A Study to Evaluate LTI-01 in Patients With Infected, Non-draining Pleural Effusions
A Phase 2, Randomized, Placebo-controlled, Double-blind, Dose-ranging Study Evaluating LTI-01 (Single-chain Urokinase Plasminogen Activator, scuPA) in Patients With Infected, Non-draining Pleural Effusions
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, 35294
- The University of Alabama at Birmingham
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California
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La Jolla, California, United States, 92037
- UC San Diego Health Jacobs Medical Center
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Los Angeles, California, United States, 90095
- University of California (UCLA)
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Sacramento, California, United States, 95816
- UC Davis Medical Group
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Colorado
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Aurora, Colorado, United States, 80445
- University of Colorado
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Connecticut
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New Haven, Connecticut, United States, 06519
- Yale School of Medicine
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Illinois
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Chicago, Illinois, United States, 60612
- Rush University Medical Center
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Kansas
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Kansas City, Kansas, United States, 66160
- The University of Kansas Medical Center
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Maryland
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Baltimore, Maryland, United States, 21205
- Johns Hopkins University
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Baltimore, Maryland, United States, 21201
- University of Maryland School of Medicine
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Massachusetts
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Boston, Massachusetts, United States, 02215
- Beth Israel Deaconess Medical Center
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Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital
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Burlington, Massachusetts, United States, 01805
- Lahey Hospital and Medical Center
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Michigan
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Ann Arbor, Michigan, United States, 48109
- University of Michigan
-
-
Minnesota
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Rochester, Minnesota, United States, 55905
- Mayo Clinic
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Mississippi
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Jackson, Mississippi, United States, 39216
- University of Mississippi Medical Center
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Missouri
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Kansas City, Missouri, United States, 64111
- St. Luke's Health System
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Saint Louis, Missouri, United States, 63110
- Washington University
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Nebraska
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Omaha, Nebraska, United States, 68124
- CHI CUMC Bergan Mercy
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New York
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Queens, New York, United States, 11040
- North Shore - Long Island Jewish Medical Center
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North Carolina
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Chapel Hill, North Carolina, United States, 27599
- University of North Carolina at Chapel Hill
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Durham, North Carolina, United States, 27705
- Duke University
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Ohio
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Columbus, Ohio, United States, 43210
- The Ohio State University
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Pennsylvania
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Hershey, Pennsylvania, United States, 17033
- The Pennsylvania State University
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Philadelphia, Pennsylvania, United States, 19104
- University of Pennsylvania
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Philadelphia, Pennsylvania, United States, 19140
- Temple University
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Tennessee
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Nashville, Tennessee, United States, 37232
- Vanderbilt Medical Center
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Texas
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Dallas, Texas, United States, 75390
- The University of Texas Southwestern Medical Center
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Houston, Texas, United States, 77030
- The University of Texas Health Science Center
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Utah
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Salt Lake City, Utah, United States, 84112
- University of Utah
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Virginia
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Fairfax, Virginia, United States, 22031
- Inova
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Richmond, Virginia, United States, 23219
- Virginia Commonwealth University
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Wisconsin
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Milwaukee, Wisconsin, United States, 53226
- Medical College of Wisconsin
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Key Inclusion Criteria:
- Male or female ≥ 18 years of age who provide written informed consent
- Clinical presentation compatible with complicated parapneumonic pleural effusion (CPE), empyema or other type of pleural infection
- Has pleural fluid requiring drainage as determined by chest ultrasonography or by chest CT, and which is either:
- a) purulent; b) gram stain positive; c) culture positive; d) pH < 7.2; or e) glucose < 60 mg/dL (3.3 mmol/L)
- Failure to adequately drain pleural fluid ≥ 3 hours post insertion of patent chest tube within the pleural space, as evidenced by one or more of the following criteria:
- > 2 cm depth of fluid by ultrasound or CT
- < 80% drainage from chest radiograph obtained prior to chest tube insertion.
Key Exclusion Criteria:
- Current pleural infection already treated with intrapleural fibrinolytic therapy
- Evidence of ipsilateral fibrothorax (e.g. CT scan with > 0.5 cm visceral pleural thickening)
- History of multiple thoracenteses or thoracic surgical procedures within 3 months of screening
- Previous pneumonectomy on the side of the pleural effusion
- Current bilateral pleural infections
- Known non-expandable lung prior to this pleural infection
- Known or high clinical suspicion of a malignant pleural effusion
- Existing indwelling or tunneled pleural catheter
- Current infected hepatic hydrothorax or evidence of another abdominal process (e.g. pancreatic cyst or renal cyst) communicating with the pleural space
- Active bleeding, or any condition in which bleeding is either a significant risk or would be difficult to manage
- Fully anticoagulated patients on heparin, warfarin or novel oral anti-coagulants who are not able to temporarily discontinue anti-coagulants while receiving study medication and for 2 days after last dose of study medication Note: patients receiving low-molecular weight heparin for immobilization or anti-platelet agents are not excluded.
- Presence of severe metabolic derangements that would interfere with study assessments
- Systolic blood pressure >185 mmHg or diastolic blood pressure > 110 mmHg at screening
- Hemodynamically unstable and/or requires use of intravenous vasopressor therapy
- Expected survival < 3 months from a pathology other than the qualifying infected, non-draining pleural effusion (e.g. metastatic lung carcinoma)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: 800,000 U LTI-01
800,000 U LTI-01 qd x 3 days administered intrapleurally
|
single-chain urokinase plasminogen activator, scuPA
|
|
Experimental: 1,200,000 U LTI-01
1,200,000 U LTI-01 qd x 3 days administered intrapleurally
|
single-chain urokinase plasminogen activator, scuPA
|
|
Placebo Comparator: Placebo
placebo (normal saline) 6ml qd x 3 days administered intrapleurally
|
normal saline
|
|
Experimental: 400,000 U LTI-01
400,000 U LTI-01 once a day (qd) x 3 days administered intrapleurally
|
single-chain urokinase plasminogen activator, scuPA
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of referral to surgery
Time Frame: Post treatment (Day 4/Hospital discharge or at time of treatment failure)
|
Treatment failure, as evidenced by continued or worsening pleural sepsis and failure to adequately drain pleural effusion, resulting in referral to surgery
|
Post treatment (Day 4/Hospital discharge or at time of treatment failure)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Relative change in pleural opacity
Time Frame: Post treatment (Day 4 or at time of treatment failure)
|
Change from baseline in absolute pleural opacity and relative change from baseline in pleural opacity volume assessed by chest CT at Day 4
|
Post treatment (Day 4 or at time of treatment failure)
|
Collaborators and Investigators
Sponsor
Sponsor
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
Other Study ID Numbers
Other Study ID Numbers
- LTI-01-2001
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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