Study of NNZ-2566 in Patients With Traumatic Brain Injury (INTREPID2566)

A Randomized, Double-Blind, Placebo-Controlled, Dose-Escalation Study of NNZ-2566 in Patients With Traumatic Brain Injury

The purpose of this study is to determine whether NNZ-2566 is safe and effective in the treatment of Traumatic Brain Injury (TBI).

Study Overview

• Status: Completed
• Conditions: Brain Injuries
• Intervention / Treatment: Drug: Placebo; Drug: NNZ-2566

Detailed Description

Moderate to severe traumatic brain injury frequently results in persistent problems with memory, attention span, mood and more complex brain functioning such as planning and organizing. There are currently no drugs available to reduce the brain damage or the persisting symptoms that result from TBI. The longer term goal of this study is to provide physicians with a safe and effective treatment for TBI.

• Study Type: Interventional
• Enrollment (Actual): 261
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • Alabama
    • Mobile, Alabama, United States, 36617
      • University of South Alabama
  • Arizona
    • Tucson, Arizona, United States, 85724
      • University of Arizona
  • California
    • Colton, California, United States, 92324
      • Arrowhead Regional Medical Center
    • Los Angeles, California, United States, 90095
      • Ronald Reagan UCLA Medical Center
    • Sacramento, California, United States, 95817
      • University of California, Davis Medical Center
  • Florida
    • Miami, Florida, United States, 33136
      • University of Miami, Lois Pope Life Center
  • Hawaii
    • Honolulu, Hawaii, United States, 96813
      • The Queen's Medical Center
  • Louisiana
    • Baton Rouge, Louisiana, United States, 70808
      • Our Lady of the Lake Hospital
  • Michigan
    • Detroit, Michigan, United States, 48235
      • Sinai Grace Hospital
    • Detroit, Michigan, United States, 48201
      • Detroit Receiving Hospital and University Health Center
    • Kalamazoo, Michigan, United States, 49007
      • Bronson Methodist Hospital
  • New York
    • Syracuse, New York, United States, 13210
      • Suny Upstate Medical University
  • Ohio
    • Cincinnati, Ohio, United States, 45219
      • University of Cincinnati, Mayfield Clinic
    • Dayton, Ohio, United States, 45409
      • Miami Valley Hospital
  • Pennsylvania
    • Bethlehem, Pennsylvania, United States, 18015
      • St Luke's University Hospital
    • Pittsburgh, Pennsylvania, United States, 15213
      • University of Pittsburgh Medical Center
  • Texas
    • Fort Worth, Texas, United States, 76104
      • Texas Health Harris Methodist Hospital Fort Worth
  • Virginia
    • Falls Church, Virginia, United States, 22042
      • Inova Fairfax Hospital
  • West Virginia
    • Charleston, West Virginia, United States, 25304
      • Charleston Area Medical Center
  • Wisconsin
    • Milwaukee, Wisconsin, United States, 53226
      • University of Wisconsin, Froedtert Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

• Non-penetrating TBI.
• Male.
• Age 18-70 years.
• Admission to hospital.
• Post resuscitation GCS 4-12.
• Have at least one reactive pupil.
• Randomization within 7 hours of injury with the ability to receive investigational product within 8 hours of injury.
• Hemodynamically stable after resuscitation (systolic blood pressure (SBP) >100 mm Hg).
• Willing to undergo all neuropsychological and activities of daily living (ADL) testing (i.e. understand English, able to read, write, have sufficient motor dexterity and, be available for follow-up visits at 4-6 weeks and 12-14 weeks post injury).

Exclusion Criteria:

• Penetrating brain injury.
• Spinal cord injury.
• Presence or known history of prior cerebral injury requiring hospitalization that would, in the opinion of the Investigator, interfere with or bias the assessment of efficacy.
• Non-traumatic brain injury.
• Known history of any medical or psychiatric disorder, or any severe concomitant disease, that in the opinion of the Investigator would interfere with or bias the assessment of efficacy. This includes the following: schizophrenia; bipolar disorder; major depressive disorder; post traumatic stress disorder (PTSD); generalized anxiety disorder; attention deficit hyperactivity disorder; neurodegenerative diseases (Alzheimer's, Parkinson's, Huntington's disease, vascular dementia, Diffuse Lewy Body Disease); stroke; brain tumor; multiple sclerosis (MS); seizure disorders; chronic pain disorder; alcoholism or substance abuse.
• Significant non-central nervous system (CNS) injuries sustained at the time of the TBI that in the opinion of the Investigator would interfere with or bias the assessment of efficacy.
• Weight >150 kg.
• Participation in another clinical trial within the previous 4 weeks.
• Clinical state requiring greater than 6 L colloid or crystalloid fluid resuscitation prior to randomization.
• Inability to obtain informed consent from legally acceptable representative.
• Prior enrollment in this study.

