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Acute Ischemic StrokePhase 1HEMERA-1NCT04677777

Safety Study of PP-007 in Subjects With Acute Ischemic Stroke

A Phase 1 study testing PP-007 (Two doses administered 24±6 hours apart) + SOC (IVT or MT or IVT+MT) in people with Acute Ischemic Stroke, run by Prolong Pharmaceuticals at 8 sites in United States.

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

The HEMERA-1 Extension (Part III) is a prospective, open-label, multicenter study to evaluate safety of two doses of PP-007 in Acute Ischemic Stroke (AIS) subjects receiving Intravenous Thrombolysis (IVT) or mechanical thrombectomy (MT) or IVT+MT as standard of care (SOC). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Acute Ischemic Stroke
What is being tested?
PP-007 (Two doses administered 24±6 hours apart) + SOC (IVT or MT or IVT+MT)
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
24 participants
Where
8 sitesUnited States
Study dates
24 Apr 2024to 20 Feb 2025
Phase
Phase 1
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

  • Subject or subject's LAR has provided informed consent.
  • ≥18 years of age.
  • If the patient were to receive MT, patient must have a history of last seen well ≤ 24 hours prior to start of MT
  • If the patient were to receive IVT, patient must have a history of last seen well ≤ 4.5 hours prior to start of IVT or as per Institution SOC Note: Onset is defined as the time point when symptoms first began, or if unknown, the last time point when the subject reported or was observed having normal (baseline) neurological function.
  • AIS patient with ASPECTS ≥ 3 to 10
  • AIS patient with life expectancy of 90 days, as determined by the investigator
Show all 20Show fewer
  • Patient with disabling stroke defined as baseline NIHSS ≥ 6 prior to IP administration
  • mRS ≤ 2 (pre-morbid), prior to onset of symptoms (self-reported or family/caregiver reported)
  • At the time of stroke, patient must be living in their own home, apartment or seniors lodge where no nursing care/support is required
  • Subject and caregiver are available for protocol-required follow-up visits
  • Contraception and pregnancy:
  • Male subjects, and females of childbearing potential (subjects and female partners of male subjects who are ovulating, premenopausal, and not surgically sterile) must use a highly effective method of contraception consistently and correctly during study participation and up to 90 days following PP-007 infusion.
  • Highly effective methods of contraception are those that, either alone or in combination, result in a failure rate of <1% per year when used consistently and correctly, including:
  • Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (i.e., oral, intravaginal, or transdermal).
  • Progesterone-only hormonal contraception associated with inhibition of ovulation (i.e., oral, injectable, or implantable).
  • Intrauterine device, intrauterine hormone-releasing system, or bilateral tubal occlusion.
  • Male sterilization performed more than six months prior to Screening. v. Sexual abstinence. c. Female subjects of non-childbearing potential must be either surgically sterile (hysterectomy, bilateral tubal ligation, salpingectomy, and/or bilateral oophorectomy at least 26 weeks before Screening) or postmenopausal, defined as spontaneous amenorrhea for at least 12 months.
  • Male subjects must abstain from sperm donation during study participation and up to 90 days following PP-007 infusion.
  • Female subjects of childbearing potential must have negative results for the pregnancy test at Screening/Baseline.
  • AIS patient with ASPECTS ≥ 3 to 10

