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Safety and Tolerability Study of EG-1962 in Aneurysmal Subarachnoid Hemorrhage (NEWTON)

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ClinicalTrials.gov Identifier: NCT01893190
Recruitment Status : Completed
First Posted : July 8, 2013
Last Update Posted : February 5, 2018
Sponsor:
Information provided by (Responsible Party):
Edge Therapeutics Inc

Brief Summary:
Phase 1/2a Multicenter, Controlled, Randomized, Open Label, Dose Escalation, Safety, Tolerability, and Pharmacokinetic Study Comparing EG-1962 and Nimodipine in Patients with Aneurysmal Subarachnoid Hemorrhage

Condition or disease Intervention/treatment Phase
Ruptured Cerebral Aneurysm Ruptured Berry Aneurysm Drug: Nimodipine Drug: Nimodipine Microparticles Phase 1 Phase 2

Detailed Description:

This is a Phase 1/2a multicenter, controlled, open label, and randomized, study.

Part 1 of the study is a single dose escalation period to determine the MTD of EG-1962. During this period, a maximum of 6 dose level cohorts with up to 12 patients per cohort will be enrolled. In each cohort, patients will be randomly assigned in a ratio of 3:1 to receive either intraventricular EG 1962 or enteral nimodipine, respectively. The first cohort will receive 100 mg EG 1962. Upon completion of the dose escalation period, a safe and tolerable dose will be selected for further study.

Part 2 of the study is a treatment period to assess the safety and tolerability of the selected dose of EG-1962.

The safety and tolerability of a single intraventricular dose of EG 1962 will be compared to enteral nimodipine (60 mg given every 4 hours orally or via nasogastric or gastrostomy tube) for 21 days.


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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 73 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Nimodipine Microparticles to Enhance Recovery While Reducing TOxicity After subarachNoid Hemorrhage: Phase I/IIa Multicenter, Controlled, Randomized, Open Label, Dose Escalation, Safety, Tolerability, and Pharmacokinectic Study Comparing EG-1962 and Nimodipine in Patients With Aneurysmal Subarachnoid Hemorrhage
Study Start Date : September 2013
Actual Primary Completion Date : January 2016
Actual Study Completion Date : January 2016

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Bleeding
Drug Information available for: Nimodipine

Arm Intervention/treatment
Active Comparator: Nimodipine
Nimodipine 60mg q4h for 21 days - oral
Drug: Nimodipine
Based upon Investigator Judgement
Other Names:
  • Nimodipine Softgel
  • Nimodipine Tablet

Experimental: Nimodipine Microparticles
Single intraventricular injection
Drug: Nimodipine Microparticles
Based upon Investigator Judgement
Other Name: EG-1962




Primary Outcome Measures :
  1. Dose Escalation Period [ Time Frame: 3 Months ]
    To determine the maximum tolerated dose (MTD) of intraventricular EG 1962.


Secondary Outcome Measures :
  1. PK measurements [ Time Frame: 3 Months ]
    To measure plasma and cerebrospinal fluid (CSF) concentrations of nimodipine



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female between the ages of 18 to 75 years, inclusive;
  • WFNS Grade 2, 3, or 4 assessed after treatment of the aneurysm but prior to administration of EG-1962;
  • Ruptured saccular aneurysm confirmed by angiography (catheter or CTA) and treated by neurosurgical clipping or endovascular coiling;
  • Subarachnoid hemorrhage on baseline CT scan that is diffuse (clot present in both hemispheres) thick (>4 mm) or thin, or local thick;
  • External ventricular drain (EVD) in place;
  • The patient is able to receive EG-1962 within 60 hours of the onset of subarachnoid hemorrhage (SAH). Onset of SAH is defined as the time the patient experiences the first symptom of SAH (e.g., severe headache or loss of consciousness reported either by patient or by a witness). If found unconscious, the onset of SAH is defined as the last time the patient was seen at baseline neurological state;
  • Weight >45 kg;
  • Hemodynamically stable after resuscitation with systolic blood pressure (SBP) ≥90 mm Hg without the use of inotropic agents;
  • Signed informed consent from the patient or the patient's legal representative after the completion of aneurysm repair and after all study criteria are confirmed; and
  • Female patients of child bearing potential must have negative pregnancy test . Male patients must agree to use adequate birth control during the study and up to 1 month after the discontinuation of the study drug treatment.

Exclusion Criteria:

