NCT07661303

Brief Summary

Hemoadsorpion in Patients With Septic Shock: Efficacy and Safety Evaluation. A Pilot Multicenter Randomized Controlled Trial. The goal of this clinical trial is the estimation of the efficacy and safety of hemoadsorption procedures (LPS (Lipopolysaccharide) and inflammatory mediators adsorption) in participants with septic shock. The main questions it aims to answer are: Does hemoadsorption decrease the severity of MODS (multiple organ disfunction syndrome)? The study will include participants aged 18 to 80 years with a verified diagnosis of septic shock according to SEPSIS 3 criteria, diagnosed within 12 hours, and a SOFA (sequential organ failure assessment) score of 9 or more. In addition to Standard of Care (SOC), blood purification, including hemoadsorption, will be used. The minimum waiting time after diagnosis of septic shock and initiation of basic therapy before inclusion of the patient in the study therapy is 4 hours. The choice of procedure will be based on the EAA (Endotoxin Activity Assay) result:

  • for an EAA level of 0.6-0.9, selective lipopolysaccharide (LPS) adsorption with duration from 2 to 10 hours;
  • for an EAA level less than 0.6, inflammatory mediator adsorption with duration from 6 to 12 hours. The choice of a specific adsorbers within the LPS and inflammatory mediator adsorption group will be based on randomization. The use of LPS adsorption is planned based on randomization: Toramyxin R-20 or Efferon LPS. The use of inflammatory mediator adsorption is planned based on randomization: Jafron (HA 330) or CytoSorb.

Trial Health

63
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
76

participants targeted

Target at P50-P75 for not_applicable

Timeline
17mo left

Started Jun 2026

Geographic Reach
1 country

7 active sites

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress7%
Jun 2026Dec 2027

First Submitted

Initial submission to the registry

June 16, 2026

Completed
6 days until next milestone

First Posted

Study publicly available on registry

June 22, 2026

Completed
3 days until next milestone

Study Start

First participant enrolled

June 25, 2026

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 25, 2027

Expected
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 25, 2027

Last Updated

July 2, 2026

Status Verified

June 1, 2026

Enrollment Period

1 year

First QC Date

June 16, 2026

Last Update Submit

June 30, 2026

Conditions

Keywords

Septic shockhemoadsorptionblood purificationMODSEndotoxemia

Outcome Measures

Primary Outcomes (1)

  • SOFA (sequential organ failure assessment) score

    MODS (multiple organ disfunction syndrome) dynamics majored by SOFA (sequential organ failure assessment) score. SOFA score ranges from 0 (best) to 24 (worst) points.

    Assessed at 72 hours after hemoadsorption initiation

Secondary Outcomes (20)

  • Vasoactive Inotropic Score (VIS) dynamics

    Assessed at 4 time points: before hemoadsorption initiation (baseline); 24 hours, 48 hours and 72 hours after hemoadsorption initiation

  • Norepinephrine dose dynamics

    Assessed at 4 time points: before hemoadsorption initiation (baseline); 24 hours, 48 hours and 72 hours after hemoadsorption initiation

  • Hemodynamic index dynamics

    Assessed at 4 time points: before hemoadsorption initiation (baseline); 24 hours, 48 hours and 72 hours after hemoadsorption initiation

  • Horowitz index dynamics

    Assessed at 4 time points: before hemoadsorption initiation (baseline); 24 hours, 48 hours and 72 hours after hemoadsorption initiation

  • Lactate level dynamics

    Assessed at 4 time points: before hemoadsorption initiation (baseline); 24 hours, 48 hours and 72 hours after hemoadsorption initiation

  • +15 more secondary outcomes

Other Outcomes (6)

  • Ventilator-free days

    Will be calculated for 28 days after hemoadsorption initiation

  • Vasopressor-free days

    Will be calculated for 28 days after hemoadsorption initiation

  • Dialysis-free days

    Will be calculated for 28 days after hemoadsorption initiation

  • +3 more other outcomes

Study Arms (4)

