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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04564833
Registration number
NCT04564833
Ethics application status
Date submitted
21/09/2020
Date registered
25/09/2020
Titles & IDs
Public title
Effect of RBT-1 on Preconditioning Response Biomarkers in Subjects Undergoing CABG and/or Cardiac Valve Surgery
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Scientific title
A Phase 2, Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Effect of RBT-1 on Preconditioning Response Biomarkers in Subjects Undergoing Coronary Artery Bypass Graft (CABG) and/or Cardiac Valve Surgery (The START Study)
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Secondary ID [1]
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REN-004
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Universal Trial Number (UTN)
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Trial acronym
START
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
AKI
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Low Dose RBT-1
Treatment: Drugs - High Dose RBT-1
Treatment: Drugs - Placebo
Experimental: Low Dose RBT-1 - Single IV infusion prior to cardiac surgery
Experimental: High Dose RBT-1 - Single IV infusion prior to cardiac surgery
Placebo comparator: Placebo - Single IV infusion prior to cardiac surgery
Treatment: Drugs: Low Dose RBT-1
intravenous administration
Treatment: Drugs: High Dose RBT-1
intravenous administration
Treatment: Drugs: Placebo
intravenous administration
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Evaluate the Efficacy of RBT-1 in Generating a Preconditioning Response as Measured by a Composite of Biomarkers
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Assessment method [1]
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Composite of the geometric mean of the ratios of the maximum PreOp value over Baseline for plasma heme oxygenase-1 (HO-1), ferritin, and interleukin-10 (IL-10)
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Timepoint [1]
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Baseline through Pre-Surgery
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Secondary outcome [1]
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Change in Renal Tubular Injury Biomarkers
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Assessment method [1]
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Geometric mean of the ratios of the maximum PostOp value over Baseline for urine KIM-1, NGAL, and cystatin C.
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Timepoint [1]
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Baseline through Day 3 post-cardiac surgery
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Secondary outcome [2]
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Number of Subjects With Reduction in Urine Output
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Assessment method [2]
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Documented AE of sustained reduction in urine output, oliguria, or anuria post-cardiac surgery through Day 5
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Timepoint [2]
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Baseline through post-cardiac surgery through Day 5
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Secondary outcome [3]
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Number of Subjects With Acute Kidney Injury (AKI)
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Assessment method [3]
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AKI is defined using the KDIGO criteria (ie, an absolute increase in serum creatinine of =1.5 × Baseline; or documented AE of sustained reduction in urine output, oliguria, or anuria; or initiation of dialysis).
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Timepoint [3]
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Baseline through Day 5 post-cardiac surgery
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Eligibility
Key inclusion criteria
1. Male or female subjects =18 years of age at Screening.
2. Able and willing to comply with all study procedures.
3. Stable kidney function per Investigator assessment and no known episodes of AKI during the preceding 4 weeks.
4. Scheduled to undergo non-emergent coronary and/or valve surgery(ies) requiring cardiopulmonary bypass, including:
* CABG alone;
* Combined CABG surgery/repair of 1 or more cardiac valves;
* Cardiac valve(s) replacement or repair alone.
5. Females and males of childbearing potential must agree to use 2 forms of contraception, with at least 1 being a barrier method, or abstain from sexual activity for 30 days following study drug administration.
6. Male subjects must agree not to donate or sell sperm for 30 days following study drug administration.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Presence of AKI (KDIGO criteria) at the time of Screening.
2. Surgery to be performed without cardiopulmonary bypass.
3. Surgery to be performed under conditions of circulatory arrest or hypothermia with rectal temperature <28°C (82.4°F).
4. eGFR =20 mL/min/1.73m2 or need for dialysis.
5. Surgery for aortic dissection or to correct a major congenital heart defect.
6. Administration of iodinated contrast media within 24 hours prior to cardiac surgery or evidence of contrast-induced nephropathy prior to cardiac surgery.
7. Cardiogenic shock or hemodynamic instability within the 24 hours prior to surgery and requirement for inotropes or vasopressors or other mechanical devices, such as intra-aortic balloon counter-pulsation.
