# Antithrombotic Protein C Activator for Hemodialysis

> **NIH NIH R44** · ARONORA, INC. · 2022 · $999,415

## Abstract

Project Summary
Although potent antithrombotic drugs are available, all inadvertently target vital hemostatic mechanisms,
resulting in dose-limiting hemorrhagic toxicity that restricts their use. Due to a lack of safe thromboprophylaxis,
thrombotic/thromboembolic blood vessel occlusions and vascular device failures remain among the leading
causes of death and severe chronic disability in the U.S. Consequently, there is a significant and urgent unmet
medical need for safe antithrombotic drugs. The safety problem with current antithrombotics is particularly
complicated in end stage renal disease (ESRD) patients on chronic hemodialysis, who are prone to both
bleeding and thromboembolic complications. Moreover, some ESRD patients develop acute heparin induced
thrombocytopenia (HIT), another potentially life-threatening complication of heparin use in a small but
significant fraction of ESRD patients, leaving them with few if any off-label options for temporal anticoagulation
during hemodialysis sessions. We are therefore continuing clinical development of our first-in-class, FDA Fast
Track designated antithrombotic enzyme, AB002 (E-WE thrombin), by evaluating its safety and antithrombotic
activity during hemodialysis. The product candidate is a hemostatically safe antithrombotic protein C activator
enzyme that has the potential to help this desperately ill patient population. AB002 has been designed to act in
part by increasing the surface concentration of the anticoagulant, profibrinolytic, and cytoprotective enzyme,
endogenous activated protein C (APC), at the site of developing blood clots via targeted cellular delivery. This
unique mechanism of action allows AB002 to target cell-rich pathological blood clots (thrombi) without disabling
vital hemostasis. In primates, bolus doses as low as 1 µg/kg are antithrombotic without significant systemic
anticoagulation or measurable antihemostatic effects. This critical Phase IIB Bridge Award grant will allow us to
continue product development by providing essential support for an FDA-mandated repeat dose toxicity study
and initiation of a phase 2 human clinical trial in hemodialysis patients where subjects will be repeatedly
exposed to AB002. The results from this study will be used to determine if repeated exposure to AB002 has
toxicity or elicits immunogenic responses. The animal toxicity study will be successful if there are no
observable drug toxicities. The clinical trial will be deemed successful and support further studies in this and
other indications if AB002 is not associated with clinically significant drug-related adverse events, while
showing evidence of antithrombotic and/or anti-inflammatory activity. Successfully achieving our SBIR
milestones will lead directly into the next product development stage: performing subsequent definitive trials in
hemodialysis and other clinically important thrombotic diseases (e.g. ischemic stroke, pulmonary embolism,
and acute myocardial infarction) for the be...

## Key facts

- **NIH application ID:** 10378696
- **Project number:** 5R44HL147695-04
- **Recipient organization:** ARONORA, INC.
- **Principal Investigator:** Erik Ian Tucker
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $999,415
- **Award type:** 5
- **Project period:** 2019-05-15 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10378696

## Citation

> US National Institutes of Health, RePORTER application 10378696, Antithrombotic Protein C Activator for Hemodialysis (5R44HL147695-04). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/10378696. Licensed CC0.

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