- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05126303
Efficacy and Safety of RMC-035 in Subjects at High Risk for Acute Kidney Injury Following Open-Chest Cardiac Surgery (AKITA)
A Phase 2, Randomized, Placebo-Controlled, Double-Blind, Adaptive, Parallel Group Clinical Study to Evaluate the Efficacy and Safety of RMC-035 in Subjects at High Risk for Acute Kidney Injury Following Open-Chest Cardiac Surgery
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Sara Thuresson
- Phone Number: +46733319438
- Email: trials@guardtherapeutics.com
Study Locations
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Hamilton, Canada
- Hamilton Health Sciences
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Montréal, Canada
- CHUM
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Montréal, Canada
- MUHC - Royal Victoria Hospital
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Québec, Canada
- Institut universitaire de cardiologie et de pneumologie de Québec
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Saint John, Canada
- St. John Regional Hospital
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Toronto, Canada
- Saint Michael's Hospital
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Hradec Kralove, Czechia
- University Hospital Hradec Kralove
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Praha 5, Czechia
- University Hospital Motol - Charles University Prague
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Bad Oeynhausen, Germany
- Herz- und Diabeteszentrum Nordrhein-Westfalen (NRW)
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Dresden, Germany
- Herzzentrum Dresden GmbH
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Essen, Germany
- Westdeutsches Herzzentrum Essen
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Gießen, Germany
- Universitätsklinikum Giessen und Marburg - Standort Giessen
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Halle, Germany
- Universitätsklinikum Halle (Saale)
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Köln, Germany
- Universitatsklinikum Koln
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München, Germany
- Deutsches Herzzentrum München
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Münster, Germany, DE-481 49
- Münster University Hospital
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Barcelona, Spain
- Hospital Sant Pau
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Córdoba, Spain
- Reina Sofia University Hospital
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Madrid, Spain
- Hospital de la Princesa
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Oviedo, Spain
- Hospital Universitario Central de Asturias
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Santiago de Compostela, Spain
- Complejo Hospitalario Universitario de Santiago (CHUS)
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Indiana
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Fort Wayne, Indiana, United States, 48604
- Indiana Ohio Heart
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Nebraska
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Lincoln, Nebraska, United States, 68506
- Bryan Heart
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New York
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Rochester, New York, United States, 14621
- Rochester Regional Health - Rochester General Hospital
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North Carolina
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Durham, North Carolina, United States, 27710
- Duke University Hospital
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Texas
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Dallas, Texas, United States, 75226
- Baylor Scott and White Research Institute - Dallas
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Virginia
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Charlottesville, Virginia, United States, 22908
- University of Virginia (UVA) Health - University Hospital
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Wisconsin
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Madison, Wisconsin, United States, 53706
- University of Wisconsin
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Milwaukee, Wisconsin, United States, 53215
- Aurora Health Care - Aurora St. Luke's Medical Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Institutional Review Board/ International Ethics Committee approved Informed Consent obtained
- Ability to understand and comply with the study requirements and able to provide written informed consent
- Age ≥18 and <85 years
- Estimated glomerular filtration rate (eGFR) is ≥30 mL/min/1.73 m2
- Subject is scheduled for non-emergent coronary artery bypass grafting (CABG) surgery and/or valve surgery and/or ascending aorta aneurysm surgery with use of cardiopulmonary bypass (CPB), and AKI risk factors are present at screening
- Female subject is not of child-bearing potential, or agreeing not to become pregnant
- Female subject must not be breastfeeding
- Female subject must not donate ova
- Male subject and their female spouse/partner(s) who are of childbearing potential must be using a highly effective form of birth control
- Male subjects must not donate sperm
- Subject agrees not to participate in another interventional study
Exclusion Criteria:
- Medical condition that makes the subject unsuitable for study participation
- Scheduled for emergent surgeries (eg, aortic dissection)
- Scheduled for CABG and/or valve surgery and/or ascending aorta aneurysm surgery combined with additional non-emergent cardiac surgeries (eg, congenital heart defects)
- Scheduled to undergo transcatheter aortic valve implantation (TAVI) or transcatheter aortic valve replacement (TAVR), or off-pump surgeries or left ventricular assist device (LVAD) implantation
- Experiences a cardiogenic shock or hemodynamic instability which require inotropes or vasopressors or other mechanical devices within 24 hours prior to surgery
- Requirement for defibrillator or permanent pacemaker, mechanical ventilation, intraaortic balloon pumping (IABP), LVAD, or other forms of mechanical circulatory support (MCS)
- Diagnosed with AKI (as defined by KDIGO criteria) within 3 months prior to surgery
- Required cardiopulmonary resuscitation within 14 days prior to cardiac surgery
- Ongoing sepsis or an untreated diagnosed clinically significant infection (viral or bacterial)
- Total bilirubin or alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥ 2 times the upper limit of normal (ULN)
- History of solid organ transplantation
- History of renal replacement therapy (RRT)
- Medical condition which requires active immunosuppressive treatment
- Severe allergic asthma
- Ongoing chemotherapy or radiation therapy for malignancy that may have an impact on kidney function
- Received an investigational medicinal product within the last 90 days (or within 5 half-lives of the investigational drug, whichever is longer)
- Subject has a known allergy to RMC-035 or one of its constituents, or has previously received RMC-035
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: RMC-035
RMC-035 is a concentrate (6.0 mg/mL) for solution for infusion for IV administration. Dosing will be based on renal function at Day -1: Subjects with eGFR ≥60 mL/min/1.73m2 will receive 1.3 mg/kg (per dose) for the first and second dose, followed by 0.65 mg/kg (per dose) for the third, fourth and fifth dose, while subjects with eGFR >30 and <60 mL/min/1.73m2 will receive 0.65 mg/kg (per dose) for all five doses Dosing occurs at time 0 and then after 6, 12, 24 and 48 hours. |
Concentrate for Solution for Infusion
Other Names:
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Placebo Comparator: Placebo
Identical to RMC-035 arm except that the placebo contains no active ingredient.