  • Subarachnoid hemorrhage due to causes other than a saccular aneurysm (e.g., trauma or rupture of fusiform or infective aneurysm);
  • WFNS Grade 1 or 5 assessed after completion of the aneurysm repair but prior to administration of EG-1962;
  • Increased intracranial pressure >30 mm Hg in sedated patients lasting >4 hours anytime since admission;
  • Intraventricular or intracerebral hemorrhage in absence of SAH or with only local, thin SAH;
  • Angiographic vasospasm prior to aneurysm repair procedure, as documented by catheter angiogram or CT angiogram;
  • Major complication during aneurysm repair such as, but not limited to, massive intraoperative hemorrhage, brain swelling, arterial occlusion, or inability to secure the ruptured aneurysm;
  • Aneurysm repair requiring flow diverting stent or stent-assisted coiling and dual antiplatelet therapy;
  • Hemodynamically unstable prior to administration of study drug (i.e., SBP <90 mm Hg, requiring >6 L colloid, or crystalloid fluid resuscitation;
  • Cardiopulmonary resuscitation was required following SAH;
  • Female patients with positive pregnancy test (blood or urine) at screening;
  • History within the past 6 months and/or physical finding on admission of decompensated heart failure (New York Heart Association Class III and IV or heart failure requiring hospitalization);
  • Acute myocardial infarction within 3 months prior to the administration of the study drug;
  • Symptoms or electrocardiogram (ECG)-based signs of acute myocardial infarction or unstable angina pectoris on admission;
  • Electrocardiogram evidence and/or physical findings compatible with second or third degree heart block or of cardiac arrhythmia associated with hemodynamic instability;
  • Echocardiogram, if performed as part of standard-of-care before treatment, revealing a left ventricular ejection fraction <40%;
  • Severe or unstable concomitant condition or disease (e.g., known significant neurologic deficit, cancer, hematologic, or coronary disease), or chronic condition (e.g., psychiatric disorder), that, in the opinion of the Investigator, may increase the risk associated with study participation or study drug administration, or may interfere with the interpretation of study results;
  • Patients who have received an investigational product or participated in another interventional clinical study within 30 days prior to randomization. Patients participating in a non-interventional study that has no bearing on assessment of EG-1962 or enteral nimodipine can be enrolled per guidelines of the local Institutional Review Board (IRB) / independent Ethics Committee (IEC).
  • Kidney disease as defined by plasma creatinine ≥2.5 mg/dl (221 μmol/l); liver disease as defined by total bilirubin >3 mg/dl (51.3 μmol/l); and/or known diagnosis or clinical suspicion of liver cirrhosis; or Known hypersensitivity to nimodipine or other dihydropyridine calcium channel antagonists, poly-D, L-lactide-co-glycolide (PLGA), or hyaluronic acid.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01893190


  Hide Study Locations
Locations
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United States, Arizona
Barrow Neurological Institute
Phoenix, Arizona, United States, 85013
United States, California
Ronald Reagan UCLA Medical Center
Los Angeles, California, United States, 90095-7436
United States, Illinois
Rush University Medical Center
Chicago, Illinois, United States, 60612
United States, Maryland
University of Maryland Medical Cnter
Baltimore, Maryland, United States, 21201
United States, New Jersey
Hackensack University Medical Center
Hackensack, New Jersey, United States, 07601
Overlook Medical Center
Summit, New Jersey, United States, 07901
United States, New Mexico
University of New Mexico
Albuquerque, New Mexico, United States, 87131
United States, New York
Mount Sinai Medical Center
New York, New York, United States, 10029
Columbia University
New York, New York, United States, 10032
Lenox Hill Hospital
New York, New York, United States, 10065
United States, North Carolina
Duke University Medical Center
Durham, North Carolina, United States, 27705
United States, Ohio
Mayfield Clinic Inc
Cincinnati, Ohio, United States, 45219
The Cleveland Clinic Foundation
Cleveland, Ohio, United States, 44195
United States, Oregon
Oregon Health and Science University
Portland, Oregon, United States, 97239
United States, South Carolina
Medical University of South Carolina (MUSC)
Charleston, South Carolina, United States, 29425
United States, Tennessee
Vanderbilt University
Nashville, Tennessee, United States, 37232
Canada, Alberta
University of Calgary, Foothills Medical Centre
Calgary, Alberta, Canada, T2N 1N4
University of Alberta Hospital
Edmonton, Alberta, Canada, T6G 2B7
Canada, Ontario
St. Michael's Hospital
Toronto, Ontario, Canada, M5B 1W8
University Health Network - Toronto General Division, Toronto Western Hospital
Toronto, Ontario, Canada, M5T 2S8
Canada, Saskatchewan
University of Saskatchewan, Royal University Hospital
Saskatoon, Saskatchewan, Canada, S7N 0W8
Czechia
Charles University, Department of Neurosurgery
Prague, Czechia, 16902
Finland
Helsinki University Central Hospital
Helsinki, Finland, 00260
Sponsors and Collaborators
Edge Therapeutics Inc
Investigators
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Principal Investigator: Daniel Hanggi HHU

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Edge Therapeutics Inc
ClinicalTrials.gov Identifier: NCT01893190     History of Changes
Other Study ID Numbers: EG-01-1962-02
2013-000954-23 ( EudraCT Number )
First Posted: July 8, 2013    Key Record Dates
Last Update Posted: February 5, 2018
Last Verified: January 2018
Keywords provided by Edge Therapeutics Inc:
Ruptured saccular aneurysm
nimodipine
safety
tolerability
Subarachnoid hemorrhage
Additional relevant MeSH terms:
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Subarachnoid Hemorrhage
Intracranial Aneurysm
Aneurysm
Hemorrhage
Rupture
Pathologic Processes
Vascular Diseases
Cardiovascular Diseases
Intracranial Hemorrhages
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Wounds and Injuries
Intracranial Arterial Diseases
Nimodipine
Antihypertensive Agents
Calcium Channel Blockers
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Calcium-Regulating Hormones and Agents
Physiological Effects of Drugs
Vasodilator Agents