- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01231139
The Paracetamol AfteR Traumatic Brain InjurY Study (PARITY)
A Multi-centre Phase 2b Randomised Controlled Trial Investigating the Efficacy and Safety of Intravenous Paracetamol in Reducing Core Body Temperature After Traumatic Brain Injury
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Traumatic head injury is a bruising of areas of the brain that occurs commonly as a result of a fall or a motor vehicle accident. Unfortunately, this is a common global occurrence and it occurs both in developing and developed countries. It causes death in nearly 1 in 3 of those who are most severely affected and a large proportion of those that survive have long-term physical or mental disability. Hence, traumatic head injury is a major global problem.
At present there are very few therapies that are known to be effective after a traumatic head injury. In particular the investigators are uncertain about whether modifying body temperature has any effect (good or bad) on the outcomes of patients. Although, this is practiced by some intensive care units around the world.
The investigators have searched extensively to look for any evidence that altering body temperature after traumatic head injury improves the outcome of patients (by reducing the amount of death or disability) and were unable to find any evidence at all. Some preliminary research in both animal experiments and clinical studies suggest that a raised temperature after forms of brain injury may in fact be harmful.
Therefore, at present the investigators believe that we do not really know what effect changing body temperature after head injury has on the outcome of patients.
The investigators are proposing to conduct a clinical study of patients who have had a severe head injury. The patients will be randomly allocated to 2 groups who will get either regular Paracetamol (dissolved in fluid) or a bottle of fluid without any Paracetamol. The 2 treatments will look identical and neither the patients nor the health care workers will know what treatment they are getting. Doing the study in this way will allow us to work out whether giving Paracetamol reduces the temperature of the body and whether there are any side effects that occur. If the study shows that Paracetamol can reduce body temperature safely in this setting then the investigators will work towards doing a larger study of treatments that reduce body temperature. The purpose of this larger study would be to see if the investigators can, not only reduce body temperature but also reduce amount of disability (physical and mental) as well as the death rate in traumatically brain injured patients.
In the proposed study the investigators will be using a higher dose of Paracetamol that is usually prescribed. Other research has shown that the dose that the investigators are proposing to use is safe and also that smaller doses in fact do not reduce body temperature.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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New South Wales
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Sydney, New South Wales, Australia
- St George Hospital
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Queensland
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Brisbane, Queensland, Australia
- Royal Brisbane and Women's Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
- Written informed consent has been obtained from the patient's next of kin
- Age > 18 and < 65
- Non penetrating head injury requiring mechanical ventilation, and, with an abnormal CT head (defined by the presence of haemorrhage, contusion, swelling, compression of basal cisterns or herniation)
- Within 72 hours of injury
- Presence (or imminent placement) of arterial cannula
- Alanine transferase level < 100
Exclusion Criteria:
- Suspected paracetamol overdose or allergy to paracetamol
- Confirmed or suspected pregnancy
- Use of pharmacological or physical intervention that reduces body temperature in the 6-hour period prior to randomisation.
- Clinician decision to institute any pharmacological or physical intervention that modifies body temperature
- Body temperature at time of recruitment less that 36°C or greater than 38.9°C
- History of chronic liver disease or chronic alcohol abuse
- Suspected malnutrition: BMI < 18 kg/m2 or weight < 60 kg
- BMI > 35 kg/m2
- Renal failure with serum creatinine > 200
- Haemodynamic instability defined as systolic blood pressure < 90 mmhg or requirement for noradrenaline or adrenaline exceeding 20mcg/minute
- Use of hepatic enzyme inducers, except for phenytoin
- Minor head injury: either normal CT head or not expected to be in intensive care for 72 hours
- GCS = 3 with fixed dilated pupils
- Moribund patient expected to die within 24 hours
Study Plan
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 |
---|---|
Experimental: Paracetamol
Paracetamol dissolved in 0.9% Sodium Chloride
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Intravenous paracetamol, 1 gram (100mls), administered over 30 minutes (every 4 hours for 3 days).
Other Names:
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Placebo Comparator: 0.9% Sodium Chloride
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Identical placebo: 100mls saline given intravenous over 30 minutes (every 4 hours for 3 days)
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Core body temperature: bladder temperature probe
Time Frame: 30 minutes after final dose of study drug has been administered
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30 minutes after final dose of study drug has been administered
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Blood Pressure (systolic and mean arterial pressure) measured by intra-arterial pressure monitor
Time Frame: 6 hourly during study treatment
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6 hourly during study treatment
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Liver function test
Time Frame: daily from first dose of study treatment to the 7th day
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daily from first dose of study treatment to the 7th day
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serum Paracetamol levels (blood analysis) after a single dose of study drug and after final dose of study drug.
Time Frame: baseline, 30, 45, 90, 240 minutes after single dose. 240 minutes after final dose of study drug
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baseline, 30, 45, 90, 240 minutes after single dose. 240 minutes after final dose of study drug
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Temperature (bladder and tympanic)
Time Frame: Hourly from first study drug treatment until 4 hours after final study drug treatment
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Time-weighted mean, area under the 3-day temperature curve, daily maximum and minimum temperature
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Hourly from first study drug treatment until 4 hours after final study drug treatment
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The use of physical cooling interventions
Time Frame: hourly during the period of study intervention
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hourly during the period of study intervention
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Intracranial pressure
Time Frame: 6 hourly during the period of study intervention
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Mean daily intracranial pressure for day 1, 2 and 3.
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6 hourly during the period of study intervention
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Incidence of cerebral hypoperfusion
Time Frame: During study intervention period
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During study intervention period
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Manoj Saxena, South East Sydney Illawarra Area Health Service
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
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
- Physiological Effects of Drugs
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Analgesics, Non-Narcotic
- Antipyretics
- Acetaminophen
Other Study ID Numbers
- PARITY
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.
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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-
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