~36 spots leftby Dec 2025

Medical Dye for Abdominal Surgery

Recruiting in Palo Alto (17 mi)
+6 other locations
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Phase 3
Recruiting
Sponsor: Astellas Pharma Global Development, Inc.
Must not be taking: Antibiotics, NIR-F agents
Disqualifiers: Ureteral stenting, Cardiac disease, others
No Placebo Group
Pivotal Trial (Near Approval)
Prior Safety Data

Trial Summary

What is the purpose of this trial?

The ureter is the tube that carries urine from the kidneys to the bladder. It is difficult for surgeons to see the ureter during abdominal surgery. This could lead to injuring the ureter which, although rare, could be serious. This study is about a potential new medical dye, called ASP5354. This dye is injected into the person at the start of surgery and is detected in the ureter. This is done by an imaging machine which has an option called near infrared fluorescence, or NIR-F. Together they show live images of specific parts of the body. In this study, ASP5354 is used with an imaging machine with a NIR-F option to show live images of the ureter during surgery. People with kidneys that work properly and those with kidney problems can take part in this study. The main goal of the study is to find out how clearly the ureter can be seen with ASP5354 during surgery in people whose kidneys work properly or who have mild kidney problems. To do this, the surgeons will inject ASP5354 into the person having surgery. Then, the surgeons will compare images of the ureter with an imaging machine using normal white light and with the NIR-F option. Imaging using normal white light is the standard way surgeons see the ureter during surgery. People 18 years or older, with or without kidney disease, who were going to have certain abdominal surgeries may be able to take part. Everyone taking part will receive ASP5354 during surgery, but how the imaging is done will depend on which group they are in. Before surgery, the people whose kidneys work properly or who have mild kidney problems will be assigned into 1 of 2 groups by chance alone. Images of the ureter will be checked in 1 group using normal white light and the other group using normal white light and NIR-F. People with more severe kidney problems will not be assigned to 1 of 2 groups: all images of the ureter will be checked using normal white light and NIR-F. At the start of surgery, the surgeon will inject ASP5354 into the person having surgery, then will start recording a video of the surgery. Then, after 30 minutes, the surgeon will record how well the ureter can be seen. This will be done by either using normal white light, or normal white light and NIR-F, depending on which group each person having surgery is assigned. For the group to be checked with normal white light and NIR-F, the surgeon will do this check every 30 minutes until the end of surgery. For the group to be checked with normal white light only, the surgeon will only do this check after the first 30 minutes. A group of medical experts will also record how well the ureter can be seen in the surgery videos. The medical experts will not be directly involved in this study. They won't know who the images belong to or which group they are from. During the study, people will visit the study hospital 3 times. The first visit is to check if they can take part in the study. People will be asked about their medical history, have a medical examination, and their vital signs checked (blood pressure and pulse rate). Also, they will have some blood and urine tests. For women this may include a pregnancy test. People will have their surgery at the second visit. This will be within 28 days of their first visit. This includes having some blood and urine tests before, during, and after surgery. Also, they will have a medical examination, an electrocardiogram (ECG) to check their heart rhythm, and have their vital signs checked. After surgery, people will return to the clinic 10 days later for a final check-up. They will be asked if they have had any medical problems. Also, they will have a medical examination, have their vital signs checked, and have blood and urine tests.

Will I have to stop taking my current medications?

The trial information does not specify if you need to stop taking your current medications. However, you cannot participate if you have taken certain imaging agents within 48 hours before the study dye is given, or if you are on dialysis.

How does the medical dye used in abdominal surgery differ from other treatments?

The medical dye used in abdominal surgery is unique because it employs near-infrared fluorescence imaging to provide real-time visualization of the ureters, reducing the risk of injury during surgery. This approach is less invasive compared to traditional methods like ureteral stents and offers a safer, more efficient way to identify ureters during procedures.12345

Research Team

MM

Medical Monitor

Principal Investigator

Astellas Pharma Global Development, Inc.

Eligibility Criteria

This trial is for adults needing certain abdominal surgeries, with normal or mildly impaired kidney function (eGFR ≥ 60 mL/min) or moderate to severe impairment (eGFR ≥ 15 to < 60 mL/min). Women must not be pregnant, breastfeeding, or donating eggs and agree to use contraception. Men must not donate sperm and if their partner can bear children, they should use contraception.

