PANHEMATIN (hemin for injection) should only be used by physicians experienced in the management of porphyrias in hospitals where the recommended clinical and laboratory diagnostic and monitoring techniques are available.
PANHEMATIN therapy should be considered after an appropriate period of alternate therapy (i.e., 400 g glucose/day for 1 to 2 days). (See " WARNINGS ", " PRECAUTIONS " and " DOSAGE AND ADMINISTRATION " sections.)
PANHEMATIN (hemin for injection) is an enzyme inhibitor derived from processed red blood cells. Hemin for injection was known previously as hematin. The term hematin has been used to describe the chemical reaction product of hemin and sodium carbonate solution. Hemin is an iron containing metalloporphyrin.
PANHEMATIN (hemin for injection) is indicated for the amelioration of recurrent attacks of acute intermittent porphyria temporally related to the menstrual cycle in susceptible women.
Manifestations such as pain, hypertension, tachycardia, abnormal mental status and mild to progressive neurologic signs may be controlled in selected patients with this disorder.
Similar findings have been reported in other patients with acute intermittent porphyria, porphyria variegata and hereditary coproporphyria. PANHEMATIN is not indicated in porphyria cutanea tarda.
Published Studies Related to Panhematin (Hemin)
Activated microglia are less vulnerable to hemin toxicity due to nitric oxide-dependent inhibition of JNK and p38 MAPK activation. [2011.08.01]
In intracerebral hemorrhage, microglia become rapidly activated and remove the deposited blood and cellular debris. To survive in a harmful hemorrhagic or posthemorrhagic condition, activated microglia must be equipped with appropriate self-defensive mechanism(s) to resist the toxicity of hemin, a component released from damaged RBCs.
Panhematin provides a therapeutic benefit in experimental pancreatitis. [2011.05]
BACKGROUND AND AIM: Acute pancreatitis (AP) can result in pancreatic necrosis and inflammation, with subsequent multi-organ failure. AP is associated with increased neutrophil recruitment and a rise in pro-inflammatory cytokines such as TNFalpha. Pretreatment with haemin, results in recruitment of haem-oxygenase-1 (HO-1)(+) macrophages and protects against experimental pancreatitis. It is not clear whether modulation of HO-1 after onset of disease has a protective role. In this study, we tested the utility of Panhematin, a water-soluble haemin formulation, in activating and inducing pancreatic HO-1, and as a therapeutic agent in treating mouse acute pancreatitis... CONCLUSIONS: Despite AP-associated mortality and morbidity, no effective treatment other than supportive care exists. We demonstrate that Panhematin leads to: (i) rapid induction and activation of pancreatic HO-1 with recruitment of HO-1(+) cells to the pancreas, (ii) amelioration of AP even when given late during the course of disease, and (iii) a decrease in leucocyte infiltration and pro-inflammatory cytokines including CXCL1. The utility of Panhematin at modest doses as a therapeutic in experimental pancreatitis, coupled with its current use and safety in humans, raises the potential of its applicability to human pancreatitis.
In vitro selection of a photoresponsive RNA aptamer to hemin. [2010.05.01]
A photoresponsive RNA aptamer to hemin was selected in vitro from a random sequence library of RNAs with azobenzene residues. The aptamer bound to hemin under visible light irradiation and was released by ultraviolet light.
Sulforaphane protects immature hippocampal neurons against death caused by exposure to hemin or to oxygen and glucose deprivation. [2010.05.01]
Oxidative stress is a mediator of cell death following cerebral ischemia/reperfusion and heme toxicity, which can be an important pathogenic factor in acute brain injury. Induced expression of phase II detoxification enzymes through activation of the antioxidant response element (ARE)/Nrf2 pathway has emerged as a promising approach for neuroprotection...