Who cannot join

  • <!-- -->
  • ASPECTS < 3 on NCCT
  • Multi-arterial territorial strokes (e.g. bilateral, anterior and posterior circulation)
  • Evidence of symptomatic intracranial hemorrhage, including subarachnoid hemorrhage, on initial CTA/CTP, or history of intracranial hemorrhage within the last 30 days.
  • Pre-existing neurological or psychiatric disease that would confound neurological or functional evaluations in the opinion of the Investigator.
  • A seizure at stroke onset that precludes obtaining an accurate screening NIHSS and mRS assessment
Show all 51Show fewer
  • Clinical history, past imaging, or clinical judgment suggests that the intracranial occlusion is chronic
  • History of severe head injury within 90 days of Baseline with residual neurological deficit at the time of AIS.
  • Clinically significant heart disease including:
  • Symptoms or ECG evidence of acute myocardial infarction or unstable angina. b. Cardiac arrhythmia associated with hemodynamic instability. c. Heart failure (New York Heart Association Class III or IV) or known ejection fraction <30%.
  • ECG with second- or third-degree heart block in the absence of a permanent pacemaker.
  • Refractory BP (systolic >200 and/or diastolic >120 mmHg).
  • Confirmed diagnosis of septic embolus or bacterial endocarditis within the past six months.
  • Aortic dissection.
  • Contraindication to radiographic imaging procedures including:
  • Known hypersensitivity to radiographic contrast agents. b. Known renal insufficiency precluding repeated contrast administration.
  • Prior treatment (within the last 30 days) or planned concurrent treatment with an investigational medication or device.
  • Blood glucose <50 mg/dL (2.78 mmol) or >400 mg/dL (22.20 mmol) that is not responsive to appropriate treatment at Baseline.
  • Known bleeding disorder (e.g., coagulopathy or thrombocytopenia).
  • Platelet count <50,000/μL at Baseline b. Any anticoagulants within the previous 48 hours that leads to Prothrombin Time (International Normalization Ratio [INR]) ≥2.0 and/or activated partial thromboplastin time (aPTT) ≥40 sec at baseline.
  • Any dual antiplatelet agents (e.g., aspirin plus clopidogrel) within the previous 48 hours that leads to Prothrombin Time (INR ≥ 2.0 and or aPTT ≥ 40 sec at baseline)
  • Known history or current evidence of renal or hepatic disease including:
  • Documented renal insufficiency (serum creatinine >3.0 × ULN).
  • History of liver disease (i.e., alanine transaminase [ALT] and/or Aspartate transaminase (AST) >2 × ULN and/or conjugated bilirubin >1.5 mg/dL).
  • Note: A subject without history or current evidence of renal or hepatic disease does not require creatinine, ALT, AST, or bilirubin results to be available prior to enrollment.
  • 17. Mass effect or intracranial mass on NCCT defined as:
  • Significant mass effect with midline shift ≥8 mm.
  • Evidence of intracranial mass (except for small non-clinically significant meningioma based on the Investigator's discretion).
  • 18. Employee of Prolong Pharmaceuticals or its designated clinical research organization or an employee or relative of the Investigator.
  • 19. Any condition or situation which may put the subject at significant risk, may confound the study results, or may interfere significantly with the subject's participation in the study in the opinion of the Investigator.
  • 20. Intracranial neoplasm, arteriovenous malformation, or aneurysm 21. Participation in another clinical trial investigating a drug, medical device, or a medical procedure in the 30 days preceding study inclusion Note: LVO and/or SVO will be allowed as long as the respective study subject meets the inclusion and exclusion criteria defined above.
  • Inclusion/Exclusion criteria for 2nd PP-007 dose: Prior to administering the second dose of PP-007, the subject, must be evaluated for the following:
  • Multi-arterial territorial strokes (e.g. bilateral, anterior and posterior circulation)
  • Evidence of symptomatic intracranial hemorrhage, including subarachnoid hemorrhage, on NCCT or CTA/CTP.
  • Clinically significant heart disease including:
  • Symptoms or ECG evidence of acute myocardial infarction or unstable angina. b. Cardiac arrhythmia associated with hemodynamic instability. c. Heart failure (New York Heart Association Class III or IV) or known ejection fraction <30%.
  • ECG with second- or third-degree heart block in the absence of a permanent pacemaker.
  • 4. Refractory BP (systolic >200 and/or diastolic >120 mmHg). 5. Confirmed diagnosis of septic embolus or bacterial endocarditis. 6. Aortic dissection. 7. Blood glucose <50 mg/dL (2.78 mmol) or >400 mg/dL (22.20 mmol). 8. Known bleeding disorder (e.g., coagulopathy or thrombocytopenia).
  • Platelet count <50,000/μL at Baseline b. For 2nd dose, patient fully anti-coagulated (heparinized) will be excluded (DBT prophylaxis is allowed) 9. Evidence of renal or hepatic disease including:
  • Documented renal insufficiency (serum creatinine >3.0 × ULN).
  • Documented liver disease (i.e., alanine transaminase [ALT] and/or Aspartate transaminase (AST) >2 × ULN and/or conjugated bilirubin >1.5 mg/dL).
  • Note: A subject without history or current evidence of renal or hepatic disease does not require creatinine, ALT, AST, or bilirubin results to be available prior to enrollment.
  • 10. Mass effect or intracranial mass on NCCT defined as:
  • Significant mass effect with midline shift ≥8 mm. b. Evidence of intracranial mass (except for small non-clinically significant meningioma based on the Investigator's discretion).
  • 11. Intracranial neoplasm, arteriovenous malformation, or aneurysm 12. Any condition or situation which may put the subject at significant risk, may confound the study results, or may interfere significantly with the subject's participation in the study in the opinion of the Investigator.
  • Parenchymal hematoma (PH-1 and PH-2)
  • Symptomatic intracranial hemorrhage
  • Hemicraniectomy
  • Midline shift ≥ 8 mm
  • Mass effect
  • Significant cerebral edema Note: LVO and/or SVO will be allowed as long as the respective study subject meets the inclusion and exclusion criteria defined above. The decision to administer the 2nd dose will be based on subject's safety and PI's discretion.

