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Hemoximer (pyridoxalated hemoglobin-polyoxyethylene conjugate, or PHP) is a chemically-modified human hemoglobin developed as a nitric oxide (NO) scavenger. Originally conceived as a hemoglobin-based oxygen carrier (HBOC), it was repurposed to treat distributive shock, a condition characterized by excessive NO production leading to pathological vasodilation and hypotension. Developed by Apex Bioscience (a subsidiary of Curacyte AG), hemoximer consists of human hemoglobin modified with pyridoxal-5-phosphate and conjugated with polyoxyethylene to increase its molecular size and circulation time. Despite reaching Phase III clinical trials for catecholamine-resistant distributive shock, development was discontinued after interim analysis revealed increased mortality in patients receiving the drug compared to those on standard vasopressor therapy.
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