nafamostat / Generic mfg. - LARVOL DELTA

Effect of extracorporeal anticoagulation with nafamostat mesilate and continuous renal replacement therapy on sepsis complicated with acute kidney injury. (PubMed, Int J Clin Pharmacol Ther) - "NM outperforms RCA in prolonging the hemofilter lifespan, reducing hemofilter replacement frequency, improving renal perfusion and renal function, and eliminating inflammatory mediators."

Journal • Acute Kidney Injury • Infectious Disease • Nephrology • Oncology • Renal Disease • Septic Shock • CST3 • IL6 • TNFA

Successful application of innovative hybrid anticoagulation in continuous renal replacement therapy for an ultra-elderly patient: a case report. (PubMed, BMC Nephrol) - "The innovative hybrid anticoagulation strategy effectively prolonged CRRT circuit longevity in an ultra-elderly patient at high risk of citrate accumulation without procedure-associated complications. This approach represents a promising alternative for patients who have contraindications to conventional citrate anticoagulation."

Journal • Acute Kidney Injury • Cardiovascular • Congestive Heart Failure • Heart Failure • Hematological Disorders • Hepatology • Liver Failure • Metabolic Disorders • Nephrology • Renal Disease • Respiratory Diseases

Searching for Novel Antiviral Agents as COVID19 Treatments: Guanidino Diaryl Thioureas. (PubMed, ChemMedChem) - "The findings suggest that reversible inhibitors may be suboptimal for TMPRSS2 targeting, as camostat and nafamostat exert their effects through irreversible covalent binding. Future efforts should focus on developing irreversible TMPRSS2 inhibitors to enhance antiviral efficacy against SARS-CoV-2."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Nafamostat mesylate in renal replacement therapy: balancing efficacy with emerging risks of hyperkalemia. (PubMed, Ren Fail) - No abstract available

Journal

Multifaceted anticancer activity of nafamostat mesylate in human fibrosarcoma: first evidence of mitochondrial apoptosis and suppressed MMP-2/-9 mRNA expression. (PubMed, BMC Pharmacol Toxicol) - "This study provides the first evidence that nafamostat mesylate exerts multifaceted anticancer effects in HT1080 fibrosarcoma cells, targeting proliferation, migration, apoptosis, and invasion. These findings support the potential repurposing of nafamostat mesylate as a therapeutic agent for fibrosarcoma and warrant further preclinical investigations to evaluate its translational applicability."

Journal • Fibrosarcoma • Oncology • Sarcoma • Solid Tumor • ANXA5 • MMP2 • MMP9

Nafamostat mesilate attenuates renal fibrosis by suppressing the IL-17 signaling pathway. (PubMed, Front Pharmacol) - "Its renal protective effect is related to the inhibition of the IL-17/c-Fos signaling pathway. The above content proves that NM can be a potential drug for the treatment of CKD."

Journal • Cardiovascular • Chronic Kidney Disease • Fibrosis • Immunology • Inflammation • Metabolic Disorders • Nephrology • Renal Disease • Reperfusion Injury • FOS • GZMB • IL17A • TGFB1

Using protease inhibitors to prevent intraperitoneal adhesions: effects of nafamostat mesylate, UAMC-00050, GM6001, and enoxaparin in the cecal ligation and puncture model and the ischemic button model. (PubMed, Surg Today) - "Enoxaparin and NFM reduced adhesions effectively, suggesting that coagulation inhibition plays a key role. These findings suggest that selective protease inhibitors, when administered in a timely manner, could reduce intraperitoneal adhesions."

Journal • Gastrointestinal Disorder

Nafamostat Mesilate as an Anticoagulation Strategy for Heparin-Induced Thrombocytopenia (KIDNEY WEEK 2025) - "Heparin was discontinued, and anticoagulation transitioned to argatroban and later nafamostat mesilate due to argatroban shortage. Key questions remain regarding heparin rechallenge safety, causative agent identification in multi-heparin exposure, and rapid differentiation of HIT from anaphylactoid reactions. Further studies are needed to optimize HIT management in high-risk populations."