Trial locations and contacts

8 sites in 1 country.

8 sites in 1 country

United States8 sites
  • Emory University School of Medicine

    Atlanta, Georgia, 30303

  • Baptist Health Research Institute

    Jacksonville, Florida, 32207

  • Saint Luke's Hospital

    Kansas City, Missouri, 64111

  • Baptist Health Miami Cardiac & Vascular Institute (MCVI)

    Miami, Florida, 33176

  • University of Oklahoma Health Sciences Center

    Oklahoma City, Oklahoma, 73104

  • UPMC Stroke Institute

    Pittsburgh, Pennsylvania, 15213

  • Oregon Stroke Center at Oregon Health & Science University (OHSU)

    Portland, Oregon, 97239

  • Mercy Health - St. Vincent Medical Center

    Toledo, Ohio, 43608

Other trials in United States

About this study

Official title: A Randomized, Phase 1, Contemporaneously Controlled, Multicenter Study to Assess the Safety of PP-007 in Subjects With Acute Ischemic Stroke (HEMERA-1)

The HEMERA-1 Extension (Part III) is a prospective, open-label, multicenter study to evaluate safety of two doses of PP-007 in Acute Ischemic Stroke (AIS) subjects receiving Intravenous Thrombolysis (IVT) or mechanical thrombectomy (MT) or IVT+MT as standard of care (SOC). Subjects will receive two doses of PP-007 infusion 24 ± 6 hours apart in addition to the site-specific SOC protocol. PP-007 is PEGylated bovine carboxyhemoglobin and will be administered via IV infusion. The effects on collateral flow, infarct size and functional outcomes will be evaluated.

Read the detailed description

Part III of the HEMERA study evaluates safety after extended drug exposure of PP-007 in subjects with AIS. Subjects would receive two PP-007 doses administered 24±6 hours apart, in addition to the site's SOC protocol of IVT or MT or IVT+MT. PP-007 is PEGylated bovine carboxyhemoglobin and will be administered via IV infusion. The effects on collateral flow, infarct size and functional outcomes (NIHSS and mRS) will also be evaluated. Other measures include assessment of plasma concentration of PP-007.

Being tested
PP-007 (Two doses administered 24±6 hours apart) + SOC (IVT or MT or IVT+MT)
Keywords
Stroke, Thrombectomy, Intravenous Thrombolysis, NIHSS, mRS, ASPECTS
Medical subject headings
Ischemic Stroke, Stroke

What participants receive

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

  • PP-007 (Two doses administered 24±6 hours apart) + SOC (IVT or MT or IVT+MT)Biological

    Also called Sanguinate

    PP-007 is PEGylated carboxyhemoglobin. Eligible patients will receive two doses of PP-007 (at least 24 hours apart) to evaluate extended drug exposure along with MT and/or IVT (individually or together) as SOC to evaluate safety in AIS patients.

Study groups in NCT04677777
Study groupRoleWhat they receive
PP-007 along with Standard of care (SOC)ExperimentalThe study has only single arm, wherein, patients will receive two doses of PP-007 (24 ± 6 hours apart), along with the Standard-of-care (SOC) as per the site's medical practice. SOC is defined as Intravenous thrombolysis (IVT) or Mechanical Thrombectomy (MT) or both (IVT+MT).
Receives: Biological: PP-007 (Two doses administered 24±6 hours apart) + SOC (IVT or MT or IVT+MT)

