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Hypovolemic ShockPhase 3NCT04045327

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

A Phase 3 study testing Normal saline + Standard Treatment and Centhaquine + Standard Treatment in people with Hypovolemic Shock, run by Pharmazz, Inc. at 18 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-III efficacy clinical study of PMZ-2010 therapy in patients with hypovolemic shock. Centhaquine (previously used names, centhaquin and PMZ-2010; International Non-proprietary Name (INN) recently approved by WHO is centhaquine)… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Hypovolemic Shock
What is being tested?
Normal saline + Standard Treatment and Centhaquine + Standard Treatment
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
105 participants
Where
18 sitesIndia
Study dates
31 Jan 2019to 27 Sep 2019
Phase
Phase 3
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients with hypovolemic shock admitted to the emergency room or ICU with systolic blood pressure ≤ 90 mmHg at presentation and continue to receive standard shock treatment. Blood Lactate level indicative of hypovolemic shock (>2.0 mmol/L).

Who cannot join

  • Development of any other terminal illness not associated with Hypovolemic shock during the 28-day observation period.
  • Patient with altered consciousness not due to Hypovolemic shock.
  • Known pregnancy.
  • Cardiopulmonary resuscitation (CPR) before randomization.
  • Presence of a do not resuscitate order.
  • 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

18 sites in 1 country.

18 sites in 1 country

India18 sites
  • Jawahar Lal Nehru Medical College & Attached Hospitals

    Ajmer, 305001

  • Radiant Superspeciality Hospital

    Amravati, 444606

  • People Tree Hospitals

    Bangalore, 560022

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

    Belagavi, 590010

  • Shri Guru Ram Rai Institute of Medical & Health Sciences

    Dehradun, 248001

  • Department of Surgery, GSVM Medical College

    Kanpur, 208002

  • Institute of Postgraduate Medical Education & Research and SSKM Hospital

    Kolkata, 700020

  • King George's Medical University

    Lucknow, 226003

  • Christian Medical College & Hospital

    Ludhiana, 141008

  • Sidhu Hospital Pvt. Ltd.

    Ludhiana, 141421

  • Department of General Medicine, JSS Hospital

    Mysuru, 570004

  • Seven Star Hospital

    Nagpur, Maha

  • New Era Hospital & Research Institute

    Nagpur, 440008

  • Rahate Surgical Hospital & ICU

    Nagpur, 440008

  • Criticare Hospital & Research Institute

    Nagpur, 440012

  • ACSR Government Medical College & Hospital

    Nellore, 524007

  • Maulana Azad Medical College and associated Lok Nayak Hospital

    New Delhi, 110002

  • Institute of Medical Sciences, Banaras Hindu University

    Varanasi, 221005

Other trials in India

About this study

Official title: A Prospective, Multi-Centric, Randomized, Double-Blind, Parallel, Phase-III Study to Assess Efficacy of PMZ-2010 as a Resuscitative Agent for Hypovolemic Shock to be Used as an Adjuvant to Standard Shock Treatment

This is a prospective, multi-centric, randomized, double-blind, parallel, controlled phase-III efficacy clinical study of PMZ-2010 therapy in patients with hypovolemic shock.

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.

Read the detailed description

Approximately 105 patients will be randomized 2:1 into 2 treatment groups after meeting the eligibility criteria. Total 70 patients will be enrolled in PMZ-2010 group (Group 1) and in Normal Saline group (Group 2) total 35 patients will be enrolled.

