- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico NCT02990793
Ensaio clínico para avaliar a segurança e a eficácia do tratamento MeRT no transtorno de estresse pós-traumático (MeRT-005-B)
Um ensaio clínico prospectivo, duplo-cego, randomizado, controlado por simulação para avaliar a segurança e a eficácia da terapia de ressonância magnética EEG guiada por biometria (MeRT) tratamento de transtorno de estresse pós-traumático com e sem sintomas pós-concussivos persistentes (PPCS) após Lesão cerebral traumática (TCE)
Visão geral do estudo
Status
Intervenção / Tratamento
Descrição detalhada
O MERT-005-B é um ensaio clínico prospectivo, duplo-cego, randomizado, controlado por simulação, grupo paralelo, estratificado e adaptativo, projetado para avaliar a eficácia do MeRT guiado por EEG em pessoas com Transtorno de Estresse Pós-Traumático com e sem Pós-Traumático Persistente Sintomas Concussivos (PPCS) após Traumatismo Cranioencefálico (TCE).
Um total de 152 participantes será randomizado na Fase de Teste, com reavaliação cega adaptativa do tamanho da amostra de até 176 participantes e uma abordagem sequencial de grupo para monitoramento da eficácia pelo Conselho de Monitoramento de Dados e Segurança (DSMB).
Uma Fase Piloto foi concluída na qual 74 participantes foram randomizados. Os dados da Fase Piloto serão usados para confirmar a segurança do MeRT. Para a fase de teste, os participantes elegíveis serão designados aleatoriamente para grupos de tratamento MeRT ou Sham MeRT em uma proporção de alocação de 1:1, com estratificação no local de recrutamento e dois níveis de comorbidade PPCS (+/-).
A avaliação inicial de elegibilidade e a coleta de dados ocorrerão na Visita de Triagem (SC). Após a visita SC, haverá um período de tratamento de 5 semanas em que o tratamento investigativo ativo ou simulado será administrado durante as visitas diárias durante a semana ao local do estudo. Todos os participantes que continuarem elegíveis receberão 2 semanas adicionais de tratamento ativo do estudo MeRT.
Os principais resultados do estudo serão coletados na segunda visita de acompanhamento (F2) na conclusão do período de tratamento de 5 semanas. Uma visita de coleta de dados abreviada ocorrerá durante a terceira semana de tratamento (a visita de acompanhamento F1). Visitas adicionais de acompanhamento ocorrerão 90 dias (F3) e 180 dias (F4) após o primeiro dia de tratamento do estudo.
Os participantes, médicos e todo o pessoal que participa da avaliação serão cegos para a designação do grupo de tratamento do estudo.
A primeira fase deste teste foi realizada em parceria com o Comando de Operações Especiais dos Estados Unidos (USSOCOM) e a Fundação Henry Jackson.
Tipo de estudo
Inscrição (Real)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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California
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Costa Mesa, California, Estados Unidos, 92626
- BrainHealth Solutions
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Long Beach, California, Estados Unidos, 90822
- VA Long Beach Healthcare System
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San Diego, California, Estados Unidos, 92103
- SoCal Neuroscience Research Unit
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North Carolina
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Raleigh, North Carolina, Estados Unidos, 27607
- UNC Rex Hospital
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Ohio
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Columbus, Ohio, Estados Unidos, 43219
- Columbus Brain Research Center
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Pennsylvania
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Bryn Mawr, Pennsylvania, Estados Unidos, 19010
- Center for Interventional Pain and Spine
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Texas
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Plano, Texas, Estados Unidos, 75093
- Texas A&M Research Center
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Washington
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Bellevue, Washington, Estados Unidos, 98004
- Seattle Neuropsychiatric Treatment Center (Seattle NTC)
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Descrição
Critério de inclusão:
Os participantes devem atender a todos os critérios de inclusão para se qualificar para a inscrição no estudo:
- Disposto e capaz de consentir em participar do estudo
- Idade 18 - 65 anos
- Diagnóstico de TEPT de acordo com os critérios do DSM-V via CAPS-5
- Início dos sintomas que atendem aos critérios do DSM-5 para sintomas de TEPT persistentes por um período mínimo de 6 meses antes da visita de triagem
- Pontuação mínima PCL-5 de 30
Critério de exclusão
Os participantes serão excluídos da participação no estudo se um ou mais dos seguintes critérios de exclusão se aplicarem:
- Trauma índice ocorrido antes dos 16 anos de idade
- História de lesão craniana aberta
História de um distúrbio neurológico, incluindo, mas não limitado a:
- Distúrbio convulsivo
- Qualquer condição que possa estar associada ao aumento da pressão intracraniana
- Lesão cerebral ocupando espaço
- História de acidente vascular cerebral
- História de aneurisma cerebral
- Anormalidades no EEG que indicam risco de convulsão, ou seja, lentidão focal ou geral anormal ou picos ictais durante a gravação do EEG
- Incapacidade de calcular a frequência alfa intrínseca do EEG na triagem
- Participação em qualquer protocolo de pesquisa intervencionista dentro de 3 meses antes da visita de triagem
- Histórico de qualquer tipo de tratamento de ECT, rTMS ou MeRT
- Tratado dentro de 30 dias da visita de triagem com qualquer medicamento antipsicótico
