Extracellular Vesicle Treatment for Acute Respiratory Distress Syndrome (ARDS) (EXTINGUISH ARDS)
Purpose
To evaluate the safety and efficacy of intravenous (IV) administration of bone marrow mesenchymal stem cell derived extracellular vesicles (EVs), ExoFlo, versus placebo for the treatment of hospitalized patients with moderate-to-severe Acute Respiratory Distress Syndrome (ARDS).
Conditions
- Acute Respiratory Distress Syndrome
- ARDS
Eligibility
- Eligible Ages
- Between 18 Years and 75 Years
- Eligible Genders
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Men and women aged 18-75 years of age 2. Presence of the following criteria for moderate to severe ARDS as defined by the Berlin Criteria within 24 hours of the first infustion: 1. Onset within 7 days of known clinical insult or requiring increasing respiratory rate, increasing oxygen flows, or increased work of breathing, and 2. Bilateral lung opacities not fully explained by pleural effusions, atelectasis, or nodules, and 3. PaO2/FiO2 (P/F ratio) ≤ 200 mm Hg, and 4. Invasive or noninvasive ventilation with a minimum PEEP 5 cm H2O or minimum of continuous positive airway pressure (CPAP) 5 cm H2O, or High Flow Nasal Oxygen at ≥ 30 L/min, and 5. Respiratory failure not fully explained by cardiac failure or fluid overload.
Exclusion Criteria
- Lack of signed and dated informed consent form (either by the individual or by the individual's healthcare proxy). 2. Stated unwillingness to comply with all study procedures and availability for the duration of the study 3. Vulnerable populations such as pregnant patients, children, individuals with severe physical or mental disabilities who cannot provide meaningful consent. 4. Active malignancy requiring treatment within the last two years, with the exception of non-melanoma skin cancers. 5. Major physical trauma in the last 2 days, including motor vehicle accidents, assaults, mechanical falls with sequelae of significant bleeding or craniofacial bruising, and surgeries, such that not one or more injury may be undiagnosed at time of screening. 6. Duration of mechanical ventilation exceeds 3 days or 72 hours from diagnosis of ARDS. 7. ALT or AST > 8 x Upper Limit of Normal (ULN). 8. Documented history of cirrhosis. 9. DNR order, as in electing not to receive chest compressions, cardiac defibrillation, cardiac drugs, or intubation. 10. Moribund-expected survival < 24 hours. 11. Severe metabolic disturbances at randomization (e.g., ketoacidosis, pH < 7.2) 12. Patient currently connected to Extracorporeal Membrane Oxygenation at initiation of screening. 13. If the candidate, either a male or female of reproductive potential, is unwilling to two methods of highly effective birth control contraception such as condoms with oral contraceptive pill or choose to remain abstinent if already practicing abstinence during the screening period. The required duration of usage of double method OR maintenance of abstinence must include the time from the beginning of the screening period until Day 61, day of withdrawal or early termination 14. Use of investigational COVID-19 agents or any other investigational agents within 30 days prior to the first dose.
Study Design
- Phase
- Phase 3
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Intervention Model Description
- Multicenter, randomized, double-blinded, placebo-controlled trial
- Primary Purpose
- Treatment
- Masking
- Triple (Participant, Care Provider, Investigator)
- Masking Description
- Double-Blinded
Arm Groups
Arm | Description | Assigned Intervention |
---|---|---|
Placebo Comparator Placebo |
Normal saline 100 mL |
|
Experimental Experimental Dose |
Normal saline 85 mL and ExoFlo 15 mL |
|
Recruiting Locations
Direct Biologics Investigational Site
Chandler, Arizona 85224
Chandler, Arizona 85224
Direct Biologics Investigational Site
Little Rock, Arkansas 72205
Little Rock, Arkansas 72205
Direct Biologics Investigational Site
Fullerton, California 92835
Fullerton, California 92835
Direct Biologics Investigational Site
Orange, California 92868
Orange, California 92868
Direct Biologics Investigational Site
Sacramento, California 95817
Sacramento, California 95817
Direct Biologics Investigational Site
San Francisco, California 94143
San Francisco, California 94143
Direct Biologics Investigational Site
Washington, District of Columbia 20010
Washington, District of Columbia 20010
Direct Biologics Investigational Site
Boise, Idaho 83712
Boise, Idaho 83712
Direct Biologics Investigational Site
Iowa City, Iowa 52242
Iowa City, Iowa 52242
Direct Biologics Investigational Site
Wichita, Kansas 67214
Wichita, Kansas 67214
Direct Biologics Investigational Site
Silver Spring, Maryland 20910
Silver Spring, Maryland 20910
Direct Biologics Investigational Site
Boston, Massachusetts 02115
Boston, Massachusetts 02115
Direct Biologics Investigational Site
Burlington, Massachusetts 01805
Burlington, Massachusetts 01805
Direct Biologics Investigational Site
Springfield, Massachusetts 01199
Springfield, Massachusetts 01199
Direct Biologics Investigational Site
Ann Arbor, Michigan 48109
Ann Arbor, Michigan 48109
Direct Biologics Investigational Site
Jackson, Mississippi 39202
Jackson, Mississippi 39202
Direct Biologics Investigational Site
Mount Holly, New Jersey 08060
Mount Holly, New Jersey 08060
Direct Biologics Investigational Site
Bronx, New York 10467
Bronx, New York 10467
Direct Biologics Investigational Site
Queens, New York 11040
Queens, New York 11040
Direct Biologics Investigational Site
Durham, North Carolina 27710
Durham, North Carolina 27710
Direct Biologics Investigational Site
Winston-Salem, North Carolina 27157
Winston-Salem, North Carolina 27157
Direct Biologics Investigational Site
Cincinnati, Ohio 45219
Cincinnati, Ohio 45219
Direct Biologics Investigational Site
Cleveland, Ohio 44106
Cleveland, Ohio 44106
Direct Biologics Investigational Site
Portland, Oregon 97239
Portland, Oregon 97239
Direct Biologics Investigational Site
Sayre, Pennsylvania 18840
Sayre, Pennsylvania 18840
Direct Biologics Investigational Site
Charleston, South Carolina 29425
Charleston, South Carolina 29425
Direct Biologics Investigational Site
Dallas, Texas 75246
Dallas, Texas 75246
Direct Biologics Investigational Site
Fort Worth, Texas 76104
Fort Worth, Texas 76104
Direct Biologics Investigational Site
Houston, Texas 77030
Houston, Texas 77030
Direct Biologics Investigational Site
Murray, Utah 84107
Murray, Utah 84107
More Details
- NCT ID
- NCT05354141
- Status
- Recruiting
- Sponsor
- Direct Biologics, LLC
Detailed Description
This is a Phase III, multicenter, randomized, double-blinded, placebo-controlled trial for the treatment of moderate-to-severe Acute Respiratory Distress Syndrome (ARDS).