Trial Outcomes & Findings for Evaluate Protein C Levels in Severe Sepsis Patients on Drotrecogin Alfa (Activated) (NCT NCT00386425)

NCT ID: NCT00386425

Last Updated: 2010-12-16

Results Overview

Mean change in protein C from Study Day 1 to Study Day 7 was tested using an unadjusted two-sample t-test with a two-sided alpha of 0.05. To be included in the primary analysis, Intention-to-Treat (ITT) patients must have at least 1 protein C value available at 24 hours or earlier and at least 1 protein C value at a post-24-hour timepoint.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

486 participants

Primary outcome timeframe

Day 1, Day 7

Results posted on

2010-12-16

Participant Flow

Efficacy results are only provided for the intent-to-treat (ITT) population (patients who actually received the randomized treatment after the 24 hour pretreatment period).

Participant milestones

Participant milestones
Measure
Standard Therapy
24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours
Alternative Therapy
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Randomized Non-ITT Population
Participants were randomized to either the Standard or Alternative Therapy and received 24 mcg/kg/hr during the first 24 hours (common therapy period); however, they did not continue on to receive the actual randomized therapy.
Overall Study
STARTED
227
206
53
Overall Study
Received Study Drug
227
206
53
Overall Study
COMPLETED
224
205
53
Overall Study
NOT COMPLETED
3
1
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Standard Therapy
24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours
Alternative Therapy
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Randomized Non-ITT Population
Participants were randomized to either the Standard or Alternative Therapy and received 24 mcg/kg/hr during the first 24 hours (common therapy period); however, they did not continue on to receive the actual randomized therapy.
Overall Study
Physician Decision
3
0
0
Overall Study
Withdrawal by Subject
0
1
0

