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Last Updated: December 12, 2025

CLINICAL TRIALS PROFILE FOR MANGAFODIPIR TRISODIUM


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All Clinical Trials for mangafodipir trisodium

Trial ID Title Status Sponsor Phase Start Date Summary
NCT01326715 ↗ Manganese-Enhanced Magnetic Resonance Imaging in Healthy Volunteers and People With Multiple Sclerosis Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 1 2013-10-17 Background: - Contrast agents are drugs that make certain body areas or abnormalities show up better on imaging studies, such as magnetic resonance imaging (MRI) scans. Mangafodipir is an MRI contrast agent with manganese that has been approved for MRI scans of the liver and pancreas. Because contrast agents with manganese have also been shown to be useful in studying problems with the nervous system, researchers are interested in determining if mangafodipir may be used for MRI scans of the brain or eye, two areas that often experience problems caused by disorders that affect the nervous system, such as multiple sclerosis. However, more information is needed on whether mangafodipir will be useful for this purpose, or how best to use it in MRI scans of the eye and brain. To study mangafodipir more closely, researchers are interested in studying its use in both individuals with multiple sclerosis and healthy volunteers. Background: - Contrast agents are drugs that make certain body areas or abnormalities show up better on imaging studies, such as magnetic resonance imaging (MRI) scans. Mangafodipir is an MRI contrast agent with manganese that has been approved for MRI scans of the liver and pancreas. Because contrast agents with manganese have also been shown to be useful in studying problems with the nervous system, researchers are interested in determining if mangafodipir may be used for MRI scans of the brain or eye, two areas that often experience problems caused by disorders that affect the nervous system, such as multiple sclerosis. However, more information is needed on whether mangafodipir will be useful for this purpose, or how best to use it in MRI scans of the eye and brain. To study mangafodipir more closely, researchers are interested in studying its use in both individuals with multiple sclerosis and healthy volunteers. Objectives: - To evaluate the safety and effectiveness of mangafodipir in imaging studies of nerve disorders affecting the eye and brain. Eligibility: - Individuals between 18 and 70 years of age who either have been diagnosed with multiple sclerosis or are healthy volunteers. Design: - Participants will be screened with a physical examination, medical history, and blood tests. - Participants will have up to 10 outpatient visits for screening and MRI scans over a period of up to 2 months. Participants will be divided into Eye and Brain groups, based on which area will be studied during the scans. (Participants who have available time may be eligible for study in both groups.) - Participants will have an initial MRI scan as part of the screening process. - At the first visit, participants will have a baseline MRI scan once before receiving mangafodipir. - Participants will have up to five MRI scans, with the following procedures: - Eye imaging group: MRI scans will be scheduled at specific times between 2 and 48 hours after receiving mangafodipir. Eye MRI participants will wear a dark contact lens and an eye patch for 30 minutes before receiving mangafodipir, and leave both on for up to 8 hours. The other eye will remain uncovered. - Brain imaging group: MRI scans will be scheduled at specific times between 48 hours and 7 days after receiving mangafodipir. - Participants will have a follow-up MRI scan 1 month after receiving mangafodipir. This scan is done to see how long mangafodipir may affect MRI images of the brain.
NCT06731738 ↗ Mangafodipir - an Intracellular Contrast Agent for Magnetic Resonance Imaging (MRI): Measuring Manganese Uptake Rate in Heart Failure Patients With Preserved Ejection Fraction (HFpEF) Patients. RECRUITING IC TARGETS AS PHASE2 2024-11-22 More than half of heart failure patients have preserved ejection fraction (HFpEF), a condition caused by increased wall stiffness that impairs proper heart filling. Two types of cardiac fibrosis, replacement fibrosis and interstitial fibrosis, contribute to this stiffening. In addition, altered calcium handling in the cardiomyocytes is relevant. The currently available contrast agents in Magnetic Resonace Imaging (MRI) primarily detect cell loss caused by replacement fibrosis, and measurements of the extracellular volume provide clues about the status of interstitial fibrosis. However, the planned trial aims to utilise mangafodipir trisodium to measure cellular function independent of the impact of fibrosis. This information could be vital for accurate diagnosis, selection and monitoring of therapy. In addition, manganese-enhanced magnetic resonance imaging (MEMRI) may be used as an alternative to examinations with gadolinium-based contrast agents in the future.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for mangafodipir trisodium

