The trial is taking place at:

JPS Health Network | Behavioral Health Service

Veeva-enabled site

Extracellular Vesicle Treatment for Acute Respiratory Distress Syndrome (ARDS) (EXTINGUISH ARDS)


Direct Biologics

Status and phase

Phase 3


Acute Respiratory Distress Syndrome


Biological: ExoFlo
Other: Intravenous normal saline

Study type


Funder types




Details and patient eligibility


To evaluate the safety and efficacy of intravenous (IV) administration of bone marrow mesenchymal stem cell derived extracellular vesicles (EVs), ExoFlo, versus placebo for the treatment of hospitalized patients with moderate-to-severe Acute Respiratory Distress Syndrome (ARDS).

Full description

This is a Phase III, multicenter, randomized, double-blinded, placebo-controlled trial for the treatment of moderate-to-severe Acute Respiratory Distress Syndrome (ARDS).


970 estimated patients




18 to 75 years old


No Healthy Volunteers

Inclusion criteria

Men and women aged 18-75 years of age

Presence of the following criteria for moderate to severe ARDS as defined by the Berlin Criteria within 24 hours of the first infustion:

  • Onset within 7 days of known clinical insult or requiring increasing respiratory rate, increasing oxygen flows, or increased work of breathing, and
  • Bilateral lung opacities not fully explained by pleural effusions, atelectasis, or nodules, and
  • PaO2/FiO2 (P/F ratio) ≤ 200 mm Hg, and
  • Invasive or noninvasive ventilation with a minimum PEEP 5 cm H2O or minimum of continuous positive airway pressure (CPAP) 5 cm H2O, or High Flow Nasal Oxygen at ≥ 30 L/min, and
  • Respiratory failure not fully explained by cardiac failure or fluid overload.

Exclusion criteria

  • Lack of signed and dated informed consent form (either by the individual or by the individual's healthcare proxy).
  • Stated unwillingness to comply with all study procedures and availability for the duration of the study
  • Vulnerable populations such as pregnant patients, children, individuals with severe physical or mental disabilities who cannot provide meaningful consent.
  • Active malignancy requiring treatment within the last two years, with the exception of non-melanoma skin cancers.
  • Major physical trauma in the last 2 days, including motor vehicle accidents, assaults, mechanical falls with sequelae of significant bleeding or craniofacial bruising, and surgeries, such that not one or more injury may be undiagnosed at time of screening.
  • Duration of mechanical ventilation exceeds 3 days or 72 hours from diagnosis of ARDS.
  • ALT or AST > 8 x Upper Limit of Normal (ULN).
  • Documented history of cirrhosis.
  • DNR order, as in electing not to receive chest compressions, cardiac defibrillation, cardiac drugs, or intubation.
  • Moribund-expected survival < 24 hours.
  • Severe metabolic disturbances at randomization (e.g., ketoacidosis, pH < 7.2)
  • Patient currently connected to Extracorporeal Membrane Oxygenation at initiation of screening.
  • If the candidate, either a male or female of reproductive potential, is unwilling to two methods of highly effective birth control contraception such as condoms with oral contraceptive pill or choose to remain abstinent if already practicing abstinence during the screening period. The required duration of usage of double method OR maintenance of abstinence must include the time from the beginning of the screening period until Day 61, day of withdrawal or early termination
  • Use of investigational COVID-19 agents or any other investigational agents within 30 days prior to the first dose.

Trial design

Primary purpose




Interventional model

Parallel Assignment


Triple Blind

970 participants in 2 patient groups, including a placebo group

Placebo Comparator group
Normal saline 100 mL
Other: Intravenous normal saline
Experimental Dose
Experimental group
Normal saline 85 mL and ExoFlo 15 mL
Biological: ExoFlo

Trial contacts and locations



Central trial contact

Bill Arana

Data sourced from

Clinical trials

Find clinical trialsTrials by location
© Copyright 2024 Veeva Systems