Volume 32, Issue 1 e13155
BRIEF COMMUNICATION

A phase Ib, open-label, single arm study to assess the safety, pharmacokinetics, and impact on humoral sensitization of SANGUINATE infusion in patients with end-stage renal disease

Bassam G. Abu Jawdeh

Corresponding Author

Bassam G. Abu Jawdeh

Division of Nephrology, Kidney C.A.R.E. Program, University of Cincinnati College of Medicine, Cincinnati, OH, USA

Cincinnati VA Medical Center, Cincinnati, OH, USA

Correspondence

Bassam G. Abu Jawdeh, MD, FASN, FAST, Division of Nephrology, Kidney C.A.R.E. Program, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Email: [email protected]

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Ervin Steve Woodle

Ervin Steve Woodle

Division of Transplant Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

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Abbie D. Leino

Abbie D. Leino

Division of Transplant Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

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Paul Brailey

Paul Brailey

Transplant Immunology Division, Hoxworth Blood Center, Cincinnati, OH, USA

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Simon Tremblay

Simon Tremblay

Division of Transplant Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

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Tonya Dorst

Tonya Dorst

Division of Transplant Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

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Mouhamad H. Abdallah

Mouhamad H. Abdallah

Division of Cardiovascular Health and Disease, University of Cincinnati College of Medicine, Cincinnati, OH, USA

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Amit Govil

Amit Govil

Division of Nephrology, Kidney C.A.R.E. Program, University of Cincinnati College of Medicine, Cincinnati, OH, USA

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Daniel Byczkowski

Daniel Byczkowski

Prolong Pharmaceuticals, South Plainfield, NJ, USA

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Hemant Misra

Hemant Misra

Prolong Pharmaceuticals, South Plainfield, NJ, USA

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Abraham Abuchowski

Abraham Abuchowski

Prolong Pharmaceuticals, South Plainfield, NJ, USA

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Rita R. Alloway

Rita R. Alloway

Division of Nephrology, Kidney C.A.R.E. Program, University of Cincinnati College of Medicine, Cincinnati, OH, USA

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First published: 15 November 2017
Citations: 13

Funding information

The study was sponsored by Prolong Pharmaceuticals, South Plainfield, NJ

Abstract

The endeavor to study desensitization in kidney transplantation has not been matched by an effort to investigate strategies to prevent sensitization. In this study (NCT02437422), we investigated the safety, impact on sensitization, and pharmacokinetics of SANGUINATE (SG), a hemoglobin-based oxygen carrier, as a potential alternative to packed red blood cells (PRBC) in transplant candidates with end-stage renal disease (ESRD). Ten ESRD subjects meeting inclusion/exclusion (I/E) criteria were planned to receive three weekly infusions of SG (320 mg/kg). The study was stopped after five subjects were enrolled, and their data were analyzed after completing a follow-up period of 90 days. Two subjects had elevated troponin I levels in setting of SG infusion, one of which was interpreted as a non-ST elevation myocardial infarction. All other adverse events were transient. SG pharmacokinetic analysis showed mean (SD) Cmax, Tmax, AUC, and half-life of 4.39 (0.69) mg/mL, 2.42 (0.91) hours, 171.86 (52.35) mg h/mL, and 40.60 (11.96) hours, respectively. None of the subjects developed new anti-HLA antibodies following SG infusion and throughout the study period. In conclusion, SG is a potential alternative to PRBCs in ESRD patients considered for kidney transplantation as it was not associated with humoral sensitization. Larger studies in highly sensitized patients are required to further evaluate for potential safety signals.

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