Trial Outcomes & Findings for A Study to Evaluate the Use and Safety of CARDIOLITE® in Pediatric Patients With Kawasaki Disease (NCT NCT00162032)

NCT ID: NCT00162032

Last Updated: 2019-07-23

Results Overview

The proportion of all patients who experienced cardiac events among patients with abnormal (SSS \>=4, high risk) and normal (SSS \<4, low risk) Cardiolite MPI scans during the follow-up period. A log-rank statistic (2-sided, alpha = 0.05) was computed to compare cardiac event-free survival in the high risk and low risk groups. The cardiac event rate is the cumulative event rate based on a Kaplan-Meier estimate conditional on the SPECT MPI score result.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

445 participants

Primary outcome timeframe

3 years

Results posted on

2019-07-23

Participant Flow

Participant milestones

Participant milestones
Measure
Children (Ages 4-11)
Arm A children 4-11 years of age
Adolescents (Ages 12-16)
Arm B children 12-16 years of age
Overall Study
STARTED
329
116
Overall Study
COMPLETED
324
114
Overall Study
NOT COMPLETED
5
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Children (Ages 4-11)
Arm A children 4-11 years of age
Adolescents (Ages 12-16)
Arm B children 12-16 years of age
Overall Study
Lost to Follow-up
4
2
Overall Study
Reason not specified
1
0

Baseline Characteristics

A Study to Evaluate the Use and Safety of CARDIOLITE® in Pediatric Patients With Kawasaki Disease

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Children (Ages 4-11)
n=329 Participants
Arm A children 4-11 years of age
Adolescents (Ages 12-16)
n=116 Participants
Arm B children 12-16 years of age
Total
n=445 Participants
Total of all reporting groups
Age, Categorical
<=18 years
329 Participants
n=93 Participants
116 Participants
n=4 Participants
445 Participants
n=27 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Age, Categorical
>=65 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Age, Continuous
7.7 years
STANDARD_DEVIATION 2.16 • n=93 Participants
13.6 years
STANDARD_DEVIATION 1.31 • n=4 Participants
9.0 years
STANDARD_DEVIATION 3.27 • n=27 Participants
Sex: Female, Male
Female
104 Participants
n=93 Participants
40 Participants
n=4 Participants
144 Participants
n=27 Participants
Sex: Female, Male
Male
225 Participants
n=93 Participants
76 Participants
n=4 Participants
301 Participants
n=27 Participants
Region of Enrollment
United States
64 participants
n=93 Participants
39 participants
n=4 Participants
103 participants
n=27 Participants
Region of Enrollment
Philippines
33 participants
n=93 Participants
8 participants
n=4 Participants
41 participants
n=27 Participants
Region of Enrollment
Taiwan
85 participants
n=93 Participants
27 participants
n=4 Participants
112 participants
n=27 Participants
Region of Enrollment
Canada
18 participants
n=93 Participants
17 participants
n=4 Participants
35 participants
n=27 Participants
Region of Enrollment
Brazil
34 participants
n=93 Participants
5 participants
n=4 Participants
39 participants
n=27 Participants
Region of Enrollment
Thailand
46 participants
n=93 Participants
6 participants
n=4 Participants
52 participants
n=27 Participants
Region of Enrollment
Korea, Republic of
43 participants
n=93 Participants
10 participants
n=4 Participants
53 participants
n=27 Participants
Region of Enrollment
Singapore
6 participants
n=93 Participants
4 participants
n=4 Participants
10 participants
n=27 Participants

PRIMARY outcome

Timeframe: 3 years

Population: Had SPECT Myocardial perfusion imaging tests and experienced a cardiac event

The proportion of all patients who experienced cardiac events among patients with abnormal (SSS \>=4, high risk) and normal (SSS \<4, low risk) Cardiolite MPI scans during the follow-up period. A log-rank statistic (2-sided, alpha = 0.05) was computed to compare cardiac event-free survival in the high risk and low risk groups. The cardiac event rate is the cumulative event rate based on a Kaplan-Meier estimate conditional on the SPECT MPI score result.

