ARAMIS-II
The Impact of Angiotensin II versus noradrenaline on renal outcomes in critically ill patients with high output shock
A phase 2b, multicentre, open-label, randomised clinical trial
Aim:
To determine whether administration of angiotensin II as the primary vasopressor, compared to conventional vasopressors, improves patient and kidney outcomes in critically ill adults with vasodilatory hypotension.
Rationale:
Current pharmacotherapy options for haemodynamic support in critically ill patients with high output shock are limited. Available agents include catecholamines (noradrenaline, adrenaline, metaraminol, phenylephrine, ephedrine) and vasopressin. A third class of agent was approved by the FDA in 2017: angiotensin II. This provides intensivists with a much-needed novel pharmacotherapy to treat patients with shock.
Angiotensin II is an endogenous hormone with vasopressor and endocrine activities. Regardless of the cause, shocked patients with decreased levels of endogenous angiotensin II may benefit from administration of manufactured angiotensin II. As well as effectively increasing blood pressure, angiotensin II appears to have favourable organ-specific effects, especially relating to the kidney.
Study Progress:
Currently recruiting at 5 hospital sites in Australia.
Funding:
NHMRC Investigator Grant Level 3 (GNT2033013)