• QTc Exclusions. The study will use the exclusion criteria as defined in ICH Guideline E14 to exclude patients with a risk of QT/QTc prolongation, as follows:

  • A marked baseline prolongation of corrected QT/QTc interval >450 ms.
  • History of risk factors for torsade de pointes (e.g. heart failure, hypokalemia (serum potassium at screening (<3.0 mmol/L)or family history of long QT syndrome).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: SUPPORTIVE_CARE
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: QUADRUPLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: NNZ-2566; 20 mg/kg intravenous bolus infusion over 10 minutes followed by a continuous intravenous infusion of 1 mg/kg/h (Cohort 1, n=20), 3 mg/kg/h (Cohort 2, n=20) or 6 mg/kg/h (Cohort 3, n=133) intravenous infusion for a total of 72 consecutive hours.	Drug: NNZ-2566; Solution for intravenous infusion. 20 mg/kg intravenous bolus infusion over 10 minutes followed by a continuous intravenous infusion of 1, 3, or 6 mg/kg/h for a total of 72 consecutive hours.; Other Names: Glycyl-L-2-Methylprolyl-L-Glutamic Acid
PLACEBO_COMPARATOR: Sodium Chloride (0.9%) for Injection; Intravenous bolus infusion over 10 minutes followed by a continuous intravenous infusion (Cohort 1, n=10), (Cohort 2, n=10) or (Cohort 3, n=67) intravenous infusion for a total of 72 consecutive hours.	Drug: Placebo; Sodium Chloride 0.9% Injection; Other Names: Sodium Chloride 0.9% Injection

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Reduced incidence, compared to placebo, of adverse events (AEs) and serious adverse events (SAEs)	AEs to discharged or Day 30 post randomization, whichever occurs first, and SAEs through to 3 months (defined as 12-14 weeks), post randomization.

Secondary Outcome Measures

Outcome Measure	Time Frame
Evidence of efficacy in modifying global outcomes by evaluating Glasgow Outcome Scale - Extended (GOS-E) and activities of daily living (Mayo-Portland Adaptability Inventory - 4th Edition (MPAI-4))	1 month (defined as 4-6 weeks) and 3 months (defined as 12-14 weeks), post randomization.
Improvement in cognitive and neuropsychological functioning.	1 month (defined as 4-6 weeks) and at 3 months (defined as 12-14 weeks), post randomization.
Modification of the acute physiological processes in TBI by evaluating electroencephalographic (EEG) determinants in patients with moderate to severe TBI (defined as GCS 4-12), and biomarker levels.	Baseline through to 72 hours post-start of infusion.
Blood pharmacokinetics (PK) of an intravenous (i.v) dose of NNZ-2566 when administered as a 10-minute infusion immediately followed by a 72-hour infusion.	Start of infusion through to 12 hours post infusion.

Collaborators and Investigators

• Sponsor: Neuren Pharmaceuticals Limited

Publications and helpful links

General Publications

• Lee JW. The EEG Ictal-Interictal Continuum-A Metabolic Roar But a Whimper of a Functional Outcome. Epilepsy Curr. 2019 Jul-Aug;19(4):234-236. doi: 10.1177/1535759719855968. Epub 2019 Jun 14.
• Lee H, Mizrahi MA, Hartings JA, Sharma S, Pahren L, Ngwenya LB, Moseley BD, Privitera M, Tortella FC, Foreman B. Continuous Electroencephalography After Moderate to Severe Traumatic Brain Injury. Crit Care Med. 2019 Apr;47(4):574-582. doi: 10.1097/CCM.0000000000003639.

Helpful Links

• Click here for more information about this study

Study record dates

Study Major Dates

• Study Start: April 1, 2010
• Primary Completion (ACTUAL): January 1, 2016
• Study Completion (ACTUAL): January 1, 2016

Study Registration Dates

• First Submitted: December 8, 2008
• First Submitted That Met QC Criteria: December 8, 2008
• First Posted (ESTIMATE): December 10, 2008

Study Record Updates

• Last Update Posted (ACTUAL): February 5, 2018
• Last Update Submitted That Met QC Criteria: February 1, 2018
• Last Verified: February 1, 2018

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Craniocerebral Trauma; Trauma, Nervous System; Brain Injuries; Wounds and Injuries; Brain Injuries, Traumatic
• Other Study ID Numbers: Neu-2566-TBI-001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO