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Trial · Interventional

CompletedPhase 2Results postedRegistry data

Evaluation of Myocardial Effects of MTP-131 for Reducing Reperfusion Injury in Patients With Acute Coronary Events

Short name EMBRACE

Overview

Status
Completed
Phase
Phase 2
Enrollment
300 participants (actual)
Sponsor
Stealth BioTherapeutics Inc. · Industry
Design
Randomized · Triple masking
Countries
4 countries

United States, Germany, Hungary, Poland

Start
Apr 2012
Primary completion
Nov 2014
Completion
Feb 2015
First posted
6 Apr 2012 (estimated)
Last update posted
11 Jun 2020
Conditions
Reperfusion Injury · STEMI

Timeline

1 trial · 1 completed · 1 with posted results

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
20122013201420152016
  1. Ph 2

    EMBRACE

    NCT01572909

    Apr 2012 to Feb 2015

Registry summary

Text and fields below are the sponsor's entries at ClinicalTrials.gov, shown as posted.

The EMBRACE-STEMI trial was a Phase 2a prospective, multicenter, multinational randomized, double-blind, placebo-controlled study designed to assess the safety, tolerability, and efficacy of IV administered elamipretide (also known as MTP-131, or Bendavia) on a background of standard-of-care therapy for reduction of reperfusion injury in patients with first time acute, anterior wall ST-segment elevation myocardial infarction (STEMI).

Interventions

  • Bendavia (MTP-131)Drug
  • PlaceboDrug

Arms2

  • Active comparator

    Bendavia™

    Bendavia™ administered intravenously at 0.05 mg/kg/hr at least 15, but no more than 60 minutes, prior to the anticipated time of the PCI, and continued for 1 hour after re-establishment of blood flow through the culprit vessel.

  • Placebo comparator

    Placebo

    Placebo administered intravenously at 60 mL/hr at least 15, but no more than 60 minutes, prior to the anticipated time of the PCI, and continued for 1 hour after re-establishment of blood flow through the culprit vessel.

Primary outcomes1

Outcomes the sponsor listed as primary.

  1. Area Under the Curve (AUC) of Serum Creatine Kinase Isoenzyme Type Muscle-brain (CK-MB)

    Time frame · The initial 24 and 72 hours post-percutaneous coronary intervention (PCI)

    Registry description

    Infarct size as measured by the AUC of serum CK-MB at 24 and 72 hours post-PCI

Secondary outcomes(19)
  1. AUC of Troponin 1 Enzyme

    Time frame · Initial 24 and 72 hours post-PCI

    Registry description

    Infarct size as calculated by the AUC of Troponin I Enzyme over the initial 24 and 72 hours post-PCI

  2. Ratio of Volume of Infarcted Myocardium to Left Ventricular Mass

    Time frame · Day 30 + 7

    Registry description

    Cardiac infarct size calculated as the ratio of volume of infarcted myocardium to left ventricular mass at Day 30 as measured by MRI.

  3. Thrombosis in Myocardial Infarction (TIMI) Perfusion Grade Flow at Completion of PCI

    Time frame · Initiation to Completion of PCI, no longer than 4 hours

    Registry description

    TIMI perfusion grade flow at completion of PCI will be categorized as 0,1, or 1.5, 2 or 2.5, 3, and treated as ordinal data, where higher score means better perfusion and lower score means worse perfusion and worse outcome.

  4. Corrected TIMI Frame Count

    Time frame · Completion of PCI, no longer than 4 hours

    Registry description

    Corrected TIMI Frame Count at Completion of PCI as captured by angiogram and analyzed as a continuous variable.

  5. ST-Segmented Elevation From Pre-PCI to 24 Hours Post-PCI and Presence of ST-Segmented Resolution

    Time frame · pre-PCI to 24 hours post-PCI

    Registry description

    ST-Segmented Elevation from pre-PCI to 24 hours post-PCI and Presence of ST-Segmented Resolution by ECG

  6. Change in Serum Creatinine From Baseline

    Time frame · Day 30 +7

    Registry description

    Change in serum creatinine, from baseline (prior to study drug administration) to Day 30 +7 post-PCI

  7. Change in Estimated Glomerular Filtration Rate (eGFR) From Baseline

    Time frame · Day 30 +/- 7

    Registry description

    Change in eGFR from baseline (prior to study drug administration) to Day 30 +7 post-PCI

  8. Cystatin C Change From Baseline

    Time frame · Day 30 + 7

    Registry description

    Change in Cystatin C from baseline (prior to study drug administration) to Day 30 +7 post-PCI

  9. Blood Urea Nitrogen (BUN) Change From Baseline

    Time frame · Baseline to Day 30

    Registry description

    Blood Urea Nitrogen (BUN) Change from baseline (prior to study drug administration) to Day 30 + 7 post-PCI

  10. Number and Percent of Grade 1 Episode of Contrast-Induced Nephropathy Post-PCI

    Time frame · Baseline to 48 hours post PCI or MRI

    Registry description

    Number of Participants with Grade 1 Episode of Contrast-Induced Nephropathy within 48 hours of initial PCI or MRI, based on lab data.