8. Requirement for any of the following within 7 days prior to cardiac surgery:
* Defibrillator or permanent pacemaker;
* Mechanical ventilation;
* Intra-aortic balloon counter-pulsation;
* Left ventricular assist device;
* Other forms of mechanical circulatory support.
9. Known history of cancer within the past 2 years, except for carcinoma in situ of the cervix or adequately treated basal cell carcinoma of the skin.
10. Known or suspected sepsis at time of Screening or confirmed or treated endocarditis within 30 days prior to cardiac surgery.
11. Other current active infection requiring systemic antibiotic treatment.
12. Inadequate hepatic function, defined as total bilirubin or alanine aminotransferase or aspartate aminotransferase >2X the upper limit of normal at time of Screening or Child Pugh Class C liver disease or higher.
13. Any congenital coagulation disorder.
14. Asplenia (anatomic or functional).
15. History of photosensitivity or active skin disease that, in the opinion of the Investigator, could be worsened by RBT-1.
16. Known hypersensitivity or previous anaphylaxis to SnPP or any tin-based product.
17. Serum ferritin >500 ng/mL or those who have received IV iron within 28 days of Screening.
18. Pregnancy or lactation.
19. Treatment with an investigational drug or participation in an interventional study within 30 days prior to administration of study drug.
20. In the opinion of the Investigator, any disease processes or confounding variables that would inappropriately alter the outcome of the study.
21. Inability to comply with the requirements of the study protocol.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
4/08/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
3/02/2023
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Sample size
Target
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Accrual to date
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Final
152
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Recruitment in Australia
Recruitment state(s)
QLD,SA,VIC
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Recruitment hospital [1]
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Gold Cost University Hospital & Health Services - Southport
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Recruitment hospital [2]
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Flinders Medical Centre - Bedford Park
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Recruitment hospital [3]
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Monash Medical Centre - Clayton
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Recruitment hospital [4]
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The Alfred Hospital - Melbourne
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Recruitment postcode(s) [1]
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4215 - Southport
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Recruitment postcode(s) [2]
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- Bedford Park
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Recruitment postcode(s) [3]
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- Clayton
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Recruitment postcode(s) [4]
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3004 - Melbourne
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Recruitment outside Australia
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United States of America
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State/province [1]
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Alabama
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California
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Connecticut
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District of Columbia
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Illinois
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Indiana
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Massachusetts
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Michigan
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Minnesota
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New Hampshire
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New York
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Texas
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Canada
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State/province [13]
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New Brunswick
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Canada
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State/province [14]
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Ontario
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Canada
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State/province [15]
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Quebec
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Renibus Therapeutics, Inc.
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to evaluate the effect of RBT-1 (stannous protoporphyrin \[SnPP\]/iron sucrose \[FeS\]) on preconditioning response biomarkers in subjects who are at risk for AKI following cardiac surgery.
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Trial website
https://clinicaltrials.gov/study/NCT04564833
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Trial related presentations / publications
Lamy A, Chertow GM, Jessen M, Collar A, Brown CD, Mack CA, Marzouk M, Scavo V, Washburn TB, Savage D, Smith J, Bennetts J, Assi R, Shults C, Arghami A, Butler J, Devereaux PJ, Zager R, Wang C, Snapinn S, Browne A, Rodriguez J, Ruiz S, Singh B; of START Investigators. Effects of RBT-1 on preconditioning response biomarkers in patients undergoing coronary artery bypass graft or heart valve surgery: a multicentre, double-blind, randomised, placebo-controlled phase 2 trial. EClinicalMedicine. 2024 Jan 8;68:102364. doi: 10.1016/j.eclinm.2023.102364. eCollection 2024 Feb.
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Public notes
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Contacts
Principal investigator
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Address
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Contact person for public queries
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/33/NCT04564833/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/33/NCT04564833/SAP_001.pdf
Results publications and other study-related documents
Type
Citations or Other Details
Journal
Lamy A, Chertow GM, Jessen M, Collar A, Brown CD, ...
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More Details
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Results not provided in
https://clinicaltrials.gov/study/NCT04564833