Clinical trial • Phase III • Neurology|Cardiology|Respiratory

PHOSPHOCREATINE SODIUM for Respiratory arrest|Threatened airway|Tachycardia|Bradypnea|Abnormal pulse rate (<40 or >140 bpm)|Acute decrease in level of consciousness|Tachypnea|Hypotension (systolic blood pressure <90 mmHg)|Decrease in Glasgow Coma Scale >2 points

Phase III trial of PHOSPHOCREATINE SODIUM for Respiratory arrest|Threatened airway|Tachycardia|Bradypnea|Abnormal pulse rate (<40 or >140 bpm)|Acute decre…

Overview

Trial Therapeutic Area
Neurology|Cardiology|Respiratory
Trial Disease
Respiratory arrest|Threatened airway|Tachycardia|Bradypnea|Abnormal pulse rate (<40 or >140 bpm)|Acute decrease in level of consciousness|Tachypnea|Hypotension (systolic blood pressure <90 mmHg)|Decrease in Glasgow Coma Scale >2 points
Trial Stage
Phase III
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
15-10-2024
First CTIS Authorization Date
18-11-2024

Trial design

Randomised, placebo comparator: sodium chloride 0.9% solution for infusion (sodio cloruro fresenius kabi italia 0,9%, soluzione per infusione) administered as infusion (product record shows max daily 400.00 ml, max total 1.20 l over treatment period). experimental arm: neoton phlebo (phosphocreatine sodium) powder for infusion (neoton phlebo 1 g prášek pro infuzní roztok); product record indicates max daily dose 8 g and max total 16 g; route infusion. exact dosing schedule and start dose not specified in ctis metadata.-controlled Phase III trial across 10 sites in Italy.

Randomised
Yes
Comparator
Placebo comparator: Sodium chloride 0.9% solution for infusion (Sodio cloruro Fresenius Kabi Italia 0,9%, soluzione per infusione) administered as infusion (product record shows max daily 400.00 ml, max total 1.20 L over treatment period). Experimental arm: Neoton Phlebo (phosphocreatine sodium) powder for infusion (Neoton Phlebo 1 g prášek pro infuzní roztok); product record indicates max daily dose 8 g and max total 16 g; route infusion. Exact dosing schedule and start dose not specified in CTIS metadata.
Target Sample Size
350
Trial Duration For Participant
30

Eligibility

Recruits 350 Vulnerable population flag selected. Written informed consent may be provided by the patient themselves or by the patient's next of kin or legal representative as requested by the ethics committee. Separate subject information and informed consent forms are provided for adults and for legal guardians (documents listed: L1_SIS and ICF adults; L1_SIS and ICF legal guardian), and privacy policy documents for adults and legal guardians are available..

Pregnancy Exclusion
Pregnancy
Vulnerable Population
Vulnerable population flag selected. Written informed consent may be provided by the patient themselves or by the patient's next of kin or legal representative as requested by the ethics committee. Separate subject information and informed consent forms are provided for adults and for legal guardians (documents listed: L1_SIS and ICF adults; L1_SIS and ICF legal guardian), and privacy policy documents for adults and legal guardians are available.

Inclusion criteria

  • {"criterion_text":"- Admitted in hospital (but outside ICU)"}
  • {"criterion_text":"- Age>=18 years"}
  • {"criterion_text":"- Written informed consent from the patient him- /herself or the patient's next of kin or the legal representative as requested by the ethics committee."}
  • {"criterion_text":"- Serum creatinine <=2 mg/dl"}
  • {"criterion_text":"- Patient with impending or underlying cardiac failure or cardiac arrest, irrespectively of the primitive organ failure, and the Medical Emergency Team (MET) is called upon at least one of the following: a. Threatened airways; b. Respiratory arrest; c. Respiratory rate <5 or >36 breaths per min; d. Pulse rate <40 or >140 beats per min; e. Systolic blood pressure < 90 mm Hg; f. Sudden fall in level of consciousness; g. Fall in Glasgow coma scale of > 2 points."}

