- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03737448
TRimetazidine for acUte on Chronic Liver Failure STudy (TRUST)
A Phase 1b Open-Label Study Assessing the Pharmacokinetics, Tolerability, and Safety of Oral Trimetazidine in Subjects With Acute-on-Chronic Liver Failure
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The study will assess the PK, tolerability, and safety of oral trimetazidine administered to subjects with acute-on-chronic (ACLF) Grades 1 and 2 with liver failure and a range of renal function. Subjects will receive up to 60 mg/day for 28 days.
Two groups of subjects will be enrolled:
Group 1
- AD with serum creatinine ≥ 1 and < 2 mg/dL, OR
ACLF 1 with
- liver failure and serum creatinine ≥ 1.5 and < 2 mg/dl, or
- liver failure and West Haven grade 1-2 hepatic encephalopathy, or
- coagulation failure and serum creatinine ≥ 1.5 and < 2 mg/dl, or
- coagulation failure and West Haven grade 1-2 hepatic encephalopathy, OR
ACLF 2 with
- liver failure and coagulation failure, or
- liver failure and West Haven grade 3-4 hepatic encephalopathy.
Group 2
- ACLF 1 with renal failure (serum creatinine ≥ 2.0 and < 3.5 mg/dL), OR
ACLF 2 with
- liver failure and renal failure (serum creatinine ≥ 2.0 and < 3.5 mg/dL), or
- coagulation failure and renal failure (serum creatinine ≥ 2.0 and < 3.5 mg/dL).
Study Type
Enrollment (Anticipated)
Phase
- Phase 1
Contacts and Locations
Study Locations
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Graz, Austria
- Medical University of Graz
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Innsbruck, Austria
- Medical University of Innsbruck
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Vienna, Austria
- Medical University of Vienna
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Antwerp, Belgium
- University of Antwerp
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Brussels, Belgium
- Erasme hospital
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Lille, France
- Hospital Claude Huriez
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Paris, France
- Hospital Pitie-Salpetriere
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Rennes, France
- Rennes University Hospital
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Villejuif, France
- Hopital Paul Brousse
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Essen, Germany
- University of Essen
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Frankfurt, Germany
- JW Goethe Clinic
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Halle, Germany
- Universitätsklinikum Halle Klinik und Poliklinik für Innere Medizin I
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Hannover, Germany
- University of Hannover
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Heidelberg, Germany
- University of Heidelberg
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Leipzig, Germany
- University of Leipzig
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Münster, Germany
- University of Munster
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Barcelona, Spain
- Hospital Clínic
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Barcelona, Spain
- Hospital Valle de Hebron
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Córdoba, Spain
- Hospital Reina Sofia
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Madrid, Spain
- Hospital Ramon y Cajal
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Madrid, Spain
- Hospital Gregorio Marañón
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Madrid, Spain
- Hospital Puerta de Hierro
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Santander, Spain
- Hospital Marques de Valdecilla Santander
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Seville, Spain
- Hospital Virgen del Rocío
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 18 to 75 years, inclusive, at screening.
- Stable diagnosis of AD, ACLF Grade 1 or ACLF Grade 2 for no less than 2 days (as determined at the discretion of the investigator)*.
- Anticipated duration of hospital stay of at least 7 days.
For Group 1:
- AD with SCr ≥ 1 and < 2 mg/dL, OR
ACLF 1 with
- Tbil ≥ 12 mg/dL, SCr ≥ 1.5 and < 2 mg/dl, and HE 0-2, or
- Tbil ≥ 12 mg/dL, and SCr < 1.5 mg/dL, and HE 1-2, or
- INR ≥ 2.5, SCr ≥ 1.5 and < 2 mg/dl, and HE 0-2, or
- INR ≥ 2.5, SCr < 1.5 mg/dL, and HE 1-2, OR
ACLF 2 with
- Tbil ≥ 12 mg/dL, INR ≥ 2.5, and SCr < 2 mg/dL, or
- Tbil ≥ 12 mg/dL, HE 3-4, and SCr < 2 mg/dL
For Group 2:
- ACLF 1 with SCr ≥ 2.0 and < 3.5 mg/dL, OR
ACLF 2 with
- Tbil ≥ 12 mg/dL, and SCr ≥ 2 and < 3.5 mg/dL, or
- INR ≥ 2.5, and SCr ≥ 2 and < 3.5 mg/dL.
