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TNFα Monoclonal Antibody for Acute Spinal Cord Injury

Phase 1
Conditions
Spinal Cord Injuries
Interventions
Drug: Saline
Drug: TNFα Monoclonal Antibody
Registration Number
NCT04988425
Lead Sponsor
Shanghai Changzheng Hospital
Brief Summary

The purpose of this study is to evaluate the safety and effectiveness of subcutaneous injection of TNFα monoclonal antibody cells for the treatment of traumatic acute spinal cord injury. Spinal cord injury can be divided into three phases, which are acute (within 2 weeks), sub-acute (2 weeks to 6 months), and chronic (over 6 months). The pathological process of spinal cord injury include primary injury (initial traumatic insult) and a progressive secondary injury cascade characterized by ischemia, proapoptotic signaling, peripheral inflammatory cell infiltration and the release of proinflammatory cytokines. Secondary injury plays a key role in the loss of spinal cord function after trauma. So early treatment to prevent the secondary injury is the key to improve prognosis. TNFα monoclonal antibody is a TNF-α inhibitor that could control inflammatory response, and now widely used in the treatment of Ankylosing spondylitis, Rheumatoid arthritis and other autoimmune diseases. In this study, the investigators will treat patients with acute spinal cord injury with TNFα monoclonal antibody and compare with the control group.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
90
Inclusion Criteria
  • Patients aged between 18 and 60 years
  • Traumatic spinal cord injury
  • ASIA Impairment Scale A-D
  • The injury must be within two weeks
  • Patients submitted written informed consent
Exclusion Criteria
  • Traumatic spinal cord injury with brain injury or peripheral nerve injury
  • Patients with severe multiple injuries and unstable vital signs
  • Non-traumatic spinal cord injury caused by spinal tumors, hematoma, myelitis, etc.
  • Patients with central spinal cord injury
  • Patients with a completely transected spinal cord
  • Patients with fever or acute infection
  • Ongoing infectious disease, such as tuberculosis, HIV, hepatitis, syphilis, etc.
  • Patients with malignant tumour
  • Patients with neurodegenerative diseases, or any neuropathies
  • Patients with ankylosing spondylitis
  • Patients with a previous history of spinal surgery

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control groupSalineInjection of the same volume of saline immediately after admission before surgery.
TNFα monoclonal antibody groupTNFα Monoclonal AntibodySubcutaneous injection of 50mg of TNFα monoclonal antibody immediately after admission before surgery.
Methylprednisolone groupMethylprednisoloneInjection of 500mg of methylprednisolone immediately after admission before surgery.
Primary Outcome Measures
NameTimeMethod
American Spinal Injury Association Impairment Scale(ASIA)baseline, 1 month, 3 months, 6 months and 12 months post-treatment

Change in sensory and motor function as measured by the American Spinal Injury Association Impairment Scale (ASIA). The scale ranked from A to E, A indicates the the most severe spinal cord injury and E indicates no neurological deficit.

Secondary Outcome Measures
NameTimeMethod
Motor Evoked Potentials (MEP) and Somatosensory Evoked Potentials (SSEP) testbaseline, 3 months, 6 months and 12 months post-treatment

Change in sensory and motor function will be measured by SSEP and MED test

Residual urine testbaseline, 3 months, 6 months and 12 months post-treatment

Change in residual urine as measured by ultrasound test

Incidence of adverse events1 month post-treatment

Any abnormal signs, symptoms, findings, or diseases that emerge or worsen relative to baseline in 1 month posttreatment will be recorded as adverse event

Trial Locations

Locations (1)

Shanghai Changzheng Hospital

🇨🇳

Shanghai, China

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