Inflammatory mediatiors adsorption with CytoSorb

EXPERIMENTAL

Inflammatory mediatiors adsorption with EAA \<0,6 with CytoSorb

Device: CytoSorb

Inflammatory mediatiors adsorption with Jafron HA 330

ACTIVE COMPARATOR

Inflammatory mediatiors adsorption with EAA \<0,6 with Jafron HA 330

Device: Jafron HA 330

Endotoxin haemoadsorption with Toramyxin PMX 20R

EXPERIMENTAL

Endotoxin haemoadsorption with EAA \[0.6-0.9\] with Toramyxin PMX 20R

Device: Toramyxin PMX 20R

Endotoxin haemoadsorption with Efferon LPS

ACTIVE COMPARATOR

Endotoxin haemoadsorption with EAA \[0.6-0.9\] with Efferon LPS

Device: Efferon LPS

Interventions

Blood purification with Efferon LPS

Endotoxin haemoadsorption with Efferon LPS

Blood purification with Toramyxin PMX 20R

Endotoxin haemoadsorption with Toramyxin PMX 20R

Blood purification with Jafron HA 330

Inflammatory mediatiors adsorption with Jafron HA 330
CytoSorbDEVICE

Blood purification with Jafron HA 330

Inflammatory mediatiors adsorption with CytoSorb

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Septic shock according to SEPSIS-3 criteria
  • Age: 18-80 years
  • SOFA ≥9 points
  • Diagnosis of septic shock established \<12 hours ago
  • Invasive hemodynamic monitoring
  • Norepinephrine dose \>0.2 mcg/kg/min

You may not qualify if:

  • Absolute neutrophil count less than 500 cells/μL
  • Pregnancy
  • End-stage heart failure (NYHA stage IV)
  • Pulmonary embolism with obstructive shock
  • Ongoing bleeding
  • Atonic coma
  • More than 30 points on the MELD scale, class C on the Child-Pugh scale
  • HIV infection
  • Burns over 10% of the body surface area
  • Patients with oncohematological diseases
  • Patients with a recognized palliative status or the definition of "metastatic cancer"
  • RRT using membranes with a high cutoff point and increased adsorption capacity within 72 hours from the initiation of the first hemoadsorption procedure
  • Use of plasma exchange within 72 hours from the initiation of the first hemoadsorption procedure

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (7)

Bakulev Scientific Center of Cardiovascular Surgery

Moscow, Russia

Location

City clinical hospital named after S. S. Yudin, Moscow City Health

Moscow, Russia

Location

City Clinical Hospital No 52, Moscow, Russia

Moscow, Russia

Location

Moscow Multi-disciplinary Clinical Center "Kommunarka"

Moscow, Russia

Location

Petrovsky National Research Centre of Surgery

Moscow, Russia

Location

Sklifosovsky Institute of Emergency Care

Moscow, Russia

Location

National Medical Research Centre for Oncology Rostov-on-Don

Rostov-on-Don, Russia

Location

Related Publications (5)

  • Onuk S, Akin AK, Sari A, Gundogan K, Baskol G, Dogru K, Sungur M. The Clinical and Laboratory Efficacy of HA 330 Treatment Combined with Continuous Renal Replacement Therapy in Septic Shock Patients: A Case Series. Blood Purif. 2023;52(2):140-147. doi: 10.1159/000528150. Epub 2023 Jan 12.

    PMID: 36634624BACKGROUND
  • Mehta Y, Mehta C, Kumar A, George JV, Gupta A, Nanda S, Kochhar G, Raizada A. Experience with hemoadsorption (CytoSorb(R)) in the management of septic shock patients. World J Crit Care Med. 2020 Jan 31;9(1):1-12. doi: 10.5492/wjccm.v9.i1.1. eCollection 2020 Jan 31.

