Shock, Traumatic Clinical Trial
Official title:
A Multi-center, Randomized, Double-blind, Controlled Dose-finding Study to Evaluate the Safety and Efficacy of MP4OX Treatment Plus Standard of Care in Severely Injured Trauma Patients With Lactic Acidosis Due to Hemorrhagic Shock
MP4OX is a novel oxygen therapeutic agent specifically developed to perfuse and oxygenate tissue at risk for ischemia and hypoxia. MP4OX is a pegylated hemoglobin-based colloid and and as a result of its molecular size and unique oxygen dissociation characteristics, targets oxygen delivery to ischemic tissues by selectively off-loading oxygen in tissues predisposed to low oxygen tension. Sangart is currently evaluating MP4OX to reduce organ dysfunction and failure in trauma patients with lactic acidosis due to severe hemorrhagic shock.
Acute traumatic injury, including both blunt and penetrating injury, is often associated
with severe bleeding which can lead to hemorrhagic shock. During shock, inadequate perfusion
of critical organs can lead to local ischemia and tissue hypoxia (insufficient oxygenation),
which can be detected by an increase in serum lactate levels. Despite optimal care, more
than 10% of trauma victims who reach hospital alive will die, and many will suffer from
organ failure. Death and significant, persistent morbidity are consequences of trauma, and
traumatic injuries are associated with lost productivity, reduced quality of life, and
direct costs to patients and health care systems worldwide. Current therapies, which also
include blood transfusion, are aimed at supporting failing organs, but a therapeutic agent
that could help to quickly restore adequate oxygenation may be beneficial to prevent or
shorten duration of organ failure and improve patient outcome.
Direct support for the proposed clinical application to use MP4OX in resuscitation from
hemorrhage is found in preclinical animal studies. Using a pig model of uncontrolled
hemorrhage and resuscitation, survival was greater and restoration of hemodynamics and
acid-base status were improved with MP4OX relative to an equivalent volume of crystalloid,
pentastarch, or unmodified hemoglobin. Administration of MP4OX improved 24-hour survival,
stabilized cardiac output and arterial pressure at nearly normal levels, and reduced lactate
levels more effectively than the control fluids. Importantly, these benefits of MP4OX were
observed with or without co-administration of autologous blood, suggesting that blood alone
was not sufficient to achieve complete resuscitation, and that the effects of MP4OX appear
to be additional to those of blood.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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