Baseline Characteristics

Evaluate Protein C Levels in Severe Sepsis Patients on Drotrecogin Alfa (Activated)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Standard Therapy
n=227 Participants
24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours
Alternative Therapy
n=206 Participants
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Randomized Non-ITT Population
n=53 Participants
Total
n=486 Participants
Total of all reporting groups
Age Continuous
62.31 years
STANDARD_DEVIATION 16.11 • n=5 Participants
61.91 years
STANDARD_DEVIATION 14.44 • n=7 Participants
66.63 years
STANDARD_DEVIATION 12.82 • n=5 Participants
62.61 years
STANDARD_DEVIATION 15.12 • n=4 Participants
Sex: Female, Male
Female
90 Participants
n=5 Participants
76 Participants
n=7 Participants
20 Participants
n=5 Participants
186 Participants
n=4 Participants
Sex: Female, Male
Male
137 Participants
n=5 Participants
130 Participants
n=7 Participants
33 Participants
n=5 Participants
300 Participants
n=4 Participants
Race/Ethnicity, Customized
African
13 Participants
n=5 Participants
4 Participants
n=7 Participants
2 Participants
n=5 Participants
19 Participants
n=4 Participants
Race/Ethnicity, Customized
Caucasian
204 Participants
n=5 Participants
189 Participants
n=7 Participants
51 Participants
n=5 Participants
444 Participants
n=4 Participants
Race/Ethnicity, Customized
East Asian
0 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
2 Participants
n=4 Participants
Race/Ethnicity, Customized
Hispanic
9 Participants
n=5 Participants
8 Participants
n=7 Participants
0 Participants
n=5 Participants
17 Participants
n=4 Participants
Race/Ethnicity, Customized
Native American
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race/Ethnicity, Customized
West Asian
1 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
3 Participants
n=4 Participants
Region of Enrollment
Australia
2 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants
4 participants
n=4 Participants
Region of Enrollment
Belgium
27 participants
n=5 Participants
23 participants
n=7 Participants
6 participants
n=5 Participants
56 participants
n=4 Participants
Region of Enrollment
Canada
22 participants
n=5 Participants
21 participants
n=7 Participants
4 participants
n=5 Participants
47 participants
n=4 Participants
Region of Enrollment
Germany
14 participants
n=5 Participants
12 participants
n=7 Participants
1 participants
n=5 Participants
27 participants
n=4 Participants
Region of Enrollment
Finland
29 participants
n=5 Participants
30 participants
n=7 Participants
2 participants
n=5 Participants
61 participants
n=4 Participants
Region of Enrollment
France
37 participants
n=5 Participants
33 participants
n=7 Participants
9 participants
n=5 Participants
79 participants
n=4 Participants
Region of Enrollment
Italy
1 participants
n=5 Participants
1 participants
n=7 Participants
0 participants
n=5 Participants
2 participants
n=4 Participants
Region of Enrollment
Puerto Rico
2 participants
n=5 Participants
4 participants
n=7 Participants
0 participants
n=5 Participants
6 participants
n=4 Participants
Region of Enrollment
Spain
19 participants
n=5 Participants
16 participants
n=7 Participants
12 participants
n=5 Participants
47 participants
n=4 Participants
Region of Enrollment
United Kingdom
32 participants
n=5 Participants
29 participants
n=7 Participants
10 participants
n=5 Participants
71 participants
n=4 Participants
Region of Enrollment
United States
42 participants
n=5 Participants
36 participants
n=7 Participants
8 participants
n=5 Participants
86 participants
n=4 Participants
Recent Surgery
Yes
68 participants
n=5 Participants
61 participants
n=7 Participants
25 participants
n=5 Participants
154 participants
n=4 Participants
Recent Surgery
No
159 participants
n=5 Participants
144 participants
n=7 Participants
28 participants
n=5 Participants
331 participants
n=4 Participants
Recent Surgery
Unknown
0 participants
n=5 Participants
1 participants
n=7 Participants
0 participants
n=5 Participants
1 participants
n=4 Participants
Number of organ dysfunctions
3.08 organ dysfunctions
STANDARD_DEVIATION 0.86 • n=5 Participants
3.08 organ dysfunctions
STANDARD_DEVIATION 0.84 • n=7 Participants
3.28 organ dysfunctions
STANDARD_DEVIATION 0.93 • n=5 Participants
3.10 organ dysfunctions
STANDARD_DEVIATION 0.86 • n=4 Participants
Time of onset of Second organ dysfunction to start of drug infusion
15.3 hours
STANDARD_DEVIATION 7.0 • n=5 Participants
15.0 hours
STANDARD_DEVIATION 7.0 • n=7 Participants
15.8 hours
STANDARD_DEVIATION 7.2 • n=5 Participants
15.3 hours
STANDARD_DEVIATION 7.0 • n=4 Participants
Total Sequential Organ Failure Assessment (SOFA) score
8.38 units on a scale
STANDARD_DEVIATION 2.83 • n=5 Participants
8.65 units on a scale
STANDARD_DEVIATION 2.70 • n=7 Participants
9.09 units on a scale
STANDARD_DEVIATION 2.25 • n=5 Participants
8.57 units on a scale
STANDARD_DEVIATION 2.72 • n=4 Participants
Acute Physiology And Chronic Health Evaluation (APACHE) II Score
26.34 units on a scale
STANDARD_DEVIATION 7.70 • n=5 Participants
26.15 units on a scale
STANDARD_DEVIATION 7.31 • n=7 Participants
28.26 units on a scale
STANDARD_DEVIATION 8.05 • n=5 Participants
26.47 units on a scale
STANDARD_DEVIATION 7.59 • n=4 Participants
Use of vasopressor
Yes
190 participants
n=5 Participants
183 participants
n=7 Participants
51 participants
n=5 Participants
424 participants
n=4 Participants
Use of vasopressor
No
37 participants
n=5 Participants
23 participants
n=7 Participants
2 participants
n=5 Participants
62 participants
n=4 Participants
Mechanical ventilation
Yes
178 participants
n=5 Participants
158 participants
n=7 Participants
44 participants
n=5 Participants
380 participants
n=4 Participants
Mechanical ventilation
No
49 participants
n=5 Participants
48 participants
n=7 Participants
9 participants
n=5 Participants
106 participants
n=4 Participants
Protein C level
44 Percent Protein C Activity
STANDARD_DEVIATION 19 • n=5 Participants
41 Percent Protein C Activity
STANDARD_DEVIATION 20 • n=7 Participants
30 Percent Protein C Activity
STANDARD_DEVIATION 18 • n=5 Participants
42 Percent Protein C Activity
STANDARD_DEVIATION 20 • n=4 Participants
Central laboratory protein C class
Severe deficiency
97 participants
n=5 Participants
100 participants
n=7 Participants
31 participants
n=5 Participants
228 participants
n=4 Participants
Central laboratory protein C class
Moderate deficiency
94 participants
n=5 Participants
76 participants
n=7 Participants
9 participants
n=5 Participants
179 participants
n=4 Participants
Central laboratory protein C class
Normal
9 participants
n=5 Participants
9 participants
n=7 Participants
0 participants
n=5 Participants
18 participants
n=4 Participants
Central laboratory protein C class
Unknown
27 participants
n=5 Participants
21 participants
n=7 Participants
13 participants
n=5 Participants
61 participants
n=4 Participants

PRIMARY outcome

Timeframe: Day 1, Day 7

Population: Intent to Treat (ITT) Last Observation Carried Forward (LOCF) population.

