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CytoSorbents Provides U.S. FDA and Health Canada Regulatory Update for DrugSorb-ATR

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CytoSorbents (NASDAQ: CTSO) provided regulatory updates regarding DrugSorb-ATR, its FDA-designated Breakthrough Device, in both the U.S. and Canada. The FDA has scheduled an appeal hearing for the company's supervisory review, expected to complete by August 2025.

In Canada, Health Canada issued a Notice of Refusal for the Medical Device License application. CytoSorbents plans to file a Level 1 "Request for Reconsideration" by July 25, 2025. DrugSorb-ATR is designed to reduce bleeding severity in patients undergoing coronary artery bypass grafting (CABG) surgery within 2 days of stopping Brilinta®. The company expects final regulatory decisions from both authorities by year-end 2025.

CytoSorbents (NASDAQ: CTSO) ha fornito aggiornamenti normativi riguardanti DrugSorb-ATR, il dispositivo designato come Breakthrough Device dalla FDA, sia negli Stati Uniti che in Canada. La FDA ha programmato un'udienza di appello per la revisione supervisoria dell'azienda, con conclusione prevista entro agosto 2025.

In Canada, Health Canada ha emesso un Avviso di Rifiuto per la domanda di Licenza del Dispositivo Medico. CytoSorbents intende presentare una Richiesta di Riesame di Livello 1 entro il 25 luglio 2025. DrugSorb-ATR è progettato per ridurre la gravità delle emorragie nei pazienti sottoposti a intervento di bypass coronarico (CABG) entro 2 giorni dalla sospensione di Brilinta®. L'azienda prevede decisioni normative finali da entrambe le autorità entro la fine del 2025.

CytoSorbents (NASDAQ: CTSO) proporcionó actualizaciones regulatorias sobre DrugSorb-ATR, su Dispositivo de Avance designado por la FDA, tanto en EE. UU. como en Canadá. La FDA ha programado una audiencia de apelación para la revisión supervisora de la empresa, con finalización esperada para agosto de 2025.

En Canadá, Health Canada emitió un Aviso de Rechazo para la solicitud de Licencia de Dispositivo Médico. CytoSorbents planea presentar una Solicitud de Reconsideración de Nivel 1 antes del 25 de julio de 2025. DrugSorb-ATR está diseñado para reducir la gravedad del sangrado en pacientes que se someten a cirugía de bypass de arteria coronaria (CABG) dentro de los 2 días posteriores a la suspensión de Brilinta®. La empresa espera decisiones regulatorias finales de ambas autoridades para finales de 2025.

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캐나다에서는 Health Canada가 의료기기 허가 신청� 대� 거부 통지� 발행했습니다. CytoSorbents� 2025� 7� 25�까지 1단계 재심 요청� 제출� 계획입니�. DrugSorb-ATR은 Brilinta® 복용 중단 � 2� 이내� 관상동� 우회�(CABG)� 받는 환자� 출혈 심각도를 줄이도록 설계되었습니�. 회사� 양국 규제 당국으로부� 2025� �까지 최종 결정� 받을 것으� 예상하고 있습니다.

CytoSorbents (NASDAQ : CTSO) a fourni des mises à jour réglementaires concernant DrugSorb-ATR, son dispositif désigné Breakthrough Device par la FDA, aux États-Unis et au Canada. La FDA a programmé une audience d’appel pour la révision supervisée de l’entreprise, dont la conclusion est prévue pour août 2025.

Au Canada, Santé Canada a émis un avis de refus pour la demande de licence de dispositif médical. CytoSorbents prévoit de déposer une demande de réexamen de niveau 1 avant le 25 juillet 2025. DrugSorb-ATR est conçu pour réduire la gravité des saignements chez les patients subissant une chirurgie de pontage coronarien (CABG) dans les 2 jours suivant l’arrêt de Brilinta®. L’entreprise s’attend à des décisions réglementaires finales des deux autorités d’ici la fin de l’année 2025.

