Sepsis Clinical Trial
Official title:
The Safety, Pharmacokinetics, and Pharmacodynamic Effects of TNX-832 (Sunol cH36) in Subjects With Acute Lung Injury/Acute Respiratory Distress Syndrome
This Phase I/IIa, multi-center, randomized, placebo-controlled, single-blinded dose-escalation study evaluated TNX-832 (also referred to as ALT-836 and Sunol cH36) in subjects with suspected or proven bacteria-induced ALI/ARDS. Up to five cohorts of at least six subjects each were originally planned. Subjects were to be randomized in a 5:1 ratio to receive TNX-832 or placebo,respectively, administered as a single bolus infusion over 15 minutes. Three cohorts of subjects were enrolled to the study and safety and pharmacokinetics of the study treatment were evaluated.
Tissue factor (TF) is a transmembrane glycoprotein that acts as the principal initiator of
the extrinsic coagulation pathway. TF is a key mediator between the immune system and
coagulation and is the principal activator of coagulation. The TF-FVIIa complex activates FX
and FIX, resulting in the cleavage of prothrombin to thrombin. Normally, localized
activation of the coagulation cascade associated with inflammatory responses plays a role in
controlling the spread of infectious agents; however, aberrant TF expression often leads to
serious thrombotic disorders. TF-dependent thrombosis has been associated with many diseases
including septic shock, coronary artery disease (CAD), cancer, and many inflammatory and
autoimmune disorders such as lupus, rheumatoid arthritis, psoriasis, and inflammatory bowel
disease.
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are forms of acute
respiratory failure characterized by diffuse pulmonary infiltrates, pulmonary hypertension,
refractory hypoxemia, loss of pulmonary compliance and normal hydrostatic pressures. ALI and
ARDS commonly occur in patients with acute catastrophic events such as sepsis, trauma and
severe pulmonary infections. The incidence of ALI and ARDS is extremely high in patients
with sepsis. By blocking the initiating events of extrinsic coagulation activation, their
effects on pro-inflammatory events in the lungs and disordered fibrin deposition may be
corrected and the evolution of severe structural and functional injury may be averted during
ALI/ARDS. TNX-832 (formerly known as Sunol-cH36), directed against human TF, which can block
the pathological complications of TF-dependent thrombus formation. The blockage by TNX-832
of initiating events in the extrinsic coagulation pathway may attenuate the effects on
pro-inflammatory events in ALI/ARDS patients, thereby averting or decreasing disordered
fibrin deposition and averting the evolution of severe structural and functional injury.
;
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
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