Mean change in protein C from Study Day 1 to Study Day 7 was tested using an unadjusted two-sample t-test with a two-sided alpha of 0.05. To be included in the primary analysis, Intention-to-Treat (ITT) patients must have at least 1 protein C value available at 24 hours or earlier and at least 1 protein C value at a post-24-hour timepoint.

Outcome measures

Outcome measures
Measure
Standard Therapy
n=227 Participants
24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours
Alternative Therapy
n=206 Participants
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Severe Deficiency
Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Moderate Deficiency
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours
Mean Change in Protein C Levels From Day 1 to Day 7
Protein C Day 1, n=226, n=205
55 Percent Protein C Activity
Standard Deviation 24
52 Percent Protein C Activity
Standard Deviation 24
Mean Change in Protein C Levels From Day 1 to Day 7
Protein C Day 7, n=221, n=203
79 Percent Protein C Activity
Standard Deviation 33
83 Percent Protein C Activity
Standard Deviation 35
Mean Change in Protein C Levels From Day 1 to Day 7
Change in Protein C, Day 1 to Day 7, n=221, n=202
24 Percent Protein C Activity
Standard Deviation 29
31 Percent Protein C Activity
Standard Deviation 29

SECONDARY outcome

Timeframe: Day 1, Day 7

Population: ITT moderately deficient population, ITT severely deficient population

Moderate Protein C Deficiency: A protein C level greater than half the lower limit of normal. Severe Protein C Deficiency: A protein C level less than or equal to half the lower limit of normal.

Outcome measures

Outcome measures
Measure
Standard Therapy
n=227 Participants
24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours
Alternative Therapy
n=206 Participants
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Severe Deficiency
Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Moderate Deficiency
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours
Mean Change in Protein C Level From Study Day 1 to Study Day 7 in Patients With Moderate and Severe Protein C Deficiency
Moderate n=175, n=171
24 Percent Protein C Activity
Standard Deviation 28
30 Percent Protein C Activity
Standard Deviation 29
Mean Change in Protein C Level From Study Day 1 to Study Day 7 in Patients With Moderate and Severe Protein C Deficiency
Severe n=46, n=31
25 Percent Protein C Activity
Standard Deviation 32
38 Percent Protein C Activity
Standard Deviation 27

SECONDARY outcome

Timeframe: Day 0 through Day 28

Population: ITT population

Outcome measures

Outcome measures
Measure
Standard Therapy
n=224 Participants
24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours
Alternative Therapy
n=205 Participants
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Severe Deficiency
Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Moderate Deficiency
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours
Day 28 All-Cause Mortality
Alive at Day 28
83.9 percentage of participants
75.1 percentage of participants
Day 28 All-Cause Mortality
Deceased at Day 28
16.1 percentage of participants
24.9 percentage of participants

SECONDARY outcome

Timeframe: Day 0 to hospital discharge or Day 90

Population: ITT population

Outcome measures

Outcome measures
Measure
Standard Therapy
n=224 Participants
24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours
Alternative Therapy
n=205 Participants
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Severe Deficiency
Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Moderate Deficiency
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours
Hospital Mortality (up to Day 90)
Discharged Alive
79.5 Percentage of participants
72.2 Percentage of participants
Hospital Mortality (up to Day 90)
Deceased
20.5 Percentage of participants
27.8 Percentage of participants

SECONDARY outcome

Timeframe: Day 0, Day 28

Population: ITT population

The presence of 5 organ dysfunctions (cardiovascular, respiratory, renal, hepatic, coagulation) was assessed using a Sequential Organ Failure Assessment (SOFA) score. Each organ has a possible dysfunction score of 0 to 4, for a total SOFA score range of 0 (no organ dysfunction) to 20 (all organs with dysfunction). SOFA scores were time-averaged.

