Intravenous peptide that blocks the inflammatory receptor TREM-1. Being studied in septic shock, especially in patients with high markers of activation of that pathway.
Regulatory status
In clinical trials
Family
Peptide inhibitor of the TREM-1 receptor
Scientific evidence
Low
Number of findings
2
Where it acts
Immunity and defense · Heart and blood
Also known as
nangibotide, LR12, Motrem
Regulatory status
FDA (US): Not approved (phase 2 trials)
EMA (EU): Not approved
Dose
In the phase 2b ASTONISH trial, continuous intravenous infusions of 0.3 or 1.0 mg/kg/h were used in the ICU (clinical trial, PMID 37269870). There is no approved dose.
Safety
Adverse effects similar to placebo in trials. Hospital-only and experimental use.
Effect by goal · level of evidence
Organ dysfunction in septic shock
no clear effectModerateRCT (AA)in people
Phase 2b with 355 patients: it did not improve the organ failure score (SOFA) at day 5, which was the primary endpoint. In patients with high sTREM-1, the high dose showed a favorable trend (difference of 1.39 points) and 28-day mortality of 28% vs 31% with placebo.
TREM-1 is a white blood cell receptor that amplifies the inflammatory response in severe infections. Nangibotide acts as a decoy that keeps TREM-1 from activating, in order to moderate the inflammatory storm without shutting down the defenses.
What the evidence says
In people
Organ dysfunction in septic shock. Phase 2b with 355 patients: it did not improve the organ failure score (SOFA) at day 5, which was the primary endpoint. In patients with high sTREM-1, the high dose showed a favorable trend (difference of 1.39 points) and 28-day mortality of 28% vs 31% with placebo. PubMed 37269870
Safety in phase 2a. 49 patients with septic shock: adverse effects similar to placebo, no antibodies against the drug, and nonsignificant trends toward SOFA improvement. PubMed 32468087