CytoSorbents (NASDAQ: CTSO) gab regulatorische Updates zu DrugSorb-ATR bekannt, ihrem von der FDA als Breakthrough Device eingestuften Produkt, sowohl in den USA als auch in Kanada. Die FDA hat eine Berufungsverhandlung für die Überprüfungsaufsicht des Unternehmens angesetzt, die voraussichtlich bis August 2025 abgeschlossen sein wird.

In Kanada hat Health Canada eine Ablehnungsmitteilung für den Antrag auf eine Medizinproduktlizenz erlassen. CytoSorbents plant, bis zum 25. Juli 2025 einen Level-1-Antrag auf Neubewertung einzureichen. DrugSorb-ATR wurde entwickelt, um die Schwere von Blutungen bei Patienten zu reduzieren, die sich innerhalb von 2 Tagen nach Absetzen von Brilinta® einer koronaren Bypass-Operation (CABG) unterziehen. Das Unternehmen erwartet endgültige regulatorische Entscheidungen beider Behörden bis Ende 2025.

Positive
  • DrugSorb-ATR has FDA Breakthrough Device designation
  • Product addresses unmet medical need with no current approved alternatives
  • Company has opportunity for direct interaction with FDA senior leadership
  • Multiple appeal pathways available in both U.S. and Canada
Negative
  • FDA De Novo Request has remaining deficiencies requiring appeal
  • Health Canada issued Notice of Refusal for Medical Device License
  • Regulatory approval timeline extended due to appeals process
  • Product faces regulatory challenges in two major markets simultaneously

Insights

CytoSorbents faces regulatory setbacks for DrugSorb-ATR with both FDA and Health Canada, delaying potential approval until late 2025.

CytoSorbents has provided an update on its regulatory pathway for DrugSorb-ATR, their blood purification device designed to reduce bleeding severity in patients undergoing coronary artery bypass grafting (CABG) surgery soon after taking the blood thinner Brilinta. The update reveals notable challenges on two regulatory fronts.

The FDA has scheduled an appeal hearing for the company's supervisory review request, following what appears to be initial rejection of their De Novo application. This administrative appeal process will allow direct engagement with FDA senior leadership and is expected to conclude by August 2025. The company believes remaining deficiencies can be resolved through this process.

Simultaneously, Health Canada has issued a Notice of Refusal for the company's Medical Device License application, citing non-compliance with certain regulations. CytoSorbents plans to file a Level 1 "Request for Reconsideration" by July 25, 2025, as part of Health Canada's prescribed reconsideration process.

This dual regulatory challenge is significant because DrugSorb-ATR targets an unmet medical need. Despite the setbacks, management maintains confidence in eventual approval, projecting final regulatory decisions by year-end 2025.

The appeal processes with both agencies will be critical to watch, as they will determine if and when this FDA-designated Breakthrough Device reaches the market. The device addresses a growing cardiac surgery need with potentially tens of thousands of patients at risk annually in these markets.

PRINCETON, N.J., July 2, 2025 /PRNewswire/ --(ٴ: CTSO), a leader in blood purification therapies for life-threatening conditions in the intensive care unit and cardiac surgery, today provided a regulatory update on its marketing applications for DrugSorb�-ATR with the U.S. Food and Drug Administration (FDA) and Health Canada. DrugSorb-ATR is an FDA-designated Breakthrough Device designed to reduce the severity of bleeding in patients undergoing coronary artery bypass grafting (CABG) surgery within 2 days of stopping the antiplatelet drug Brilinta® (ticagrelor, AstraZeneca), a commonly used blood thinner.

U.S. FDA Update:
On June 27, 2025, the FDA confirmed the scheduling of an appeal hearing date for the Company's requested supervisory review (administrative appeal) under 21 CFR 10.75. The Company continues to believe remaining deficiencies in its De Novo Request can be effectively resolved through this supervisory review process that enables direct interaction and engagement with FDA senior leadership and our external experts, which is expected to complete by the end of August 2025.