Outcome measures

Outcome measures
Measure
Standard Therapy
n=227 Participants
24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours
Alternative Therapy
n=206 Participants
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Severe Deficiency
Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Moderate Deficiency
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours
28-Day Time Averaged Sequential Organ Failure (SOFA) Score
Liver
0.78 Units on a scale
Standard Deviation 1.22
0.89 Units on a scale
Standard Deviation 1.21
28-Day Time Averaged Sequential Organ Failure (SOFA) Score
Total
5.96 Units on a scale
Standard Deviation 5.21
6.62 Units on a scale
Standard Deviation 5.23
28-Day Time Averaged Sequential Organ Failure (SOFA) Score
Cardiovascular
1.28 Units on a scale
Standard Deviation 1.21
1.41 Units on a scale
Standard Deviation 1.26
28-Day Time Averaged Sequential Organ Failure (SOFA) Score
Respiratory
2.22 Units on a scale
Standard Deviation 0.99
2.38 Units on a scale
Standard Deviation 0.88
28-Day Time Averaged Sequential Organ Failure (SOFA) Score
Renal
0.92 Units on a scale
Standard Deviation 1.28
1.04 Units on a scale
Standard Deviation 1.31
28-Day Time Averaged Sequential Organ Failure (SOFA) Score
Hematology
0.80 Units on a scale
Standard Deviation 1.16
0.93 Units on a scale
Standard Deviation 1.20

SECONDARY outcome

Timeframe: Day 0 through Day 28

Population: Randomized participants who received randomized therapy (intention to treat population).

Serious bleeding events (SBE): intracranial hemorrhage, life-threatening or fatal bleed, or bleeding event assessed as an SAE. Patients may have multiple events with onset in different time periods. SAEs include SBEs. The 3 SBEs in Alternative-Moderate Deficiency arm (days 5-8) occurred after completion of study drug infusion. One event (pleural haemorrhage) occurred same day of completion of infusion and 2 events (cerebral haemorrhage, shock haemorrhagic) occurred day after completion.

Outcome measures

Outcome measures
Measure
Standard Therapy
n=51 Participants
24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours
Alternative Therapy
n=176 Participants
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Severe Deficiency
n=33 Participants
Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Moderate Deficiency
n=173 Participants
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours
Number of Participants With Serious Adverse Events (SAE) and Serious Bleeding Events (SBE) by Time Period
Serious Bleeding Events: Study Days 5 through 8
1 number of patients with at least 1 event
0 number of patients with at least 1 event
0 number of patients with at least 1 event
3 number of patients with at least 1 event
Number of Participants With Serious Adverse Events (SAE) and Serious Bleeding Events (SBE) by Time Period
Serious Adverse Events: Study Days 0 through 4
0 number of patients with at least 1 event
10 number of patients with at least 1 event
5 number of patients with at least 1 event
17 number of patients with at least 1 event
Number of Participants With Serious Adverse Events (SAE) and Serious Bleeding Events (SBE) by Time Period
Serious Adverse Events: Study Days 5 through 8
2 number of patients with at least 1 event
4 number of patients with at least 1 event
1 number of patients with at least 1 event
8 number of patients with at least 1 event
Number of Participants With Serious Adverse Events (SAE) and Serious Bleeding Events (SBE) by Time Period
Serious Adverse Events: Study Days 9 through 28
3 number of patients with at least 1 event
8 number of patients with at least 1 event
4 number of patients with at least 1 event
14 number of patients with at least 1 event
Number of Participants With Serious Adverse Events (SAE) and Serious Bleeding Events (SBE) by Time Period
Serious Bleeding Events: Study Days 0 through 4
0 number of patients with at least 1 event
2 number of patients with at least 1 event
0 number of patients with at least 1 event
9 number of patients with at least 1 event
Number of Participants With Serious Adverse Events (SAE) and Serious Bleeding Events (SBE) by Time Period
Serious Bleeding Events: Study Days 9 through 28
0 number of patients with at least 1 event
1 number of patients with at least 1 event
0 number of patients with at least 1 event
1 number of patients with at least 1 event

SECONDARY outcome

Timeframe: 28 days

Population: ITT Population - All patients who are randomly assigned to treatment and receive any amount of randomized therapy

Normalization was defined as having 2 consecutive protein C measurements above the lower limit of normal through Study Day 7.

Outcome measures

Outcome measures
Measure
Standard Therapy
n=232 Participants
24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours
Alternative Therapy
n=197 Participants
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Severe Deficiency
Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Moderate Deficiency
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours
Mortality by Protein C Normalized Versus Not-normalized
10.3 Percentage of participants
32.0 Percentage of participants

OTHER_PRE_SPECIFIED outcome

Timeframe: 28 Days, up to 90 days

Population: ITT Population - All patients who are randomly assigned to treatment and receive any amount of randomized therapy. ITT patients with severe protein C deficiency. Severe deficiency is defined by the 24-hour local laboratory protein C value reported to the Interactive voice response system (IVRS).