Cardiovascular • Chronic Kidney Disease • Hematological Disorders • Nephrology • Renal Disease • Thrombocytopenia

In vitro anticoagulant effect of nafamostat mesylate in andexanet-induced heparin resistance. (PubMed, Thromb Res) - No abstract available

Journal • Preclinical

Effect of nafamostat mesylate anticoagulation and regional citrate anticoagulation during continuous renal replacement therapy in critically ill patients: a retrospective study of efficacy and safety. (PubMed, Ren Fail) - "RCA demonstrated superior anticoagulation efficacy in prolonging filter survival, while NM may offer a more favorable metabolic safety profile. The choice of anticoagulant should be individualized based on efficacy priorities and metabolic risk."

Journal • Retrospective data • Endocrine Disorders • Metabolic Disorders

Comparison of the efficacy and safety of nafamostat mesylate and heparin in blood purification therapy for patients with severe acute pancreatitis: A randomized controlled trial (ChiCTR) - P4 | N=140 | Not yet recruiting | Sponsor: Weifang People's Hospital; Weifang People's Hospital

New P4 trial • Pancreatitis

The Safety and Efficacy of Different Anticoagulation Strategies in Double Filtration Plasmapheresis Therapy (ChiCTR) - P=N/A | N=300 | Not yet recruiting | Sponsor: West China Hospital of Sichuan University; West China Hospital of Sichuan University

New trial

Clinical research on nafamostat mesylate for injection (ChiCTR) - P3 | N=220 | Not yet recruiting | Sponsor: The Second Affiliated Hospital of Nanjing Medical University; The Second Affiliated Hospital of Nanjing Medical University

New P3 trial • Renal Disease

Low antithrombin III activity, nafamostat monotherapy without heparin, and small filter size are associated with a shorter circuit lifespan in pediatric continuous kidney replacement therapy: A single-center retrospective cohort study. (PubMed, Blood Purif) - "Low ATIII activity, NM monotherapy without heparin, and small filter size were independent risk factors for a shorter circuit lifespan in pediatric CKRT."

Journal • Monotherapy • Retrospective data • Pediatrics

In vitro inhibition of snake venom toxins by varespladib, marimastat, nafamostat and dimercaprol. (PubMed, Toxicon) - "Nafamostat proved to be an inhibitor of snake venom serine protease (svSP) in B. arietans (IC50 = 3.72 μM), B. gabonica (IC50 = 3.80 μM) and Causus rhombeatus (IC50 = 0.261 μM). These data demonstrate that SMTs are effective inhibitors of the relevant enzymes in several snake species and support the proposal that SMTs could be developed for therapeutic intervention in snakebite envenoming."

Journal • Preclinical

Development of a predictive model for nafamostat mesylate dosing in hemodialysis. (PubMed, BMC Nephrol) - "The nafamostat dosage prediction model can be used to calculate the dose required for individual patients. However, further studies for model improvement and external validation are required."

Journal

NEPHRO: Nafamostat Efficacy in Phase 3 Registrational CRRT Study (clinicaltrials.gov) - P=N/A | N=70 | Recruiting | Sponsor: Talphera, Inc | N=166 ➔ 70

Enrollment change • Acute Kidney Injury • Nephrology • Renal Disease

NEPHRO: Nafamostat Efficacy in Phase 3 Registrational CRRT Study (clinicaltrials.gov) - P=N/A | N=166 | Recruiting | Sponsor: Talphera, Inc | Trial completion date: Dec 2024 ➔ Dec 2025 | Trial primary completion date: Dec 2024 ➔ Dec 2025

Trial completion date • Trial primary completion date • Acute Kidney Injury • Nephrology • Renal Disease

