Safety and Efficacy of Polymyxin B Hemoperfusion (PMX) for Septic Shock (EUPHRATES)
Evaluating the Use of Polymyxin B Hemoperfusion in a Randomized Controlled Trial of Adults Treated for Endotoxemia and Septic Shock
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Alberta
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Calgary, Alberta, Canada
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Edmonton, Alberta, Canada
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British Columbia
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Victoria, British Columbia, Canada
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Ontario
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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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Quebec
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Quebec City, Quebec, Canada
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Alabama
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Birmingham, Alabama, United States
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Arizona
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Tucson, Arizona, United States
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Arkansas
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Little Rock, Arkansas, United States
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California
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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
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Colorado Springs, Colorado, United States
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Delaware
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Newark, Delaware, United States
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District of Columbia
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Washington, District of Columbia, United States
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Georgia
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Augusta, Georgia, United States
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Idaho
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Idaho Falls, Idaho, United States
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Illinois
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Oak Park, Illinois, United States
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Peoria, Illinois, United States
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Iowa
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Iowa City, Iowa, United States
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Kentucky
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Hazard, Kentucky, United States
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Maryland
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Baltimore, Maryland, United States
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Massachusetts
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Springfield, Massachusetts, United States
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Michigan
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Ann Arbor, Michigan, United States
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Detroit, Michigan, United States
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Minnesota
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Rochester, Minnesota, United States
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Mississippi
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Jackson, Mississippi, United States
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Missouri
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Saint Louis, Missouri, United States
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Nebraska
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Omaha, Nebraska, United States
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New Jersey
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Camden, New Jersey, United States
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New York
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New York, New York, United States
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North Carolina
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Greenville, North Carolina, United States
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Ohio
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Columbus, Ohio, United States
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Pennsylvania
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Philadelphia, Pennsylvania, United States
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Pittsburgh, Pennsylvania, United States
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Tennessee
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Chattanooga, Tennessee, United States
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Texas
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Houston, Texas, United States
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San Antonio, Texas, United States
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Virginia
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Richmond, Virginia, United States
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
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
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Sham Comparator: Control
Standard medical care for septic shock
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Standard medical care for septic shock
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Experimental: Treatment
Two (2) PMX cartridges will be administered approximately 24 hours apart plus standard medical care for septic shock
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Standard medical care for septic shock
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).
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Mortality
Time Frame: 28 days
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Compare mortality at 28 days in subjects treated with standard medical care plus PMX cartridge, versus subjects who received standard medical care alone
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28 days
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Phillip Dellinger, Dr., Cooper Health System
Publications and helpful links
General Publications
- 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.
- 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.
- 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.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- SDI-PMX-NA001
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