Clinical trial • Phase III • Infectious Disease

Ivabradine hydrochloride for Septic shock

Phase III trial of Ivabradine hydrochloride for Septic shock.

Overview

Trial Therapeutic Area
Infectious Disease
Trial Disease
Septic shock
Trial Stage
Phase III
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
27-09-2024
First CTIS Authorization Date
02-12-2024

Trial design

Randomised, placebo of procoralan 5 mg (placebo arm); procoralan 5 mg film-coated tablets (ivabradine hydrochloride) — two ivabradine arms. product information: procoralan 5 mg film-coated tablets (active substance ivabradine hydrochloride), max daily dose 7.5 mg, max treatment period 14 days. trial-specific dosing/schedule not specified in the record.-controlled, adaptive Phase III trial across 28 sites in France.

Randomised
Yes
Comparator
Placebo of Procoralan 5 mg (placebo arm); Procoralan 5 mg film-coated tablets (ivabradine hydrochloride) — two ivabradine arms. Product information: Procoralan 5 mg film-coated tablets (active substance ivabradine hydrochloride), max daily dose 7.5 mg, max treatment period 14 days. Trial-specific dosing/schedule not specified in the record.
Adaptive
Yes
Target Sample Size
429
Trial Duration For Participant
28

Eligibility

Recruits 429 Vulnerable population selected. Informed consent must be obtained in accordance with local regulations. Emergency inclusion/informed consent forms are provided (NIFC-adulte_FormulaireInclusionUrgence) and separate subject information and ICF documents exist for adult patients and for a legal representative/relative ("Proche") and continuation/follow-up forms, indicating procedures for obtaining consent/consent by proxy in this critically ill population..

Pregnancy Exclusion
Known pregnancy, breast feeding, women with childbearing potential will be tested for pregnancy and excluded if pregnant
Vulnerable Population
Vulnerable population selected. Informed consent must be obtained in accordance with local regulations. Emergency inclusion/informed consent forms are provided (NIFC-adulte_FormulaireInclusionUrgence) and separate subject information and ICF documents exist for adult patients and for a legal representative/relative ("Proche") and continuation/follow-up forms, indicating procedures for obtaining consent/consent by proxy in this critically ill population.

Inclusion criteria

  • {"criterion_text":"- 18 years of age or older"}
  • {"criterion_text":"- Proven or suspected site of infection"}
  • {"criterion_text":"- Proven or suspected site of infection, -\tSeptic shock (defined as hypotension unresponsive to fluid resuscitation and requiring vasopressor treatment to maintain adequate blood pressure in the context of proven or suspected site of infection) for at least 2 hours and less than 24 hours (inclusion is possible before 2 hours in case of increasing doses of norepinephrine)"}
  • {"criterion_text":"- In sinus rhythm with heart rate ≥ 95 bpm at time of randomization"}
  • {"criterion_text":"- Informed consent obtained in accordance with local regulations"}
  • {"criterion_text":"- Affiliation to a social security regime"}