Twenty-eight day mortality is the patient's mortality status at the predefined timepoint of 672 hours from the start of study drug infusion. Hospital mortality is the patient's survival status at the end of the hospital stay or study day 90 (if the patient remains in the hospital).

Outcome measures

Outcome measures
Measure
Standard Therapy
n=51 Participants
24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours
Alternative Therapy
n=33 Participants
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Severe Deficiency
Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Moderate Deficiency
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours
Mortality for Severe Protein C Deficiency
28 Day Mortality - Deceased at Day 28
31.4 Percentage of participants
24.2 Percentage of participants
Mortality for Severe Protein C Deficiency
28 Day Mortality - Alive at Day 28
68.6 Percentage of participants
75.8 Percentage of participants
Mortality for Severe Protein C Deficiency
Hospital Mortality - Deceased
33.3 Percentage of participants
30.3 Percentage of participants
Mortality for Severe Protein C Deficiency
Hospital Mortality - Discharged Alive
66.7 Percentage of participants
69.7 Percentage of participants

POST_HOC outcome

Timeframe: 28 Days

Population: ITT Population - ITT Switch-No Population, ITT patients who did not answer yes to the switch question.

Outcome measures

Outcome measures
Measure
Standard Therapy
n=135 Participants
24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours
Alternative Therapy
n=142 Participants
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Severe Deficiency
Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours
Alternative Therapy - Moderate Deficiency
Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours
Mortality for Moderate Protein C Deficiency by Infusion Duration
<97 Hours n=65, n=71
13.8 percent participants deceased
28.2 percent participants deceased
Mortality for Moderate Protein C Deficiency by Infusion Duration
>=97 Hours n=70, n=71
11.4 percent participants deceased
23.9 percent participants deceased