- Tratado dentro de 30 dias da visita de triagem com qualquer medicamento benzodiazepínico ou anticonvulsivante
- Tratamento atual com qualquer medicação concomitante restrita (ou seja, NDRI, SSRI, SNRI ou QBDZ) que não tenha estado estável nos 60 dias anteriores no momento da visita de triagem
- Implante intracraniano (por exemplo, clipes de aneurisma, shunts, estimuladores, implantes cocleares, stents ou eletrodos) ou qualquer outro objeto de metal dentro da cabeça, excluindo a boca ou na cabeça, que não possa ser removido com segurança
- Dispositivos biomédicos, incluindo aqueles que não estão na cabeça, implantados ou cuja remoção não é segura, que podem ser afetados pelo campo magnético do estimulador (por exemplo, marca-passo cardíaco, cardioversor desfibrilador (CDI) ou dispositivo de administração de medicamentos)
- Doença ou condição médica clinicamente significativa, incluindo, mas não se limitando a, quaisquer distúrbios descontrolados da tireoide, disfunção hepática, cardíaca, pulmonar e renal, ou consumo crônico excessivo de álcool, que no julgamento do investigador pode representar um risco potencial de segurança para o participante ou limitar a interpretação dos resultados do ensaio
- Grávida ou mulher que não deseja usar controle de natalidade eficaz durante o estudo
- Planejar se mudar da área, ou saber que haverá ausência da área, dentro de 80 dias após a Visita de Triagem (inclusive)
- Não querer ou não poder aderir ao tratamento do estudo, cronograma de coleta de dados ou procedimentos do estudo, ou qualquer condição, incluindo incapacidade de se comunicar em inglês, que no julgamento do Investigador possa impedir o participante de concluir o estudo, tornar os resultados do estudo ininterpretáveis, ou representar um risco de segurança inaceitável para o participante ou equipe do estudo que não esteja listado nos critérios de exclusão.
- Psicopatologia clinicamente significativa, incluindo, mas não se limitando a, esquizofrenia ou transtorno bipolar, ou outro transtorno psiquiátrico que, no julgamento do investigador, possa representar um risco potencial à segurança do participante ou limitar a interpretação dos resultados do estudo
- Um risco elevado de suicídio ou violência contra outras pessoas
- Tratamento psicoterapêutico atual, previsto para continuar durante o estudo, iniciado nos 60 dias anteriores no momento da visita de triagem
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Triplo
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Comparador Ativo: Tratamento MeRT ativo
O tratamento ativo consistirá em 6 segundos por minuto durante 30 minutos por dia, 5 dias por semana durante 5 semanas.
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Um protocolo personalizado guiado por biometria conhecido como tratamento de terapia de ressonância magnética EEG/ECG (MeRT) que é adaptado especificamente para a frequência alfa intrínseca (IAF) de EEG de cada participante.
O rTMS é aplicado no IAF do participante.
Outros nomes:
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Comparador Falso: Tratamento Sham MeRT
O tratamento simulado consistirá em 6 segundos por minuto durante 30 minutos por dia, 5 dias por semana durante 5 semanas.
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A bobina rTMS não emite estimulação magnética.
Outros nomes:
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Alteração nos sintomas de TEPT
Prazo: Cinco semanas
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Mudança nos sintomas de TEPT conforme medido pela Lista de Verificação-5 de TEPT (PCL-5).
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Cinco semanas
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Mudança no PPCS
Prazo: Cinco semanas
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Alteração nos sintomas persistentes pós-concussão medidos pela redução na pontuação total de gravidade do Questionário de sintomas pós-concussão Rivermead (RPQ-16) no subconjunto de participantes com PPCS após TCE.
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Cinco semanas
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Outras medidas de resultado
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Resultados de segurança - incidentes e tipos de eventos adversos
Prazo: Aproximadamente 3 meses
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Número e tipo de eventos adversos (EAs) e eventos adversos graves (SAEs)
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Aproximadamente 3 meses
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Kenneth Ramos, MD,PhD, Texas A&M University
- Cadeira de estudo: Adele Gilpin, PhD,JD, GilpinPhillips BIOMED, LLC
Publicações e links úteis
Publicações Gerais
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Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimado)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
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Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Transtornos Relacionados a Traumas e Estressores
- Doenças Cerebrais
- Doenças do Sistema Nervoso Central
- Doenças do Sistema Nervoso
- Transtornos Mentais, Desordem Mental
- Ferimentos e Lesões
- Trauma Craniocerebral
- Trauma, Sistema Nervoso
- Traumatismos na Cabeça, Fechado
- Ferimentos Não Penetrantes
- Lesões cerebrais
- Transtornos de Estresse Traumático
- Lesões Cerebrais Traumáticas
- Concussão cerebral
- Transtornos de Estresse Pós-Traumático
Outros números de identificação do estudo
- MeRT-005-B
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
produto fabricado e exportado dos EUA
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