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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
Centre Hospitalier de Bicêtre
Le Kremlin-Bicêtre, France
CHRU de Lille - Hôpital Claude Huriez
Lille, France
Hôpital Dupuytren
Limoges, France
Serum lactate clearance
Time frame: 2 hours
All-cause mortality
Time frame: 28 days
Ventilator-free days
Time frame: 28 days
ICU-free days
Time frame: 28 days
Hospital-free days
Time frame: 28 days
Sepsis-related Organ Failure Assessment (SOFA) score
Time frame: Daily
Modified Denver score
Time frame: Daily
Composite endpoint of Time to Complete Organ Failure Resolution (CTCOFR)
Time frame: At 14 and 21 days
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TREATMENT
Masking
QUADRUPLE
Enrollment
51
Hôpital Pitié-Salpêtrière
Paris, France
Charité Campus Virchow Klinikum
Berlin, Germany
Klinikum der Johann-Wolfgang-Goethe-Universität
Frankfurt, Germany
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