Efficacy and Safety of FP-1201-lyo (Interferon Beta-1a) in Prevention of Multi-Organ Failure on Patients After Open Surgery for a RAAA (INFORAAA)

• ClinicalTrials.gov Identifier: NCT03119701
• Recruitment Status: Terminated
• First Posted: April 19, 2017
• Results First Posted: January 14, 2021
• Last Update Posted: January 14, 2021
• Sponsor: Faron Pharmaceuticals Ltd
• Information provided by (Responsible Party): Faron Pharmaceuticals Ltd

Study Description

Brief Summary:

A study to assess effectiveness and safety of a drug FP-1201-lyo (Recombinant Human Interferon Beta-1a) in the Prevention of Multi-Organ Failure on patients after Open Surgery for a Ruptured Abdominal Aortic Aneurysm

Condition or disease	Intervention/treatment	Phase
Preventive Medicine; Multi Organ Failure	Drug: Interferon Beta-1A; Drug: Placebo	Phase 2

Detailed Description:

This trial is multicentre, randomised, double-blinded, Phase II, parallel group comparison study of the efficacy and safety of FP-1201-lyo compared to placebo in patients surviving emergency open surgery for an infra-renal ruptured abdominal aortic aneurysm. Investigational medicinal product will be administered as post-surgical preventive treatment either 10µg FP-1201-lyo or placebo. Treatment will be administered daily every 24 hrs for 6 days. The first dose will be given after successful surgery at the point when the patient arrives to the Intensive Care Unit (ICU).

Both treatment groups will receive standard supportive care.

Aim is randomise and initiate treatment of 152 patients. For the final analysis, a minimum of 129 evaluable patients will be required.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 40 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Intervention Model Description: Multicentre, randomised, double-blinded, Phase II, parallel group comparison study of the efficacy and safety of FP-1201-lyo compared to placebo in patients surviving emergency open surgery for an infra-renal ruptured abdominal aortic aneurysm.
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Primary Purpose: Prevention
• Official Title: A Randomised, Parallel Group 2:1 Comparison of the Efficacy and Safety of FP-1201-lyo (Interferon Beta-1a) and Placebo in the Prevention of Multi-Organ Failure on Patients Surviving Open Surgery for a Ruptured Abdominal Aortic Aneurysm
• Actual Study Start Date: February 18, 2017
• Actual Primary Completion Date: September 23, 2019
• Actual Study Completion Date: October 3, 2019

Arms and Interventions

Arm	Intervention/treatment
Experimental: FP-1201-lyo 10 µg; FP-12-lyo 10 µg (Interferon Beta-1a) will be administered once daily as an intravenous bolus injection for 6 days. Investigational product is lyophilisate for solution for injection which will be reconstituted in water for injection.	Drug: Interferon Beta-1A; Lyophilisate for solution for injection.; Other Names: FP-1201-lyo; ATC code L03AB07
Placebo Comparator: FP-1201-lyo Placebo; FP-1201-lyo Placebo will be administered once daily as an intravenous bolus injection for 6 days. Investigational placebo is lyophilisate for solution for injection which will be reconstituted in water for injection	Drug: Placebo; Lyophilisate for solution for injection as placebo.; Other Name: Placebo for investigational drug

Outcome Measures

Primary Outcome Measures :

1. The Efficacy of FP-1201-lyo Compared to Placebo Concerning All Cause Mortality [ Time Frame: Day 30 ]
   Number of fatalities

Secondary Outcome Measures :

1. The Efficacy of FP-1201-lyo Compared to Placebo Concerning All Cause Mortality [ Time Frame: Day 90 ]
   Number of fatalities
2. The Efficacy of FP-1201-lyo Compared to Placebo Concerning Number of Ventilator Free Days (VFDs) [ Time Frame: Day 30 ]
   Number of ventilator free days. VFDs to Day 30 were defined as the number of calendar days after initiating unassisted breathing (UAB) to Day 30 from first treatment, assuming that a patient survives at least 48 consecutive hours after initiating UAB. Patients who die without initiating UAB were assigned a VFD value of zero.
3. The Efficacy of FP-1201-lyo Compared to Placebo Concerning Number of Days Receiving Hemodialysis [ Time Frame: Day 30 and Day 90 ]
   Number of days receiving hemodialysis. There were only few reported values other than zero.
4. The Efficacy of FP-1201-lyo Compared to Placebo Concerning Number of Organ Failure Free Days by Means of the Sequential Organ Failure Assessment (SOFA) Score [ Time Frame: Day 30 ]

