A Phase 4 interventional study of Defibrotide and Placebo (0.9% sodium chloride) in Healthy Volunteers and Endotoxemia, sponsored by Bernd Jilma. Completed at 1 site in Austria. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2019-12-19.
Sponsored by Bernd Jilma · Phase 4, Interventional, and Basic science
Defibrotide is an anti-inflammatory and anti-coagulatory agent approved for treatment of veno-occlusive disease. Although it has been in clinical use for almost 30 years, the exact mechanism of action has never been fully elucidated. Thus, the effects of defibrotide will be investigated in the human endotoxemia model in order to gather further information on its actions.
Defibrotide (DF) is a highly complex polydisperse mixture of single-stranded phosphodiester oligodeoxyribonucleotides derived from the controlled depolymerization of porcine intestinal mucosal DNA. The entire mode of action remains unknown. Its actions may be summarized to pro-fibrinolytic, anti-inflammatory and anti-coagulatory actions. To better define the mechanisms of Defibrotide the effects of the substance will be investigated in the well-established endotoxemia model. Sixteen healthy volunteers will be randomized to receive LPS±defibrotide/placebo and four subjects will be randomized to receive Placebo± defibrotide/placebo in a single center, randomized, double blind, placebo controlled, two-way crossover trial. Immediately after a 2h infusion of 6,25mg/kg bodyweight defibrotide or placebo a LPS bolus of 2ng/kg bodyweight will be infused. Analyses will be performed by blood sampling at pre-defined time-points.
81 studies on the registry are indexed under Endotoxemia; 7 are open to participants now.
This study's enrollment of 20 is below the median of 31 across 70 interventional studies indexed under Endotoxemia.
Browse Endotoxemia studies →This is the only study on the registry with Bernd Jilma as lead sponsor.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
The human immunodeficiency virus, which weakens the immune system.
Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.
An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.
Platelets
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
HIV
The human immunodeficiency virus, which weakens the immune system.
Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Hypersensitivity
An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
2ng/kg lipopolysaccharide period I: 6.25mg/kg bodyweight defibrotide or placebo (0.9% sodium chloride) period II: vice versa 16 healthy volunteers will receive 2ng/kg bodyweight LPS plus Defibrotide or Placebo 4 healthy volunteers will receive 0.9% saline (NO LPS) plus Defibrotide or Placebo
Drug: Defibrotide · Drug: Lipopolysaccharide
2ng/kg lipopolysaccharide period I: 6.25mg/kg bodyweight defibrotide or placebo (0.9% sodium chloride) period II: vice versa 16 healthy volunteers will receive 2ng/kg bodyweight LPS plus Defibrotide or Placebo 4 healthy volunteers will receive 0.9% saline (NO LPS) plus Defibrotide or Placebo
Drug: Placebo (0.9% sodium chloride) · Drug: Lipopolysaccharide
Placebo (0.9% sodium chloride) period I: 6.25mg/kg bodyweight defibrotide or placebo (0.9% sodium chloride) period II: vice versa 16 healthy volunteers will receive 2ng/kg bodyweight LPS plus Defibrotide or Placebo 4 healthy volunteers will receive 0.9% saline (NO LPS) plus Defibrotide or Placebo
Drug: Defibrotide · Drug: Placebo (0.9% sodium chloride bolus)
Placebo (0.9% sodium chloride) period I: 6.25mg/kg bodyweight defibrotide or placebo (0.9% sodium chloride) period II: vice versa 16 healthy volunteers will receive 2ng/kg bodyweight LPS plus Defibrotide or Placebo 4 healthy volunteers will receive 0.9% saline (NO LPS) plus Defibrotide or Placebo
Drug: Placebo (0.9% sodium chloride) · Drug: Placebo (0.9% sodium chloride bolus)
6.25mg/kg bodyweight over 2h infusion
(0.9% sodium chloride) infusion over 2h infusion
bolus infusion of 2ng/kg bodyweight lps
(0.9% sodium chloride) bolus infusion
Prothrombin Fragments f1+2
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h. The "placebo period" (4 subjects who did not receive lipopolysaccharide) was only included for a descriptive comparison, but not for statistical comparison
Time frame: The parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h.