Exclusion criteria

  • {"criterion_text":"- Cardiac arythmia, conduction disorder, sinus syndrome (\"sick sinus syndrome\"), sino-atrial block; 3rd degree atrioventricular block"}
  • {"criterion_text":"- Severe chronic renal failure (creatinine clearance <15 ml/min) or hepatic failure (prothrombin time <20%)"}
  • {"criterion_text":"- Enteral feeding impossible, vomiting, congenital galactosemia, lactase deficiency, glucose-galactose malabsorption syndrome"}
  • {"criterion_text":"- Tachycardia due to hyperthyroidism, pheochromocytoma or severe anemia (<7 g/dL)"}
  • {"criterion_text":"- Prior enrolment in the trial, participation in another interventional study on septic shock"}
  • {"criterion_text":"- Known legal incapacity (patients under guardianship or curatorship)"}
  • {"criterion_text":"- Decision to limit full care taken before obtaining informed consent"}
  • {"criterion_text":"- Patient under AME (state emergency medical help)"}
  • {"criterion_text":"- Lack of affiliation to social security"}
  • {"criterion_text":"- Cardiogenic shock or unstable or acute heart failure without proven or suspected infection"}
  • {"criterion_text":"- Acute myocardial infarction with angiographic documentation; CCS class ≥ II angina pectoris;"}
  • {"criterion_text":"- Septic shock requiring vasopressor treatment for more than 24 hours"}
  • {"criterion_text":"- Refractory shock with systolic arterial pressure <90 mm Hg) despite the use of high doses of vasopressors (norepinephrine BASE or epinephrine BASE > 2.4 µg/kg/min; these doses should be multiplied by two for noradrenaline salt (tartrate or bitartrate)"}
  • {"criterion_text":"- Co-treatment with drugs inducing bradycardia, QT lengthening or strong inhibition of CYP4503A4, pacemaker, defibrillator, kalemia <3 mM"}
  • {"criterion_text":"- Co-treatment with verapamil or diltiazem (which are moderate CYP4503A4 inhibitors with heart rate reducing properties)"}
  • {"criterion_text":"- Known allergy to ivabradine or to any of the excipients, retinitis pigmentosa, congenital galactosemia, lactase deficiency, glucose or galactose malabsorption"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- i) for treatment selection at interim analysis: the percentage of patients with heart rate within the predefined threshold (80-94 bpm) at hour-48; in case of similar percentages, the percentage of time elapsed within the threshold between inclusion and hour-48 will be considered","definition_or_measurement_approach":"Percentage of patients with heart rate within 80-94 bpm at hour 48; if percentages are similar between arms the tie-breaker is the percentage of time within the threshold between inclusion and hour-48."}
  • {"endpoint_text":"- ii) for the final analysis: 28-day mortality.","definition_or_measurement_approach":"All-cause mortality assessed at day 28."}

Secondary endpoints

  • {"endpoint_text":"- Determine the tolerance of ivabradine","definition_or_measurement_approach":"Not specified in the provided record."}
  • {"endpoint_text":"- Evaluate the impact of ivabradine-driven heart rate control on systemic hemodynamics, myocardial stress, organ dysfunction, morbidity, and intensive care mortality","definition_or_measurement_approach":"Not specified in the provided record; endpoint describes clinical outcomes and hemodynamic/organ dysfunction measures."}
  • {"endpoint_text":"- Determine the pharmacokinetics of ivabradine","definition_or_measurement_approach":"PK parameters to be determined (details not provided in the record)."}

Recruitment

Planned Sample Size
429
Recruitment Window Months
63
Consent Approach
Informed consent obtained in accordance with local regulations. The submission includes subject information and informed consent forms for adults, emergency inclusion form (NIFC-adulte_FormulaireInclusionUrgence), ICFs for patient and for a legal representative/relative (Proche), and continuation/follow-up ICFs, indicating procedures to obtain consent or consent by proxy in emergency/critically ill settings. Language availability not fully specified in the record (translations available in French).

Geography

Total Number Of Sites
28
Total Number Of Participants
429

France

Earliest CTIS Part Ii Submission Date
04-10-2024
Latest Decision Or Authorization Date
07-01-2026
Processing Time Days
460
Number Of Sites
28
Number Of Participants
429