  • Group 1: PMZ-2010 (Dose: 0.01 mg/kg) + Standard of care
  • Group 2: Normal Saline (Dose: Equal volume) + Standard of care In both treatment groups, patients will be provided the standard of care. PMZ-2010 or Normal Saline will be administered intravenously after randomization to hypovolemic shock patients with systolic arterial blood pressure ≤ 90 mmHg at presentation and continue to receive standard Shock Treatment. In PMZ-2010 group, dose of PMZ-2010 (0.01 mg/kg) will be administered as an intravenous (IV) infusion over 1 hour in 100 mL of normal saline. Second dose of PMZ-2010 will be administered if SBP falls below or remains below or equal to 90 mmHg but not before 4 hours of previous dose and total doses per day (in 24 hours) will not exceed 3 doses. PMZ-2010 administration if needed will continue for two days post randomization. Minimum 1 dose or maximum 6 doses of PMZ-2010 will be administered within first 48 hours. post randomization. In Control group, single dose of equal volume of Normal Saline will be administered as intravenous (IV) infusion over 1 hour in 100 mL of normal saline post randomization. Condition of administration will remain same as for PMZ-2010 group. Each patient will be monitored closely throughout his/her hospitalization and will be followed until discharge from randomization. Each patient will be assessed for efficacy parameters over 28 days from randomization to a clinic visit.
Being tested
Normal saline + Standard Treatment, Centhaquine + Standard Treatment
Medical subject headings
Shock

What participants receive

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

  • Normal saline + Standard TreatmentDrug

    Also called Vehicle

    Normal Saline to be Used as Vehicle in the Phase-III Study to Assess Efficacy of PMZ-2010 as a Resuscitative Agent for Hypovolemic Shock

  • Centhaquine + Standard TreatmentDrug

    Also called PMZ-2010

    Phase-III Study to Assess Efficacy of PMZ-2010 as a Resuscitative Agent for Hypovolemic Shock

Study groups in NCT04045327
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 + Standard Treatment
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 + Standard Treatment

What is being measured

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

  1. Change in systolic and diastolic blood pressure

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

    Measured: 48 hours

  2. Change in blood lactate level

    Change in blood lactate level - Mean through 48 hours

    Measured: 48 hours

  3. Change in base-deficit

    Change in Base-deficit - Mean through 48 hours

    Measured: 48 hours

Secondary outcomes (10)
  1. Total Urine Output

    Total volume of urine output - Mean through 48 hours

    Measured: 48 hours

  2. Vasopressor(s) infused

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

    Measured: 48 hours

  3. Volume of fluid administered

    Total volume of fluid administered - 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. Incidence of mortality

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

    Measured: 28 days

  6. 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

  7. 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

  8. 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

  9. 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

  10. Incidence of adverse events

    Proportion of patients with drug related adverse events during 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 posted5 Aug 2019
  2. Study start31 Jan 2019
  3. Primary completion23 Sep 2019
  4. Study completion27 Sep 2019

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
105 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04045327
Sponsor's protocol ID
PMZ-2010/CT-3.1/2018
Other IDs
CTRI/2019/01/017196
Status last verified
Oct 2019
First submitted
31 Jul 2019
Last updated
4 Oct 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, Choudhuri R, Gupta A, Singh S, Ali SKN, Sidhu GK, Haque PD, Rahate P, Bothra AR, Singh GP, Maheshwari S, Jeswani D, Haveri S, Agarwal A, Agrawal NR. A Multicentric, Randomized, Controlled Phase III Study of Centhaquine (Lyfaquin(R)) as a Resuscitative Agent in Hypovolemic Shock Patients. Drugs. 2021 Jun;81(9):1079-1100. doi: 10.1007/s40265-021-01547-5. Epub 2021 Jun 1.

    PubMed 34061314
  • Gulati A, Choudhuri R, Gupta A, Singh S, Noushad Ali SK, Sidhu GK, Haque PD, Rahate P, Bothra AR, Singh GP, Maheshwari S, Jeswani D, Haveri S, Agarwal A, Agrawal NR. A multicentric, randomized, controlled phase III study of centhaquine (Lyfaquin (R) ) as a resuscitative agent in hypovolemic shock patients. medRxiv [Preprint]. 2021 May 9:2020.07.30.20068114. doi: 10.1101/2020.07.30.20068114.

    PubMed 33173916

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Normal saline + Standard Treatment and Centhaquine + Standard Treatment in people with Hypovolemic Shock, run by Pharmazz, Inc. at 18 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 1 inclusion and 7 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 4 Oct 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 18 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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?

Change in systolic and diastolic blood pressure (time frame: 48 hours). The study lists 3 primary outcomes in all. 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 NCT04045327, which also lists 9 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 4 Oct 2019.

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