Study to Evaluate the Safety and Activity of BB3 to Treat Heart Attack
Study Details
Study Description
Brief Summary
The study will evaluate the effect of BB3 to preserve myocardial (heart) tissue and function following myocardial infarction (heart attack).
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
Phase 2 |
Detailed Description
Percutaneous coronary intervention (PCI) has become the mainstay for treatment of ST-segment elevation myocardial infarction (STEMI). Whereas early recanalization undoubtedly salvages myocardial tissue, reperfusion following prolonged ischemia can also exacerbate injury. Infarct size needs to be limited, and the conditions favoring adaptive ventricular healing and remodeling optimized because in patients with acute myocardial infarction (AMI) who do not die of out-of-hospital arrhythmias, long-term prognosis is dependent on the amount of myocardium that is lost, and the outcome of ventricular remodeling. Angion Biomedical Corp. has identified BB3, a small molecule mimetic of hepatocyte growth factor/scatter factor (HGF/SF) whose activity is expected to preserve tissue viability and attenuate dysfunction in the setting of organ injury while obviating the logistical difficulties associated with gene or protein therapy. HGF/SF is a naturally occurring cell survival factor that holds significant therapeutic potential. BB3 has been shown to possess HGF/SF activities, including protection against heart injury following myocardial infarction. This study is designed to evaluate clinical efficacy of BB3 in patients presenting with acute ST segment elevation myocardial infarction (A-STEMI) who undergo PCI.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Experimental: BB3 Daily intravenous administration of 2 mg/kg BB3 for four (4) days |
Drug: BB3
Daily intravenous administration of 2 mg/kg BB3 for four (4) days
|
Placebo Comparator: Normal Saline Daily intravenous administration for four (4) days |
Drug: Normal saline
Daily intravenous administration for four (4) days. The volume of normal saline will vary by estimated weight.
|
Outcome Measures
Primary Outcome Measures
- Evaluation of Reduction in Infarct Size [6 month]
Evaluation of reduction in infarct size by MRI between the BB3 and placebo treatment groups at 6 months based on index of myocardial salvage
- Evaluation of the Degree of Late Ventricular Remodeling [6 months]
Evaluation of the degree of late ventricular remodeling between the BB3 and placebo treatment groups at 6 months, as measured by increase in LV end-diastolic volume index (LVEDVI) from initial MR image (day 5±1) to late MR image (6 months).
Secondary Outcome Measures
- Change in CK-MB and Troponin [6 months]
- Change in BNP Levels [6 months]
- Change in Symptoms and Clinical Signs of CHF [6 months]
- Change in LVEDVI, LVESVI and LV Ejection Fraction (EF) After MI Assessed by Cine MR (SSFP Imaging) [6 months]
- LVEDVI, LVESVI and LVEF After MI Assessed by 2D and 3D Echocardiography [6 months]
- Change Between Initial Semi-quantitative Regional Wall Motion Score (17 Segment Model) by Echocardiography [1 and 6 months]
- Change in Regional Myocardial Radial, Circumferential and Longitudinal Strain [1 and 6 months]
- Frequency of MACE [6 months]
- Frequency of New Onset CHF Through 6 Months [6 months]
- Number of Hospitalizations for CHF Through 6 Months [6 months]
- Incidence of Complete ST Segment Resolution 60 ± 30 Minutes After Last Angiogram [6 months]
- Frequency of AE, SAEs [6 months]
- Frequency of MACCE [6 months]
- All-cause Mortality [6 months]
- Development of Ventricular Fibrillation or Other Life-threatening Arrhythmia [6 months]
- Change From Baseline eCrCl [6 months]
- Change in Body Weight [6 months]
- Symptoms and Clinical Signs of CHF [6 months]
Symptoms and clinical signs of CHF measured by NYHA classification
Eligibility Criteria
Criteria
Inclusion Criteria:
-
The subject or legally authorized representative has been informed of the nature of the study, agrees to its provisions, and has been provided and signed written informed consent, approved by the Institutional Review Board (IRB), prior to performance of any study related procedure including screening procedure.