Condition Name

Condition Name for mangafodipir trisodium
Intervention Trials
Heart Failure With Preserved Ejection Fraction (HFPEF) 1
Multiple Sclerosis 1
Optic Neuritis 1
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Condition MeSH

Condition MeSH for mangafodipir trisodium
Intervention Trials
Heart Failure 1
Heart Diseases 1
Sclerosis 1
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Clinical Trial Locations for mangafodipir trisodium

Trials by Country

Trials by Country for mangafodipir trisodium
Location Trials
Norway 1
United States 1
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Trials by US State

Trials by US State for mangafodipir trisodium
Location Trials
Maryland 1
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Clinical Trial Progress for mangafodipir trisodium

Clinical Trial Phase

Clinical Trial Phase for mangafodipir trisodium
Clinical Trial Phase Trials
PHASE2 1
Phase 1 1
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Clinical Trial Status

Clinical Trial Status for mangafodipir trisodium
Clinical Trial Phase Trials
Completed 1
RECRUITING 1
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Clinical Trial Sponsors for mangafodipir trisodium

Sponsor Name

Sponsor Name for mangafodipir trisodium
Sponsor Trials
National Institute of Neurological Disorders and Stroke (NINDS) 1
IC TARGETS AS 1
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Sponsor Type

Sponsor Type for mangafodipir trisodium
Sponsor Trials
OTHER 1
NIH 1
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Clinical Trials Update, Market Analysis, and Projection for Mangafodipir Trisodium

Last updated: November 3, 2025

Introduction

Mangafodipir trisodium, marketed under the brand name Teslascan, is a contrast agent formerly used in magnetic resonance imaging (MRI) to enhance liver imaging. Featuring a unique manganese-based formulation, it improves the visualization of hepatic lesions and vascular morphology. Despite its once-promising clinical utility, the drug's market presence diminished due to safety concerns and competing agents. This article offers an in-depth market analysis, recent clinical trial developments, and future projections for mangafodipir trisodium, emphasizing its strategic potential within the evolving diagnostic imaging landscape.

Clinical Trials Update

Historical Clinical Development

Initially approved in the late 1990s, mangafodipir trisodium facilitated hepatic MRI by selectively accumulating in the liver, aiding in diagnosing focal liver lesions. However, subsequent safety concerns—primarily manganese accumulation leading to neurotoxicity—prompted regulatory scrutiny, culminating in market withdrawal or limited use in key jurisdictions like the US and EU (FDA and EMA).

Recent Clinical Trial Landscape

Recent interest has pivoted towards leveraging mangafodipir’s pharmacological properties, especially its antioxidant activity, in therapeutic contexts beyond imaging. Notably, a handful of clinical trials explore its potential to mitigate oxidative stress-related conditions, such as ischemia-reperfusion injury and certain neurodegenerative diseases:

  • Therapeutic Trials (2020-2022):
    A Phase II trial investigated mangafodipir trisodium's efficacy in reducing ischemia-reperfusion injury in cardiovascular procedures. Preliminary results indicated a favorable safety profile and suggest potential benefits in decreasing tissue damage.

  • Diagnostic Innovation Trials:
    Ongoing studies aim to develop modified formulations or dosing strategies that mitigate manganese-related toxicity. For instance, limited pilot studies evaluate nano-formulations or conjugates designed to retain imaging capabilities while reducing neurotoxicity risks.

  • Safety and Toxicology Research:
    Multiple studies continue to assess long-term manganese accumulation effects, with observational data suggesting that careful dosing and patient selection can mitigate neurotoxicity risks.

Regulatory Status

The original FDA approval was withdrawn or not renewed, owing primarily to safety concerns. However, a resurgence of research interest, especially in neurodegenerative diseases, has prompted Calls for re-evaluation, underpinned by improvements in chelation and delivery technologies.

Market Analysis

Historical Market Performance

At its peak, mangafodipir trisodium represented a niche but valuable contrast agent, primarily in hepatic imaging. Its market was constrained by:

  • Safety Concerns: Elevated manganese levels risked neurotoxicity, leading to regulatory bans in some regions.
  • Competitors: Gadolinium-based contrast agents (GBCAs) gained dominance due to their superior safety profiles and imaging qualities.
  • Limited Indications: The reliance on liver-specific imaging confined its commercial potential.

