Quantum Leap Healthcare Collaborative sponsor of the I-SPY COVID Trial, will not proceed with further testing of the Aerpio Pharmaceuticals (Nasdaq: ARPO) drug, razuprotafib. Razuprotafib was chosen for testing in the I-SPY COVID Trial because it is hypothesized to stabilize and repair the blood vessels in the lung and improve gas exchange. The I-SPY COVID Trial is a Phase II adaptive platform trial that is testing agents that show promise for reducing the risk of death from and severity of illness for people who become critically ill after contracting COVID-19. The purpose of the trial is to rapidly screen multiple agents to find those with the best chance of effectively improving outcomes for those critically ill. The I-SPY COVID Trial now includes 18 sites as well as leaders in pulmonary and critical care centers from around the country who are working to identify and test new agents to improve patient outcomes. The sponsor halted testing of Aerpio’s razuprotafib in the I-SPY COVID Trial because it was challenging to administer in the setting of COVID-19, with 30% of patients discontinuing the agent due to disease-related hypotension, including protocol-mandated stopping rules. There was no indication that razuprotafib caused the hypotension that led to clinical decline in systolic blood pressure. However, at the conclusion of two safety lead-in cohorts, it was determined there was a small but not clinically significant decline in systolic blood pressure and mean arterial blood pressure by approximately 4–5 mm Hg; there was no significant difference between the 10 mg and 20 mg dose in blood pressure decline. In addition, there was little if any blood pressure reduction in patients with pre-dose blood pressure readings of less than 100 mm Hg, even when on vasopressors, and there was no evidence that razuprotafib reduced the efficacy of vasopressors. Because blood pressure monitoring with additional scrutiny is challenging in the setting of a surge in ICU admissions from COVID-19, the Data Monitoring Committee recommended that razuprotafib not be advanced after the second safety lead-in. This agent could be revisited in the setting of acute respiratory distress syndrome (ARDS) absent pandemic COVID-19.