CM4620 Injectable Emulsion Versus Supportive Care in Patients With Acute Pancreatitis and SIRS

NCT ID: NCT03401190

Last Updated: 2021-12-07

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 21 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-03-12
• Study Completion Date: 2019-04-30

Brief Summary

This open-label, dose-response study will evaluate the safety and efficacy of CM4620-IE in patients with acute pancreatitis and accompanying SIRS. The study will consist of two phases. The first phase will consist of 4 female and 4 male patients (cohorts 1 and 2, respectively), enrolled concurrently, randomized in a 3:1 ratio to receive CM4620-IE plus standard of care versus standard of care alone. Planned doses for first phase will be CM4620-IE 1.0 mg/kg on Day 1 and then 1.4 mg/kg on Days 2 - 4.

The second phase will consist of 8 female and 8 male patients (cohorts 3 and 4, respectively), enrolled concurrently, randomized in a 3:1 ratio to receive CM4620-IE plus standard of care versus standard of care alone. Planned doses for second phase will be CM4620-IE 2.08 mg/kg on Days 1 and 2 and then 1.6 mg/kg on Days 3 and 4. Dose escalation to second phase would only occur if needed for efficacy reasons and if no events suggesting a safety signal would occur with higher dosing.

The study is not powered for the analysis of study data with inferential statisitcs as the primary purpose of the study is to explore what endpoints would be most appropriate for future trials.

Detailed Description

After review of the efficacy, tolerability and safety data from cohorts 1 and 2 by the sponsor and the United States Food and Drug Administration, the decision was made to continue the low-dose regimen (CM4620-IE 1.0 mg/kg on Day 1 and then 1.4 mg/kg on Days 2 - 4) in cohort 3. Cohort 4 received the high-dose regimen (CM4620-IE 2.08 mg/kg on Days 1 and 2 and then 1.6 mg/kg on Days 3 and 4) as planned. Efficacy analysis were combined because no dose escalation occurred in cohort 3.

Patients were followed for 90 days after randomization.

Conditions

Acute Pancreatitis; Systemic Inflammatory Response Syndrome

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: SEQUENTIAL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Low Dose Group

Phase 1: Cohorts 1 \& 2 will consist of 4 female and 4 male patients enrolled concurrently who will be randomized 3:1 to receive CM4620-IE plus standard of care versus standard of care alone. Planned doses for patients who are randomized to receive CM4620-IE are 1.0 mg/kg on Days 1 and 1.4 mg/kg on Days 2-4.

Group Type: EXPERIMENTAL

CM4620 Injectable Emulsion (Low Dose)

Intervention Type: DRUG

CM4620-IE 1.0 mg/kg on Day 1 and then 1.4 mg/kg on Days 2-4, during the first phase of the study (Cohorts 1 and 2). All doses of CM4620-IE will be administered intravenously (IV) over 4 hours.

High Dose Group

Phase 2: Cohorts 3 \& 4 will consist of 8 female and 8 male patients enrolled concurrently who will be randomized 3:1 to receive CM4620-IE plus standard of care versus standard of care alone. Planned doses for patients who are randomized to receive CM4620-IE are 2.08 mg/kg of CM4620-IE on Days 1 and 2, and 1.6 mg/kg on Days 3 and 4.

Group Type: EXPERIMENTAL

CM4620 Injectable Emulsion (High Dose)

Intervention Type: DRUG

CM4620-IE 2.08 mg/kg on Days 1 and 2 and then 1.6 mg/kg on Days 3 and 4, during the second phase of the study (Cohorts 3 and 4). All doses of CM4620-IE will be administered intravenously (IV) over 4 hours.

Standard of Care

For all cohorts, patients will be randomized 3:1 to CM4620-IE plus standard of care versus standard of care alone.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

CM4620 Injectable Emulsion (Low Dose)

CM4620-IE 1.0 mg/kg on Day 1 and then 1.4 mg/kg on Days 2-4, during the first phase of the study (Cohorts 1 and 2). All doses of CM4620-IE will be administered intravenously (IV) over 4 hours.

Intervention Type: DRUG

CM4620 Injectable Emulsion (High Dose)

CM4620-IE 2.08 mg/kg on Days 1 and 2 and then 1.6 mg/kg on Days 3 and 4, during the second phase of the study (Cohorts 3 and 4). All doses of CM4620-IE will be administered intravenously (IV) over 4 hours.

Intervention Type: DRUG

Other Intervention Names

CM4620-IE (Low Dose); CM4620-IE (High Dose)

Eligibility Criteria

Inclusion Criteria

1. Diagnosis of acute pancreatitis established by the presence of abdominal pain consistent with acute pancreatitis and 1 of the following 2 criteria:

1. Serum lipase and/or serum amylase > 3 times the upper limit of normal (ULN);

2. Characteristic findings of acute pancreatitis on abdominal imaging;

2. A SpO2 <96% with a FiO2 of 21% (room air) to 27%, or a SpO2 <97% with a FiO2 ≥28%;

3. Diagnosis of SIRS, defined by the presence of at least 2 of the following 4 criteria:

1. Temperature < 36°C or > 38°C;

2. Heart rate > 90 beats/minute;

3. Respiratory rate >20 breaths/minute or arterial carbon dioxide tension (PaCO2) <32 mmHg;

4. White blood cell count (WBC) >12,000 mm3, or <4,000 mm3, or > 10% immature (band) forms;

4. No evidence of pancreatic necrosis on contrast-enhanced computed tomography (CECT performed in the 18 hours prior to consent or after consent and before Day 1;

5. Adults ≥ 18 years of age;

6. A female patient of child bearing potential who is sexually active with a male partner must be willing to practice acceptable methods of birth control for 365 days after the last dose of CM4620-IE;

7. A male patient who is sexually active with a female partner of childbearing potential must be willing to practice acceptable methods of birth control for 365 days after the last dose of CM4620-IE and must not donate sperm for 365 days.

8. Willing and able to, or have a legal authorized representative (LAR) that is willing and able to, provide informed consent to participate, and to cooperate with all aspects of the protocol.

Exclusion Criteria

1. Any concurrent clinical condition that a study physician believes could potentially pose an unacceptable health risk to the patient while involved in the study, including a CV SOFA score of 4 at the time of screening, or may limit expected survival to <6 months;

2. Suspected presence of cholangitis in the judgment of the treating investigator;

3. ERCP performed in the previous 7 days;

4. Any malignancy being treated with chemotherapy or immunotherapy;

5. Any autoimmune disease being treated with immunosuppressive medication or immunotherapy;

6. History of:

1. Acute pancreatitis with pancreatic necrosis on Contrast-Enhanced Computed Tomography (CECT) of the pancreas;

2. Chronic pancreatitis, pancreatic necrosis or necrosectomy, or pancreatic enzyme replacement therapy;

3. Biopsy proven cirrhosis, portal hypertension, hepatic failure/hepatic encephalopathy;

4. Known hepatitis B or C, or HIV;

5. History of organ or hematologic transplant;

6. Resuscitated cardiac arrest, myocardial infarction, revascularization, cardiovascular accident (CVA) in the 30 days prior to Day 1;

7. Current renal replacement therapy;

8. Current known abuse of cocaine or methamphetamine;

9. Known to be pregnant or are nursing;

10. Participated in another study of an investigational drug or therapeutic medical device in the 30 days prior to Day 1;

11. History of allergy to eggs or known hypersensitivity to any components of CM4620-IE.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

CalciMedica, Inc.

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Sudarshan Hebbar, MD

Role: STUDY_DIRECTOR

Chief Medical Officer

Locations

Detroit Receiving Hospital (Wayne State)

Detroit, Michigan, United States

Henry Ford Hospital

Detroit, Michigan, United States

Sinai-Grace Hospital (Wayne State)

Detroit, Michigan, United States

Hennepin County Medical Center

Minneapolis, Minnesota, United States

Regions Hospital

Saint Paul, Minnesota, United States

Washington University

St Louis, Missouri, United States

MetroHealth (Case Western)

Cleveland, Ohio, United States

Riverside Methodist

Columbus, Ohio, United States

Ben Taub (Baylor College of Medicine)

Houston, Texas, United States

Countries

United States

References

Bruen C, Miller J, Wilburn J, Mackey C, Bollen TL, Stauderman K, Hebbar S. Auxora for the Treatment of Patients With Acute Pancreatitis and Accompanying Systemic Inflammatory Response Syndrome: Clinical Development of a Calcium Release-Activated Calcium Channel Inhibitor. Pancreas. 2021 Apr 1;50(4):537-543. doi: 10.1097/MPA.0000000000001793.

Reference Type: DERIVED

PMID: 33939666 (View on PubMed)

Provided Documents

Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

CM4620-201

Identifier Type: -

Identifier Source: org_study_id