Inclusion Criteria

Participant agrees not to participate in another interventional study while participating in the present study.
I am not pregnant and follow the required birth control measures.
I agree to use contraception with my partner who can have children.
See 2 more

Exclusion Criteria

Participant has any physical or psychiatric condition unsuitable for study participation
I have a health issue that makes surgery risky for me.
Participant has known or suspected hypersensitivity to ASP5354, indocyanine green (ICG) or any components of the formulation used
See 7 more

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 visit (in-person)

Treatment

Participants undergo surgery where ASP5354 is administered and imaging is conducted using normal white light and/or NIR-F

1 day
1 visit (in-person)

Follow-up

Participants return for a final check-up to monitor for any medical problems and conduct additional tests

10 days after surgery
1 visit (in-person)

Safety Monitoring

Participants are monitored for adverse events and vital sign abnormalities

Up to Day 25

Treatment Details

Interventions

  • ASP5354 (Other)
Trial OverviewThe study tests a new medical dye called ASP5354 designed to help surgeons see the ureter more clearly during surgery using near infrared fluorescence imaging. Participants will receive the dye and have their ureters imaged with standard white light and/or NIR-F technology depending on their group assignment.
Participant Groups
3Treatment groups
Experimental Treatment
Group I: White Light/near-infrared fluorescence - Adults with normal renal function or mild renal impairmentExperimental Treatment1 Intervention
Adult participants with normal renal function or mild renal impairment will receive a single dose of ASP5354
Group II: White Light/near-infrared fluorescence - Adults with moderate or severe renal impairmentExperimental Treatment1 Intervention
Adult participants with moderate or severe renal impairment will receive a single dose of ASP5354
Group III: White Light - Adults with normal renal function or mild renal impairmentExperimental Treatment1 Intervention
Adult participants with normal renal function or mild renal impairment will receive a single dose of ASP5354

Find a Clinic Near You

Who Is Running the Clinical Trial?

Astellas Pharma Global Development, Inc.

Lead Sponsor

Trials
204
Recruited
123,000+

Tadaaki Taniguchi

Astellas Pharma Global Development, Inc.

Chief Medical Officer

M.D., Ph.D.

Naoki Okamura profile image

Naoki Okamura

Astellas Pharma Global Development, Inc.

Chief Executive Officer

Not available

Findings from Research

In a phase 2 study involving adults undergoing laparoscopic colorectal surgery, pudexacianinium (ASP5354) effectively provided intraoperative ureter visualization, with successful fluorescence observed in 5 out of 6 participants at the 1.0 mg dose and all 3 participants at the 3.0 mg dose.
The treatment was found to be safe and well tolerated, with only one mild adverse event related to the drug, indicating that pudexacianinium could be a promising tool for preventing ureteral injuries during surgery.
Pudexacianinium (ASP5354) chloride for ureter visualization in participants undergoing laparoscopic, minimally invasive colorectal surgery.Albert, M., Delgado-Herrera, L., Paruch, J., et al.[2023]
Patent blue dye, when mixed with lidocaine hydrochloride, can form water-insoluble precipitates, making it unsuitable for use in parenteral prescriptions, which could affect its efficacy and safety.
The study highlights that patent blue is not approved by the FDA and has reported toxicities, suggesting caution in its clinical use, especially in combination with other medications.
Evaluation of preparations of patent blue (Alphazurine 2G) dye for parenteral use.Newton, DW., Rogers, AG., Becker, CH., et al.[2019]
The fluorescent dye UL-766 significantly improves the identification of ureters during laparoscopic surgery in inflamed conditions, allowing visualization within 5-10 minutes after injection, even when surrounding tissue is swollen or red.
This dye not only aids in locating ureters but also helps detect partial ureteral injuries that would be missed using standard laparoscopic techniques, indicating its potential as a valuable tool in surgical settings.
Ureter Identification In an Inflammatory Pig Model Using a Novel Near-Infrared Fluorescent Dye.Lau, LW., Luciano, M., Schnermann, M., et al.[2022]

References

Pudexacianinium (ASP5354) chloride for ureter visualization in participants undergoing laparoscopic, minimally invasive colorectal surgery. [2023]
Evaluation of preparations of patent blue (Alphazurine 2G) dye for parenteral use. [2019]
Ureter Identification In an Inflammatory Pig Model Using a Novel Near-Infrared Fluorescent Dye. [2022]
A zwitterionic near-infrared fluorophore for real-time ureter identification during laparoscopic abdominopelvic surgery. [2021]
Laparoscopic Fluorescent Visualization of the Ureter With Intravenous IRDye800CW. [2022]