-
Subject is male or female
-
Subject is 21 to 80 years of age
-
Estimated body weight < 120 kg and BMI < 40
-
Subject is experiencing clinical symptoms consistent with acute myocardial infarction (AMI) (e.g., chest pain, arm pain, etc.,) >30 minutes duration and unresponsive to nitroglycerin; with ST segment elevation of more than 1 mm in at least two contiguous leads of ECG or new or presumed new onset bundle branch block (BBB)
-
Fulfills clinical center's criteria for primary PCI
-
PCI will be done within 12 hours of onset of STEMI.
-
The subject and his/her physician are willing to comply with the requirements of the study and the specified follow-up evaluations.
-
If female, either surgically sterile or post-menopausal or using acceptable contraception and agree to use effective birth control regimen during the study period. Men must agree to use condoms during the study period. Women of child bearing potential must have a negative urine or serum pregnancy test.
-
In the opinion of the Investigator, the subject is capable of understanding and complying with the protocol.
Exclusion Criteria:
-
Pregnant or nursing subjects and those who plan pregnancy in the period up to 6 months following index procedure.
-
Cardiogenic shock (Killip class 4) or cardiac arrest
-
History of prior myocardial infarction or pre-existing Q waves on ECG
-
An elective surgical procedure is planned that would necessitate interruption of anti-platelet agents during the first six months post enrollment;
-
Any contraindication to undergo MRI imaging. This will include any of the following exclusions:
-
Cardiac pacemaker or implantable defibrillator;
-
Non-MRI-compatible aneurysm clip;
-
Neural stimulator (e.g., TENS-Unit);
-
Any implanted or magnetically activated device (e.g., insulin pump);
-
Any type of non-MRI-compatible metallic ear implant;
-
Metal shavings in the orbits;
-
Any metallic foreign body, shrapnel, or bullet in a location which the physician feels would present a risk to the subject;
-
Any history indicating contraindication to MRI, including claustrophobia or allergy to gadolinium;
-
Inability to follow breathhold instructions or to maintain a breathhold for >15 seconds;
-
Irregular cardiac rhythm not expected to resolve after treatment of the acute cardiac condition (e.g., chronic atrial fibrillation)
-
Known hypersensitivity or contraindication to gadolinium contrast.
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Subject has active bleeding or a history of bleeding diathesis or coagulopathy (including heparin induced thrombocytopenia), or refusal to receive blood transfusions if necessary;
-
Subjects presenting with cardiogenic shock (SBP <80 mmHg for >30 minutes, or requiring IV pressors or emergency IABP for hypotension treatment) or cardiopulmonary resuscitation prior to randomization;
-
History of intracerebral mass, aneurysm, arteriovenous malformation, or hemorrhagic stroke; stroke or transient ischemic attack within the past 6 months, or any permanent residual neurologic defect; known preceding cardiac ventricular arrhythmia
-
Impaired renal function (eGFR of ≤30 ml/min/1.73m2, as estimated by the MDRD4v equation) or on dialysis.
-
Impaired hepatic function (ALT > 2x upper limit of normal, or a total bilirubin greater than 1.5 x upper limit of normal).
