Safety and Efficacy of Polymyxin B Hemoperfusion (PMX) for Septic Shock

NCT ID: NCT01046669

Last Updated: 2019-02-26

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

450 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-06-30

Study Completion Date

2017-06-30

Brief Summary

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To compare the safety and efficacy of the PMX cartridge based on mortality at 28-days in subjects with septic shock who have high levels of endotoxin and are treated with standard medical care plus use of the PMX cartridge, versus subjects who receive standard medical care alone.

Detailed Description

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Conditions

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Septic Shock Endotoxemia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Control

Standard medical care for septic shock

Group Type SHAM_COMPARATOR

Standard medical care for septic shock

Intervention Type OTHER

Standard medical care for septic shock

Treatment

Two (2) PMX cartridges will be administered approximately 24 hours apart plus standard medical care for septic shock

Group Type EXPERIMENTAL

TORAYMYXIN PMX-20R (PMX cartridge)

Intervention Type DEVICE

TORAYMYXIN PMX-20R (PMX cartridge), Extracorporeal hemoperfusion device. Each treatment will target 2 hours with a minimum of 1 ½ hours, at a flow rate of approximately 100 ml/minute, (range of 80 to 120 ml/minute).

Standard medical care for septic shock

Intervention Type OTHER

Standard medical care for septic shock

Interventions

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TORAYMYXIN PMX-20R (PMX cartridge)

TORAYMYXIN PMX-20R (PMX cartridge), Extracorporeal hemoperfusion device. Each treatment will target 2 hours with a minimum of 1 ½ hours, at a flow rate of approximately 100 ml/minute, (range of 80 to 120 ml/minute).

Intervention Type DEVICE

Standard medical care for septic shock

Standard medical care for septic shock

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Hypotension requiring vasopressor support
* The subject must have received intravenous fluid resuscitation
* Documented or suspected infection
* Endotoxin Activity Assay ≥ 0.60 EAA units
* Evidence of at least 1 new onset organ dysfunction

Exclusion Criteria

* Inability to achieve or maintain a minimum mean arterial pressure (MAP) of 65mmHg
* Subject has end stage renal disease and requires chronic dialysis
* There is clinical support for non-septic shock
* Subject has had chest compressions as part of CPR
* Subject has had an acute myocardial infarction (AMI)
* Subject has uncontrolled hemorrhage
* Major trauma within 36 hours of screening
* Subject has severe granulocytopenia
* HIV infection with a last known or suspected CD4 count of \<50/mm3
* Subject has sustained extensive third-degree burns
* Body weight \< 35 kg (77 pounds)
* Known hypersensitivity to polymyxin B
* Subject has known sensitivity or allergy to heparin
* Subject has screening MOD score of ≤9
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Spectral Diagnostics (US) Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Phillip Dellinger, Dr.

Role: PRINCIPAL_INVESTIGATOR

Cooper Health System

Locations

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Birmingham, Alabama, United States

Site Status

Tucson, Arizona, United States

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Little Rock, Arkansas, United States

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Loma Linda, California, United States

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San Diego, California, United States

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Stanford, California, United States

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Colorado Springs, Colorado, United States

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Newark, Delaware, United States

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Washington D.C., District of Columbia, United States

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Augusta, Georgia, United States

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Idaho Falls, Idaho, United States

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Oak Park, Illinois, United States

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Peoria, Illinois, United States

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Iowa City, Iowa, United States

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Hazard, Kentucky, United States

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Baltimore, Maryland, United States

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Springfield, Massachusetts, United States

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Ann Arbor, Michigan, United States

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Detroit, Michigan, United States

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Rochester, Minnesota, United States

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Jackson, Mississippi, United States

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St Louis, Missouri, United States

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Omaha, Nebraska, United States

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Camden, New Jersey, United States

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New York, New York, United States

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Greenville, North Carolina, United States

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Columbus, Ohio, United States

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Philadelphia, Pennsylvania, United States

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Pittsburgh, Pennsylvania, United States

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Chattanooga, Tennessee, United States

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Houston, Texas, United States

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San Antonio, Texas, United States

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Richmond, Virginia, United States

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Calgary, Alberta, Canada

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Edmonton, Alberta, Canada

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Victoria, British Columbia, Canada

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Oshawa, Ontario, Canada

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Ottawa, Ontario, Canada

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Toronto, Ontario, Canada

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Québec, Quebec, Canada

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Countries

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United States Canada

References

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Klein DJ, Foster D, Walker PM, Bagshaw SM, Mekonnen H, Antonelli M. Polymyxin B hemoperfusion in endotoxemic septic shock patients without extreme endotoxemia: a post hoc analysis of the EUPHRATES trial. Intensive Care Med. 2018 Dec;44(12):2205-2212. doi: 10.1007/s00134-018-5463-7. Epub 2018 Nov 23.

Reference Type DERIVED
PMID: 30470853 (View on PubMed)

Dellinger RP, Bagshaw SM, Antonelli M, Foster DM, Klein DJ, Marshall JC, Palevsky PM, Weisberg LS, Schorr CA, Trzeciak S, Walker PM; EUPHRATES Trial Investigators. Effect of Targeted Polymyxin B Hemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level: The EUPHRATES Randomized Clinical Trial. JAMA. 2018 Oct 9;320(14):1455-1463. doi: 10.1001/jama.2018.14618.

Reference Type DERIVED
PMID: 30304428 (View on PubMed)

Klein DJ, Foster D, Schorr CA, Kazempour K, Walker PM, Dellinger RP. The EUPHRATES trial (Evaluating the Use of Polymyxin B Hemoperfusion in a Randomized controlled trial of Adults Treated for Endotoxemia and Septic shock): study protocol for a randomized controlled trial. Trials. 2014 Jun 11;15:218. doi: 10.1186/1745-6215-15-218.

Reference Type DERIVED
PMID: 24916483 (View on PubMed)

Other Identifiers

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SDI-PMX-NA001

Identifier Type: -

Identifier Source: org_study_id

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