A Single Site Safety and Tolerability Study of HBOC-201 in Trauma Subjects

A Single-Center, Study to Evaluate the Safety and Tolerability of Hemoglobin-Based Oxygen Carrier-201 (HBOC 201) in Trauma Subjects. (Phase II - Safety and Tolerability)

The main purpose of this study is to determine if HBOC-201 is safe and tolerable to trauma subjects, when given to treat the inadequate supply of blood and nutrients to tissues and organs.

Study Overview

• Status: Unknown
• Conditions: Wounds and Injuries
• Intervention / Treatment: Drug: Hemoglobin-based oxygen carrier-201 (HBOC 201); Other: Standard of Care

Detailed Description

This Phase II study will be a single-center, randomized, single-blind, parallel-group, standard therapy-controlled, variable dose study of HBOC 201 administered to trauma subjects with bleeding or potential for bleeding who require standard fluid therapy for treatment of hypoperfusion. The type and incidence of adverse events and serious adverse events attributed to the study drug will be analyzed.

Secondary variables in this safety and tolerability study, will be summarized with descriptive statistics and frequency tables. The purpose of this data collection is to assess efficacy variables and the feasibility of utilizing these parameters in future trauma studies that will assess parameters of morbidity and mortality and include, but are not limited to:

• Time to improvement of serum (or plasma) lactate
• Time to improvement in the Base Deficit
• Time to maintained stability (BD<5) over 24 hours
• Overall improvement in Base Deficit over 24 Hours
• Stability of subjects at 24 hours
• Time to meet treatment-stopping criteria
• Volume to meet treatment-stopping criteria
• Incidence of infectious complications (e.g., incidence of ventilator-associated pneumonia)
• Length of time on ventilator
• Incidence of multiple organ dysfunction (MOD)

Hemorrhage with subsequent hypoperfusion is a major cause of both immediate and delayed death in subjects who have sustained traumatic injuries. Effective therapies for hemorrhage to treat hypoperfusion that can be given immediately following injury are lacking. The following issues confound this problem further:

• Hemorrhaging trauma victims often have an immediate need for therapy to ensure adequate delivery of oxygen to vital tissues;
• Standard of care fluids such as Lactated Ringers Solution do not provide oxygen and blood can not be readily stored, transported or easily used in pre-hospital settings
• In the absence of oxygen-carrying fluid, traditional approaches to sustain vital organ perfusion, such as administration of intravenous fluid therapy, may have detrimental effects if given prior to hemostasis in certain subjects, particularly those with penetrating truncal injuries.

• Study Type: Interventional
• Enrollment (Anticipated): 53
• Phase: Phase 2

Contacts and Locations

Study Locations

• South Africa
  • Gauteng
    • Johannesburg, Gauteng, South Africa
      • Recruiting
      • Department of Surgery: Johannesburg Hospital
      • Contact: Ronel Snyman; Phone Number: 011 488 3943; Email: research.jhb@mweb.co.za
      • Principal Investigator: Professor Ken D Boffard, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

INCLUSION CRITERIA:

• Male or Female (females not of childbearing potential or negative pregnancy test prior to enrollment)
• Age ≥ 18 years and ≤ 65 years of age
• Trauma with bleeding or a potential for bleeding arriving at initial treatment facility directly from scene of injury
• Subject should be enrolled within four (4) hours of injury
• Base Deficit (BD) greater than 5.0 and one of the following:

Systolic Blood Pressure ≤ 100 mm Hg OR Sustained (≥ 10 minutes) Heart Rate ≥ 100

• No localized signs of traumatic brain injury and a Glasgow Coma Score of ≥9 with the exception of drug-induced lowered GCS.
• Informed consent, or independent physician authorization obtained

EXCLUSION CRITERIA:

• Known or suspected Traumatic Brain Injury
• Non-survivable injury (Falcone Criteria)
• Traumatic arrest
• Known prior cardiac arrest (i.e., preceding trauma episode)
• Known or suspected pregnancy
• Known allergy to bovine products
• Prior treatment with blood (subsequent to current trauma)
• Informed consent or independent physician authorization unable to be obtained
• Unable to meet protocol or follow-up criteria

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1; HBOC-201 followed by standard therapy	Drug: Hemoglobin-based oxygen carrier-201 (HBOC 201); HBOC-201 is an investigational solution of sterile, ultrapurified, glutaraldehyde polymerized, modified bovine hemoglobin (Hb) in a balanced electrolyte solution. HBOC-201 has an Hb concentration of 12-14g/dL. HBOC-201 is an isosmotic solution that is stable for at least 36 months at 2-30ºC. It requires no reconstitution and can be administered directly into a peripheral or central vein. Blood typing is not required because all other cellular components, including the RBC membranes that carry the blood group antigens, have been removed.
Active Comparator: 2; Standard Therapy	Other: Standard of Care; Standard Therapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Safety/Tolerability of HBOC-201 for treatment of hypoperfusion in trauma by analysis of AEs/SAEs attributed to study drug	Duration of the study (Randomization through 28-day follow-up)

Secondary Outcome Measures

Outcome Measure	Time Frame
Efficacy/feasibility of the following measurements in trauma studies (list is not all inclusive): Time to serum lactate improvement, Base deficit (BD) improvement, BD > 5 over 24 hrs, 24 hr stability, Infection, Vent time	Duration of the study (Randomization through 28-day follow-up)

Collaborators and Investigators

• Sponsor: Biopure Corporation
• Investigators: Study Director: A. Gerson Greenburg, MD, PhD, Biopure Corporation; Principal Investigator: Professor Ken D Boffard, MD, Wits University Medical School

Study record dates

Study Major Dates

• Study Start: July 1, 2004
• Primary Completion (Anticipated): September 1, 2008
• Study Completion (Anticipated): December 1, 2008

Study Registration Dates

• First Submitted: March 10, 2006
• First Submitted That Met QC Criteria: March 10, 2006
• First Posted (Estimate): March 13, 2006

Study Record Updates

• Last Update Posted (Estimate): March 6, 2008
• Last Update Submitted That Met QC Criteria: March 5, 2008
• Last Verified: February 1, 2008

More Information

Terms related to this study

• Keywords: multiple trauma; blunt trauma; bleeding injuries; gunshot wounds; stab wounds; penetrating injuries; multiple wounds
• Additional Relevant MeSH Terms: Wounds and Injuries; Physiological Effects of Drugs; Peripheral Nervous System Agents; Analgesics; Sensory System Agents; Anti-Inflammatory Agents, Non-Steroidal; Analgesics, Non-Narcotic; Anti-Inflammatory Agents; Antirheumatic Agents; Blood Substitutes; Chrysarobin; HBOC 201
• Other Study ID Numbers: HEM-0125