-
Currently participating in or has participated in an investigational drug or medical device study within 30 days or 5 half-lives, whichever is longer, prior to enrollment into this study
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Have an active malignancy or history of solid, metastatic, or hematologic malignancy with the exception of basal or squamous cell carcinoma of the skin that has been removed
-
History of positive human immunodeficiency virus (HIV) test
-
History of rheumatoid arthritis
-
History of proliferative retinopathy or laser surgery for retinopathy
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Subjects who require cytochrome P450 1A2 (CYP1A2) inhibitors, ciprofloxacin and/or fluvoxamine (Luvox®)
-
Subject has other medical illness or known history of substance abuse (alcohol, cocaine, heroin etc.) that may cause non-compliance with the protocol, confound the data interpretation or is associated with a limited life expectancy of less than 6 months,
-
Any significant medical condition which in the Investigator's opinion may interfere with the subject's optimal participation in the study;
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Subject has a known hypersensitivity or allergy to stainless steel, nickel, cobalt chromium, nitinol, titanium or known hypersensitivity or allergy to contrast media (e.g. rash) that cannot effectively be controlled by premedication with steroids and/or diphenhydramine. Subjects with hypersensitivity or allergy to any of the components of the device (structural, drug or polymer components) and subjects with true prior anaphylaxis to contrast media should not be enrolled
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Minneapolis Heart Institute Foundation | Minneapolis | Minnesota | United States | 55417-1139 |
2 | Yale University Medical Center | New Haven | New York | United States | 06520 |
Sponsors and Collaborators
- Angion Biomedica Corp
- National Heart, Lung, and Blood Institute (NHLBI)
Investigators
- Study Director: Weizhong Cai, Sponsor GmbH
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 001-10
- 5R44HL091699
Study Results
Participant Flow
Recruitment Details | |
---|---|
Pre-assignment Detail |
Arm/Group Title | BB3, 4 Daily Doses | Placebo; 4 Daily Doses |
---|---|---|
Arm/Group Description | BB3: Daily intravenous administration of 2 mg/kg BB3 for four (4) days ; 10 to 12 minutes; small molecule mimetic of hepatocyte growth factor | Placebo: Normal saline; Daily intravenous administration for four (4) days. The volume of normal saline will vary by estimated weight. |
Period Title: Overall Study | ||
STARTED | 3 | 2 |
Complete Study Treatment | 1 | 2 |
COMPLETED | 0 | 2 |
NOT COMPLETED | 3 | 0 |
Baseline Characteristics
Arm/Group Title | BB3, 4 Daily Doses | Placebo | Total |
---|---|---|---|
Arm/Group Description | BB3: Daily intravenous administration of 2 mg/kg BB3 for four (4) days | Normal saline. Daily intravenous administration for four (4) days. | Total of all reporting groups |
Overall Participants | 3 | 2 | 5 |
Age (years) [Mean (Full Range) ] | |||
Mean (Full Range) [years] |
61
|
57.5
|
59
|
Sex: Female, Male (Count of Participants) | |||
Female |
1
33.3%
|
0
0%
|
1
20%
|
Male |
2
66.7%
|
2
100%
|
4
80%
|
Region of Enrollment (participants) [Number] | |||
United States |
3
100%
|
2
100%
|
5
100%
|
Outcome Measures
Title | Evaluation of Reduction in Infarct Size |
---|---|
Description | Evaluation of reduction in infarct size by MRI between the BB3 and placebo treatment groups at 6 months based on index of myocardial salvage |
Time Frame | 6 month |
Outcome Measure Data
Analysis Population Description |
---|
Five subjects were enrolled into the study; 3 subjects were randomized to BB3 and 2 subjects to placebo. Of the 3 subjects randomized to BB3, 1 completed study treatment; all three subjects discontinued the study prematurely. The two subjects randomized to placebo completed study treatment and neither discontinued the study prematurely. |
Arm/Group Title | BB3, 4 Daily Doses | Placebo, 4 Daily Doses |
---|---|---|
Arm/Group Description | BB3: Daily intravenous administration of 2 mg/kg BB3 for four (4) days | Normal saline. Daily intravenous administration for four (4) days. |
Measure Participants | 0 | 0 |
Title | Evaluation of the Degree of Late Ventricular Remodeling |
---|---|