- Female patients must be of non-childbearing potential, or, if non-sterile, must agree to sexual abstinence or use a highly effective method of contraception from Screening to 3 days after the final dose.
- Non sterile male patients must agree to sexual abstinence or use a highly effective method of contraception from Screening to 3 days after the final dose if sexually active.
- Able to comprehend and willing to sign an informed consent form, or, if unable to consent, consent is conducted per local requirements.
Exclusion Criteria:
- Diagnosis of AD or ACLF (of any grade) >14 days before enrollment*.
- Circulatory failure.
- Respiratory failure i.e. PaO2/FiO2 ≤ 200 and/or baseline SpO2/FiO2 ≤ 214.
- Brain failure (West Haven grade 3 or 4 hepatic encephalopathy) with coagulation failure (INR > 2.5).
- Gastrointestinal bleeding within 72 hours prior to enrollment. (Subjects who fail this criterion may qualify after 72 hours).
- Uncontrolled bacterial infection (urinary tract infection, spontaneous bacterial peritonitis, pneumonia, bacteremia, soft tissue infections, etc.) (as determined at the discretion of the investigator).
- Invasive fungal infection.
- Platelet count <30,000 cells/mL.
- White blood cell count <1000 cells/uL.
- Patients on hemodialysis or continuous venovenous hemofiltration.
- Patients who have undergone or are scheduled for imminent organ transplantation. (Patients may be on a transplant list as long as no date has been set for transplantation)
- Hospitalization for ACLF within the 3 months prior to screening.
- History of hepatocellular carcinoma, unless within Milan Criteria (up to 3 lesions each < 3 cm or 1 lesion < 5 cm; no extrahepatic involvement; no evidence of gross vascular invasion).
- Active non-hepatic malignancy.
- Parkinson's disease, Parkinsonian-type symptoms (gait disorder, tremor, etc.), restless leg syndrome or other movement disorders other than asterixis.
- Fulminant Wilson's, fulminant autoimmune hepatitis, or Budd-Chiari syndrome.
- Septic shock (hypotension requiring vasopressors to maintain a mean arterial pressure of 65 mm Hg or greater and having a serum lactate level greater than 2 mmol/L (> 18 mg/dL) after adequate fluid resuscitation.
- Patients who have undergone placement of a transjugular intrahepatic portosystemic shunt (TIPS) or surgical shunt in the past 6 months.
- Any invasive procedure within 48 hours prior to enrollment with high risk of uncontrolled bleeding (as determined at the discretion of the investigator).
- Female with a positive pregnancy test or lactating.
- Positive results for human immunodeficiency virus HIV-1 or HIV-2.
- Current treatment with trimetazidine.
- Known allergy to trimetazidine or excipients.
- Currently receiving an investigational treatment.
- Any condition that, in the opinion of the Investigator (or designee), would limit the subject's ability to complete or participate in this clinical study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: OTHER
- Allocation: NON_RANDOMIZED
- Interventional Model: SEQUENTIAL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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EXPERIMENTAL: Group 1
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Subjects with receive up to 60 mg daily
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EXPERIMENTAL: Group 2
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Subjects with receive up to 60 mg daily
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
plasma pharmacokinetics
Time Frame: 28 days
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Cmax
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28 days
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plasma pharmacokinetics
Time Frame: 28 days
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AUC
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28 days
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of treatment-emergent adverse events [Safety and Tolerability]
Time Frame: 90 days
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Adverse events
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90 days
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Collaborators and Investigators
Sponsor
Investigators
- Study Director: Chief Medical Officer, Martin Pharmaceuticals
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- MP-0614-001
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
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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