A multicenter, randomized, double-blinded, placebo-controlled study of two dosing frequencies of recombinant Interleukin-7 (CYT107) treatment to restore absolute lymphocyte counts in sepsis patients; IRIS-7A (Immune Reconstitution of Immunosuppressed Sepsis patients). A parallel study will be performed in United State of America to allow a common statistical analysis of the primary end points and analysis for the enrolled patient population.
Sepsis is the leading cause of death in critically ill patients in most intensive care units in Europe and the US. Recently, evidence has accumulated that sepsis progresses from a state of hyper-inflammation to a state of immunosuppression. This immunosuppressive phase is characterized by increased incidence of secondary infections often with relatively avirulent opportunistic type pathogens. Currently, new therapeutic approaches to sepsis are occurring using immuno-adjuvants that boost host immunity. One of the most promising agents Interleukin-7 is an essential, non-redundant, pluripotent cytokine produced mainly by bone marrow and thymic stromal cells that is required for T-cell survival.In addition to its anti-apoptotic properties, IL-7 induces potent proliferation of naïve and memory T-cells potentially supporting replenishment of the peripheral T-cell pool which is severely depleted during sepsis. These effects were confirmed in clinical trials at the National Cancer Institute and in HIV+ patients. This clinical study will test the ability of IL-7 to restore the absolute lymphocyte counts in septic patients who have markedly reduced levels of circulating lymphocytes. An effect already confirmed in preclinical models of sepsis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
16
IM administration of CYT107 recombinant glycosylated human IL-7 (SC administration for patients with INR\>2.5 or platelet count \< 35,000
IM administration of Placebo (SC administration for patients with INR\>2.5 or platelet count \< 35,000
CHU LIMOGES Service de Réanimation
Limoges, France
Hospice Civil de Lyon - Hôpital Edouard Herriot - Service de Réanimation Médicale
Lyon, France
Hopital Lariboisière - Service d'anesthésie-réanimation
Paris, France
White blood count
Number of patients with absolute lymphocyte counts (Multiply the Lymphocytes percentage above by the total number White Blood Count) increased by more than 50% from baseline at Day 42 Kinetic of immune restoration through weekly measures of Absolute Lymphocyte Counts
Time frame: day 1 to Day 42
lymphocyte percentage
Number of patients with absolute lymphocyte counts (Multiply the Lymphocytes percentage above by the total number White Blood Count) increased by more than 50% from baseline at Day 42 Kinetic of immune restoration through weekly measures of Absolute Lymphocyte Counts
Time frame: Day 1 to Day 42
Incidence of treatment-Emergent Adverse Events
Clinical occurrence of adverse events (AEs) and serious adverse events (SAEs) during the duration of the study period ending day 42, as assessed by DAIDS (2.0)
Time frame: Day 1 to Day 42
Mortality
Time frame: Day 60
Mortality
Time frame: Day 190
Mortality
Time frame: Day 180
Mortality
Time frame: Day 360
CYT107 Pharmacokinetic Cmax
CYT107 PK: Measure of Peak plasma concentration "Cmax" at Day 1 and Day 22
Time frame: Day 1 and Day 22
CYT107 Pharmacokinetic AUC
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
CYT107 PK: Measure of Area under plasma concentration versus time curve at day 1 and day 22
Time frame: Day 1 and Day 22
CYT107 Pharmacokinetic half life
CYT107 PK: Measure plasma concentration half life at day 1 and day 22
Time frame: Day 1 and Day 22
Quantification of positive binding antibodies against CYT107
number of patients with positive binding antibodies against CYT107 at Day 1, Day 11, Day 22, Day 60, Day 180 if Day 60 is positive and Day 360 if Day 180 is positive.
Time frame: Day 1, Day 11, Day 22, Day 60, Day 180 and Day 360
Specific CYT107 neutralizing antibodies
Number of patients with CYT107 neutralizing antibodies if positive binding antibodies against CYT107 is detected.
Time frame: Day 1, Day 11, Day 22, Day 60, Day 180 and Day 360
Incidence of hospital acquired secondary infections
Incidence of hospital acquired secondary infections at Day 42
Time frame: Day 42
SOFA score
SOFA score at Day 0 Day 4, Day 8, Day 15, Day 22, Day 29.
Time frame: Day 0 Day 4, Day 8, Day 15, Day 22, Day 29
APACHE II score
APACHE II score at Day 0, Day 4, Day 8, Day 15, Day 22, Day 29.
Time frame: Day 0, Day 4, Day 8, Day 15, Day 22, Day 29
CYT107 Pharmacodynamic
CYT107 effects on cell counts: T-CD4+, T-CD8+, T-CD127+ (IL-7R), monocyte HLA-DR+
Time frame: Day 1, Day 8, Day 15, Day 22, Day 29