Description | Evaluation of the degree of late ventricular remodeling between the BB3 and placebo treatment groups at 6 months, as measured by increase in LV end-diastolic volume index (LVEDVI) from initial MR image (day 5±1) to late MR image (6 months). |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Change in CK-MB and Troponin |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Change in BNP Levels |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Change in Symptoms and Clinical Signs of CHF |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Change in LVEDVI, LVESVI and LV Ejection Fraction (EF) After MI Assessed by Cine MR (SSFP Imaging) |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | LVEDVI, LVESVI and LVEF After MI Assessed by 2D and 3D Echocardiography |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Change Between Initial Semi-quantitative Regional Wall Motion Score (17 Segment Model) by Echocardiography |
---|---|
Description | |
Time Frame | 1 and 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Change in Regional Myocardial Radial, Circumferential and Longitudinal Strain |
---|---|
Description | |
Time Frame | 1 and 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Frequency of MACE |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Frequency of New Onset CHF Through 6 Months |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Number of Hospitalizations for CHF Through 6 Months |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Incidence of Complete ST Segment Resolution 60 ± 30 Minutes After Last Angiogram |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Frequency of AE, SAEs |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Frequency of MACCE |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | All-cause Mortality |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Development of Ventricular Fibrillation or Other Life-threatening Arrhythmia |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Change From Baseline eCrCl |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Change in Body Weight |
---|---|
Description | |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Title | Symptoms and Clinical Signs of CHF |
---|---|
Description | Symptoms and clinical signs of CHF measured by NYHA classification |
Time Frame | 6 months |
Outcome Measure Data
Analysis Population Description |
---|
[Not Specified] |
Arm/Group Title |
---|
Arm/Group Description |
Adverse Events
Time Frame | ||||
---|---|---|---|---|
Adverse Event Reporting Description | ||||
Arm/Group Title | BB3 Small Molecule Mimetic of Hepatocyte Growth Factor | Placebo | ||
Arm/Group Description | small molecule mimetic of hepatocyte growth factor/scatter factor BB3: Daily intravenous administration of 2 mg/kg BB3 for four (4) days | Normal saline Placebo: Daily intravenous administration for four (4) days. The volume of normal saline will vary by estimated weight. | ||
All Cause Mortality |
||||
BB3 Small Molecule Mimetic of Hepatocyte Growth Factor | Placebo | |||
Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
Total | / (NaN) | / (NaN) | ||
Serious Adverse Events |
||||
BB3 Small Molecule Mimetic of Hepatocyte Growth Factor | Placebo | |||
Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
Total | 0/3 (0%) | 0/2 (0%) | ||
Other (Not Including Serious) Adverse Events |
||||
BB3 Small Molecule Mimetic of Hepatocyte Growth Factor | Placebo | |||
Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
Total | 2/3 (66.7%) | 1/2 (50%) | ||
Cardiac disorders | ||||
bradycardia | 1/3 (33.3%) | 0/2 (0%) | ||
ventricular tachycardia | 1/3 (33.3%) | 0/2 (0%) | ||
Ear and labyrinth disorders | ||||
tinnitus | 0/3 (0%) | 1/2 (50%) | ||
Gastrointestinal disorders | ||||
nausea and vomiting | 1/3 (33.3%) | 0/2 (0%) | ||
General disorders | ||||
headache | 0/3 (0%) | 1/2 (50%) | ||
hyperhidrosis | 1/3 (33.3%) | 0/2 (0%) | ||
dizziness | 1/3 (33.3%) | 0/2 (0%) | ||
fatigue | 0/3 (0%) | 1/2 (50%) | ||
Infections and infestations | ||||
sinusitis | 0/3 (0%) | 1/2 (50%) | ||
Surgical and medical procedures | ||||
infusion site pain | 1/3 (33.3%) | 0/2 (0%) | ||
Vascular disorders | ||||
hypotension | 1/3 (33.3%) | 0/2 (0%) |
Limitations/Caveats
More Information
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is more than 60 days but less than or equal to 180 days. The sponsor cannot require changes to the communication and cannot extend the embargo.
Results Point of Contact
Name/Title | Dr. Joesph Brennan |
---|---|
Organization | Yale University Medical Center |
Phone | (203) 483-8300 |
Brennan.Joesph@yale.edu |
- 001-10
- 5R44HL091699