Outcome measures

Outcome measures
Measure
Children (4 -11 Years) Normal
n=287 Participants
SSS (summed stress score) \<=4, low risk
Adolescents (12-16 Years) Normal
n=93 Participants
SSS (summed stress score) \<4, low risk
Children (4-11 Years) Abnormal
n=26 Participants
SSS (summed stress score)\>4, high risk
Adolescents (12-16 Years) Abnormal
n=19 Participants
sss (summed stress score \>4, high risk
Determine the Predictive Value of Cardiolite® Rest and Stress MPI to Define Pediatric Populations With Kawasaki Disease at High and Low Risk of Developing Cardiac Events.
0.041 proportion of participants
Interval 0.015 to 0.066
0.033 proportion of participants
Interval 0.0 to 0.071
0.115 proportion of participants
Interval 0.0 to 0.238
0.233 proportion of participants
Interval 0.0 to 0.493

SECONDARY outcome

Timeframe: 6 months

Population: Per-protocol population of pooled adolescents and children who underwent coronary angiography

Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of myocardial perfusion imaging (MPI) for the diagnosis of ischemic heart disease (IHD) relative to coronary angiography. Coronary stenoses of ≥ 50% were classified as disease. SSS \> 4 in MPI was classified as positive for IHD.

Outcome measures

Outcome measures
Measure
Children (4 -11 Years) Normal
n=50 Participants
SSS (summed stress score) \<=4, low risk
Adolescents (12-16 Years) Normal
SSS (summed stress score) \<4, low risk
Children (4-11 Years) Abnormal
SSS (summed stress score)\>4, high risk
Adolescents (12-16 Years) Abnormal
sss (summed stress score \>4, high risk
Estimate the Performance of Cardiolite® Rest and Stress MPI for the Detection of Myocardial Ischemia in Adolescents and Children Versus Coronary Angiography
Sensitivity
0.35 proportion
Interval 0.11 to 0.69
Estimate the Performance of Cardiolite® Rest and Stress MPI for the Detection of Myocardial Ischemia in Adolescents and Children Versus Coronary Angiography
Specificity
0.62 proportion
Interval 0.45 to 0.77
Estimate the Performance of Cardiolite® Rest and Stress MPI for the Detection of Myocardial Ischemia in Adolescents and Children Versus Coronary Angiography
Positive Predictive Value
0.21 proportion
Interval 0.06 to 0.46
Estimate the Performance of Cardiolite® Rest and Stress MPI for the Detection of Myocardial Ischemia in Adolescents and Children Versus Coronary Angiography
Negative Predictive Value
0.77 proportion
Interval 0.59 to 0.9

SECONDARY outcome

Timeframe: 3 years

Population: All subjects who had undergone stress cardiac MPI studies

Examine the incidence of hard cardiac events (myocardial infarction \[MI\] or cardiac death) in KD subjects with positive and negative MPI scans.

Outcome measures

Outcome measures
Measure
Children (4 -11 Years) Normal
n=287 Participants
SSS (summed stress score) \<=4, low risk
Adolescents (12-16 Years) Normal
n=93 Participants
SSS (summed stress score) \<4, low risk
Children (4-11 Years) Abnormal
n=26 Participants
SSS (summed stress score)\>4, high risk
Adolescents (12-16 Years) Abnormal
n=19 Participants
sss (summed stress score \>4, high risk
Incidence of Hard Cardiac Events
0 participants
0 participants
0 participants
0 participants

SECONDARY outcome

Timeframe: 24 hours

Sensitivity, specificity, PPV, and NPV of SDS for myocardial perfusion corresponding to the left anterior descending (LAD) for the diagnosis of IHD in the distribution of the left anterior descending (LAD) artery relative to coronary angiography based diagnosis were determined. Coronary stenoses of ≥ 50% for arteries associated with LAD territories were classified as LAD disease. SDS LAD \> 1 was classified as positive for IHD for the LAD distribution.