   Organ failure free days were defined as the number of days in the first 30 days after the first dose of study medication that the patient was alive and free of organ failure with a SOFA score of zero for the following six organ parameters: respiration, coagulation, liver, cardiovascular, central nervous system and renal function. It is graded from 0 to 4 according to the degree of dysfunction/ failure (higher scores indicate more severe organ failure). Patients who died without achieving a SOFA score of zero was assigned an organ failure free days value of zero.

   Note: the information for organ failure free days has been only collected when the patients have been in the Intensive Care Unit (ICU). As ICU free days have been reported in a separate variable, it was decided that presented information will be kept, without trying to conduct imputation.

5. The Efficacy of FP-1201-lyo Compared to Placebo Concerning Prevalence of Abdominal Compartment Syndrome by Intra-abdominal Pressure (IAP) [ Time Frame: Days 1 - 6, D9 and D13 during Intensive Care Unit (ICU) stay ]
   Intra-abdominal pressure values, which were routinely measured during ICU stay via urine bladder catheter.
6. The Efficacy of FP-1201-lyo Compared to Placebo Concerning Neutralizing Antibodies Against IFN Beta-1a (NAbs) in Whole Blood Samples [ Time Frame: Day 30 ]
   IFN beta-1a neutralizing antibodies immune response. Blood samples for the NAbs assessments were collected at Day 0 pre-dose (baseline) and at Day 30.
7. The Efficacy of FP-1201-lyo Compared to Placebo Concerning Disability by Modified Ranking Scale (mRS). [ Time Frame: Day 90 ]
   Scale gives the degree of disability or dependence in the daily activities. Single mRS value is applied for every patient based on patient or caregiver interview. The scale runs from 0-6, from perfect health without symptoms to death. Pre-operation Baseline Visit mRS value is collected for reference.
8. Safety Parameters of Clinically Significant Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events, Vital Signs and Clinical Laboratory Parameters [ Time Frame: Day 0 to Day 30 ]
   Number of TEAEs from vital signs data, laboratory data, physical examinations and spontaneous reporting when conscious.
9. Pharmacoeconomic Information of Length of ICU Stay, Length of Hospital Stay, Length of Stay at Another Health Care Facility, Length of Hemodialysis Needed, Ventilation Free Days [ Time Frame: Day 30 or Day 90 ]

   Economic measurement:

   • Length of ICU stay, in terms of ICU free days at D30
   • Length of hospital stay, in terms of hospital free days at D90
   • Length of stay at another health care facility at D90
   • The number of days on hemodialysis at D30 and at D90
   • The number of organ failure free days at D30
   • The number of ventilation free days at D30

Other Outcome Measures:

1. Myxovirus Resistant Protein A (MxA) Concentration in Whole Blood Samples as Pharmacodynamic Marker [ Time Frame: Day 0 up to Day 13 ]
   Concentration of Myxovirus Resistant Protein A (MxA)
2. Tentative Disease Specific Marker Cluster of Differentiation 73 (CD73, Ecto-5'-Nucleotidase Enzyme) Concentration in Serum Samples [ Time Frame: Day 0 up to Day 13 ]
   CD73 (ecto-5'-nucleotidase enzyme) concentration
3. Tentative Disease Specific, Potential Inflammatory Marker - Interleukin 6 (IL-6) in Serum Samples [ Time Frame: Day 0 up to Day 13 ]
   IL-6 concentration.
4. Tentative Disease Specific, Potential Inflammatory Marker - Hepatocyte Growth Factor [HGF]) in Serum Samples [ Time Frame: Day 0 up to Day 13 ]
   HGF concentration.