Thrombin-Antithrombin Complexes
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h. The "placebo period" (4 subjects who did not receive lipopolysaccharide) was only included for a descriptive comparison, but not for statistical comparison
Time frame: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.
Plasmin-Antiplasmin Complexes
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h. The "placebo period" (4 subjects who did not receive lipopolysaccharide) was only included for a descriptive comparison, but not for statistical comparison
Time frame: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, and 6h and AUC was calculated based on these measurements.
Tumor Necrosis Factor (TNF)-Alpha
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h.
Time frame: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.
Tissue-type Plasminogen Activator
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h.
Time frame: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.
Interleukin-6
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h.
Time frame: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.
E-Selectin
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h.
Time frame: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.
Plasminogen Activator Inhibitor 1
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h.
Time frame: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.
Von Willebrand Factor Antigen
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The quantification of von Willebrand Factor is based on reference values and results are in % of "normal". The respective arbitrary unit therefore is %\*h.
Time frame: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.
Clotting Time in Thromboelastometry
In this analysis, first of all a ratio of the measurement time point to the baseline was calculated. Thereafter deltas (baeline-ratio) were calculated. With the results an AUC was calculated. The respective arbitrary unit therefore is fold\*h.
Time frame: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h, 24h and AUC was calculated based on these measurements.
Maximum Lysis in Thromboelastometry
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h.
Time frame: This parameter was assessed at baseline, at 0h, 1h, 2h, 4h, 6h and AUC was calculated based on these measurements.
This was a crossover study. Of 20 healthy volunteers 16 were randomly assigned to receive LPS, while 4 received Placebo only. All participants underwent two study periods: A defibrotide and a placebo period. The system will not let us enter this study design of a crossover study. Only 20 healthy volunteers participated.
| Milestone | LPS+ First Defibrotide, Then Placebo | LPS+ First Placebo, Then Defibrotide | Placebo+ First Defibrotide, Then Placebo | Placebo+ First Placebo, Then Defibrotide |
|---|---|---|---|---|
| Started | 8 | 8 | 2 | 2 |
| Completed | 8 | 8 | 2 | 2 |
| Not completed | 0 | 0 | 0 | 0 |
| Milestone | LPS+ First Defibrotide, Then Placebo | LPS+ First Placebo, Then Defibrotide | Placebo+ First Defibrotide, Then Placebo | Placebo+ First Placebo, Then Defibrotide |
|---|---|---|---|---|
| Started | 8 | 8 | 2 | 2 |
| Completed | 8 | 8 | 1 | 2 |
| Not completed | 0 | 0 | 1 | 0 |
| Withdrew: Unforeseen unavailability | 0 | 0 | 1 | 0 |
| Milestone | LPS+ First Defibrotide, Then Placebo | LPS+ First Placebo, Then Defibrotide | Placebo+ First Defibrotide, Then Placebo | Placebo+ First Placebo, Then Defibrotide |
|---|---|---|---|---|
| Started | 8 | 8 | 1 | 2 |
| Completed | 8 | 8 | 1 | 2 |
| Not completed | 0 | 0 | 0 | 0 |
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h. The "placebo period" (4 subjects who did not receive lipopolysaccharide) was only included for a descriptive comparison, but not for statistical comparison
| fold-change*h | LPS Plus Defibrotide | LPS Plus Placebo | Placebo Plus Defibrotide | Placebo Plus Placebo |
|---|---|---|---|---|
| Prothrombin Fragments f1+2 | 31.1 (16.96 to 61.6) | 34.08 (20.38 to 60.8) | 27.41 (27.21 to 46.48) | 36.02 (23.64 to 51.95) |
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h. The "placebo period" (4 subjects who did not receive lipopolysaccharide) was only included for a descriptive comparison, but not for statistical comparison
| fold*h | LPS Plus Defibrotide | LPS Plus Placebo | Placebo Plus Defibrotide | Placebo Plus Placebo |
|---|---|---|---|---|
| Thrombin-Antithrombin Complexes | 23.39 (15.19 to 32.52) | 27.4 (21.47 to 41.57) | 17.46 (15.58 to 20.46) | 21.83 (16.09 to 23.26) |
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h. The "placebo period" (4 subjects who did not receive lipopolysaccharide) was only included for a descriptive comparison, but not for statistical comparison
| fold*h | LPS Plus Defibrotide | LPS/Placebo | Placebo Plus Defibrotide | Placebo Plus Placebo |
|---|---|---|---|---|
| Plasmin-Antiplasmin Complexes | 11.8 (9.59 to 15.12) | 9.99 (8.15 to 13.16) | 7 (6.31 to 7.19) | 7.12 (6.34 to 7.79) |
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h.
