Claims for Patent: 9,220,745

Summary for Patent: 9,220,745

Title:	Angiotensin II alone or in combination for the treatment of hypotension
Abstract:	The present invention relates, inter alia, to a method comprising administering to a subject having high output shock and undergoing treatment with a catecholamine at a dose equivalent to at least about 0.2 mcg/kg/min of norepinephrine a dose of angiotensin II which is effective to raise the blood pressure of the subject to a mean arterial pressure (MAP) of about 65 mm Hg or above, and which is effective to reduce the dose of the catecholamine required to maintain a MAP of about 65 mm Hg to the equivalent of about 0.05-0.2 mcg/kg/min norepinephrine or less, or to the equivalent of about 0.05 mcg/kg/min norepinephrine or less.
Inventor(s):	Chawla; Lakhmir (McLean, VA)
Assignee:	The George Washington University, a Congressionally Not-for-Profit Corporation (Washington, DC)
Application Number:	14/575,127
Patent Claims:	1. A method of treating a subject having high output shock and undergoing treatment with a catecholamine at a dose equivalent to above about 5 mcg/min of norepinephrine, comprising: administering angiotensin II to the subject at a rate effective to raise or maintain mean arterial pressure (MAP) of the subject above about 80 mm Hg; reducing the dose of the catecholamine, while maintaining the MAP of the subject above about 80 mm Hg; and reducing the rate at which angiotensin II is administered, while maintaining the MAP of the subject above about 80 mm Hg. 2. A method of treating a subject having high output shock and undergoing treatment with a catecholamine at a dose equivalent to above about 10 mcg/min of norepinephrine, comprising: administering angiotensin II to the subject at a rate effective to raise or maintain mean arterial pressure (MAP) of the subject above about 80 mm Hg; reducing the dose of the catecholamine, while maintaining the MAP of the subject above about 80 mm Hg; and reducing the rate at which angiotensin II is administered, while maintaining the MAP of the subject above about 80 mm Hg. 3. The method of claim 2, wherein reducing the dose of the catecholamine comprises reducing the dose of the catecholamine to the equivalent of about 5 mcg/min norepinephrine or less. 4. A method of maintaining a mean arterial pressure (MAP) of 65 mm Hg or above in a patient suffering from hypotension and undergoing treatment with a catecholamine at a rate equivalent to at least 0.2 mcg/kg/min of norepinephrine, comprising administering angiotensin II to the patient at a rate effective to maintain the MAP of the patient at about 65 mm Hg or above; reducing the rate at which the catecholamine is administered, while maintaining the MAP of the patient at about 65 mm Hg or above; and reducing the rate at which angiotensin II is administered, while maintaining the MAP of the patient at about 65 mm Hg or above. 5. The method of claim 4, wherein reducing the rate at which the catecholamine is administered comprises reducing the rate to the equivalent of about 0.2 mg/kg/min norepinephrine or less, wherein the MAP of the patient is maintained at about 65 mm Hg or above. 6. The method of claim 5, wherein reducing the rate at which the catecholamine is administered comprises reducing the rate to the equivalent of about 0.05 mg/kg/min norepinephrine or less, wherein the MAP of the patient is maintained at about 65 mm Hg or above. 7. The method of claim 4, wherein the patient is suffering from shock. 8. The method of claim 7, wherein reducing the rate at which the catecholamine is administered comprises reducing the rate to the equivalent of about 0.2 mg/kg/min norepinephrine or less, wherein the MAP of the patient is maintained at about 65 mm Hg or above. 9. The method of claim 7, wherein reducing the rate at which the catecholamine is administered comprises reducing the rate to the equivalent of about 0.05 mg/kg/min norepinephrine or less, wherein the MAP of the patient is maintained at about 65 mm Hg or above. 10. The method of claim 7, wherein the shock is high output shock. 11. The method of claim 10, wherein reducing the rate at which the catecholamine is administered comprises reducing the rate to the equivalent of about 0.2 mg/kg/min norepinephrine or less, wherein the MAP of the patient is maintained at about 65 mm Hg or above. 12. The method of claim 11, wherein reducing the rate at which the catecholamine is administered comprises reducing the rate to the equivalent of about 0.05 mg/kg/min norepinephrine or less, wherein the MAP of the patient is maintained at about 65 mm Hg or above. 13. The method of claim 1, wherein the patient is catecholamine-resistant. 14. The method of claim 1, wherein the catecholamine is norepinephrine, or the catecholamine is epinephrine and the dose equivalent to 5 mcg/min of norepinephrine is 5 mcg/min; or the catecholamine is dopamine and the dose equivalent to 5 mcg/min of norepinephrine is 750 mcg/min; or the catecholamine is phenylephrine and the dose equivalent to 5 mcg/min of norepinephrine is 50 mcg/min. 15. The method of claim 1, wherein reducing the rate at which angiotensin II is administered comprises reducing the rate to about 0.25 ng/kg/min to about 10 ng/kg/min. 16. The method of claim 15, wherein reducing the rate at which angiotensin II is administered comprises reducing the rate to about 0.25 ng/kg/min to about 5 ng/kg/min. 17. The method of claim 16, wherein reducing the rate at which angiotensin II is administered comprises reducing the rate to about 1 ng/kg/min. 18. The method of claim 16, wherein reducing the rate at which angiotensin II is administered comprises reducing the rate to about 2 ng/kg/min. 19. The method of claim 16, wherein reducing the rate at which angiotensin II is administered comprises reducing the rate to about 3 ng/kg/min. 20. The method of claim 1, wherein reducing the rate at which angiotensin II is administered comprises reducing the rate to about 2.5 ng/kg/min to about 35 ng/kg/min. 21. The method of claim 1, wherein the angiotensin II and the catecholamine are administered intravenously, intramuscularly, subcutaneously or by inhalation. 22. The method of claim 21, wherein the angiotensin II and the catecholamine are administered intravenously. 23. The method of claim 1, wherein the subject is a human. 24. The method of claim 4, wherein reducing the rate at which the catecholamine is administered is performed before reducing the rate at which angiotensin II is administered. 25. The method of claim 4, wherein reducing the rate at which angiotensin II is administered is performed before reducing the rate at which the catecholamine is administered. 26. The method of claim 4, wherein reducing the rate at which angiotensin II is administered is performed concomitantly with reducing the rate at which the catecholamine is administered. 27. The method of claim 4, wherein the rate effective to maintain the MAP of the patient at about 65 mm Hg or above is about 10 ng/kg/min to about 50 ng/kg/min. 28. The method of claim 4, wherein the rate effective to maintain the MAP of the patient at about 65 mm Hg or above is at least about 20 ng/kg/min. 29. The method of claim 28, wherein the rate effective to maintain the MAP of the patient at about 65 mm Hg or above is about 20 ng/kg/min to about 40 ng/kg/min.