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Concentrate for Solution for Infusion
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of subjects developing AKI, as defined per Kidney Disease Improving Global Outcomes (KDIGO) criteria
Time Frame: 72 hours
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AKI based on Serum Creatinine and/or Urine Output per KDIGO definition
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72 hours
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Safety and Tolerability
Time Frame: 90 days
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Nature, frequency and severity of treatment-emergent adverse events
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90 days
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Area under the curve (AUC) of Serum creatinine (SCr)
Time Frame: 72 hours
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Time-corrected area under the curve (AUC) of serum creatinine
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72 hours
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Duration of AKI
Time Frame: 90 days
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Duration of AKI defined as the number of days meeting the definition of AKI (KDIGO definition) starting within 72 hours after first dose of IMP until resolution
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90 days
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Post-baseline changes in renal function: SCr and cystatin C values
Time Frame: 90 days
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SCr and cystatin C (and corresponding eGFR values) at 12, 24, 48, and 72 hours, respectively, and at Day 7/discharge, Day 30 and Day 90
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90 days
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Post-baseline changes in renal function: Peak SCr and cystatin C values
Time Frame: 7 days
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Change from baseline of peak SCr and cystatin C
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7 days
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Post-baseline changes in renal function: AUC of cystatin C
Time Frame: 72 hours
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Time-corrected AUC of cystatin C for Day 1 to Day 4 (72 hours after first dose of IMP)
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72 hours
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Need for renal replacement therapy: Dialysis treatment
Time Frame: 7 days
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Dialysis treatment (for any reason)
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7 days
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Need for renal replacement therapy: Dialysis free
Time Frame: 90 days
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Dialysis free days
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90 days
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Major adverse kidney event (MAKE)
Time Frame: 90 days
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MAKE at Day 30 and Day 90, defined as death, any dialysis, or ≥25% reduction of eGFR compared to baseline Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation (either SCr, cystatin C, or both)
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90 days
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AKI Characteristics: AKI within 72 hours based on cystatin C and UO
Time Frame: 72 hours
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AKI based on cystatin C and/or urine output (UO)
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72 hours
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AKI Characteristics: AKI within 7 days
Time Frame: 7 days
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AKI based on SCr and/or UO criteria, or cystatin C and/or UO criteria
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7 days
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AKI Characteristics: Persistence
Time Frame: 7 days
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AKI persistence, defined as an AKI (KDIGO definition) developing within 72 hours after first dose of IMP and with a duration of ≥72 hours
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7 days
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AKI Characteristics: Severity
Time Frame: 7 days
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AKI severity stage per KDIGO criteria
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7 days
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Change in urine albumin to creatinine ratio (UACR) and urine protein to creatinine ratio (UPCR)
Time Frame: 90 days
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Post-baseline changes in UACR and UPCR at Day 4, Day 30, and Day 90
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90 days
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Pharmacokinetics of RMC-035
Time Frame: 7 days
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AUC of RMC-035 concentrations in plasma
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7 days
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Pharmacokinetics of RMC-035
Time Frame: 7 days
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Cmax of RMC-035 concentrations in plasma
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7 days
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Presence and titers of anti-drug antibodies (ADA)
Time Frame: 90 days
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Presence and titers of ADA at Day 1 (pre-surgery), Day 30, and Day 90
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90 days
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Characteristics of ADA
Time Frame: 90 days
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Characteristics of ADA developed at Day 30 and Day 90 with regards to isotype, neutralizing capacity, and cross-reactivity with endogenous alpha-1-microglobulin (A1M)
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90 days
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Collaborators and Investigators
Sponsor
Investigators
- Study Director: Tobias Agervald, MD, Guard Therapeutics
- Principal Investigator: Alexander Zarbock, MD, Muenster University Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 21-ROS-05
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
product manufactured in and exported from the U.S.
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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