- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00559494
Minocycline and Perfusion Pressure Augmentation in Acute Spinal Cord Injury
March 15, 2013 updated by: Steve Casha, University of Calgary
A Pilot Study to Assess Clinical Safety and Tolerance of Minocycline and Spinal Perfusion Pressure Augmentation in Acute Spinal Cord Injury
While research in animal models of spinal cord injury have provided many promising insights, human studies have failed to produce effective therapies.
We propose to investigate the drug Minocycline (a metalloproteinase inhibitor) for the treatment of spinal cord injured patients aiming to limit neurological injury and improve neurological outcome.
This drug influences several secondary injury mechanisms implicated in spinal cord injury and has been effective in improving outcome after spinal cord injury in animal models.
We also propose to examine the safety and feasibility of spinal cord perfusion pressure augmentation with a protocol of IV fluids and inotrope medications versus standard maintenance of mean arterial pressure in subjects who exhibit a decrease in perfusion pressure to less than 75 mmHg.
The purpose of this pilot study is 1) to evaluate the feasibility of a clinical trial protocol for Minocycline in patients with acute spinal cord injury, and 2) to ensure adequate drug dosing and metabolic effect.
After undergoing a process of informed consent, patients agreeing to participate in the study will be randomized to placebo or treatment groups in a double-blind fashion.
Clinical neurological examinations, patient-reported quality of life, and functional independence categorization will be combined with serum and cerebrospinal fluid laboratory investigations to establish some of the pharmacological properties and the safety profile of this medication in this group of patients.
In addition, patient tolerance to the dosing regimen will be assessed.
The results of this study will provide the preliminary data necessary to plan for a larger prospective, randomized, controlled, double-blind clinical trial to assess efficacy and to further assess safety.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
52
Phase
- Phase 2
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Alberta
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Calgary, Alberta, Canada, T2N 2T9
- Foothills Medical Centre
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years and older (Child, Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age 16 or over
- Motor complete or motor incomplete acute spinal cord injury involving bony spinal levels between C0 and T11
- Patient able to provide informed consent
- Randomization and commencement of administration of first drug dose within 12 hours of injury
- surgical decompression if needed to be performed within 24 hours of the injury
- subjects exhibiting spinal cord perfusion pressure (lumbar drain transduced pressure - mean arterial pressure)> 75 mmHg will be randomized to active augmentation protocol versus maintenance of mean arterial pressure
Exclusion Criteria:
- Acute spinal cord injury >12 hours old
- Isolated sensory deficit, motor intact
- Isolated cauda equina injury or injury at bony level T12 or below
- History of systemic lupus erythematosus (SLE)
- Pre-existing hepatic or renal disease
- Tetracycline hypersensitivity
- Pregnancy or breast feeding
- Isolated sensory deficit
- Isolated radicular motor deficit
- Significant leukopenia (white blood cell count < ½ times the lower limit of normal) at screening
- Elevated liver function tests (AST, ALT, alkaline phosphatase, or total bilirubin > 2 times the upper limit of normal) at screening
- Presence of systemic disease that might interfere with patient safety, compliance or evaluation of the condition under study (e.g. insulin-dependent diabetes, Lyme disease, clinically significant cardiac disease, HIV, HTLV-1)
- Associated traumatic conditions interfering with informed consent or outcome assessment (e.g. closed head injury, liver contusion)
- Known uncorrected severe coronary artery disease or evidence of active coronary ischemia (ECG changes, positive Troponin) will be excluded from SCPP randomization
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Placebo
|
Normal saline 250cc via central line similar to minocycline arm administration protocol
Other Names:
|
Experimental: Minocycline
|
Minocycline IV BID x 7 days (first 10 patients 200 mg/dose, subsequent patients adjusted based on pharmacodynamic profiling to 800 mg loading dose, tapered 100 mg each dose to 400 mg then maintain at 400mg until day 7)
Other Names:
|
Experimental: SCPP augmentation
|
maintenance of spinal cord perfusion pressure at 75 mmHg with fluids and inotrope protocol
|
Sham Comparator: SCPP control
|
maintenance of Mean arterial pressure of >65 mmHg with fluids and inotropes protocol without spinal cord perfusion pressure as target or guiding therapy
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Protocol compliance, feasibility and adverse events
Time Frame: 2 years
|
2 years
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
American Spinal Injury Association - motor score (primary clinical outcome) and sensory scores
Time Frame: 2 years
|
2 years
|
Short Form 36 - Quality of Life Assessment
Time Frame: 2 years
|
2 years
|
Functional Independence Measure
Time Frame: 2 years
|
2 years
|
London Handicap Scale
Time Frame: 2 years
|
2 years
|
Spinal Cord Injury Measure
Time Frame: 2 years
|
2 years
|
CSF collection (6/day) and biochemical assays
Time Frame: 7 days
|
7 days
|
Sequential Anatomical MRI
Time Frame: 1 year
|
1 year
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Steven Casha, MD PhD FRCSC, University of Calgary
- Principal Investigator: R. John Hurlbert, MD PhD FRCSC, University of Calgary
- Principal Investigator: David Zygun, MD MSc, University of Calgary
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Casha S, Zygun D, McGowan MD, Bains I, Yong VW, Hurlbert RJ. Results of a phase II placebo-controlled randomized trial of minocycline in acute spinal cord injury. Brain. 2012 Apr;135(Pt 4):1224-36. doi: 10.1093/brain/aws072.
- Carnini A, Casha S, Yong VW, Hurlbert RJ, Braun JE. Reduction of PrP(C) in human cerebrospinal fluid after spinal cord injury. Prion. 2010 Apr-Jun;4(2):80-6. doi: 10.4161/pri.4.2.11756. Epub 2010 Apr 10.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
June 1, 2004
Primary Completion (Actual)
August 1, 2010
Study Completion (Actual)
August 1, 2010
Study Registration Dates
First Submitted
November 14, 2007
First Submitted That Met QC Criteria
November 14, 2007
First Posted (Estimate)
November 16, 2007
Study Record Updates
Last Update Posted (Estimate)
March 18, 2013
Last Update Submitted That Met QC Criteria
March 15, 2013
Last Verified
March 1, 2013
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 17007
- PVA2414 (Other Grant/Funding Number: Paralyzed Veterans of America)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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