  11. Immediate Myocardial Complications: Ventricular Tachycardia or Fibrillation

    Time frame · Baseline up to 1 hour post-PCI

    Registry description

    Number and percent of participants with Immediate Myocardial Complications: Ventricular Tachycardia or Fibrillation Requiring Medical Intervention

  12. Immediate Myocardial Complications: Mechanical Complications

    Time frame · Baseline up to 1 hour post-PCI

    Registry description

    Number and Percent of Participants with Immediate Myocardial Complications: Mechanical Complications: (Free wall Rupture, Ventricular Septal Defect, Ischemic Mitral Regurgitation)

  13. Emergency Use of Medications During PCI Procedure

    Time frame · Initiation to Completion of PCI, no longer than 4 hours

    Registry description

    Emergency Use of Nitroprusside, Calcium Channel Blocker, Adenosine Administration During the PCI Procedure

  14. ProB-type Natriuretic Peptide (NT-proBNP) Change From Baseline to Day 30

    Time frame · Baseline to Day 30

    Registry description

    NT-proBNP: Change from baseline to Day 30 +7 (Laboratory marker for chronic heart failure (CHF) and systemic inflammation.)

  15. High Sensitivity C-Reactive Protein (hsCRP): Change From Baseline to Day 30

    Time frame · Baseline to Day 30

    Registry description

    High Sensitivity C-Reactive Protein (hsCRP): Change from baseline to Day 30 +7 (Laboratory Marker for CHF and Systemic Inflammation)

  16. Left Ventricular (LV) Ejection Fraction (%)

    Time frame · Day 4 to Day 30

    Registry description

    Difference in Left Ventricular (LV) Ejection Fraction (%) from Day 4 To Day 30

  17. Difference Between Left Ventricular End Diastolic Volume, Corrected

    Time frame · Day 4 and Day 30

    Registry description

    Difference between Left Ventricular End Diastolic Volume Corrected for Body Surface Area between Day 4 and Day 30

  18. Difference Between Left Ventricular End Systolic Volume, Corrected

    Time frame · Day 4 and Day 30

    Registry description

    Difference between Left Ventricular End Systolic Volume Corrected for Body Surface Area from Day 4 and Day 30

  19. Chronic Heart Failure

    Time frame · Within 24 hours after PCI

    Registry description

    Number and Percentage of Patients with Clinical Events: Chronic Heart Failure beginning within 24 hours after PCI but within the duration of the index hospitalization (Subjects with CHF started within 24 hours after the last balloon deflation while the patient was still in the hospital {including patients who had missing discharge date}).

Posted results

Values are shown as posted at ClinicalTrials.gov, with their units. PepBank has not converted, pooled or compared them.

Primary outcome results

Primary outcomeMean· The initial 24 and 72 hours post-percutaneous coronary intervention (PCI)

Area Under the Curve (AUC) of Serum Creatine Kinase Isoenzyme Type Muscle-brain (CK-MB)

GroupValue (ng*hr/mL)Spread
Bendavia™6582.03270.6
Placebo6738.33775.4
Secondary and other outcome results(7)
Secondary outcomeMean· Initial 24 and 72 hours post-PCI

AUC of Troponin 1 Enzyme

GroupValue (ng*hr/mL)Spread
Bendavia™5422.93430.9
Placebo4647.22834.7
Secondary outcomeMean· Day 30 + 7

Ratio of Volume of Infarcted Myocardium to Left Ventricular Mass

GroupValue (ratio)Spread
Bendavia™242.387.3
Placebo225.290.70
Secondary outcomeCount of participants· Initiation to Completion of PCI, no longer than 4 hours

Thrombosis in Myocardial Infarction (TIMI) Perfusion Grade Flow at Completion of PCI

GroupValue (Participants)
Bendavia™0
Placebo0
Secondary outcomeMean· Completion of PCI, no longer than 4 hours

Corrected TIMI Frame Count

GroupValue (corrected frame count)Spread
Bendavia™79.7122.8
Placebo166.0286.8
Secondary outcomeCount of participants· pre-PCI to 24 hours post-PCI

ST-Segmented Elevation From Pre-PCI to 24 Hours Post-PCI and Presence of ST-Segmented Resolution

GroupValue (Participants)
Bendavia™30
Placebo29
Secondary outcomeMean· Day 30 +7

Change in Serum Creatinine From Baseline

GroupValue (umol/L)Spread
Bendavia™10.5517.642
Placebo88.0422.462
Secondary outcomeMean· Day 30 +/- 7

Change in Estimated Glomerular Filtration Rate (eGFR) From Baseline

GroupValue (mL/min/SSA)Spread
Bendavia™-12.3318.873
Placebo-8.9414.242

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
Bendavia™Participants received Bendavia (MTP-131) as an IV infusion at 0.05 mg/kg/hr at least 15 minutes but no more than 1 hour prior to the anticipated reperfusion event and continued through approximately 1 hour following re-establishment of blood flow through the culprit vessel via primary percutaneous coronary intervention and stenting.10 / 15020 / 150112 / 150
PlaceboParticipants received placebo as an IV infusion at 60 mL/hr at least 15 minutes but no more than 1 hour prior to the anticipated reperfusion event and continued through approximately 1 hour following re-establishment of blood flow through the culprit vessel via primary percutaneous coronary intervention and stenting.3 / 14714 / 147106 / 147

Each cell reads participants affected / participants at risk, as the registry posted them.