| fold*h | LPS Plus Defibrotide | LPS Plus Placebo | Placebo Plus Defibrotide | Placebo Plus Placebo |
|---|---|---|---|---|
| Tumor Necrosis Factor (TNF)-Alpha | 286 (162 to 453) | 326 (172 to 366) | 28.08 (22.19 to 28.35) | 21.01 (16.75 to 25.27) |
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h.
| fold*h | LPS Plus Defibrotide | LPS Plus Placebo | Placebo Plus Defibrotide | Placebo Plus Placebo |
|---|---|---|---|---|
| Tissue-type Plasminogen Activator | 21.8 (14.9 to 29.3) | 17 (13.9 to 23.9) | 20.57 (19.75 to 21.45) | 23.54 (21.72 to 24.78) |
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h.
| fold*h | LPS Plus Defibrotide | LPS Plus Placebo | Placebo Plus Defibrotide | Placebo Plus Placebo |
|---|---|---|---|---|
| Interleukin-6 | 1543 (815 to 2919) | 1144 (22 to 1923) | 35 (32 to 113) | 31 (23 to 51) |
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h.
| fold*h | LPS Plus Defibrotide | LPS Plus Placebo | Placebo Plus Defibrotide | Placebo Plus Placebo |
|---|---|---|---|---|
| E-Selectin | 35 (32 to 40) | 33 (24 to 45) | 21 (18 to 36) | 41 (20 to 63) |
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h.
| fold*h | LPS Plus Defibrotide | LPS Plus Placebo | Placebo Plus Defibrotide | Placebo Plus Placebo |
|---|---|---|---|---|
| Plasminogen Activator Inhibitor 1 | 216 (32 to 898) | 477 (49 to 1000) | 25 (25 to 29.5) | 24.86 (22.7 to 25) |
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The quantification of von Willebrand Factor is based on reference values and results are in % of "normal". The respective arbitrary unit therefore is %\*h.
| %*h | LPS Plus Defibrotide | LPS Plus Placebo | Placebo Plus Defibrotie | Placebo Plus Placebo |
|---|---|---|---|---|
| Von Willebrand Factor Antigen | 54 (41 to 70) | 53 (41 to 65) | 27 (27 to 31) | 26 (24 to 29) |
In this analysis, first of all a ratio of the measurement time point to the baseline was calculated. Thereafter deltas (baeline-ratio) were calculated. With the results an AUC was calculated. The respective arbitrary unit therefore is fold\*h.
| fold*h | LPS Plus Defibrotide | LPS Plus Placebo | Placebo Plus Defibrotide | Placebo Plus Placebo |
|---|---|---|---|---|
| Clotting Time in Thromboelastometry | 1.12 (0.8 to 1.43) | 1.12 (1.04 to 1.41) | -0.2 (-6 to 2.17) | 2.14 (0.31 to 4.28) |
Based on the changes from baseline an area-under the concentration-time curve will be calculated and will be compared between the placebo and the verum phase within each subject. The respective arbitrary unit therefore is fold\*h.
