Spinal Cord Injury Neuroprotection With Glyburide (SCING)
Spinal Cord Injury Neuroprotection With Glyburide; Pilot Study: An Open-Label Prospective Evaluation of the Feasibility, Safety, Pharmacokinetics, and Preliminary Efficacy of Oral Glyburide (DiaBeta) in Patients With Acute Traumatic Spinal Cord Injury
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
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Ohio
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Columbus, Ohio, United States, 43210
- The Ohio State University
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age: ≥ 18 years and ≤ 80 years
- Written informed consent by patient or legal authorized representative
- No other life-threatening injury
- No evidence of sepsis
- Acute cervical SCI with ASIA Impairment Scale grade A, B or C on admission
- Non-penetrating SCI at neurologic level from C2 to C8
- Initiation of study drug within 8 hours of injury
Exclusion Criteria
- Unconsciousness or other mental impairment that prevents neurological assessment within the first 8 hours
- Acute SCI with ASIA Impairment Scale grade D or E
- Currently involved in another non-observational SCI research study or receiving another investigational drug
- History of hypersensitivity to sulfonylureas, in particular glyburide, or any of its components
- Other illness (including mental disorder) that could preclude accurate medical and neurological evaluation (at discretion of the site investigator)
- Unable to commit to the follow-up schedule
- A recent history of regular substance abuse (illicit drugs, alcohol), which in the opinion of the investigator would interfere with the subject's participation in the study
- Any condition likely to result in the patient's death within the next 12 months
- Prisoner
- Severe renal disorder from the patient's history (e.g. dialysis) or baseline eGFR of < 30 mL/min/1.73 m2
- Known severe liver disease, or ALT > 3 times upper limit of normal or bilirubin > 2 times upper limit normal. Subjects may be randomized if liver function tests have been drawn but are not yet available and the subject has no known history of liver disease; however, treatment with DiaBeta will be discontinued prior to the second dose if liver function tests indicate ALT > 3 times upper limit of normal or bilirubin > 2 times upper limit of normal
- Blood glucose <55 mg/dL at enrollment or immediately prior to administration of DiaBeta, or a clinically significant history of hypoglycemia
- Acute ST elevation myocardial infarction, and/or acute decompensated heart failure, and/or QTc > 520 ms, and/or known history of cardiac arrest (PEA, VT, VF, asystole), and/or admission for an acute coronary syndrome, myocardial infarction, or coronary intervention (percutaneous coronary intervention or coronary artery surgery) within the past 3 months
- Known treatment with Bosentan within past 7 days
- Known G6PD enzyme deficiency
- Pregnancy: Women must be either post-menopausal, permanently sterilized or, if ≤ 50 years old, must have a negative test for pregnancy obtained before enrollment
- Breast-feeding women who do not agree to stop breast-feeding during and for 7 days following the end of oral glyburide administration
- Subjects who in the opinion of the investigator are not suitable for inclusion in the study (reason to be documented).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Glyburide Treatment Arm
Enrolled patients will receive 12 doses of Glyburide starting within 8 hours of SCI.
The dosing regimen involves an initial dose of 1.25 mg followed by eleven consecutive doses of 0.625 mg every 6 hours.
The total daily dose of Glyburide on Day 1, Day 2 and Day 3 will be 3.125 mg, 2.5 mg, and 2.5 mg respectively.
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3 day drug regimen beginning 8 hours after acute traumatic spinal cord injury.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With tSCI Recruited Within the Specified Time Window
Time Frame: Enrollment Period (within 8 hours of tSCI)
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A measure of feasibility of undertaking a larger phase II study among this population of patients where treatment must begin within a short injury-to-drug time window.
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Enrollment Period (within 8 hours of tSCI)
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Number of Drug Related Adverse Events
Time Frame: One year post enrollment
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A measure of safety of treating patients with traumatic spinal cord injury with Glyburide administered orally within a short injury-to-drug time window.
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One year post enrollment
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Number of Participants With Neurologic Recovery Following tSCI
Time Frame: One year post enrollment
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The neurologic status of patients will be assessed using the American Spinal Injury Association (ASIA) Impairment Scale (AIS) as assessed by International Standards for Neurological Classification of SCI (ISNCSCI) criteria.
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One year post enrollment
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Serum Pharmacokinetic and Biomarker Analysis
Time Frame: Enrollment through post-treatment day 7
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Plasma concentrations will be serially quantified through day 3 following tSCI to evaluate the pharmacokinetics of Glyburide in the acute tSCI population.
Comparisons will be made to reported levels achieved in healthy patient cohorts.
Standard enzyme-linked immunosorbent assay (ELISA) techniques will be used to measure blood levels of neurofilament light chain, neuron- specific enolase, tau, S100b, and glial fibrillary acidic protein levels on admission, at 24 hours and on days 3 and 7 following tSCI to evaluate serum biomarker levels.
Comparisons will be made to previously published values observed in non-treated control patients
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Enrollment through post-treatment day 7
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: H. Francis Farhadi, MD, PhD, Ohio State University
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2014H0335
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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