Title

Open-label, Test-retest Study Assessing Reproducibility of Quantitative Measurements of Myocardial Uptake of AdreView.
A Phase 4, Open-label Test-retest Study to Assess the Reproducibility of Quantitative Measurements of Myocardial Uptake of AdreView (Iobenguane I 123 Injection)
  • Phase

    Phase 4
  • Study Type

    Interventional
  • Study Participants

    63
The aim of the study was to assess the reproducibility of quantitative measurements of myocardial uptake of Iobenguane I 123 on planar and single photon emission computed tomography (SPECT) imaging following intravenous (i.v.) administration of AdreView. Efficacy was assessed based upon the absolute differences between quantitative analyses of imaging data on 2 scans performed 5 to 14 days apart.
Study Started
Aug 31
2013
Primary Completion
Feb 28
2014
Study Completion
Feb 28
2014
Results Posted
Jan 26
2015
Estimate
Last Update
Dec 08
2016
Estimate

Drug AdreView (Iobenguane I 123 Injection)

AdreView 10 mCi as a single i.v administration

  • Other names: meta-iodobenzylguanidine (123 I-mIBG)

AdreView (Iobenguane I 123 Injection) Experimental

Two administrations of single intravenous (i.v) injection of Iobenguane I 123 10 millicuries (mCi) (370 MBq) over 1 to 2 minutes within an interval of 5 to 14 days.

Criteria

Inclusion Criteria:

The participant was originally diagnosed with New York Heart Association (NYHA) Class II-III HF due to ischemic heart disease at least 3 months or due to non-ischemic cardiomyopathy at least 6 months before enrollment into the study.
The participant had Left Ventricular (LV) dysfunction with Left Ventricular Ejection Fraction (LVEF) less than or equal to 35% measured by an appropriate method (e.g., radionuclide or contrast ventriculography, electrocardiogram [ECG]-gated SPECT myocardial perfusion imaging [MPI], magnetic resonance [MR] imaging, computed tomography [CT] or echocardiography) within 6 months of enrollment into the study and documented in the participant's medical record.
The participant had a history of compliance with prescribed heart failure (HF) medications and took HF guidelines-based medication at study entry including at a minimum a beta-blocker and either an angiotensin converting enzyme inhibitor or angiotensin receptor antagonist unless documented to be intolerant to any of these classes of medications.
The participant had been on a stable medical regimen for a minimum of 3 months, with no hospitalizations or change in HF medications or HF symptoms.
Participants must be clinically stable for at least 7 days before enrolling into the study (e.g., not experiencing continuing chest pain or hemodynamic instability).

Exclusion Criteria:

The participant had previously received 123 I-mIBG or 131 I-mIBG.
The participant had known or suspected hypersensitivity/allergy to iodine, Iobenguane or to any of the excipients in AdreView.
The participant had a heart transplant at any time prior to enrollment.
The participant had LVEF >35% as measured by an appropriate method (e.g., radionuclide or contrast ventriculography, ECG-gated SPECT MPI, MR, CT, or echocardiography) within 30 days prior to enrollment into the study.
The participant had received defibrillation either external or via an implantable cardioverter defibrillator (ICD), anti-tachycardia pacing, or cardioversion to treat an arrhythmic event in the previous 90 days.
The participant had a cardiac revascularization, insertion of an ICD, or acute myocardial infarction within 30 days before study entry.
The participant used any of the following medications: Amitriptyline and derivatives, imipramine and derivatives, other antidepressants that inhibit the norepinephrine transporter, antihypertensives that deplete norepinephrine stores or inhibit reuptake, sympathomimetic amines and cocaine.
The participant had either NYHA Class I or NYHA Class IV HF at the time of study entry.
The participant had renal insufficiency (creatinine >3 mg/dl).
The participant had participated in a clinical trial involving IMP or devices within 30 days prior to first administration of AdreView™.
In the investigator's opinion, the participant's medical history included either extensive lifetime exposure to ionizing radiation (medical, occupational, other) or documented total radiation dose >50 mSv during the previous 5 years.
The participant had experienced HF hospitalization, increased HF symptoms without hospitalization, or had a change or increase in HF medications during the previous 3 months.
The participant had a serious non-cardiac medical condition associated with significant elevation of plasma catecholamines, including pheochromocytoma.