ACE2-Decoy-Conjugated PLGA-PEG Nanoparticles Loaded with Nafamostat for Potent Antiviral Activity. (PubMed, Viruses) - "Notably, NM-PP-Pro NPs displayed potent antiviral activity, with an IC50 < 0.05 nM against wild-type SARS-CoV-2 and remained effective against the D614G variant (IC50 = 2 nM). These results underscore the potential of NM-PP-Pro NPs as a versatile nanotherapeutic platform for targeting SARS-CoV-2 and its emerging variants."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Targeting viral RNA pseudoknots: a multi-level computational approach to identify RNA-binding novel small molecules. (PubMed, Mol Divers) - "Compared to the control compound Nafamostat, F2879-5340 exhibited superior predicted pharmacokinetic properties, including higher intestinal absorption, better bioavailability, and no mutagenic potential. These results suggest that F2879-5340 is a potent candidate for further experimental validation as an orally bioavailable - 1 PRF inhibitor. This work presents a novel computational pipeline for RNA-targeted drug discovery in the context of SARS-CoV-2."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Use of Nafamostat Mesilate for Anticoagulation in Patients With ECMO (clinicaltrials.gov) - P=N/A | N=80 | Recruiting | Sponsor: Xiaotong Hou | Not yet recruiting ➔ Recruiting | Trial primary completion date: Mar 2026 ➔ Nov 2026

Enrollment open • Trial primary completion date • Cardiovascular

Therapeutic Potential of Tubular Serine Protease Inhibitors in Proteinuria. (PubMed, Am J Physiol Renal Physiol) - "Serine protease inhibitors, such as aprotinin, camostat mesylate, and nafamostat mesylate, as well as off-target effects of amiloride, have shown promise in preclinical and early clinical studies by mitigating these pathological processes. We identify key knowledge gaps, including the need for mechanistic pharmacodynamic trials, biomarker-guided patient selection using urinary serine protease activity, and long-term efficacy and safety studies. Serine protease inhibitors are a promising, underexplored therapeutic strategy in proteinuric conditions that may complement existing treatments by targeting specific pathogenic mechanisms involved in disease progression."

Journal • Chronic Kidney Disease • Fibrosis • Immunology • Inflammation • Nephrology • Renal Disease

Chlamydia pneumoniae modulates neutrophil inflammation via unconventional pathways (ERS 2025) - " Bone marrow-derived neutrophils (BMDNs) were stimulated with C. pneumoniae or Streptococcus pneumoniae in vitro, with or without Cl-amidine (PAD4 inhibitor), nafamostat mesylate (serine protease inhibitor), or disulfiram (GSDMD inhibitor). C. pneumoniae modulates NETosis possibly via heat-labile chlamydia protease or other chlamydial proteins. Our goal is to clarify its role in NETosis and lung disease pathogenesis."

Asthma • Chronic Obstructive Pulmonary Disease • Infectious Disease • Inflammation • Pneumococcal Infections • Pneumonia • C5AR1 • IL1B

Large Library Docking and Biophysical Analysis of Small-Molecule TMPRSS2 Inhibitors. (PubMed, J Med Chem) - "Furthermore, we established a readily crystallizable form of TMPRSS2 protein that produced high-resolution crystal structures with nafamostat, '157, and 6-amidino-2-naphthol. A novel noncovalent inhibitor scaffold is biochemically validated as a potential avenue for developing TMPRSS2-selective inhibitors."

Journal • Infectious Disease • Influenza • Novel Coronavirus Disease • Respiratory Diseases • TMPRSS2

Application of nafamostat mesylate in 5 cases of extracorporeal carbon dioxide removal combined with continuous renal replacement therapy. (PubMed, Front Pharmacol) - "Extracorporeal carbon dioxide removal combined with continuous renal replacement therapy can partially replace lung ventilation function and improve hypercapnia. NM can be used as an anticoagulant in this technology, with an ideal anticoagulation effect and no significant risk of bleeding."

Journal • Acute Kidney Injury • Chronic Obstructive Pulmonary Disease • Immunology • Infectious Disease • Nephrology • Pneumonia • Pulmonary Disease • Renal Disease • Respiratory Diseases