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

To be eligible for inclusion into this study, each patient must fulfil the following inclusion criteria during screening and prior to the first dose of study medication being administered on D0 (criteria 1 or 2 and all 3, 4 and 5):

1. Patients (male or female) presenting with a ruptured abdominal aortic aneurysm (RAAA) diagnosed by ultrasound or CT-scan in the emergency room

   • all forms of infrarenal RAAAs with or without coexisting iliac aneurysms are included or

2. Patients (male or female) presenting with symptoms of RAAA known to have an infrarenal AAA and proceeding straight to open repair without radiological assessment and confirmed rupture (=retroperitoneal haematoma) in operation

   and

3. Aneurysma repair must be infra-renal, i.e. the proximal anastomosis must be below the renal arteries and the renal arteries have to stay intact. Temporary above the renal clamping can be used for a maximum of 30 minutes (total clamping time)

   and

4. Patients providing informed consent

   and

5. Age of 18 years or higher

Exclusion Criteria:

To be eligible for inclusion into this study, each patient must not meet any of the following exclusion criteria during screening or prior to the first dose of study medication being administered:

1. Moribund patient not eligible for treatment in ICU or expected to survive surgery
2. Markedly short life expectancy, e.g. advanced malignant disease
3. Current participation in another experimental treatment protocol
4. Significant congestive heart failure, defined as New York Heart Association (NYHA) class IV
5. Current treatment with Interferon (IFN) alpha or IFN beta
6. Dialysis therapy for chronic renal failure
7. Irreversible shock from haemorrhage
8. Unconsciousness or inability to give consent
9. Ruptured Endovascular Aortic Repair (rEVAR) first (prior attempt for endovascular aortic repair for the current rupture)
10. Diagnosed cirrhosis
11. Pregnancy and women with child bearing potential without negative pregnancy test
12. Rupture not confirmed by CT or intra-operatively (impending ruptures are excluded)

13. RAAA requiring repair of the renal arteries or the proximal aorta

    • thoracoabdominal aneurysms requiring immediate repair
    • damaged renal arteries during emergency clamping requiring repair

Note:

• temporary clamping above the renal arteries (max 30 min total clamping time above the renal arteries) does not lead to exclusion
• ligation of the left renal vein does not lead to exclusion

Contacts and Locations

Locations

Estonia

Tartu University Hospital

Tartu, Estonia, 51014

Finland

Helsinki University Hospital

Helsinki, Finland, FI-00290

Central Finland Central Hospital

Jyväskylä, Finland, FI-40620

South Karelia Central Hospital

Lappeenranta, Finland, FI-53130

Oulu University Hospital

Oulu, Finland, FI-90220

Tampere University Hospital

Tampere, Finland, FI-33520

Turku University Hospital

Turku, Finland, FFI-20520

Lithuania

Hospital of Lithuanian University of Health Sciences Kauno klinikos

Kaunas, Lithuania, LT-50161

Vilnius University Hospital Santaros klinikos

Vilnius, Lithuania, LT-08661

Sponsors and Collaborators

Faron Pharmaceuticals Ltd

Investigators

• Principal Investigator: Harri Hakovirta, MD; Turku University Hospital
• Principal Investigator: Maarit Venermo, MD; Helsinki University Central Hospital

  Study Documents (Full-Text)

Documents provided by Faron Pharmaceuticals Ltd:

Study Protocol  [PDF] April 16, 2019

Statistical Analysis Plan  [PDF] December 19, 2019

More Information

• Responsible Party: Faron Pharmaceuticals Ltd
• ClinicalTrials.gov Identifier: NCT03119701
• Other Study ID Numbers: FP1CLI006; 2014-000899-25 ( EudraCT Number )
• First Posted: April 19, 2017
• Results First Posted: January 14, 2021
• Last Update Posted: January 14, 2021
• Last Verified: December 2020

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Faron Pharmaceuticals Ltd:

Patients Surviving Open Surgery; Ruptured Abdominal Aortic Aneurysm

Additional relevant MeSH terms:

Multiple Organ Failure; Pathologic Processes; Shock; Interferons; Interferon-beta; Interferon beta-1a; Antineoplastic Agents; Antiviral Agents; Anti-Infective Agents; Immunologic Factors; Physiological Effects of Drugs; Adjuvants, Immunologic