Summary

AdreView (Iobenguane I 123 Injection)

All Events

Event Type Organ System Event Term

To Assess Test-retest Reproducibility of Iobenguane I 123 Injection Myocardial Uptake in Heart Failure (HF) Participants on Planar Imaging at 3 Hours 50 Minutes Following I.V. Injection of AdreView (Iobenguane I 123 Injection)

Participants underwent 2 AdreView (Iobenguane I 123 Injection) exams on the same gamma camera within 5 to 14 days, with the requirement that there was no change in the clinical condition of the participant or in the imaging equipment between the 2 procedures. Each imaging study was processed and read independently by 3 technologists. Mean heart/mediastinum (H/M) ratio difference (with 95% confidence interval [CI]) was used as the measure of test stability.

AdreView (Iobenguane I 123 Injection)

Average (Dosings:absolute difference) (n=47)

0.065
Ratio (Mean)
Standard Deviation: 0.0348

Average (post dosing-1) (n=47)

1.429
Ratio (Mean)
Standard Deviation: 0.2160

Average (post dosing-2) (n=47)

1.433
Ratio (Mean)
Standard Deviation: 0.2048

Technologist A(Dosings:absolute difference) (n=46)

0.07
Ratio (Mean)
Standard Deviation: 0.0612

Technologist A (post dosing-1) (n=46)

1.435
Ratio (Mean)
Standard Deviation: 0.2238

Technologist A (post dosing-2) (n=47)

1.422
Ratio (Mean)
Standard Deviation: 0.2229

Technologist B(Dosings:absolute difference) (n=47)

0.06
Ratio (Mean)
Standard Deviation: 0.0413

Technologist B (post dosing-1) (n=47)

1.43
Ratio (Mean)
Standard Deviation: 0.220

Technologist B (post dosing-2) (n=47)

1.436
Ratio (Mean)
Standard Deviation: 0.2069

Technologist C(Dosings:absolute difference) (n=47)

0.067
Ratio (Mean)
Standard Deviation: 0.0537

Technologist C (post dosing-1) (n=47)

1.427
Ratio (Mean)
Standard Deviation: 0.2115

Technologist C (post dosing-2) (n=47)

1.441
Ratio (Mean)
Standard Deviation: 0.1945

To Assess the Test-retest Reproducibility of Iobenguane I 123 Injection Myocardial Uptake on Planar Imaging at 15 Minutes Following Administration of AdreView (Iobenguane I 123 Injection)

Measurements of H/M ratio and the extent of difference between H/M measurements following AdreView administration and 15 minutes delayed planar imaging on 2 separate days within an interval of 5 to 14 days, was used to assess the test-retest reproducibility. Data from test-retest study was used to estimate the normal ranges for variation in quantitation of myocardial tracer uptake using AdreView. H/M ratios were calculated by 3 technologists and average of 3 technologists was calculated based on non-missing technologists reviewing results. All non-missing technologist evaluations were averaged per participant.

AdreView (Iobenguane I 123 Injection)

Average (Dosings:absolute difference) (n=47)

0.072
Ratio (Mean)
Standard Deviation: 0.0485

Average (post dosing-1) (n=47)

1.581
Ratio (Mean)
Standard Deviation: 0.2212

Average (post dosing-2) (n=47)

1.564
Ratio (Mean)
Standard Deviation: 0.2195

Technologist A(Dosings:absolute difference) (n=47)

0.081
Ratio (Mean)
Standard Deviation: 0.0765

Technologist A (post dosing-1) (n=47)

1.584
Ratio (Mean)
Standard Deviation: 0.2258

Technologist A (post dosing-2) (n=47)

1.567
Ratio (Mean)
Standard Deviation: 0.2267

Technologist B(Dosings:absolute difference) (n=47)

0.062
Ratio (Mean)
Standard Deviation: 0.0532

Technologist B (post dosing-1) (n=47)

1.568
Ratio (Mean)
Standard Deviation: 0.2262

Technologist B (post dosing-2) (n=47)

1.553
Ratio (Mean)
Standard Deviation: 0.2169

Technologist C(Dosing:absolute difference) (n=47)

0.071
Ratio (Mean)
Standard Deviation: 0.0541

Technologist C (post dosing-1) (n=47)

1.593
Ratio (Mean)
Standard Deviation: 0.2227

Technologist C (post dosing-2) (n=47)

1.571
Ratio (Mean)
Standard Deviation: 0.2203

Age, Continuous

65.2
years (Mean)
Standard Deviation: 12.46

Safety Assessment

51
participants

Region of Enrollment

Sex: Female, Male

Overall Study

AdreView (Iobenguane I 123 Injection)

Drop/Withdrawal Reasons

AdreView (Iobenguane I 123 Injection)