Allopregnanolone for the Treatment of Traumatic Brain Injury

Phase 2

Completed

• Conditions: Traumatic Brain Injury; Posttraumatic Epilepsy
• Interventions: Drug: Placebo injection; Drug: Allopregnanolone injection

• Registration Number: NCT01673828
• Lead Sponsor: Michael A. Rogawski, MD, PhD

Brief Summary

This study will provide initial data on the safety and effectiveness of allopregnanolone in improving neurobehavioral outcome and reducing mortality in adults with moderate and severe traumatic brain injury.

Detailed Description

This is a double-blind, placebo-controlled, randomized, dose-finding, two-stage adaptive, clinical trial study comparing allopregnanolone to placebo when administered intravenously for 5 days beginning within 8 hours after injury. Test products to be administered are low and high dose allopregnanolone (Products L and H, respectively) and placebo (Product P) intravenous solutions. The products are administered during a 4-day treatment period followed by a 1-day dose de-escalation period. Stage 1 of the study will assess safety and confirm that dosing with Products L and H achieve the target steady-state plasma concentrations set for each of these products. Dosing will be adjusted in Stage 1, if necessary. Stage 2 will initially allocate subjects equally to Products L, H and P but will then use adaptive randomization to allocate subjects between Products L and H to optimized the probability of yielding a better 3-month Glasgow Outcome Score Extended (GOS-E) score.

Study Timeline

• Study First Submitted: 2012-08-20
• Study First Submitted QC: 2012-08-27
• Study First Posted: 2012-08-28
• Study Start: 2013-04
• Primary Completion: 2015-05
• Study Completion: 2016-07
• Results First Submitted: 2017-03-20
• Status Verified: 2017-05
• Results First Submitted QC: 2017-05-25
• Last Update Submitted: 2017-05-25
• Results First Posted: 2017-06-28
• Last Update Posted: 2017-06-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 13

Inclusion Criteria

• English or Spanish speaking person
• Moderate to severe closed or blunt traumatic brain injury [post resuscitation Glasgow Coma Score (GCS) 3-12 with abnormal head CT scan if GCS is 9-12]
• Less than 8 hours from injury to study initiation
• Able to participate for the full term of the study

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Exclusion Criteria

• Subjects with life expectancy of less than 24 hours
• Isolated epidural hematoma
• Hypoxia (pulse oximetry saturation ≤90% for 15 or more minutes before enrollment)
• Hypotension (systolic blood pressure ≤90 mm Hg on 2 or more reliable measurements before enrollment)
• Cardiopulmonary arrest prior to randomization
• Spinal cord injury with motor deficits
• Bilateral non-reactive pupils with Glasgow Coma Scale 3
• Body weight >120 kg
• Pregnancy
• Active breast or reproductive organ cancer
• Allergy to progesterone
• History of thromboembolic events
• Receipt of activated Factor VII before enrollment
• Any disease that is unstable or which could jeopardize the safety of the subject including severe renal impairment (creatinine clearance <50 ml/min)
• Prisoner/ward of the state
• Known treatment with another investigational drug therapy or procedure within 30 days of injury

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Placebo	Placebo injection	Placebo injection (intravenous solution) continuous infusion for 5 days
Allopregnanolone	Allopregnanolone injection	Allopregnanolone injection (intravenous solution) continuous infusion for 5 days

Primary Outcome Measures

Name	Time	Method
Extended Glasgow Outcome Scale (GOS-E) Score	6 months after injury	GOS-E is a global scale for functional outcome that rates patient status into one of 8 levels. The minimum score is 1 and the maximum score is 8. 1 = dead; 2 = vegetative state; 3 = low severe disability; 4 = upper severe disability; 5 = low moderate disability; 6 = upper moderate disability; 7 = low good recovery; 8 = upper good recovery. GOS-E was assessed by 19 question structured interview.

Trial Locations

Locations (1)

University of California, Davis Medical Center; 🇺🇸 Sacramento, California, United States