Adverse Events

Standard Therapy

Serious events: 33 serious events
Other events: 51 other events
Deaths: 0 deaths

Alternative Therapy

Serious events: 48 serious events
Other events: 46 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Standard Therapy
n=250 participants at risk
Participants assigned to standard therapy (24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours) who received any amount of study drug.
Alternative Therapy
n=236 participants at risk
Participants assigned to alternative therapy (Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours) who received any amount of study drug.
Cardiac disorders
Acute coronary syndrome
0.40%
1/250 • Number of events 1
0.00%
0/236
Cardiac disorders
Arrhythmia
0.00%
0/250
0.42%
1/236 • Number of events 3
Cardiac disorders
Atrial fibrillation
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Cardiac disorders
Cardiac arrest
0.00%
0/250
0.85%
2/236 • Number of events 2
Cardiac disorders
Cardiac failure
0.40%
1/250 • Number of events 1
0.00%
0/236
Cardiac disorders
Cardio-respiratory arrest
0.00%
0/250
0.42%
1/236 • Number of events 1
Cardiac disorders
Electromechanical dissociation
0.00%
0/250
0.42%
1/236 • Number of events 1
Cardiac disorders
Supraventricular tachycardia
0.40%
1/250 • Number of events 2
0.00%
0/236
Cardiac disorders
Ventricular fibrillation
0.80%
2/250 • Number of events 2
0.42%
1/236 • Number of events 1
Cardiac disorders
Ventricular tachycardia
0.00%
0/250
0.42%
1/236 • Number of events 1
Gastrointestinal disorders
Faeces discoloured
0.40%
1/250 • Number of events 1
0.00%
0/236
Gastrointestinal disorders
Gastric haemorrhage
0.40%
1/250 • Number of events 1
0.00%
0/236
Gastrointestinal disorders
Gastrointestinal haemorrhage
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Gastrointestinal disorders
Intestinal ischaemia
0.40%
1/250 • Number of events 1
0.85%
2/236 • Number of events 2
Gastrointestinal disorders
Intestinal obstruction
0.00%
0/250
0.42%
1/236 • Number of events 1
Gastrointestinal disorders
Intra-abdominal haemorrhage
0.00%
0/250
0.42%
1/236 • Number of events 1
Gastrointestinal disorders
Large intestine perforation
0.00%
0/250
0.42%
1/236 • Number of events 1
Gastrointestinal disorders
Peritoneal haemorrhage
0.00%
0/250
0.42%
1/236 • Number of events 1
Gastrointestinal disorders
Peritonitis
0.00%
0/250
0.42%
1/236 • Number of events 1
Gastrointestinal disorders
Upper gastrointestinal haemorrhage
0.00%
0/250
0.42%
1/236 • Number of events 1
General disorders
Catheter site haemorrhage
0.00%
0/250
0.85%
2/236 • Number of events 2
General disorders
Death
0.40%
1/250 • Number of events 1
0.00%
0/236
Hepatobiliary disorders
Hepatic haemorrhage
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Infections and infestations
Abdominal sepsis
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Candida pneumonia
0.00%
0/250
0.42%
1/236 • Number of events 1
Infections and infestations
Clostridium difficile colitis
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Empyema
0.00%
0/250
0.42%
1/236 • Number of events 1
Infections and infestations
Endocarditis
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Endocarditis staphylococcal
0.00%
0/250
0.42%
1/236 • Number of events 1
Infections and infestations
Pneumonia
0.80%
2/250 • Number of events 2
0.42%
1/236 • Number of events 1
Infections and infestations
Sepsis
0.80%
2/250 • Number of events 2
0.85%
2/236 • Number of events 2
Infections and infestations
Septic shock
0.00%
0/250
1.7%
4/236 • Number of events 4
Infections and infestations
Staphylococcal infection
0.00%
0/250
0.42%
1/236 • Number of events 1
Injury, poisoning and procedural complications
Anastomotic complication
0.40%
1/250 • Number of events 1
0.00%
0/236
Injury, poisoning and procedural complications
Anastomotic leak
