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Phase 2 a Study to Assess Safety and Pharmacokinetics of VAS203 in Patients With Traumatic Brain Injury (NOSTRA)

8. februar 2016 opdateret af: Vasopharm GmbH

An Exploratory Phase 2 a Study to Assess Safety, Tolerability, Pharmacodynamic and Pharmacokinetics of VAS203 in Patients With Moderate and Severe Traumatic Brain Injury

In the exploratory multi-center Phase 2 a study safety, tolerability, pharmacodynamics and pharmacokinetics of the Nitric Oxide Synthase inhibitor VAS203 is assessed in patients with moderate and severe traumatic brain injury. Traumatic brain injury patients (32 males) receive 15, 20 and 30 mg/kg VAS203, respectively, by continuous infusion in three cohorts (Cohort 1 open; Cohorts 2 and 3 double blind, randomised placebo-controlled). End of Study for all patients will be Day 14; adverse events and concomitant medications will be documented throughout the study.

Objectives are to assess safety and tolerability of VAS203, to evaluate concentrations of metabolites of VAS203 in plasma and microdialysate and to assess pharmacodynamic effects of VAS203 on surrogate parameters. Safety parameter will include vital signs (blood pressure heart rate, respiration rate, oxygen saturation and blood gases), fluid balance, ECG, laboratory examinations (clinical chemistry, liver function, haematology/coagulation, urinalysis, renal parameters) and adverse events. Concentration of VAS203 will be determined in plasma and microdialysate. Pharmacodynamic parameters will include intracranial pressure (ICP), biochemical parameters in microdialysate (nitrite/nitrate, arginine, citrulline, pyruvate, lactate, glucose), Partial Oxygen Pressure in brain parenchyma and Therapy Intensity Level (TIL).

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Intravenous administration of study medication for each patient will start as soon as possible but not later than 12 hours after trauma. Patients in Group 1 will receive open label study drug (VAS203). Patients in Group 2 and 3 will be randomised to treatment with VAS203 or placebo.

In addition to study treatment, each patient will receive the best "standard of care" for the study centre; no treatment will be withheld.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

32

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Det Forenede Kongerige
      • Southampton, Det Forenede Kongerige, SO16 6YD
        • Southampton University Hospital Division of Clinical Neurosciences
  • Frankrig
      • Toulon, Frankrig, 83800
        • HIA Sainte-Anne Boulevard Sainte-Anne
  • Schweiz
      • Zuerich, Schweiz, 8091
        • University Hospital Zuerich Surgical Intensive Care
  • Spanien
      • Barcelona, Spanien, 08035
        • Vall d'Hebron University Hospital Department of Neurosurgery
      • Barcelona, Spanien, 08036
        • Hospital Clinic University of Barcelona Surgical Intensive Care Unit
  • Østrig
      • Innsbruck, Østrig, 6020
        • Medical University Innsbruck Department of Neurology

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 65 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Written informed consent from patient's legal guardian or legal representative
  • 18 - 65 years of age, inclusive
  • Head trauma within the last 12 hours
  • Traumatic brain injury with Glasgow Coma Score (GCS) ≥ 5 and that requires ICP monitoring
  • Catheter placement for monitoring and management of increased ICP
  • Microdialysis probe placement in penumbra zone or ipsilateral to contusion if focal
  • Systolic blood pressure ≥ 100 mmHg
  • Females of child-bearing potential must have a negative pregnancy test

Exclusion Criteria:

