A Prospective, Multi-centric, Randomized, Double-blind, Parallel, Saline Controlled Phase II Safety and Efficacy Study of PMZ-2010 as a Resuscitative Agent for Hypovolemic Shock to be Used Along With Standard Shock Treatment.
Trial Snapshot
- Phase
- Phase 2
- Status
- Completed
- Sponsor
- Pharmazz, Inc.
- Enrollment
- 50
- Locations
- 7
- Primary Endpoint
- Incidence of PMZ-2010 related adverse events
Study Overview
Brief Summary
This is a prospective, multi-centric, randomized, double-blind, parallel, controlled phase-II efficacy clinical study of PMZ-2010 therapy in patients with hypovolemic shock.
Centhaquine is highly safe and well tolerated. Toxicological studies showed high safety margin in preclinical studies. Its safety and tolerability has been demonstrated in a human phase I study in 25 subjects (CTRI/2014/06/004647; NCT02408731).
Detailed Description
Centhaquine (previously used names, centhaquin and PMZ-2010; International Non-proprietary Name (INN) recently approved by WHO is centhaquine) has been found to be an effective resuscitative agent in rat, rabbit and swine models of hemorrhagic shock, it decreased blood lactate, increased mean arterial pressure, cardiac output, and decreased mortality. An increase in cardiac output during resuscitation is mainly attributed to an increase in stroke volume. Centhaquine acts on the venous α2B-adrenergic receptors and enhances venous return to the heart, in addition, it produces arterial dilatation by acting on central α2A-adrenergic receptors to reduce sympathetic activity and systemic vascular resistance.
Unlike presently used vasopressors, centhaquine increased mean arterial pressure by increasing stroke volume and cardiac output, and it decreased systemic vascular resistance. The most common adverse effects of vasopressors as a class include arrhythmias, fluid extravasation, and ischemia. Centhaquine does NOT act on beta-adrenergic receptors, and therefore the risk of arrhythmias is mitigated. It is NOT a vasopressor; however, it increases blood pressure and cardiac output by augmenting venous blood return to the heart and enhanced tissue perfusion by arterial dilatation. Enhancing tissue perfusion is a significant advantage over existing vasopressors.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 70 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Adult males or females aged 18-70 years.
- •Patients with Hypovolemic shock due to blood loss admitted to the emergency room or ICU with systolic blood pressure ≤ 90 mmHg at presentation and continue to receive standard shock treatment (endotracheal intubation; fluid resuscitation and vasopressors). Standard of care to be provided to the patients shall be the one used in the particular hospital setup.
- •Body weight 45 kg - 85 kg.
- •Female subject is either: (1) Not of childbearing potential, defined as postmenopausal for at least 1 year or surgically sterile (bilateral tubal ligation, bilateral oophorectomy or hysterectomy) or, (2) If of childbearing potential, agrees to use any of the following effective separate forms of contraception throughout the study, up to and including the follow-up visits: Condoms, sponge, foams, jellies, diaphragm or intrauterine device, or A vasectomised partner OR abstinence.
Exclusion Criteria
- •Terminal illness
- •Development of any other terminal illness not associated with Hypovolemic shock due to blood loss during the 28 day observation period
- •Patient with severe brain injury or with a Glasgow Coma Scale (GCS) < 8
- •Type of injury is not known
- •Inability to obtain intravenous access
- •Known pregnancy
- •Cardiopulmonary resuscitation (CPR) before randomization
- •Presence of a do not resuscitate order
- •Patient taking beta adrenergic antagonists
- •Untreated tension pneumothorax
- •Untreated cardiac tamponade
- •Bilateral absent pupillary light reflex (both pupils fixed and dilated)
- •Patient is participating in another interventional study
- •Patients with systemic diseases which were already present before having trauma, such as: cancer, chronic renal failure, liver failure, decompensated heart failure or AIDS
Arms & Interventions
Normal Saline
Hypovolemic shock patients will be provided the standard of care. Following randomization 100 ml (equal volume to experimental arm) of normal saline will be administered intravenously over 1 hour.
Intervention: Normal Saline (Drug)
PMZ-2010 (centhaquine)
Hypovolemic shock patients will be provided the standard of care. Following randomization PMZ-2010 (0.01 mg/kg) will be administered intravenously over 1 hour in 100 mL of normal saline.
Intervention: Centhaquine (Drug)
Outcomes
Primary Outcomes
Incidence of PMZ-2010 related adverse events
Time Frame: 28 days
The primary objective of the study is to determine incidence of drug (PMZ-2010) related adverse events.
Secondary Outcomes
- Vasopressor(s) infused(48 hours)
- Change in fibrinogen(48 hours)
- Doses of study drug(48 hours)
- Change in platelet count(48 hours)
- Change in international normalized ratio (INR)(48 hours)
- Change in Acute Respiratory Distress Syndrome(28 days)
- Incidence of mortality(28 days)
- Change in blood lactate level(48 hours)
- Change in Multiple Organ Dysfunction Syndrome Score(28 days)
- Change in prothrombin time(48 hours)
- Change in Glasgow coma score(28 days)
- Volume of blood products administered(48 hours)
- Volume of fluid administered(48 hours)
- Change in systolic and diastolic blood pressure(48 hours)
- Change in base-deficit(48 hours)
- Stay in hospital, in ICU and/or on Ventilator(28 days)