A Study of Tenecteplase for Restoration of Function in Dysfunctional Hemodialysis (HD) Catheters

• Status: Completed
• Trial end date: 2008-10-01
• Target enrollment: 0
• Participant gender: All

Summary

This was a Phase III, open-label study conducted at 44 centers in the United States, Canada, and Puerto Rico. 223 subjects who required hemodialysis (HD) and had a dysfunctional HD catheter were enrolled in the study.

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Genentech, Inc.
• Treatments: Tenecteplase; Tissue Plasminogen Activator

Criteria

Inclusion Criteria: for the Study

• Clinically stable, in the opinion of the investigator

• Use of a cuffed, tunneled HD catheter

• HD prescribed at a blood flow rate (BFR) of ≥300 mL/min

• Baseline BFR (at any time during the first 60 minutes of HD) of <300 mL/min at an associated pre-pump negative arterial pressure in the range between and including -240 mmHg and -280 mmHg

• Baseline BFR (at any time during the first 60 minutes of HD) at least 25 mL/min below the prescribed BFR

• Demonstrated BFR of ≥300 mL/min (using catheter lines in the customary direction) at an arterial pressure in the range of 0 to -280 mmHg in at least one HD session in the 14 days prior to Visit 1

• Anticipated use of the same catheter for at least four consecutive HD sessions, on the same type and model of HD apparatus

• Able to have fluids infused at the volume necessary to instill study drug into the HD catheter

Exclusion Criteria: for the Study

• HD catheter with sustainable BFR of ≥300 mL/min following subject repositioning

• HD catheter inserted <2 days prior to screening

• Evidence of a mechanical, non-thrombotic cause of HD catheter dysfunction (e.g., kink in the catheter or suture constricting the catheter) or dysfunction caused by known fibrin sheath

• Use of an implantable port

• HD catheter that is internally coated with any therapeutic agent (e.g., the Decathlon™ Gold catheter)

• Anticipated use of catheter for any other type of diagnostic or therapeutic procedure (i.e., other than HD) during study drug treatment

• Previously treated in this study or any tenecteplase catheter clearance trial

• Use of any investigational drug or therapy (defined as any drug or therapy that is not FDA approved) within 28 days prior to screening

• Use of a fibrinolytic agent (e.g. alteplase, tenecteplase, reteplase, or urokinase) within 7 days prior to Visit 1

• Known to be pregnant or breastfeeding at screening or at Visit 1

• Known bacteremia or known or suspected infection in the HD catheter

• Known history of any of the following: intracranial hemorrhage (within the previous 3 years), intracranial aneurysm, or arteriovenous malformation

• Use of heparin (unfractionated or low molecular weight) or other anticoagulants (e.g., for the treatment of heparin-induced thrombocytopenia) within 24 hours prior to Visit 1, except for heparin used only during HD or for prophylaxis (e.g., heparin lock or deep vein thrombosis prophylaxis)

• Subjects treated with warfarin only: international normalized ratio (INR) >3.0 within 7 days prior to Visit 1, or a target INR range that allows for an INR >3.0

• Initiation of or increase in dose of Plavix® (clopidogrel bisulfate) within 7 days prior to Visit 1

• Hemoglobin ≥12.0 g/dL if on an erythropoiesis-stimulating agent (e.g., darbepoetin or erythropoietin) and the dose of the erythropoiesis-stimulating agent has not been held or reduced per institutional policy

• At high risk for bleeding events or embolic complications (i.e., recent pulmonary embolus, deep vein thrombosis, endarterectomy, or clinically significant right-to-left shunt) in the opinion of the investigator, or with known condition for which bleeding constitutes a significant hazard

• BFR of <300 mL/min because of symptomatic hypotension

• Uncontrolled hypertension in the opinion of the investigator

• Known hypersensitivity to tenecteplase or any component of the formulation