Sites

Site Name
Assistance Publique Hopitaux De Paris
Department Name
Médecine Intensive Réanimation
Principal Investigator Name
Antoine VIEILLARD-BARON
Principal Investigator Email
antoine.vieillard-baron@aphp.fr
Contact Person Name
Antoine VIEILLARD-BARON
Site Name
Centre Hospitalier Universitaire De Rennes
Department Name
Service des maladies infectieuses et réanimation médicale
Principal Investigator Name
Pauline GUILLOT
Principal Investigator Email
pauline.guillot@chu-rennes.fr
Contact Person Name
Pauline GUILLOT
Contact Person Email
pauline.guillot@chu-rennes.fr
Site Name
Hospital Foch
Department Name
Réanimation polyvalente et ISU neurochirurgicale
Principal Investigator Name
Charles CERF
Principal Investigator Email
c.cerf@hopital-foch.org
Contact Person Name
Charles CERF
Contact Person Email
c.cerf@hopital-foch.org
Site Name
Centre Hospitalier Regional Universitaire De Tours
Department Name
Service de Médecine Intensive Réanimation
Principal Investigator Name
Sophie JACQUIER
Principal Investigator Email
s.jacquier@chu-tours.fr
Contact Person Name
Sophie JACQUIER
Contact Person Email
s.jacquier@chu-tours.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Médecine Intensive Réanimation
Principal Investigator Name
Charles-Edouard LUYT
Principal Investigator Email
charles-edouard.luyt@aphp.fr
Contact Person Name
Charles-Edouard LUYT
Contact Person Email
charles-edouard.luyt@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Réanimation médico-chirurgicale
Principal Investigator Name
Cyrielle DESNOS
Principal Investigator Email
cyrielle.desnos@aphp.fr
Contact Person Name
Cyrielle DESNOS
Contact Person Email
cyrielle.desnos@aphp.fr
Site Name
Centre Hospitalier Universitaire Amiens Picardie
Department Name
Médecine intensive Réanimation
Principal Investigator Name
Michel SLAMA
Principal Investigator Email
s.michel@chu-amiens.fr
Contact Person Name
Michel SLAMA
Contact Person Email
s.michel@chu-amiens.fr
Site Name
Hôpital Saint Camille
Department Name
Service d’Anesthésie-Réanimation
Principal Investigator Name
Serge CARREIRA
Principal Investigator Email
s.carreira@cch-bry.org
Contact Person Name
Serge CARREIRA
Contact Person Email
s.carreira@cch-bry.org
Site Name
Les Hopitaux Universitaires De Strasbourg
Department Name
Service de Médecine Intensive-Réanimation
Principal Investigator Name
Julie HELMS
Principal Investigator Email
julie.helms@chu-strasbourg.fr
Contact Person Name
Julie HELMS
Contact Person Email
julie.helms@chu-strasbourg.fr
Site Name
Les Hopitaux Universitaires De Strasbourg
Department Name
Service de Médecine Intensive Réanimation
Principal Investigator Name
Vincent CASTELAIN
Principal Investigator Email
vincent.castelain@chru-strasbourg.fr
Contact Person Name
Vincent CASTELAIN
Site Name
Centre Hospitalier Universitaire De Poitiers
Department Name
Service de Médecine Intensive et Réanimation
Principal Investigator Name
Florence BOISSIER
Principal Investigator Email
florence.boissier@chu-poitiers.fr
Contact Person Name
Florence BOISSIER
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Réanimation médicale
Principal Investigator Name
Xavier MONNET
Principal Investigator Email
xavier.monnet@aphp.fr
Contact Person Name
Xavier MONNET
Contact Person Email
xavier.monnet@aphp.fr
Site Name
Centre Hospitalier Saint Joseph Saint Luc
Department Name
Réanimation Polyvalente
Principal Investigator Name
Emmanuel VIVIER
Principal Investigator Email
evivier@ch-stjoseph-stluc-lyon.fr
Contact Person Name
Emmanuel VIVIER
Site Name
Centre Hospitalier Regional Et Universitaire De Brest
Department Name
Réanimation médicale
Principal Investigator Name
Gwenael PRAT
Principal Investigator Email
gwenael.prat@chu-brest.fr
Contact Person Name
Gwenael PRAT
Contact Person Email
gwenael.prat@chu-brest.fr
Site Name
Hopitaux Prives De Metz
Department Name
Service de Réanimation Polyvalente
Principal Investigator Name
Peter ESZTO
Principal Investigator Email
peter.eszto@uneos.fr
Contact Person Name
Peter ESZTO
Contact Person Email
peter.eszto@uneos.fr
Site Name