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Injury, poisoning and procedural complications
Gastrointestinal anastomotic leak
0.00%
0/250
0.42%
1/236 • Number of events 1
Injury, poisoning and procedural complications
Overdose
0.40%
1/250 • Number of events 1
0.00%
0/236
Injury, poisoning and procedural complications
Suture related complication
0.40%
1/250 • Number of events 1
0.00%
0/236
Injury, poisoning and procedural complications
Urinary bladder rupture
0.00%
0/250
0.42%
1/236 • Number of events 1
Injury, poisoning and procedural complications
Vascular graft complication
0.40%
1/250 • Number of events 1
0.00%
0/236
Injury, poisoning and procedural complications
Vascular pseudoaneurysm
0.00%
0/250
0.42%
1/236 • Number of events 1
Investigations
Haemoglobin decreased
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Investigations
Platelet count decreased
0.40%
1/250 • Number of events 1
0.00%
0/236
Musculoskeletal and connective tissue disorders
Fistula
0.00%
0/250
0.42%
1/236 • Number of events 1
Musculoskeletal and connective tissue disorders
Muscular weakness
0.00%
0/250
0.42%
1/236 • Number of events 1
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Metastasis
0.00%
0/250
0.42%
1/236 • Number of events 1
Nervous system disorders
Central nervous system lesion
0.00%
0/250
0.42%
1/236 • Number of events 1
Nervous system disorders
Cerebral haematoma
0.40%
1/250 • Number of events 1
0.00%
0/236
Nervous system disorders
Cerebral haemorrhage
0.00%
0/250
0.42%
1/236 • Number of events 1
Nervous system disorders
Hypoxic encephalopathy
0.00%
0/250
0.42%
1/236 • Number of events 1
Nervous system disorders
Ischaemic stroke
0.40%
1/250 • Number of events 1
0.85%
2/236 • Number of events 2
Nervous system disorders
Polyneuropathy
0.40%
1/250 • Number of events 1
0.00%
0/236
Nervous system disorders
Status epilepticus
0.00%
0/250
0.42%
1/236 • Number of events 1
Renal and urinary disorders
Renal haemorrhage
0.00%
0/250
0.42%
1/236 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Asphyxia
0.00%
0/250
0.42%
1/236 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Aspiration
0.00%
0/250
0.42%
1/236 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Haemoptysis
0.80%
2/250 • Number of events 2
0.42%
1/236 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Hypoxia
0.40%
1/250 • Number of events 1
0.00%
0/236
Respiratory, thoracic and mediastinal disorders
Pleural haemorrhage
0.00%
0/250
0.42%
1/236 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Pneumonia aspiration
0.00%
0/250
0.42%
1/236 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Pneumothorax
0.00%
0/250
0.85%
2/236 • Number of events 2
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
0.80%
2/250 • Number of events 2
0.42%
1/236 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Pulmonary fistula
0.40%
1/250 • Number of events 1
0.00%
0/236
Respiratory, thoracic and mediastinal disorders
Pulmonary oedema
0.40%
1/250 • Number of events 2
0.00%
0/236
Respiratory, thoracic and mediastinal disorders
Respiratory failure
0.40%
1/250 • Number of events 1
0.00%
0/236
Vascular disorders
Air embolism
0.40%
1/250 • Number of events 1
0.00%
0/236
Vascular disorders
Arterial haemorrhage
0.00%
0/250
0.42%
1/236 • Number of events 1
Vascular disorders
Deep vein thrombosis
0.00%
0/250
0.42%
1/236 • Number of events 1
Vascular disorders
Extremity necrosis
0.00%
0/250
0.42%
1/236 • Number of events 1
Vascular disorders
Haematoma
0.00%
0/250
0.42%
1/236 • Number of events 1
Vascular disorders
Hypotension
0.40%
1/250 • Number of events 1
0.00%
0/236
Vascular disorders
Ischaemia
0.00%
0/250
0.42%
1/236 • Number of events 1
Vascular disorders
Shock
0.00%
0/250
0.85%
2/236 • Number of events 2
Vascular disorders
Shock haemorrhagic
0.00%
0/250
0.42%
1/236 • Number of events 1