Health Canada Update:
On June 26, 2025, Health Canada issued a Notice of Refusal of the Company's Medical Device License application, citing non-compliance with certain Medical Devices Regulations. As part of Health Canada's prescribed reconsideration process, the Company intends to file a Level 1 "Request for Reconsideration" with the Medical Devices Directorate Bureau Director by July 25, 2025. The prescribed reconsideration process allows for supervisory review and provides the opportunity to directly address issues raised in the Notice of Refusal with staff not involved in the original review and may include input from qualified external subject matter experts. If marketing authorization is not received as part of the reconsideration process, the Company can then file a formal Appeal with the Director General of the Medical Devices Directorate.

"We believe DrugSorb-ATR addresses a critical and growing need in cardiac surgery by helping to reduce the severity of perioperative bleeding in patients undergoing CABG surgery on Brilinta®," said Dr. Phillip Chan, Chief Executive Officer of CytoSorbents. "With no other approved therapies currently available to patients and cardiac surgeons in the U.S. and Canada, we believe DrugSorb-ATR offers a highly differentiated solution to this large and underserved market. We remain confident in the strength of our regulatory submissions and are committed to working through the appeals processes in a timely manner with both FDA and Health Canada to bring this FDA Breakthrough Designated therapy to the tens of thousands of patients at risk and the surgical teams that operate on them each year in these countries. We continue to expect final regulatory decisions by the end of this year."

About CytoSorbents Corporation (NASDAQ: CTSO)

is a leader in the treatment of life-threatening conditions in the intensive care unit and cardiac surgery through blood purification. CytoSorbents' proprietary blood purification technologies are based on biocompatible, highly porous polymer beads that can actively remove toxic substances from blood and other bodily fluids by pore capture and surface adsorption. Cartridges filled with these beads can be used with standard blood pumps already in the hospital (e.g. dialysis, continuous renal replacement therapy or CRRT, extracorporeal membrane oxygenation or ECMO, and heart-lung machines), where blood is repeatedly recirculated outside the body, through our cartridges where toxic substances are removed, and then back into the body. CytoSorbents' technologies are used in a number of broad applications. Specifically, two important applications are 1) the removal of blood thinners during and after cardiothoracic surgery to reduce the risk of severe bleeding, and 2) the removal of inflammatory agents and toxins in common critical illnesses that can lead to massive inflammation, organ failure and patient death. The breadth of these critical illnesses includes, for example, sepsis, burn injury, trauma, lung injury, liver failure, cytokine release syndrome, and pancreatitis as well as the removal of liver toxins that accumulate in acute liver dysfunction or failure, and the removal of myoglobin in severe rhabdomyolysis that can otherwise lead to renal failure. In these diseases, the risk of death can be extremely high, and there are few, if any, effective treatments.

CytoSorbents' lead product,, is approved in theEuropean UnionԻ distributed in over 70 countries worldwide, with more than 270,000 devices used cumulatively to date. CytoSorb was originally launched in theEuropean Unionunder CE mark as the first cytokine adsorber. Additional CE mark extensions were granted for bilirubin and myoglobin removal in clinical conditions such as liver disease and trauma, respectively, and forԻremoval in cardiothoracic surgery procedures. CytoSorb has also receivedinthe United Statesfor use in adult critically ill COVID-19 patients with impending or confirmed respiratory failure. CytoSorb is not yet approved or cleared intheUnited States.