Outcome measures

Outcome measures
Measure
Children (4 -11 Years) Normal
n=29 Participants
SSS (summed stress score) \<=4, low risk
Adolescents (12-16 Years) Normal
n=22 Participants
SSS (summed stress score) \<4, low risk
Children (4-11 Years) Abnormal
SSS (summed stress score)\>4, high risk
Adolescents (12-16 Years) Abnormal
sss (summed stress score \>4, high risk
Estimate the Performance of Cardiolite® Rest and Stress MPI for the Detection of Myocardial Ischemia in the Left Anterior Descending (LAD) Artery in Adolescents and Children Versus Coronary Angiography
Sensitivity
.25 proportion
Interval 0.01 to 0.81
0.00 proportion
Interval 0.0 to 0.71
Estimate the Performance of Cardiolite® Rest and Stress MPI for the Detection of Myocardial Ischemia in the Left Anterior Descending (LAD) Artery in Adolescents and Children Versus Coronary Angiography
Specificity
0.76 proportion
Interval 0.55 to 0.91
0.74 proportion
Interval 0.49 to 0.91
Estimate the Performance of Cardiolite® Rest and Stress MPI for the Detection of Myocardial Ischemia in the Left Anterior Descending (LAD) Artery in Adolescents and Children Versus Coronary Angiography
Positive Predictive Value
0.14 proportion
Interval 0.0 to 0.58
0.00 proportion
Interval 0.0 to 0.52
Estimate the Performance of Cardiolite® Rest and Stress MPI for the Detection of Myocardial Ischemia in the Left Anterior Descending (LAD) Artery in Adolescents and Children Versus Coronary Angiography
Negative Predictive Value
0.86 proportion
Interval 0.65 to 0.97
0.82 proportion
Interval 0.57 to 0.96

SECONDARY outcome

Timeframe: 6 months

Population: Efficacy Evaluable Population

Determine the incidence of cardiac events occurring over a 6 month follow up period in pediatric subjects with normal myocardial perfusion scans.

Outcome measures

Outcome measures
Measure
Children (4 -11 Years) Normal
n=287 Participants
SSS (summed stress score) \<=4, low risk
Adolescents (12-16 Years) Normal
n=93 Participants
SSS (summed stress score) \<4, low risk
Children (4-11 Years) Abnormal
n=26 Participants
SSS (summed stress score)\>4, high risk
Adolescents (12-16 Years) Abnormal
n=19 Participants
sss (summed stress score \>4, high risk
Predictive Value of Cardiolite For Cardiac Events
3 Participants
1 Participants
3 Participants
2 Participants

Adverse Events

Children (Ages 4-11)

Serious events: 1 serious events
Other events: 8 other events
Deaths: 0 deaths

Adolescents (Ages 12-16)

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Children (Ages 4-11)
n=329 participants at risk
Arm A children 4-11 years of age
Adolescents (Ages 12-16)
n=116 participants at risk
Arm B adolescents 12-16 years of age
Injury, poisoning and procedural complications
Overdose
0.30%
1/329 • Number of events 1 • AEs within 24+- 12 hours. SAEs up to 14 days.
0.00%
0/116 • AEs within 24+- 12 hours. SAEs up to 14 days.

Other adverse events

Other adverse events
Measure
Children (Ages 4-11)
n=329 participants at risk
Arm A children 4-11 years of age
Adolescents (Ages 12-16)
n=116 participants at risk
Arm B adolescents 12-16 years of age
Nervous system disorders
Headache
1.2%
4/329 • Number of events 4 • AEs within 24+- 12 hours. SAEs up to 14 days.
4.3%
5/116 • Number of events 5 • AEs within 24+- 12 hours. SAEs up to 14 days.
Gastrointestinal disorders
Nausea
1.5%
5/329 • Number of events 5 • AEs within 24+- 12 hours. SAEs up to 14 days.
0.00%
0/116 • AEs within 24+- 12 hours. SAEs up to 14 days.

Additional Information

Cesare Orlandi, MD, Chief Medical Officer

Lantheus Medical Imaging

Phone: 978-671-8686

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60