Registry data comes from ClinicalTrials.gov. Study results come from studies, not from the registry. How PepBank works

Studies2

Studies that cite this trial.

Studies with results

0 studies on this page

Indexing hint: Randomized controlled trial · 2016

Relation of Left Ventricular Mass and Infarct Size in Anterior Wall ST-Segment Elevation Acute Myocardial Infarction (from the EMBRACE STEMI Clinical Trial).

Daaboul et al. 2016The American journal of cardiologycited by 9

PMID 27392509DOI 10.1016/j.amjcard.2016.06.025PUB-27392509

Full text at the publisher
Publisher page

PubMed tag: none · 2013

Rationale and design of the EMBRACE STEMI study: a phase 2a, randomized, double-blind, placebo-controlled trial to evaluate the safety, tolerability and efficacy of intravenous Bendavia on reperfusion injury in patients treated with standard therapy including primary percutaneous coronary intervention and stenting for ST-segment elevation myocardial infarction.

Chakrabarti et al. 2013American heart journalcited by 59

PMID 23537966DOI 10.1016/j.ahj.2012.12.008PUB-23537966

Full text at the publisher
Publisher page

Eligibility

Who could join, as posted.

Sex
All
Age
from 18 Years up to 85 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
Inclusion Criteria: * Age ≥18 and \<85 years * The patient presents with first-time acute, anterior wall STEMI scheduled to undergo primary PCI and stenting. * The patient has symptoms of cardiac ischemia of ≥10 minutes. * The patient must demonstrate an anterior wall STEMI with \>0.1 millivolt (mV) ST-segment elevation in at least two contiguous precordial leads (i.e., V1-V4) or presumed new left bundle branch block. * The time from onset of symptoms of cardiac ischemia to the anticipated time of initial PCI balloon inflation does not exceed four (4) hours and it is anticipated that the door-to-balloon time will be \<2 hours. * For female patients of child-bearing potential, an adequate form of contraception must be adhered to prior to entry into the study and for a further 3 months after the follow-up visit. Female patients of childbearing potential must have a negative serum pregnancy test prior to entry into the study. * Female patients not of childbearing potential (i.e. female patients who are postmenopausal since last regular menses, or have been surgically sterilized at least 1 year prior to screening visit) are eligible to enter the study. * For male patients with female partners of child-bearing potential, an adequate form of contraception must be adhered to prior to entry into the study and for a further 3 months after the post-study medical. * Written informed consent obtained that strictly adheres to the written guidelines from the local Institutional Review Board (IRB)/ Ethical Committee (EC). Exclusion Criteria * Cardiogenic shock or maximal systolic blood pressure (BP) \<80 mm Hg after fluid and/or vasopressor resuscitation on at least two consecutive readings. * Ongoing vasopressor support. * Uncontrolled hypertension defined as a systolic BP \>180 mm Hg or a diastolic BP \>110 mm Hg on at least two consecutive readings. * Cardiac arrest or arrhythmia requiring prolonged (\>5 minutes) chest compressions/ cardiopulmonary resuscitation (CPR). * Prior coronary artery bypass graft surgery (CABG). * Prior myocardial infarction (MI). * Implantable cardioverter-defibrillator (ICD) or permanent pacemaker (PPM) unless known to be MRI safe. The presence of an MRI-compatible pacemaker or other MRI-compatible hardware will not be a contraindication to participation in this trial. * Known left ventricular ejection fraction \<30% prior to the qualifying infarct. * History of clinically significant hepatic disturbance or chronic renal impairment at the time of admission. * Cerebrovascular accident (CVA) or transient ischemic attack (TIA) within the last 30 days. * Any known disorder that is associated with immunologic dysfunction (e.g., cancer, lymphoma, a positive serologic test for the human immunodeficiency virus, or hepatitis) more recently than 6 months before presentation or the administration of immunosuppressive drugs within 10 days of the STEMI at doses expected to be associated with immunosuppression including high dose steroids (\>2.5 mg/d hydrocortisone or equal potency of synthetic steroids), tumor necrosis factor-alpha (TNF-α) blockers or methotrexate/azathioprine. * Any condition that, in the Investigator's opinion, would prevent adherence to the requirements of the protocol including language barrier or current alcohol or drug abuse. * Contraindications (including claustrophobia) to cardiac MRI at study entry. * Participation in an investigational drug or device study within the 30 days prior to enrollment into the EMBRACE-STEMI Trial or anticipated within the next 4 days. * Female patients who are pregnant or breastfeeding during the study or intend to within 30 days of receiving study drug.

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