| fold*h | LPS Plus Defibrotide | LPS Plus Placebo | Placebo Plus Defibrotide | Placebo Plus Placebo |
|---|---|---|---|---|
| Maximum Lysis in Thromboelastometry | 7.9 (7.1 to 10.1) | 7.7 (6.6 to 9) | 6.84 (6.72 to 7.07) | 6.85 (6.32 to 7.05) |
Collected over For the individual subject, adverse events were assessed during every study visit (screening, study day1, study day 2, follow up) during the whole study. The whole study period lastet for a minimum of 8 weeks, but could be longer for individual subjects (washout period was a minimum of 6 weeks). The respective time frame could therefore differ between the individual subjects but was a minimum of 8 weeks.. Non-serious events are listed at a 1% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Defibrotide Plus LPS | 0/16 (0%) | 0/16 (0%) | 13/16 (81.3%) |
| Placebo Plus LPS | 0/16 (0%) | 0/16 (0%) | 15/16 (93.8%) |
| Defibrotide Plus Placebo | 0/3 (0%) | 0/3 (0%) | 1/3 (33.3%) |
| Placebo/Placebo | 0/4 (0%) | 0/4 (0%) | 1/4 (25%) |
| Event | Defibrotide Plus LPS | Placebo Plus LPS | Defibrotide Plus Placebo | Placebo/Placebo |
|---|---|---|---|---|
| HeadacheNervous system disorders | 13/16 | 11/16 | 0/3 | 1/4 |
| ArthralgiaGeneral disorders | 2/16 | 7/16 | 0/3 | 0/4 |
| Flu-like SymptomsGeneral disorders | 6/16 | 6/16 | 0/3 | 0/4 |
| ChillsGeneral disorders | 3/16 | 6/16 | 0/3 | 0/4 |
| Urticarial rashSkin and subcutaneous tissue disorders | 0/16 | 0/16 | 1/3 | 0/4 |
| NauseaGeneral disorders | 2/16 | 1/16 | 0/3 | 0/4 |
| VertigoNervous system disorders | 1/16 | 0/16 | 0/3 | 0/4 |
| Impaired ConcentrationGeneral disorders | 0/16 | 1/16 | 0/3 | 0/4 |
| FatigueGeneral disorders | 0/16 | 1/16 | 0/3 | 0/4 |
| PrecollapseGeneral disorders | 1/16 | 0/16 | 0/3 | 0/4 |
| Age, Categorical(Participants) | LPS+ First Defibrotide, Then Placebo | LPS+ First Placebo, Then Defibrotide | Placebo+ First Defibrotide, Then Placebo | Placebo+ First Placebo, Then Defibrotide | Total |
|---|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 8 | 8 | 2 | 2 | 20 |
| >=65 years | 0 | 0 | 0 | 0 | 0 |
| Age, Continuous(years) | LPS+ First Defibrotide, Then Placebo | LPS+ First Placebo, Then Defibrotide | Placebo+ First Defibrotide, Then Placebo | Placebo+ First Placebo, Then Defibrotide | Total |
|---|---|---|---|---|---|
| Mean | 32 ± 9 | 29 ± 7 | 41 ± 8 | 21 ± 0 | 31 ± 9 |
| Sex: Female, Male(Participants) | LPS+ First Defibrotide, Then Placebo | LPS+ First Placebo, Then Defibrotide | Placebo+ First Defibrotide, Then Placebo | Placebo+ First Placebo, Then Defibrotide | Total |
|---|---|---|---|---|---|
| Female | 0 | 0 | 0 | 2 | 2 |
| Male | 8 | 8 | 2 | 0 | 18 |
| Race and Ethnicity Not Collected(Participants) | LPS+ First Defibrotide, Then Placebo | LPS+ First Placebo, Then Defibrotide | Placebo+ First Defibrotide, Then Placebo | Placebo+ First Placebo, Then Defibrotide | Total |
|---|---|---|---|---|---|
| Count of participants | — | — | — | — | 0 |
| Region of Enrollment(participants) | LPS+ First Defibrotide, Then Placebo | LPS+ First Placebo, Then Defibrotide | Placebo+ First Defibrotide, Then Placebo | Placebo+ First Placebo, Then Defibrotide | Total |
|---|---|---|---|---|---|
| Austria | 8 | 8 | 2 | 2 | 20 |
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: No — Data will be published in a peer-reviewed medical journal, individual data will not be presented or published, but may be made available by direct request to the PI (data may be made available in an anonymized fashion)
Ran from Apr 2017 to primary completion in Feb 2018, 9 months.
Results were first posted in Dec 2019, 1 year 10 months after primary completion.
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Studies of the drug tested here: Defibrotide