What is being measured

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

  1. Vital Signs

    Change from baseline in systolic and diastolic blood pressure in mm Hg

    Measured: 90 days

  2. Heart-rate

    Change from baseline in heart-rate in bpm

    Measured: 90 days

  3. 12-lead ECG

    Change from baseline in msec for QT, QTc, RR and PR intervals

    Measured: 90 days

  4. Clinically significant change from baseline in Biochemical, hematological, coagulation and urinalysis measures

    Number of subjects with clinically significant change from baseline in Biochemical, hematological, coagulation and urinalysis measures

    Measured: 90 days

  5. Cardiovascular Adverse Events (MI, myocardial injury, hypertension. hypertensive crisis, pulmonary hypertension) & Mortality

    Number of occurrences

    Measured: 90 days

  6. Symptomatic intracranial hemorrhage

    Incidence of symptomatic intracranial hemorrhage, number of occurrences

    Measured: 90 days

  7. Major Bleeding incidences

    Number of occurrences

    Measured: 90 days

  8. Adverse Events

    Presence or absence

    Measured: 90 days

  9. Bleeding requiring surgical intervention

    Number of occurrences

    Measured: 90 days

  10. Bleeding requiring intravenous vasoactive drugs

    Number of occurrences

    Measured: 90 days

  11. Intracranial hemorrhage

    Number of occurrences

    Measured: 90 days

  12. Intraocular bleed compromising vision

    Number of occurrences

    Measured: 90 days

  13. Fatal bleeding

    Number of occurrences

    Measured: 90 days

  14. AESI, Blood pressure

    Number of events of systolic blood pressure [SBP] >220 mmHg or diastolic blood pressure [DBP] >120 mmHg

    Measured: 90 days

  15. AESI, Liver panel

    Number of events of Liver enzymes elevation >3.0 × Baseline or upper limit of normal [ULN]

    Measured: 90 days

  16. AESI, neurological deterioration

    Number of occurrences of Neurological deterioration (≥4-point increase from Baseline in National Institutes of Health Stroke Scale (NIHSS).

    Measured: 90 days

Secondary outcomes (6)
  1. Clinical Activity, ASITN collateral score

    American Society of Interventional and Therapeutic Neuroradiology collateral score (CT Change from baseline in angiography [CTA] Score 0-4 pre- and post-dose

    Measured: 90 days

  2. Clinical Activity

    Non-contrast computed tomography (NCCT 24 hours)

    Measured: 90 days

  3. Clinical Activity, NIHSS and mRS

    Change from baseline in NIHSS and mRS score

    Measured: 90 days

  4. Plasma Concentration of PP007

    Plasma PP007 concentration in mg/mL at end of infusion and 24 h post infusion

    Measured: 24 hours

  5. Clinical Activity, eTICI

    Change from baseline in Expanded treatment in cerebral infarction (eTICI) score 2b or 3 post-thrombectomy change

    Measured: 90 days

  6. Clinical Activity, infarct growth

    Predicted infarct growth for CT/CTP and collateral score

    Measured: 90 days

Timeline

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

  1. First posted21 Dec 2020
  2. Study start24 Apr 2024
  3. Primary completion20 Feb 2025
  4. Study completion20 Feb 2025

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 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
Contemporaneously controlled, open-label safety study
Masking
None (open label)
Enrolment
24 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04677777
Sponsor's protocol ID
PIS007-101
Acronym
HEMERA-1
Status last verified
Nov 2025
First submitted
11 Nov 2020
Last updated
14 Nov 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Linfante I, Clark W, Haussen DC, Hanel R, Reshi R, Dabus G, Jubin R, Roshan MP, Belnap S, Nguyen TN, Grotta J, Wicks R, Cipolla MJ, Liebeskind DS, Nogueira RG. HEMERA 1 CarboxyHEMoglobin oxygEn delivery for Revascularization in Acute Stroke: A Prospective, Randomized Phase 1 Clinical Trial. Stroke Vasc Interv Neurol. 2024 Apr 23;4(4):e001246. doi: 10.1161/SVIN.123.001246. eCollection 2024 Jul.

    PubMed 41585378

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing PP-007 (Two doses administered 24±6 hours apart) + SOC (IVT or MT or IVT+MT) in people with Acute Ischemic Stroke, run by Prolong Pharmaceuticals at 8 sites in United States.

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 20 inclusion and 51 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 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in United States. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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?

Vital Signs (time frame: 90 days). The study lists 16 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 NCT04677777, which also lists 1 linked publication.

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 Nov 2025; AzTrials last refreshed its copy on 7 Nov 2026.

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