) or platelet count <75,000/mm^3 (moderate) with evidence of concurrent TIMI major bleeding.
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From week 0 to week 32
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Change in Systolic Blood Pressure (SBP)
Time Frame: Baseline (week 1), week 32
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Change from baseline in systolic blood pressure at week 32 are presented.
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Baseline (week 1), week 32
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Change in Diastolic Blood Pressure (DBP)
Time Frame: Baseline (week 1), week 32
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Change from baseline in diastolic blood pressure at week 32 are presented.
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Baseline (week 1), week 32
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Change in Respiratory Rate
Time Frame: Baseline (week 1), week 32
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Change from baseline in respiratory rate at week 32 are presented.
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Baseline (week 1), week 32
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Change in Body Mass Index (BMI)
Time Frame: Baseline (week 1), week 24
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Change from baseline in BMI at week 24 are presented.
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Baseline (week 1), week 24
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Change in Heart Rate
Time Frame: Baseline (week 1), week 32
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Change from baseline in heart rate at Week 32 are presented.
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Baseline (week 1), week 32
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Change in Temperature
Time Frame: Baseline (week 1), week 32
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Change from baseline in temperature at week 32 are presented.
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Baseline (week 1), week 32
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Change in Electrocardiogram (ECG)
Time Frame: Baseline (week -1), Week 24
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The ECG was assessed by the investigator at baseline (week -1) and week 24 and categorised as abnormal clinically significant, abnormal not clinically significant, indeterminate, normal, not evaluable and unknown.
Number of participants in each ECG category at baseline and week 24 are presented.
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Baseline (week -1), Week 24
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Change in Alkaline Phosphatase (ALP), Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AAT) Levels
Time Frame: Baseline (week 1), week 32
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Change from baseline in ALP, ALT and AAT levels at week 32 are presented.
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Baseline (week 1), week 32
|
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Change in Bicarbonate, Chloride, Potassium, Sodium
Time Frame: Baseline (week 1), week 32
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Change from baseline in bicarbonate, chloride, potassium, sodium at week 32 are presented.
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Baseline (week 1), week 32
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Change in Direct Bilirubin, Bilirubin, Calcium, Creatinine, Glucose, Phosphate and Urea Nitrogen
Time Frame: Baseline (week 1), week 32
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Change from baseline in direct bilirubin, bilirubin, calcium, creatinine, glucose, phosphate and urea nitrogen at week 32 are presented.
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Baseline (week 1), week 32
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Follicle Stimulating Hormone (FSH) Levels
Time Frame: Baseline (week -1)
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FSH levels at baseline (week -1) are presented.
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Baseline (week -1)
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Number of Participants With Anti-drug Antibodies (ADAs)
Time Frame: From week 0 to week 32
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Participants who had at least 1 positive sample (treatment-boosted or treatment-induced) at any time after their first Ziltivekimab administration were classified as positive for ADAs.
In the instance that a participant had a positive sample at the baseline visit, the participant was considered positive only if the peak titer of the post-treatment sample was at least 2-fold higher (i.e., >=2-fold) than the titer of the baseline sample.
Number of participants positive for antibodies to Ziltivekimab are presented.
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From week 0 to week 32
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Clinical Transparency (dept. 1452), Novo Nordisk A/S
Publications and helpful links
General Publications
- Ridker PM, Devalaraja M, Baeres FMM, Engelmann MDM, Hovingh GK, Ivkovic M, Lo L, Kling D, Pergola P, Raj D, Libby P, Davidson M; RESCUE Investigators. IL-6 inhibition with ziltivekimab in patients at high atherosclerotic risk (RESCUE): a double-blind, randomised, placebo-controlled, phase 2 trial. Lancet. 2021 May 29;397(10289):2060-2069. doi: 10.1016/S0140-6736(21)00520-1. Epub 2021 May 17.
- Kreiner FF, Kraaijenhof JM, von Herrath M, Hovingh GKK, von Scholten BJ. Interleukin 6 in diabetes, chronic kidney disease, and cardiovascular disease: mechanisms and therapeutic perspectives. Expert Rev Clin Immunol. 2022 Apr;18(4):377-389. doi: 10.1080/1744666X.2022.2045952. Epub 2022 Mar 1.
- Aherrahrou R, Reinberger T, Hashmi S, Erdmann J. GWAS breakthroughs: mapping the journey from one locus to 393 significant coronary artery disease associations. Cardiovasc Res. 2024 Nov 5;120(13):1508-1530. doi: 10.1093/cvr/cvae161.
- Pergola PE, Davidson M, Jensen C, Mohseni Zonoozi AA, Raj DS, Andreas Schytz P, Tuttle KR, Perkovic V. Effect of Ziltivekimab on Determinants of Hemoglobin in Patients with CKD Stage 3-5: An Analysis of a Randomized Trial (RESCUE). J Am Soc Nephrol. 2024 Jan 1;35(1):74-84. doi: 10.1681/ASN.0000000000000245. Epub 2023 Dec 13.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Pathologic Processes
- Male Urogenital Diseases
- Kidney Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Chronic Disease
- Disease Attributes
- Renal Insufficiency
- Pathological Conditions, Signs and Symptoms
- Cardiovascular Diseases
- Inflammation
- Renal Insufficiency, Chronic
- ziltivekimab
Other Study ID Numbers
Other Study ID Numbers
- NN6018-4779
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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