Hemin exerts multiple protective mechanisms and attenuates dextran sulfate sodium-induced colitis. [2010.02]
OBJECTIVE: Inflammatory bowel disease (IBD) is characterized by recurrent and severe gastrointestinal inflammation. Activation of inflammatory cells, such as TH17 lymphocytes, and/or deficiency of regulatory T cells (Treg) are responsible for the pathogenesis of IBD. As an acute phase reactant, heme oxygenase-1 (HO-1) has been shown to play an anti-inflammatory and immunomodulatory role in many disease processes. In this study, we used a dextran sulfate sodium (DSS)-induced murine colitis model to investigate the effect of upregulating HO-1 by hemin on the development of colonic inflammation... CONCLUSIONS: These results demonstrate that upregulation of HO-1 by hemin ameliorated experimental colitis. Moreover, our study suggests a broader protective mechanism of hemin.
Clinical Trials Related to Panhematin (Hemin)
Hemin to Prevent Post-ERCP (Endoscopic Retrograde Cholangiopancreatography) Acute Pancreatitis [Recruiting]
ERCP (endoscopic retrograde cholangiopancreatography) has been largely demonstrated to be
effective in multiple bilio-pancreatic indications. However, one of the feared complication
of this technique is acute pancreatitis, which happens in 5 to 25% of cases. Some patient
groups have been demonstrated to present a higher risk linked to individual factors or to
the procedure. Some interventions (endoscopic or pharmacologic) have been evaluated to
reduce the incidence of this complication but each has his own inconvenient. Recently, the
activation of heme oxygenase (HO) by intraperitoneal administration of hemin has been
demonstrated to be effective in prevention and treatment of acute pancreatitis mice models.
This protective effect has been associated to intrapancreatic HO-1 positive macrophage
recruitment activated by hemin. The investigators thus propose to conduct a prospective
randomized double blind controlled trial to demonstrate a protective effect of hemin
administration against post-ERCP acute pancreatitis in high risk patients.
Controlled Trial of Panhematin in Treatment of Acute Attacks of Porphyria [Recruiting]
This study aims to provide high quality evidence for the effectiveness and safety of hemin
(PanhematinTM , Recordati) for treatment of acute attacks of porphyria. These types of
studies have not been done before with either PanhematinTM or the hemin preparation
available in Europe (NormosangTM, Orphan Europe).
There are two treatment groups in this study. One group will be treated with PanhematinTM
plus glucose, and the other group will be treated with glucose plus an inactive salt
solution (called a "placebo"). To avoid prejudice, the treatment given to each participant
will be blinded (meaning the participants and most of the hospital staff will not know which
treatment the participant will receive) and randomized (meaning participants will have an
equal chance of receiving either treatment, like the flip of a coin). A placebo-controlled,
randomized study is the standard method used to prove treatments are effective and safe.
PanhematinTM and glucose will be given in the same manner as is usual for treating an attack
of porphyria. For participants who are chosen to receive the placebo, their treatment will
be switched to real PanhematinTM at any time if their symptoms do not improve. This is
called "rescue" treatment, and assures that they study is safe and patients who need hemin
will receive it. Treatment with hemin will be for 4 days, or longer if needed. Since the
study treatment is started as soon as possible after symptoms appear, there will be very
little delay in providing hemin to those who need it. Funding Source - Office of Orphan
Products Development (FDA OOPD)
A Pilot Study of Hemin Therapy for Gastroparesis (Diabetes Mellitus) [Active, not recruiting]
This study is designed to learn if hemin can increase the production of heme oxygenase 1 and
improve gastric (stomach) emptying and symptoms in patients with slow gastric emptying
Hemin in Healthy Subjects [Completed]
This study is being done because we want to learn if hemin can increase the production of
heme oxygenase 1. Heme oxygenase 1 (HO-1) is an enzyme which protects cells from physical,
chemical, and biologic stress. Hemin is produced from red blood cells and is approved by the
Food and Drug Administration for treating acute porphyria, which is an inherited condition
caused by an enzyme deficiency.
Induction of HO-1; a Therapeutic Approach to Reduce Ischaemia Reperfusion Injury (IRI) Following Deceased Donor Renal Transplantation [Completed]
This is a blinded, placebo-controlled, randomised controlled trial looking at the effects of
Heme arginate (HA) on cadaveric renal transplantation. The investigators know that HA can
upregulate HO-1, which has been shown to have a protective effect on animal transplants.
The investigators will be giving HA/placebo to participants prior to transplant and repeat
again on day 2 post-transplant and compare outcomes.
Page last updated: 2011-12-09