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Hypovolemic ShockPhase 2NCT04056065

PMZ-2010 (Centhaquine) as a Resuscitative Agent for Hypovolemic Shock

A Phase 2 study testing Normal Saline and Centhaquine in people with Hypovolemic Shock and Blood Loss, run by Pharmazz, Inc. at 7 sites in India.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial 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. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Hypovolemic Shock, Blood Loss
What is being tested?
Normal Saline and Centhaquine
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
7 sitesIndia
Study dates
29 May 2017to 21 Oct 2018
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 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.

Who cannot join

  • 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
Show all 14Show fewer
  • 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

Trial locations and contacts

7 sites in 1 country.

7 sites in 1 country

India7 sites
  • KLE's Dr. Prabhakar Kore Hospital & Medical Research Centre

    Belagavi, 590010

  • Post Graduate Institute of Medical Education and Research

    Chandigarh, 160012

  • Institute of Postgraduate Medical Education & Research and SSKM Hospital

    Kolkata, 700020

  • Dayanand Medical College & Hospital

    Ludhiana, 141001

  • Seven Star Hospital

    Nagpur, Maha

  • New Era Hospital & Research Institute

    Nagpur, 440008

  • ORIANA Hospital

    Varanasi, 221005

Other trials in India

About this study

Official title: 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.

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).

Read the 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.

Being tested
Normal Saline, Centhaquine
Keywords
Resuscitative agent, Vasopressor
Medical subject headings
Shock, Hemorrhage

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Normal SalineDrug

    Also called Vehicle

    In addition to standard of care normal saline to be used as vehicle in the phase-II study to assess efficacy of PMZ-2010 as a resuscitative agent for hypovolemic shock

  • CenthaquineDrug

    Also called PMZ-2010

    In addition to standard of care PMZ-2010 to be used as an experimental drug in the phase-II study to assess its efficacy as a resuscitative agent for hypovolemic shock

Study groups in NCT04056065
Study groupRoleWhat they receive
Normal SalineActive comparatorHypovolemic 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.
Receives: Drug: Normal Saline
PMZ-2010 (centhaquine)ExperimentalHypovolemic 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.
Receives: Drug: Centhaquine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of PMZ-2010 related adverse events

    The primary objective of the study is to determine incidence of drug (PMZ-2010) related adverse events.

    Measured: 28 days

Secondary outcomes (16)
  1. Volume of fluid administered

    Total volume of fluid administered - Mean through 48 hours

    Measured: 48 hours

  2. Volume of blood products administered

    Total volume of blood products administered - Mean through 48 hours

    Measured: 48 hours

  3. Vasopressor(s) infused

    Amount of total vasopressor(s) infused - Mean through 48 hours

    Measured: 48 hours

  4. Doses of study drug

    Number of doses of study drug administered in first 48 hours post randomization

    Measured: 48 hours

  5. Change in systolic and diastolic blood pressure

    Change in systolic and diastolic blood pressure - Mean through 48 hours

    Measured: 48 hours

  6. Change in blood lactate level

    Change in blood lactate level - Mean through 48 hours

    Measured: 48 hours

  7. Change in base-deficit

    Change in Base-deficit - Mean through 48 hours

    Measured: 48 hours

  8. Change in platelet count

    Change in platelet count as part of coagulation parameters mean through 48 hours. Platelets are parts of the blood that helps the blood clot. Average platelet counts are 150,000 to 450,000 number of platelets per microliter.

    Measured: 48 hours

  9. Change in prothrombin time

    Change in prothrombin time as part of coagulation parameters mean through 48 hours. Prothrombin time (PT) is a blood test that measures the time it takes for the blood to clot. The average time range for blood to clot is about 10 to 14 seconds.

    Measured: 48 hours

  10. Change in international normalized ratio (INR)

    Change in international normalized ratio (INR) as part of coagulation parameters mean through 48 hours. The results of the prothrombin time test vary from laboratory to laboratory, therefore, a ratio called the international normalized ratio (INR) is calculated. It allows for differences in laboratories across the world so that test results become more relevant and can be compared. The average INR range is 0.8 to 1.1.

    Measured: 48 hours

  11. Change in fibrinogen

    Change in fibrinogen as part of coagulation parameters mean through 48 hours. Fibrinogen is a protein, specifically a clotting factor (factor I), that is essential for proper blood clot formation. The reference range for fibrinogen is 150-400 mg/dL

    Measured: 48 hours

  12. Change in Multiple Organ Dysfunction Syndrome Score

    Change in Multiple Organ Dysfunction Syndrome Score (MODS) - Mean through 28 days. MODS is a 5 grade scale from 0 to 4, where 0 is the best and 4 is the worst outcome.

