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This is a randomized, single-blind, single-center, concurrently controlled, exploratory, Phase I study to determine the in vivo kinetics (24-hour post-infusion recovery and T50 survival) of EryDex System (EDS) -processed autologous red blood cells (RBC) in non-patient volunteers. A total of 12 non-patient volunteer subjects will be enrolled and assigned to one of the 2 groups (6 subjects in active arm group, 6 subjects in sham arm group).
EryDex System (EDS) is a combination product used to administer dexamethasone sodium phosphate (DSP) by ex vivo encapsulation in autologous erythrocytes which are re-infused. DSP is dephosphorylated in RBCs to release dexamethasone.
The 12 subjects who meet all of the inclusion/exclusion criteria will be assigned to one of the 2 groups, consisting of 6 subjects each, as follows:
One 50±5mL aliquot of blood collected from each subject will be treated using the EDS process (either active drug or sham) and the resultant processed RBCs will be radiolabeled with Chromium-51 (51Cr) for the in vivo kinetic study. A second 10±5mL simultaneously collected sample will be labeled with Technetium-99m (99mTc) to estimate the subject's blood volume. These labeled aliquots will be mixed, and simultaneously infused through a peripheral vein via butterfly or similar catheter (total dose 20-40 μCi). Blood samples will be collected from the subject's contralateral arm immediately pre-infusion and at 5, 7.5, 10, 12.5, 15, 20, and 30 minutes (± 3 min), and on Day 1, 24 hours (±2 h) after completion of infusion. Vital signs will be assessed after the 30-min sample on Day 0 and again on Day 1 before the 24-h sample is collected. Additional blood samples will be collected at 48 (±4 h) and 72 (±4 h) hours and 7 (±1 d) days post-infusion, and then weekly through 49 days post-infusion, with a window of ±2 days for each visit.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| DSP loaded RBC using EryDex System | Active Comparator | Autologous RBC loaded with DSP using the EDS process, and treated RBC are infused to the subject. |
|
| Sham treated RBC using the EryDex System | Sham Comparator | Autologous RBC are treated with buffer using the EDS process, and treated RBC are infused to the subject. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| DSP loaded RBC using EryDex System | Drug | Intravenous infusion of 10 mg DSP encapsulated in autologous erythrocytes. Peripheral blood samples are taken over 49 days to determine the 24-hour recovery and survival (T50) of the infused RBC. |
| Measure | Description | Time Frame |
|---|---|---|
| 24-hour post transfusion recovery of infused autologous RBCs | The 24-hour recovery of autologous RBCs loaded with DSP or sham using the EDS will be greater than 75% with 95% confidence. For RBC kinetics and recovery will be reported as mean, 2-sided 95% CI on the mean, standard deviation, minimum and maximum. | 24 hours |
| Long-term survival of infused autologous RBCs assessed with T50 (Time to disappearance of 50% of the labelled red blood cells from the circulation) | For RBC T50 will be reported as mean, 2-sided 95% CI on the mean, standard deviation, minimum and maximum. | up to 49 days |
| Measure | Description | Time Frame |
|---|---|---|
| Special laboratory tests | pH at 37°C, hemolysis, ATP, 2,3-DPG, extracellular potassium, extracellular glucose, extracellular lactate, packed cell volume, RBC morphology and RBC indices. In particular free haemoglobin and and hematuria will be assessed on all defined time points.The measure is a composite outcome | up to 49 days |
| Measure | Description | Time Frame |
|---|---|---|
| Safety: Physical exam | Physical exam | up to 49 days |
| Safety: Number of abnormal ECGs | Number of abnormal ECGs | up to 49 days |
Inclusion Criteria:
Exclusion Criteria:
Females that are of childbearing potential, pregnant, or are breast-feeding Women of childbearing potential using two forms of birth control (e.g. barrier and hormonal) will be eligible
Loss/removal of 500 mL or more of blood <4 weeks
A disability that may prevent the subject from completing all study requirements
Noncompliance with the study requirements
Current participation in another clinical study
Significant occupational exposure to ionizing radiation
Current or previous neoplastic disease
History of any impairment of the immunological system
History of drug or alcohol abuse (<5 years)
A current diagnosis of severe or unstable cardiovascular disease.
Any history or current evidence of a cardiac illness as determined by the investigator.
History or current diagnosis of a psychiatric illness, other than an anxiety disorder, or neurodegenerative disorder.
History of hemoglobinopathy or G6PD deficiency.
History of recurrent or chronic infections
History of tuberculosis
Have any other significant disease or condition that in the Investigator's opinion would put the subject at risk for participating in the trial, including acute gastric ulcer or diabetes.
Vital signs persistently outside the following ranges:
Any clinically significant ECG abnormality
Any clinically significant abnormality on standard laboratory examinations, as determined by the Investigator
Positive serum pregnancy test
Positive confirmed findings of an infectious disease based on results from the standard blood donor infectious disease screening panel
Positive results of the drug or alcohol tests at baseline (Day 0 pre-dose) at the unit
Any previous oral or parenteral steroid use <4 weeks before baseline. Treatment with inhaled or intranasal steroids for asthma or allergies, as well as use of topical steroids will be permitted
Chronic condition or prior allergic reaction representing a contraindication to the use of dexamethasone or other steroid drugs
Have participated in any other trial with an investigational drug and received a dose <30 days or 10 half-lives (whichever is greater) from the start of the screening period.
Requirement for any concomitant medication prohibited by the protocol. Subjects with a history of treatment with oral or depot antipsychotic medication will be excluded
A drug or treatment known to cause major organ system toxicity during the past year.
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| Name | Affiliation | Role |
|---|---|---|
| Larry J Dumont, PhD, MBA | Dartmouth Dartmouth-Hitchcock Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dartmouth-Hitchcock Medical Center | Lebanon | New Hampshire | 03576 | United States |
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| Sham treated RBC using the EryDex System | Drug | Intravenous infusion of sham treated autologous erythrocytes. Peripheral blood samples are taken over 49 days to determine the 24-hour recovery and survival (T50) of the infused RBC. |
|
|
| Safety: Number of adverse events | Number of adverse events | up to 49 days |
| Safety: Number of abnormal routine lab values | Number of abnormal routine lab values (haematology, chemistry and urinalysis) | up to 49 days |
| Safety: vital signs | Vital signs : HR, systolic/diastolic pressure, temperature | up to 49 days |