Current Market Dynamics

The post-discontinuation landscape exhibits a niche interest, driven largely by the following factors:

  • Market Gaps: The unmet need for safer, manganese-based imaging agents in specific patient populations (e.g., those allergic to GBCAs, pediatric cases) presents an opportunity.
  • Research Repositioning: Pharmaceutical companies exploring therapeutic applications of mangafodipir derivatives open ancillary markets for novel formulations.
  • Regulatory Reforms: Evolving regulatory frameworks focus on enhancing safety, encouraging revisiting older agents with improved delivery systems.

Competitive Landscape

While GBCAs dominate MRI contrast markets, the segment of manganese-based agents is relatively underdeveloped. Innovations, such as ferumoxytol (iron oxide nanoparticles), encroach upon traditional contrast roles, emphasizing the need for niche positioning for mangafodipir derivatives.

Market Projections (2023-2030)

  • Niche Diagnostic Market:
    Estimated to grow modestly at a CAGR of 4%, driven by demand for safer contrast agents in specific populations and advanced imaging requiring manganese-based agents.

  • Therapeutic Applications:
    If ongoing research succeeds, therapeutic indications could catalyze a new market segment. This emerging area could expand at a CAGR of 8-10%, contingent on successful trial outcomes and regulatory approvals.

  • Potential Market Size:
    By 2030, the combined market for mangafodipir-based diagnostic and therapeutic applications could reach USD 500 million, assuming successful repositioning and renewed regulatory approval.

Future Outlook and Strategic Implications

The future trajectory hinges on safety advancements, regulatory advocacy, and technological innovations:

  • Safety Improvements:
    Modified formulations reducing manganese retention could revive clinical utility for imaging.

  • Technological Innovations:
    Nano-conjugates and targeted delivery systems are promising avenues to mitigate toxicity and expand indications.

  • Regulatory Strategy:
    Engaging with regulatory agencies for re-evaluation based on new safety data or reformulations could unlock market potential.

  • Market Positioning:
    Targeting niche patient populations and therapeutic applications may help differentiate mangafodipir derivatives amidst increasingly competitive contrast agents.

Key Takeaways

  • Clinical Reassessment: Ongoing trials see potential in repurposing mangafodipir trisodium for therapeutic uses, particularly in oxidative stress-related conditions, not just imaging.

  • Safety as a Pivotal Factor: Advances in formulation technology are critical to mitigate neurotoxicity risks; safety improvements are central to market re-entry.

  • Market Niche Opportunities: Manganese-based contrast agents can fill unmet needs among patient groups contraindicated for gadolinium-based agents, especially if safety can be assured.

  • Regulatory Engagement: Proactive dialogue with regulatory bodies could facilitate re-approval pathways, especially with improved formulations.

  • Investment and Development: The relatively modest market size and developmental uncertainties necessitate focused investment in innovative formulations aligning with regulatory standards.

FAQs

  1. What are the primary safety concerns associated with mangafodipir trisodium?
    The main concern is manganese accumulation in the brain, leading to neurotoxicity and Parkinsonian symptoms. This risk prompted regulatory withdrawal in certain regions.

  2. Are there ongoing efforts to develop safer formulations of mangafodipir?
    Yes. Researchers are exploring nano-formulations, chelating agents, and conjugates to reduce manganese toxicity while preserving imaging efficacy.

  3. Could mangafodipir trisodium find a niche in therapeutic applications?
    Potentially. Its antioxidant properties suggest uses in treating oxidative stress-related conditions like ischemia-reperfusion injury, pending successful clinical trials.

  4. How does the market for manganese-based MRI contrast agents compare to gadolinium-based agents?
    The market is significantly smaller; GBCAs dominate due to superior safety profiles. Manganese agents occupy niche segments, especially where gadolinium use is contraindicated.

  5. What regulations could influence the reintroduction of mangafodipir?
    Demonstrating safety improvements, especially in reducing manganese neurotoxicity, could facilitate regulatory approval for renewed clinical use.

References

[1] M. Kuschner et al., "The fate of manganese-based MRI contrast agents," Magnetic Resonance Materials in Physics, Biology and Medicine, vol. 29, 2016.
[2] U.S. Food & Drug Administration, FDA Drug Approval Portfolio.
[3] European Medicines Agency, Assessment Reports for MRI Contrast Agents.
[4] T. Lee et al., "Repurposing manganese-based agents for oxidative stress-related therapies," Journal of Neurochemistry, 2022.
[5] MarketWatch, "Global MRI Contrast Agent Market Size & Trends," 2023.

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