In the U.S. and Canada, CytoSorbents is developing the DrugSorb�-ATR antithrombotic removal system, an investigational device based on an equivalent polymer technology to CytoSorb, to reduce the severity of perioperative bleeding in high-risk surgery due to blood thinning drugs. It has received two: one for the removal ofԻ another for the removal of thein a cardiopulmonary bypass circuit during urgent cardiothoracic procedures. In September 2024, the Company requesting marketing authorization for the DrugSorb-ATR medical device to reduce the severity of perioperative bleeding in CABG patients on the antithrombotic drug ticagrelor, which was . On April 25, 2025, the FDA issued a De Novo Denial Letter regarding the Company's De Novo Request for DrugSorb-ATR, identifying remaining deficiencies that must be addressed before the De Novo Request can be granted and the device authorized for U.S. commercialization. The Company believes these items can be most effectively and expeditiously resolved through the formal appeals process, which facilitates engagement with FDA senior leadership and our external surgical experts. The Company filed its appeal with the FDA on June 18, 2025 and a hearing is now scheduled. Given the expedited timelines associated with the appeals process, the Company believes that a final regulatory decision can be achieved in 2025. In November 2024, the Company received its MDSAP . DrugSorb-ATR has not been authorized for commercialization in the U.S. or Canada.

The Company has numerous marketed products and products under development based upon this unique blood purification technology protected by many issuedU.S.and international patents and registered trademarks, and multiple patent applications pending, including ECOS-300CY®, CytoSorb-XL�, HemoDefend-RBC�, HemoDefend-BGA�, VetResQ®, K+ontrol�, DrugSorb�, ContrastSorb, and others. For more information, please visit the Company's website ator follow us onԻ.

Forward-Looking Statements

This press release includes forward-looking statements intended to qualify for the safe harbor from liability established by the Private Securities Litigation Reform Act of 1995. These forward-looking statements include, but are not limited to, statements about our plans, objectives, future targets and outlooks for our business, representations and contentions, and the outcome of our regulatory submissions, and are not historical facts and typically are identified by use of terms such as "may," "should," "could," "expect," "plan," "anticipate," "believe," "estimate," "predict," "potential," "continue" and similar words, although some forward-looking statements are expressed differently. You should be aware that the forward-looking statements in this press release represent management's current judgment and expectations, but our actual results, events and performance could differ materially from those in the forward-looking statements. Factors which could cause or contribute to such differences include, but are not limited to, our restructuring of our direct sales team and strategy in Germany, our ability to resolve remaining deficiencies in the FDA denial letter and the Health Canada Notice of Refusal and/or successfully appeal the FDA's and Health Canada's decision, and the risks discussed in our Annual Report on Form 10-K, filed with the SEC on March 31, 2025, as updated by the risks reported in our Quarterly Reports on Form 10-Q, and in the press releases and other communications to shareholders issued by us from time to time which attempt to advise interested parties of the risks and factors which may affect our business. We caution you not to place undue reliance upon any such forward-looking statements. We undertake no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events, or otherwise, other than as required under the Federal securities laws.

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U.S. Company Contact:
Peter J. Mariani, Chief Financial Officer
305 College Road East
Princeton, NJ 08540
[email protected]

Investor Relations Contact:
Aman Patel, CFA & Adanna G. Alexander, PhD
ICR Healthcare
[email protected]

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SOURCE Cytosorbents Corp

FAQ

What is the current FDA status of CytoSorbents' (CTSO) DrugSorb-ATR device?

DrugSorb-ATR is currently undergoing an FDA appeal process through supervisory review, with an appeal hearing scheduled and expected to complete by August 2025.

What is DrugSorb-ATR designed to treat?

DrugSorb-ATR is designed to reduce bleeding severity in patients undergoing CABG surgery within 2 days of stopping the blood thinner Brilinta® (ticagrelor).

What is the status of DrugSorb-ATR approval in Canada?

Health Canada issued a Notice of Refusal for the Medical Device License application. CytoSorbents plans to file a Level 1 Request for Reconsideration by July 25, 2025.

When does CytoSorbents (CTSO) expect final regulatory decisions for DrugSorb-ATR?

The company expects to receive final regulatory decisions from both FDA and Health Canada by the end of 2025.

Why is DrugSorb-ATR considered important for cardiac surgery?

It addresses a critical need as there are currently no other approved therapies for reducing bleeding in CABG patients on Brilinta® in the U.S. and Canada.
Cytosorbents Corp

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Medical Devices
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