    Measured: 28 days

  13. Change in Acute Respiratory Distress Syndrome

    Change in Acute Respiratory Distress Syndrome (ARDS) - Mean through 28 days. ARDS will be determined using Murray Score for Acute Lung Injury which is based upon radiological findings, oxygenation status, ventilation status of the patient. A lower score of 0 is the best and about 2.5 is the worst outcome.

    Measured: 28 days

  14. Change in Glasgow coma score

    Change in Glasgow coma score (GCS) - Mean through 28 days. GCS is a 15 point scale to assess the level of consciousness of patients where less than 3 is comatose state and 15 is fully awake.

    Measured: 28 days

  15. Stay in hospital, in ICU and/or on Ventilator

    Days in hospital, in ICU and/or on Ventilator - Mean through 28 days

    Measured: 28 days

  16. Incidence of mortality

    Proportion of patients with all-cause mortality at 48 hours and 28 days

    Measured: 28 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Aug 2019
  2. Study start29 May 2017
  3. Primary completion19 Sep 2018
  4. Study completion21 Oct 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04056065
Sponsor's protocol ID
PMZ-02 Version 03 2017
Other IDs
CTRI/2017/03/008184
Status last verified
Aug 2019
First submitted
11 Aug 2019
Last updated
14 Aug 2019
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Plan to publish the findings after completion of the study

Publications

  • Kontouli Z, Staikou C, Iacovidou N, Mamais I, Kouskouni E, Papalois A, Papapanagiotou P, Gulati A, Chalkias A, Xanthos T. Resuscitation with centhaquin and 6% hydroxyethyl starch 130/0.4 improves survival in a swine model of hemorrhagic shock: a randomized experimental study. Eur J Trauma Emerg Surg. 2019 Dec;45(6):1077-1085. doi: 10.1007/s00068-018-0980-1. Epub 2018 Jul 13.

    PubMed 30006694
  • Papalexopoulou K, Chalkias A, Pliatsika P, Papalois A, Papapanagiotou P, Papadopoulos G, Arnaoutoglou E, Petrou A, Gulati A, Xanthos T. Centhaquin Effects in a Swine Model of Ventricular Fibrillation: Centhaquin and Cardiac Arrest. Heart Lung Circ. 2017 Aug;26(8):856-863. doi: 10.1016/j.hlc.2016.11.008. Epub 2016 Dec 19.

    PubMed 28385449
  • Papapanagiotou P, Xanthos T, Gulati A, Chalkias A, Papalois A, Kontouli Z, Alegakis A, Iacovidou N. Centhaquin improves survival in a swine model of hemorrhagic shock. J Surg Res. 2016 Jan;200(1):227-35. doi: 10.1016/j.jss.2015.06.056. Epub 2015 Jun 29.

    PubMed 26216751
  • Gulati A, Zhang Z, Murphy A, Lavhale MS. Efficacy of centhaquin as a small volume resuscitative agent in severely hemorrhaged rats. Am J Emerg Med. 2013 Sep;31(9):1315-21. doi: 10.1016/j.ajem.2013.05.032. Epub 2013 Jul 19.

    PubMed 23871440
  • Lavhale MS, Havalad S, Gulati A. Resuscitative effect of centhaquin after hemorrhagic shock in rats. J Surg Res. 2013 Jan;179(1):115-24. doi: 10.1016/j.jss.2012.08.042. Epub 2012 Sep 2.

    PubMed 22964270
  • Gulati A, Lavhale MS, Garcia DJ, Havalad S. Centhaquin improves resuscitative effect of hypertonic saline in hemorrhaged rats. J Surg Res. 2012 Nov;178(1):415-23. doi: 10.1016/j.jss.2012.02.005. Epub 2012 Apr 2.

    PubMed 22487389
  • Anil Gulati, Dinesh Jain, Nilesh Agrawal, Prashant Rahate, Soumen Das, Rajat Chowdhuri, Deba Dhibar, Madhav Prabhu, Sameer Haveri, Rohit Agarwal, Manish Lavhale. Clinical Phase II Results Of PMZ-2010 (centhaquin) As A Resuscitative Agent For Hypovolemic Shock. Critical Care Medicine Volume 47, Issue 1, Page 12.

  • Gulati A, Jain D, Agrawal NR, Rahate P, Choudhuri R, Das S, Dhibar DP, Prabhu M, Haveri S, Agarwal R, Lavhale MS. Resuscitative Effect of Centhaquine (Lyfaquin(R)) in Hypovolemic Shock Patients: A Randomized, Multicentric, Controlled Trial. Adv Ther. 2021 Jun;38(6):3223-3265. doi: 10.1007/s12325-021-01760-4. Epub 2021 May 10.

    PubMed 33970455

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Normal Saline and Centhaquine in people with Hypovolemic Shock and Blood Loss, run by Pharmazz, Inc. at 7 sites in India.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 14 Aug 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in India. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of PMZ-2010 related adverse events (time frame: 28 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04056065, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Aug 2019.

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