Exclusion criteria

  • {"criterion_text":"- Age < 18 years"}
  • {"criterion_text":"- Known allergy to PCr"}
  • {"criterion_text":"- Pregnancy"}
  • {"criterion_text":"- Previous enrollment and randomization into this trial"}
  • {"criterion_text":"- Administration of PCr in the previous 30 day"}
  • {"criterion_text":"- Ongoing cardiac massage"}
  • {"criterion_text":"- Current hospital admission from a care nursing facility"}
  • {"criterion_text":"- Planned discharge to a care nursing facility"}
  • {"criterion_text":"- Reasons for withdrawal of life-sustaining therapy"}
  • {"criterion_text":"- History of kidney transplantation"}
  • {"criterion_text":"- Solitary kidney (by any reason)"}
  • {"criterion_text":"- Serum Creatinine > 2 mg/dl"}
  • {"criterion_text":"- Immediate need for ICU admission"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- How to calculate DAH30 (days alive and out-of-hospital at day 30): Has patient died in hospital or after discharge on any day within the first 30-days after randomization? If YES we will give 0 points Is the patient discharged from hospital on Day 5 after randomization but is subsequently readmitted for 5-days before their second hospital discharge? If YES we will give 20 points Is patient in a post- discharge nursing facility? If YES: we won’t consider as days at home.","definition_or_measurement_approach":"DAH30 (days alive and out-of-hospital at day 30) calculated as follows: if the patient dies in hospital or after discharge within the first 30 days after randomization => 0 points; example rule: if discharged on day 5 and then readmitted for 5 days before a subsequent discharge => give 20 points; days spent in a post-discharge nursing facility are not counted as days at home."}

Recruitment

Planned Sample Size
350
Recruitment Window Months
31
Consent Approach
Written informed consent required from the patient themselves or, if not possible, from the patient's next of kin or legal representative as requested by the ethics committee. Separate ICFs are available for adults and for legal guardians (L1_SIS and ICF adults; L1_SIS and ICF legal guardian). Languages of ICFs not specified in the CTIS metadata.

Geography

Total Number Of Sites
10
Total Number Of Participants
350

Italy

Earliest CTIS Part Ii Submission Date
29-10-2024
Latest Decision Or Authorization Date
22-04-2026
Processing Time Days
540
Number Of Sites
10
Number Of Participants
350

Sites

Site Name
Azienda Socio Sanitaria Territoriale Degli Spedali Civili Di Brescia
Department Name
Anesthesia and Intensive Care
Contact Person Name
Matteo Filippini
Contact Person Email
matteo.filippini123@gmail.com
Site Name
Ospedale Cardinal Massaia
Department Name
Anesthesia and Intensive Care
Contact Person Name
Agostino Roasio
Contact Person Email
aroasio@asl.at.it
Site Name
Azienda Ospedaliera Regionale San Carlo
Department Name
Cardiovascular Anaesthesia and ICU
Contact Person Name
Gianluca Paternoster
Site Name
Azienda Unita Sanitaria Locale Della Romagna
Department Name
Anesthesia and Intensive Care
Contact Person Name
Andrea Portoraro
Site Name
Azienda Ospedaliera di Padova
Department Name
Anesthesia and Intensive Care
Contact Person Name
Nicolò Sella
Contact Person Email
n.sella89@gmail.com
Site Name
Azienda Ospedaliera-Universitaria Di Cosenza
Department Name
Anesthesia and Intensive Care
Contact Person Name
Andrea Bruni
Contact Person Email
Andrea.bruni@unical.it
Site Name
Ospedale San Raffaele S.r.l.
Department Name
Anesthesia and Intesive care unit
Contact Person Name
Silvia Ajello
Contact Person Email
ajello.silvia@hsr.it
Site Name
Azienda Ospedaliero Universitaria Pisana
Department Name
Anaesthesia and Critical Care Medicine
Contact Person Name
Fabio Guarracino
Site Name
Azienda Sanitaria Universitaria Friuli Centrale
Department Name
Anesthesia and Intensive Care
Contact Person Name
Francesco Meroi
Site Name
Azienda Unita Sanitaria Locale Della Romagna (Faenza)
Department Name
Emergency Room - Emergency Medicine
Contact Person Name
Francesco Savelli

Sponsor

Primary sponsor

Full Name
Ospedale San Raffaele S.r.l.
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Italy

Third parties

  • {"country":"Czech Republic","full_name":"ALFASIGMA S.P.A.","duties_or_roles":"Marketing authorisation holder / product supplier for Neoton Phlebo (phosphocreatine sodium)","organisation_type":"Pharmaceutical company"}
  • {"country":"Italy","full_name":"FRESENIUS KABI ITALIA S.R.L.","duties_or_roles":"Manufacturer / supplier of sodium chloride 0.9% infusion (used as placebo control)","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
Neoton Phlebo 1 g prášek pro infuzní roztok
Active Substance
PHOSPHOCREATINE SODIUM
Modality
Small molecule
Routes Of Administration
Infusion
Route
Infusion
Authorisation Status
Authorised (marketing authorisation present: 41/153/91-C/C; prodAuthStatus:2)
Maximum Dose
Max daily 8 g; max total 16 g (treatment period up to 3 days)
Investigational Product Name
Sodio cloruro Fresenius Kabi Italia 0,9%, soluzione per infusione
Active Substance
SODIUM CHLORIDE
Modality
Small molecule
Routes Of Administration
Infusion
Route
Infusion
Authorisation Status
Authorised (marketing authorisation present: 031938412; prodAuthStatus:2)
Maximum Dose
Max daily 400 ml; max total 1.20 L (treatment period up to 3 days)

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