NAI for Sepsis With Persistent Lymphopenia
Phase 2, Randomized, Open-Label Clinical Trial Evaluating Nogapendekin Alfa Inbakicept in Combination With Standard of Care Versus Standard of Care Alone in Critically Ill Adults With Sepsis and Persistent Lymphopenia
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
Sepsis is characterized by a biphasic immune response: an initial hyperinflammatory phase followed by a prolonged immunosuppressive phase with persistent lymphopenia. The majority of sepsis deaths (>70%) occur during the immunosuppressive phase rather than the initial hyperinflammatory phase. This acquired immunosuppression correlates with markedly increased 28-day mortality rates exceeding 40% and significantly elevated risk of secondary infections.
This study evaluates NAI, an IL-15 receptor agonist that promotes proliferation and activation of NK cells and CD8+ T cells, as a potential therapy to restore immune function in critically ill adults with sepsis and persistent lymphopenia (ALC <1,000 cells/µL on two consecutive measurements within 72 hours of sepsis diagnosis).
Study Arms:
- Experimental Arm: NAI 1.2 mg subcutaneous injection administered on Days 3 (or earlier than Day 3 if ALC is <700 cells/µL), Day 14, and Day 21 if needed for ALC <1,000 cells/µL, plus institutional standard of care for sepsis
- Control Arm: Institutional standard of care for sepsis alone Standard of care may include antimicrobial therapy, fluid resuscitation, vasopressor support, organ support, and mechanical ventilation as clinically indicated. Treatment will be discontinued if a participant has unacceptable toxicity, withdraws consent, or if the Investigator feels it is no longer in the participant's best interest to continue.
All participants will be followed for 90 days post the first dose of study treatment to capture late adverse events, rehospitalization, or mortality.
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- フェーズ2
連絡先と場所
研究連絡先
研究連絡先
- 名前:Tamra Madenwald
- メール:Tamra.Madenwald@immunitybio.com
研究連絡先のバックアップ
- 名前:Alex Golway
- 電話番号:516-225-0068
- メール:Alex.Golway@ImmunityBio.com
参加基準
適格基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Age 18 years or older at the time of informed consent
- Admitted to the ICU with a diagnosis of sepsis as defined by Sepsis-3 criteria: life-threatening organ dysfunction caused by a dysregulated host response to infection, operationalized as a Sequential Organ Failure Assessment (SOFA) score increase of 2 or more points
- Documented persistent lymphopenia defined as ALC <1,000 cells/µL on at least two consecutive measurements within 72 hours of sepsis diagnosis (measurements must be separated by at least 12 hours)
- Prior initiation of appropriate antimicrobial therapy per institutional guidelines
- Ability to obtain written informed consent from the participant or legally authorized representative
- Agreement to practice effective contraception for female participants of child-bearing potential and non-sterile males (for up to 7 months after completion of therapy)
Exclusion Criteria:
- Hematologic malignancies including leukemia, lymphoma, and myelodysplastic syndromes
- Prior CAR-T cell therapy or hematopoietic stem cell transplant (HSCT) within 3 months of screening
- Active cytokine release syndrome (CRS) at screening
- Current or recent (within 7 days) use of colony stimulating factors (G-CSF, GM-CSF)
- Lymphopenia attributable to chemotherapy, radiation therapy, or immunosuppressive medications administered within 30 days prior to screening
- High-dose immunosuppressive therapy (>0.5 mg/kg prednisone equivalent daily), excluding physiologic replacement and stress-dose hydrocortisone for septic shock
- Life expectancy less than 24 hours as assessed by the treating physician
- Active uncontrolled bleeding requiring >2 units of packed red blood cells in the preceding 24 hours
- Known HIV infection with CD4 count <350 cells/µL and detectable viral load
- Known active viral hepatitis (hepatitis B or C with detectable viral load)
- Advanced dementia or other conditions precluding meaningful participation
- Known hypersensitivity to any component of the investigational products
- Participation in another interventional trial with an investigational immunomodulatory agent within 30 days prior to screening
- Pregnant or breastfeeding
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的:NAI + Standard of Care
NAI 1.2 mg subcutaneous injection administered on Days 3 (or earlier if ALC <700 cells/µL), Day 14, and Day 21 if needed for ALC <1,000 cells/µL, plus institutional standard of care for sepsis
|
IL-15 receptor agonist complex; 1.2 mg subcutaneous injection administered on Days 3 (or earlier if ALC <700 cells/µL), Day 14, and Day 21 if needed for ALC <1,000 cells/µL
他の名前:
Institutional standard of care for sepsis including antimicrobial therapy, fluid resuscitation, vasopressor support, organ support, and mechanical ventilation as clinically indicated
|
|
アクティブコンパレータ:Standard of Care Alone
Institutional standard of care for sepsis including antimicrobial therapy, fluid resuscitation, vasopressor support, and mechanical ventilation as clinically indicated
|
Institutional standard of care for sepsis including antimicrobial therapy, fluid resuscitation, vasopressor support, organ support, and mechanical ventilation as clinically indicated
|
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
28-day all-cause mortality rate
時間枠:28 days
|
Proportion of participants who die from any cause within 28 days of randomization
|
28 days
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in absolute lymphocyte count (ALC)
時間枠:Baseline through Day 28
|
Change in ALC from baseline (Day 1 pre-dose) through Day 28
|
Baseline through Day 28
|
|
ICU re-admission rate
時間枠:Up to Day 90
|
Proportion of participants re-admitted to ICU after discharge by Day 90
|
Up to Day 90
|
|
Secondary infections
時間枠:Up to Day 90
|
Proportion of participants with secondary infections after discharge by Day 90
|
Up to Day 90
|
|
90-day all-cause mortality rate
時間枠:90 days
|
Proportion of participants who die from any cause within 90 days of randomization
|
90 days
|
|
Safety and tolerability
時間枠:Through Day 30 after last dose
|
Incidence and severity of treatment-emergent adverse events (TEAEs), serious adverse events (SAEs), and Grade ≥3 TEAEs graded per NCI CTCAE v6.0
|
Through Day 30 after last dose
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (推定)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- ResQ2204-SEPSIS
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。