  • Penetrating head injury (e.g. missile, stab wound)
  • Not expected to survive more than 24 hours after admission
  • Concurrent, but not pre-existing, spinal cord injury
  • Unilateral and bilateral fixed and dilated pupil (> 4 mm)
  • Cardiopulmonary resuscitation performed post injury
  • continuing bleeding likely to require multiple transfusions (> 4 units red blood cells)
  • Coma due to a "pure" epidural hematoma (lucid interval and absence of structural brain damage on CT scan)
  • Coma suspected to be primarily due to other causes than head injury (e.g. drug overdose)
  • Known or CT scan evidence of pre-existing major cerebral damage
  • Decompressive craniectomy, planned prior to randomization
  • Polytraumatic patients with Injury Severity Score > 25, or rhabdomyolysis
  • Injuries to ascending aorta and/or carotid arteries
  • serum creatinine values > 1.5 mg/dL
  • estimated Glomerular Filtration Rate < 60 ml/min (MDRD-formula)
  • body mass index (BMI) > 35, Body weight > 120 kg
  • Any severe concomitant condition (cancer; hematologic, renal, hepatic, coronary disease; major psychiatric disorder; alcohol or drug abuse), that can be ascertained at admission
  • Known to have received an experimental drug within 4 weeks prior to current injury
  • Administration of > 100 ml of contrast media containing iodine

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Firedobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: VAS203 15 mg/kg
Three 5 mg/kg/12-hours infusion with 12 hours break after each infusion. Total dose: 15 mg/kg
Medicin: VAS203
i.v. infusion
Andre navne:
  • Ronopterin
Eksperimentel: VAS203 20 mg/kg
10 mg/kg/24 hours, 48 hour continuous infusion. Total dose: 20 mg/kg
Medicin: VAS203
i.v. infusion
Andre navne:
  • Ronopterin
Eksperimentel: VAS203 30 mg/kg
10 mg/kg/24 hours, 72 hour continuous infusion. Total dose: 30 mg/kg
Medicin: VAS203
i.v. infusion
Andre navne:
  • Ronopterin
Placebo komparator: Saline
0.9 % Sodium chloride infusion
Medicin: Saline
i.v. infusion
Andre navne:
  • 0,9 % NaCl

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Safety and Tolerability of VAS203 in Patients With Moderate and Severe TBI
Tidsramme: 14 days

Tolerability (good, satisfactory, sufficient, poor) of VAS203 in patients with moderate and severe TBI, as judged by the investigators at day 14.

Safety outcome measure description see safety section
14 days

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Duration (Number of Time-points) of Intracranial Pressure (ICP) > 20 mmHg
Tidsramme: Hourly from start of infusion to 144 hours
Hourly from start of infusion to 144 hours
Duration (Number of Hours) of Cerebral Perfusion Pressure (CPP) < 60 mmHg
Tidsramme: Hourly from start of infusion to 144 hours
Duration (number of hours) of cerebral perfusion pressure (CPP) < 60 mmHg calculated from ICP and mean arterial blood pressure (MAP): CPP = MAP - ICP)
Hourly from start of infusion to 144 hours
Therapy Intensity Level Score
Tidsramme: Daily from day 1 to day 6

Therapy Intensity Level Score: Total Score calculated daily as the sum of all individual measures, range from 3 (good outcome) to 50 (worst outcome):

Scores:

0-2 Head elevation 0-8 Sedation 0-1 Paralysis 1-3 Hyperventilation 0-2 Increased Oxygenation 1-3 Cooling 0-2 Osmotherapy 0-3 CSF Drainage 0-1 Red Blood Cell Transfusion 1-3 Cerebral perfusion pressure 0-1 Surgery for mass lesion 0/5/10 none/unilateral/bilateral Decompressive Craniectomy 0/10 Laparatomy to treat intracranial hypertension due to abdominal hypertension
Daily from day 1 to day 6

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Vasopharm GmbH

Efterforskere

  • Studieleder: Frank Tegtmeier, Dr., Vasopharm GmbH

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. november 2009

Primær færdiggørelse (Faktiske)

1. juni 2012

Studieafslutning (Faktiske)

1. september 2012

Datoer for studieregistrering

Først indsendt

10. december 2013

Først indsendt, der opfyldte QC-kriterier

13. december 2013

Først opslået (Skøn)

16. december 2013

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

7. marts 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

8. februar 2016

Sidst verificeret

1. februar 2016

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • VAS203/II/1/03

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

Ingen

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Kliniske forsøg med Traumatisk hjerneskade

Kliniske forsøg med VAS203

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