Other adverse events

Other adverse events
Measure
Standard Therapy
n=250 participants at risk
Participants assigned to standard therapy (24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 hours) who received any amount of study drug.
Alternative Therapy
n=236 participants at risk
Participants assigned to alternative therapy (Moderate Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 24 mcg/kg/hr for an additional 72 to 144 hours Severe Protein C Deficiency: 24 mcg/kg/hr for 24 hours, followed by 30 or 36 mcg/kg/hr for an additional 72 to 144 hours) who received any amount of study drug.
Blood and lymphatic system disorders
Anaemia
1.2%
3/250 • Number of events 3
1.3%
3/236 • Number of events 3
Blood and lymphatic system disorders
Coagulopathy
0.00%
0/250
0.42%
1/236 • Number of events 1
Blood and lymphatic system disorders
Thrombocytopenia
2.0%
5/250 • Number of events 5
0.42%
1/236 • Number of events 1
Cardiac disorders
Atrial fibrillation
0.00%
0/250
0.42%
1/236 • Number of events 1
Eye disorders
Conjunctival haemorrhage
0.40%
1/250 • Number of events 1
0.00%
0/236
Gastrointestinal disorders
Aphthous stomatitis
0.40%
1/250 • Number of events 1
0.00%
0/236
Gastrointestinal disorders
Gastric haemorrhage
0.40%
1/250 • Number of events 1
0.00%
0/236
Gastrointestinal disorders
Gastrointestinal haemorrhage
1.2%
3/250 • Number of events 3
0.85%
2/236 • Number of events 2
Gastrointestinal disorders
Haematemesis
0.80%
2/250 • Number of events 2
0.42%
1/236 • Number of events 2
Gastrointestinal disorders
Lower gastrointestinal haemorrhage
0.40%
1/250 • Number of events 1
0.00%
0/236
Gastrointestinal disorders
Mouth haemorrhage
0.80%
2/250 • Number of events 2
0.42%
1/236 • Number of events 1
Gastrointestinal disorders
Small intestinal haemorrhage
0.00%
0/250
0.42%
1/236 • Number of events 1
Gastrointestinal disorders
Upper gastrointestinal haemorrhage
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
General disorders
Bloody discharge
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
General disorders
Catheter site haemorrhage
1.6%
4/250 • Number of events 6
2.1%
5/236 • Number of events 9
General disorders
Mucosal haemorrhage
0.80%
2/250 • Number of events 2
0.85%
2/236 • Number of events 2
General disorders
Puncture site haemorrhage
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
General disorders
Vessel puncture site haemorrhage
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Abdominal infection
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Aspergillosis
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Bacteraemia
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Candidiasis
0.40%
1/250 • Number of events 1
0.85%
2/236 • Number of events 2
Infections and infestations
Catheter sepsis
0.80%
2/250 • Number of events 2
0.42%
1/236 • Number of events 1
Infections and infestations
Citrobacter infection
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Clostridial infection
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Empyema
0.00%
0/250
0.42%
1/236 • Number of events 1
Infections and infestations
Enterobacter infection
0.00%
0/250
0.42%
1/236 • Number of events 1
Infections and infestations
Enterobacter pneumonia
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Enterococcal infection
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Infections and infestations
Escherichia urinary tract infection
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Infections and infestations
Fungal infection
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Gastroenteritis
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Genital infection fungal
0.00%
0/250
0.42%
1/236 • Number of events 1
Infections and infestations
Infection
0.00%
0/250
0.42%
1/236 • Number of events 1
Infections and infestations
Klebsiella infection
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Lower respiratory tract infection
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Lung infection
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Infections and infestations
Lung infection pseudomonal
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Morganella infection
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Oral herpes
0.00%
0/250
0.42%
1/236 • Number of events 1
Infections and infestations
Pneumonia
0.80%
2/250 • Number of events 2
0.85%
2/236 • Number of events 2
Infections and infestations
Pneumonia staphylococcal
0.00%
0/250
0.42%
1/236 • Number of events 1
Infections and infestations
Pseudomembranous colitis
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Pseudomonas infection
1.2%
3/250 • Number of events 3
0.85%
2/236 • Number of events 2
Infections and infestations
Respiratory tract infection bacterial
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Staphylococcal infection
0.00%
0/250
0.85%
2/236 • Number of events 2
Infections and infestations
Stenotrophomonas infection
0.00%
0/250
0.42%
1/236 • Number of events 1
Infections and infestations
Systemic candida
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Tracheitis
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Urinary tract infection
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Infections and infestations
Urinary tract infection bacterial
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Urinary tract infection enterococcal
0.40%
1/250 • Number of events 1
0.00%
0/236
Infections and infestations
Urinary tract infection fungal
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Infections and infestations
Viral infection
0.00%
0/250
0.42%
1/236 • Number of events 1
Infections and infestations
Wound infection
0.00%
0/250
0.42%
1/236 • Number of events 1
Infections and infestations
Wound infection fungal
0.40%
1/250 • Number of events 1
0.00%
0/236
Injury, poisoning and procedural complications
Bloody airway discharge
0.40%
1/250 • Number of events 1
0.00%
0/236
Injury, poisoning and procedural complications
Operative haemorrhage
0.40%
1/250 • Number of events 1
0.85%
2/236 • Number of events 2
Injury, poisoning and procedural complications
Post procedural haematuria
0.00%
0/250
0.42%
1/236 • Number of events 1
Injury, poisoning and procedural complications
Post procedural haemorrhage
0.80%
2/250 • Number of events 2
0.42%
1/236 • Number of events 1
Injury, poisoning and procedural complications
Tracheal haemorrhage
1.2%
3/250 • Number of events 3
0.00%
0/236
Investigations
Bacteria blood identified
0.00%
0/250
0.42%
1/236 • Number of events 1
Investigations
Blood alkaline phosphatase increased
0.00%
0/250
0.42%
1/236 • Number of events 1
Investigations
Blood urine present
0.00%
0/250
0.42%
1/236 • Number of events 1
Investigations
Haematocrit decreased
0.00%
0/250
0.42%
1/236 • Number of events 1
Investigations
Haemoglobin decreased
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Investigations
Platelet count decreased
0.40%
1/250 • Number of events 1
0.00%
0/236
Investigations
Prothrombin time shortened
0.00%
0/250
0.85%
2/236 • Number of events 2
Investigations
Sputum culture positive
0.00%
0/250
0.42%
1/236 • Number of events 1
Musculoskeletal and connective tissue disorders
Muscle haemorrhage
0.40%
1/250 • Number of events 1
0.00%
0/236
Renal and urinary disorders
Haematuria
0.80%
2/250 • Number of events 2
2.1%
5/236 • Number of events 5
Respiratory, thoracic and mediastinal disorders
Epistaxis
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
0.40%
1/250 • Number of events 1
0.00%
0/236
Respiratory, thoracic and mediastinal disorders
Pulmonary haemorrhage
0.40%
1/250 • Number of events 1
0.42%
1/236 • Number of events 1
Skin and subcutaneous tissue disorders
Ecchymosis
0.00%
0/250
0.42%
1/236 • Number of events 1
Vascular disorders
Haematoma
1.2%
3/250 • Number of events 3
0.42%
1/236 • Number of events 1
Vascular disorders
Wound haemorrhage
0.80%
2/250 • Number of events 2
0.00%
0/236

Additional Information

Chief Medical Officer

Eli Lilly and Company

Phone: 800-545-5979

Results disclosure agreements

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

Restriction type: GT60