This is a prospective, randomized (1:1), double-blind, multi-center, Phase II clinical study to test the safety and efficacy of a recombinant chimeric anti-tissue factor antibody (ALT-836) versus placebo in patients with sepsis and acute lung injury/acute respiratory distress syndrome (ALI/ARDS). This study was divided into two parts and the first part of the study has been completed. In the first part of the study, sixty patients were randomized at a 1:1 ratio to receive one dose of the study drug or placebo. In the second part of the study, ninety patients will be randomized at a 1:1 ratio to receive a multi-dose treatment regimen of single doses every 72 hours up to a maximum of 4 doses of the study drug or placebo, provided there are no safety concerns.
Tissue factor (TF)-dependent procoagulant activity and associated inflammatory processes may play a role in the severity and progression of ALI/ARDS. Recent studies demonstrated that TF levels were elevated in plasma and pulmonary edema fluid of ARDS/ALI patients compared to control patients with hydrostatic pulmonary edema. These higher plasma TF levels were correlated with increased mortality, fewer ventilation-free days, the presence of disseminated intravascular coagulation and the presence of sepsis in patients with ALI/ARDS, suggesting that systemic activation of coagulation may be clinically important in ALI/ARDS. Moreover, the pulmonary TF levels in patients with ALI/ARDS were found to range between 0.5 and 2 nM, approximately 100-fold higher than simultaneous plasma levels, suggesting an intra-alveolar source of TF. Thus, anti-TF antibody blockage of TF activity may therefore provide an effective therapeutic mechanism for the treatment of inflammatory disorders such as ALI and ARDS. This study will test the hypothesis that administration of anti-TF antibody (ALT-836) to septic patients with ALI/ARDS will improve the clinical outcome by shortening the duration of mechanical ventilation for these patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
150
In the first part of this study, recombinant chimeric anti-tissue factor antibody ALT-836 was administered as a single dose (0.06 mg/Kg) via intravenous infusion over 15 minutes. In the second part of this study, up to four doses (0.06 mg/Kg) of ALT-836 will be administered via intravenous infusion over 15 minutes.
In the first part of this study, a single dose of Placebo was administered via intravenous infusion over 15 minutes. In the second part of this study, up to four doses of Placebo will be administered via intravenous infusion over 15 minutes.
Los Angeles County and USC Medical Center
Los Angeles, California, United States
UC Davis Medical Center
Sacramento, California, United States
Stanford University
Stanford, California, United States
Yale University
New Haven, Connecticut, United States
Northwestern University
Chicago, Illinois, United States
West Suburban Hospital Medical Center
Oak Park, Illinois, United States
Illinois Lung and Critical Care Institute
Peoria, Illinois, United States
University of Iowa
Iowa City, Iowa, United States
Kentucky Lung Clinic
Hazard, Kentucky, United States
University of Louisville-Division of Pulmonary and Critical Care
Louisville, Kentucky, United States
...and 10 more locations
Safety profile of the study drug
Time frame: Throughout the 28 days following treatment
Number of ventilator-free days at Day 28
Time frame: Determined at Day 28
Mortality at Day 7, 14, 21, 28 and 60
Time frame: Determined at Day 7, 14, 21, 28 and 60
Length of hospitalization at Day 28
Time frame: Determined at Day 28
Length of ICU stay at Day 28
Time frame: Determined at Day 28
Number of Non-pulmonary organ failure free days at Day 28
Time frame: Determined at Day 28
Changes in physiological variables of lung injury
Time frame: Throughout the 28 days following treatment
Changes in disease severity and lung injury scores
Time frame: Throughout the 28 days following treatment
Effects of the study drug and the etiology of the disease (i.e. pulmonary or extra-pulmonary origin)
Time frame: Determined at Day 28
Pharmacokinetics & Pharmacodynamics
Time frame: Throughout the 28 days following treatment
Immunogenicity
Time frame: Throughout the 28 days following treatment
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