This phase II randomized study will assess the effect of receiving IV recombinant human IL-7 (CYT107) versus placebo in lymphopenic sepsis patients The aim is to confirm the immune cell reconstitution observed in other studies and other patient populations among which the IRIS-7 A\&B study which was conducted in the same patient population.
Lymphopenic sepsis Patients will be randomized 3:1 to receive either: a) Intravenous (IV) administration of CYT107 at 10 μg/kg twice a week for 3 weeks or b) IV placebo (normal saline). The effect of CYT107 on Lymphocyte and various T cell populations will be documented with a focus on the first 29 days. Stopping rules will apply if ALC increases to \>2.5 times the upper limit of normal range. The IRIS-7C \& D studies will be conducted at multiple sites in France and the United States. All sites will use the same study design and similar study protocol for a common statistical analysis of 40 evaluable participants.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
21
University of Florida
Gainesville, Florida, United States
Washington University School of Medicine
St Louis, Missouri, United States
CHU Angers
Angers, France
Hopital HENRI MONDOR
Créteil, France
Lymphocyte reconstitution
Change in absolute lymphocyte count (ALC) of ≥ 50%. If this 50% increase over baseline is reached in the placebo group due to natural immune reconstitution, then the day 29 percent increase of ALC over baseline will be compared between the two groups.
Time frame: day 29 versus baseline
adverse events
Incidence and scoring of all grade 3-4 adverse events
Time frame: 90 days after study treatment initiation
Secondary Infections
Incidence of secondary infections based on pre-specified criteria as adjudicated by the Secondary Infections Committee (SIC)
Time frame: within 90 days after treatment initiation
Days in the ICU
Number of days in ICU following study treatment initiation during the index hospitalization
Time frame: within 90 days after treatment initiation
readmissions to the ICU
Number of readmissions to ICU following study treatment initiation during index hospitalization
Time frame: within 90 days after treatment initiation
organ support free days
Number of organ support free days (OSFDs) following study treatment initiation during the index hospitalization
Time frame: within 90 days after treatment initiation
re-hospitalization
the incidence of re-hospitalization
Time frame: within 90 days following study treatment initiation
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CHU Dijon Bourgogne
Dijon, France
University Hospital of Limoges
Limoges, France
Hôpital Edouard Herriot
Lyon, France
Chr Orleans
Orléans, France
Hopital COCHIN
Paris, France
Chru Bretonneau
Tours, France
Mortality rate
All-cause mortality
Time frame: 90 days after study treatment initiation
T cell reconstitution
Absolute numbers of CD4+ and CD8+T-cell counts
Time frame: through day 90
Percentage of patients reaching normal ALC
Percentage of patients reaching absolute lymphocyte counts (ALC) \> 1200
Time frame: through day 90
Quantification of IL-7 receptor
Effects on soluble and cellular IL-7 receptor (CD127) expression
Time frame: through day 90
Quantification of HLA-DR on monocytes
Effects on circulating monocyte HLA-DR expression
Time frame: through day 90
Change of IL-6 blood levels
Effects on whole blood circulating cytokines IL-6
Time frame: through day 90
Change of IL-10 blood levels
Effects on whole blood circulating IL-10
Time frame: through day 90
Change of TNF-α blood levels
Effects on whole blood circulating TNF-α
Time frame: through day 90
CYT107 Pharmacokinetic Tmax
determination of Tmax
Time frame: Day 1 and Day 15
CYT107 Pharmacokinetic Cmax
determination of Cmax
Time frame: Day 1 and Day 15
CYT107 Pharmacokinetic half life
determination of half-life
Time frame: Day 1 and Day 15
CYT107 Pharmacokinetic clearance
determination of clearance
Time frame: Day 1 and Day 15
CYT107 Pharmacokinetic area under curve
determination of area under curve
Time frame: Day 1 and Day 15
anti-CYT107 antibodies
Quantification of circulating anti-CYT107 antibodies
Time frame: day 1, day 29 or hospital discharge, day 90 and day 180 if previous sample positive