    PMID: 32104647BACKGROUND
  • Rey S, Kulabukhov VM, Popov A, Nikitina O, Berdnikov G, Magomedov M, Kim T, Masolitin S, Ignatenko O, Krotenko N, Marysheva A, Chaus N, Ohinko L, Mendibaev M, Chumachenko A, Pisarev V. HEMOPERFUSION USING THE LPS-SELECTIVE MESOPOROUS POLYMERIC ADSORBENT IN SEPTIC SHOCK: A MULTICENTER RANDOMIZED CLINICAL TRIAL. Shock. 2023 Jun 1;59(6):846-854. doi: 10.1097/SHK.0000000000002121. Epub 2023 Apr 6.

    PMID: 37018802BACKGROUND
  • Cruz DN, Antonelli M, Fumagalli R, Foltran F, Brienza N, Donati A, Malcangi V, Petrini F, Volta G, Bobbio Pallavicini FM, Rottoli F, Giunta F, Ronco C. Early use of polymyxin B hemoperfusion in abdominal septic shock: the EUPHAS randomized controlled trial. JAMA. 2009 Jun 17;301(23):2445-52. doi: 10.1001/jama.2009.856.

    PMID: 19531784BACKGROUND
  • Klein DJ, Foster D, Walker PM, Bagshaw SM, Mekonnen H, Antonelli M. Polymyxin B hemoperfusion in endotoxemic septic shock patients without extreme endotoxemia: a post hoc analysis of the EUPHRATES trial. Intensive Care Med. 2018 Dec;44(12):2205-2212. doi: 10.1007/s00134-018-5463-7. Epub 2018 Nov 23.

    PMID: 30470853BACKGROUND

MeSH Terms

Conditions

Shock, SepticMultiple Organ FailureEndotoxemia

Condition Hierarchy (Ancestors)

SepsisInfectionsSystemic Inflammatory Response SyndromeInflammationPathologic ProcessesPathological Conditions, Signs and SymptomsShockBacteremiaToxemia

Study Officials

  • Denis Protsenko, MD, PHD

    Moscow Multi-disciplinary Clinical Center "Kommunarka"

    STUDY DIRECTOR

Central Study Contacts

Aleksandr Burov, PHD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
Double (Investigator, Outcomes Assessor)
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Prospective, pilot, multicenter, parallel-group randomized controlled trial. Participants are independently stratified into 2 parallel groups based on the Endotoxin activity Assay (EAA) level: Group 1- inflammatory mediatiors adsorption (EAA\<0.6), group 2- Endotoxin adsorption (EAA 0.6-0.9). Within each distinct group, participants are randomized in a 1:1 ratio to receive either a CytoSorb (subgroup 1)/Jafron HA 330 (subgroup 2) in group 1 or Toramyxin PMX 20R (subgroup 3)/Efferon LPS (subgroup 4) in group 2. Every patient will receive 2 procedures of hemoadsorption
Sponsor Type
OTHER GOV
Responsible Party
SPONSOR

Study Record Dates

First Submitted

June 16, 2026

First Posted

June 22, 2026

Study Start

June 25, 2026

Primary Completion (Estimated)

June 25, 2027

Study Completion (Estimated)

December 25, 2027

Last Updated

July 2, 2026

Record last verified: 2026-06

Data Sharing

IPD Sharing
Will share

De-identified individual participant data (IPD) that underlie the results reported in the primary publication (including baseline characteristics, blood purification parameters, hemodynamics and SOFA score dynamics, clinical outcomes) will be made publicly available to ensure absolute transparency and academic reproducibility.

Shared Documents
STUDY PROTOCOL, SAP, CSR
Time Frame
Data will become available immediately following the official publication of the primary trial results, approximately at 12/2027.
Access Criteria
The dataset will be openly accessible to any researcher, clinician, or analyst interested in replicating the study findings, conducting systematic reviews, or performing secondary meta-analyses. The data will be hosted publicly, and no formal research proposal review or data use agreements are required for access.

Locations