- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02645552
Pre-hospital Administration of Tranexamic Acid for Moderate and Severe Traumatic Brain Injury
Pre-hospital Administration of Tranexamic Acid for Adults With Moderate and Severe Traumatic Brain Injury: a Randomized, Double-blinded, Placebo-controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Traumatic brain injury (TBI) remains a significant public health concern with poor outcome and one of the unmet needs in medical care. Tranexamic acid (TXA) has been shown to reduce blood loss after elective surgery and improve outcomes after traumatic injury due to bleeding without obvious adverse events. In the CRASH-2 Intracranial Bleeding Study, with the nested randomized trial design, the study showed that treatment with TXA within 8 hours of injury was associated with a reduction in haemorrhage growth [adjusted difference, -3.8 ml, 95% confidence interval (CI), -11.5 ml to 3.9 ml], fewer focal ischaemic lesions [adjusted odds ratio (OR) 0.54, 95% CI 0.20 to 1.46] and fewer death (adjusted OR 0.49, 95% CI 0.22 to 1.06) for patients with TBI (Glasgow coma score ≤ 14). The study also provided direction for future research of TXA in TBI, especially for the patients with moderate and severe TBI in whom an intracranial intracranial bleed (defined as the presence of parenchymal, subdural or epidural haemorrhage) is common.
Furtherly, results of the CRASH-2 trial stressed the importance of early adminstration with TXA for trauma patients, with the evidence showing that treatment of TXA within 1 hour post injury could significantly reduce the risk of death, while the benefit did not exist when TXA was administered more than 3 hours after injury. If the use of TXA could be incorporated into the pre-hospital management of TBI, the outcome of traumatically injured patients would be improved in an early stage. Thus, our study sets out to employ a randomized controlled study design, with a sample of 400 patients, to evaluate the efficacy and safety of early use of TXA in the pre-hospital management for moderate and severe TBI.
Study Type
Enrollment (Anticipated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Junfeng Feng, MD, PhD
- Phone Number: 86-21-68383707
- Email: fengjfmail@163.com
Study Contact Backup
- Name: Yanqing Ni, MD
- Phone Number: 86-13601602411
- Email: pd120xz@126.com
Study Locations
-
-
Shanghai
-
Shanghai, Shanghai, China, 200127
- Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University
-
Contact:
- Junfeng Feng, MD, PhD
- Phone Number: 86-21-68383707
- Email: fengjfmail@163.com
-
Contact:
- Yanqing Ni, MD
- Phone Number: 86-21-68383707
- Email: pd120xz@126.com
-
Principal Investigator:
- Guoyi Gao, MD, PhD
-
Principal Investigator:
- Yanqing Ni, MD
-
Sub-Investigator:
- Qing Mao, MD, PhD
-
Sub-Investigator:
- Junfeng Feng, MD, PhD
-
Sub-Investigator:
- Jijun Sheng, MD
-
Sub-Investigator:
- Hua Jiang, MD
-
Sub-Investigator:
- Junlai Gu, MD
-
Sub-Investigator:
- Jinghong Yang, MD
-
Sub-Investigator:
- Xianghui Lu, MD
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Sub-Investigator:
- Xianfeng Qin, MD
-
Sub-Investigator:
- Zhiguo Wang, MD
-
Sub-Investigator:
- Jingde Xu, MD
-
Sub-Investigator:
- Hongguan Wang, MD
-
Sub-Investigator:
- Aiqun Cao, MD
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Sub-Investigator:
- Cao Wang, MD
-
Sub-Investigator:
- Kaizhi Wang, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- moderate to severe injuries(post-resuscitation scores Glasgow coma score of 4-12)
- age >= 18 year
- non-penetrating TBI in 2 hours onset
Exclusion Criteria:
- patients with coagulopathy
- pregnancy
- receiving any medication which affects haemostasis
- no consenting form
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Tranexamic acid
Focused intervention
|
Tranexamic acid 1 gram in 100 ml saline, by intravenous drip over 10 minutes, once patient admitted to the trial on the spot of TBI
Other Names:
|
Placebo Comparator: Sodium chloride
Placebo control
|
Sodium Chloride solution (0.9%) 1 ml (gram) in 100 ml saline, by intravenous drip over 10 minutes, once patient admitted to the trial on the spot of TBI
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Glasgow Outcome Scale (GOS)
Time Frame: 6 months post injury
|
The GOS is five-category scale used for assessing the neurologic outcome after brain injury as follows: 1, death; 2, vegetative state - unable to interact with the environment; 3, severe disability - unable to live independently but able to follow commands; 4, moderate disability - capable of living independently but unable to return to work or school; and 5, good recovery - able to return to work or school.
In our statistical analyses, the outcome will be further dichotomized in unfavorable (GOS 1-3) vs favorable (GOS 4-5); the proportion of unfavorable outcome will be compared between groups.
|
6 months post injury
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Vascular occlusive events
Time Frame: 6 months post injury
|
Vascular occlusive events includes myocardial infarction, stroke, pulmonary embolism, clinical evidence of deep vein thrombosis.
|
6 months post injury
|
Death
Time Frame: 6 months post injury
|
6 months post injury
|
|
Length of intensive care unit stay
Time Frame: 6 months post injury
|
6 months post injury
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Guoyi Gao, MD, PhD, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
- Molecular Mechanisms of Pharmacological Action
- Fibrin Modulating Agents
- Antifibrinolytic Agents
- Hemostatics
- Coagulants
- Tranexamic Acid
Other Study ID Numbers
- TXA4TBI
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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