Grand Hopital De L Est Francilien
Department Name
Médecine intensive et réanimation
Principal Investigator Name
Frank CHEMOUNI
Principal Investigator Email
frank.chemouni@gmail.com
Contact Person Name
Frank CHEMOUNI
Contact Person Email
frank.chemouni@gmail.com
Site Name
Groupe Hospitalier Du Sud Ile De France
Department Name
Service de Réanimation
Principal Investigator Name
Oumar SY
Principal Investigator Email
oumar.sy@ghsif.fr
Contact Person Name
Oumar SY
Contact Person Email
oumar.sy@ghsif.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Réanimation médicale et infectieuse
Principal Investigator Name
Romain SONNEVILLE
Principal Investigator Email
romain.sonneville@aphp.fr
Contact Person Name
Romain SONNEVILLE
Contact Person Email
romain.sonneville@aphp.fr
Site Name
Hospices Civils De Lyon
Department Name
Service de Médecine Intensive-Réanimation
Principal Investigator Name
Laurent ARGAUD
Principal Investigator Email
laurent.argaud@chu-lyon.fr
Contact Person Name
Laurent ARGAUD
Contact Person Email
laurent.argaud@chu-lyon.fr
Site Name
Centre Hospitalier Sud Francilien
Department Name
Réanimation Polyvalente
Principal Investigator Name
Cécilia BILLIOU
Principal Investigator Email
unite.rechercheclinique@chsf.fr
Contact Person Name
Cécilia BILLIOU
Site Name
Centre Hospitalier Intercommunal De Poissy Saint Germain
Department Name
Service de Médecine intensive- réanimation
Principal Investigator Name
Nesrine FRAJ
Principal Investigator Email
Nesrine.fraj@ght-yvelinesnord.fr
Contact Person Name
Nesrine FRAJ
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Service d’Anesthésie-Réanimation
Principal Investigator Name
Bernard CHOLLEY
Principal Investigator Email
bernard.cholley@aphp.fr
Contact Person Name
Bernard CHOLLEY
Contact Person Email
bernard.cholley@aphp.fr
Site Name
Centre Hospitalier Universitaire De Nice
Department Name
Service de Médecine Intensive Réanimation
Principal Investigator Name
Denis DOYEN
Principal Investigator Email
doyen.d@chu-nice.fr
Contact Person Name
Denis DOYEN
Contact Person Email
doyen.d@chu-nice.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Réanimation Médicale et toxicologique
Principal Investigator Name
Nicolas DEYE
Principal Investigator Email
nicolas.deye@aphp.fr
Contact Person Name
Nicolas DEYE
Contact Person Email
nicolas.deye@aphp.fr
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Réanimation Médicale
Principal Investigator Name
Armand MEKONTSO-DESSAP
Principal Investigator Email
armand.dessap@aphp
Contact Person Name
Armand MEKONTSO-DESSAP
Contact Person Email
armand.dessap@aphp
Site Name
Assistance Publique Hopitaux De Paris
Department Name
Service de Réanimation Médico-chirurgicale
Principal Investigator Name
Djillali ANNANE
Principal Investigator Email
djillali.annane@aphp.fr
Contact Person Name
Djillali ANNANE
Contact Person Email
djillali.annane@aphp.fr
Site Name
Centre Hospitalier Victor Dupouy
Department Name
Service de Réanimation Polyvalente
Principal Investigator Name
Damien CONTOU
Principal Investigator Email
damien.contou@ch-argenteuil.fr
Contact Person Name
Damien CONTOU
Contact Person Email
damien.contou@ch-argenteuil.fr
Site Name
University Hospital Of Clermont-Ferrand
Department Name
Service de Médecine Intensive et Réanimation
Principal Investigator Name
Claire DUPUIS
Principal Investigator Email
cdupuis1@chu-clermondferrand.fr
Contact Person Name
Claire DUPUIS

Sponsor

Primary sponsor

Full Name
Assistance Publique Hopitaux De Paris
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
France

Investigational products

Investigational Product Name
Procoralan 5 mg film-coated tablets
Active Substance
Ivabradine hydrochloride
Modality
Small molecule
Routes Of Administration
ENTERAL FEEDING TUBE (film-coated tablet/oral formulation)
Route
Enteral (tablet) / Enteral feeding tube
Authorisation Status
Authorised (marketing authorisation EU/1/05/316/007)
Maximum Dose
7.5 mg per day
Investigational Product Name
Placebo of Procoralan 5 mg
Modality
Other

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