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A Safety Study for Cethrin (BA-210) in the Treatment of Acute Thoracic and Cervical Spinal Cord Injuries

Primary Purpose

Spinal Cord Injury

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Cethrin
Sponsored by
Vertex Pharmaceuticals Incorporated
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Spinal Cord Injury focused on measuring biologic drug, transport sequence, rho, spinal cord injury, paralysis, paraplegia, tetraplegia, quadraplegia, trauma, nervous system, fibrin sealant, neurosurgery

Eligibility Criteria

16 Years - 70 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Patients will be enrolled in this study only if they meet all of the following criteria:

  • Informed Consent Form signed by the patient or patient's legal representative.
  • Male or female, aged 16-70 years, inclusive.
  • For Group 1, patients with acute thoracic (T2-T12) spinal cord injury; for Group 2, patients with acute cervical (C4-T1) spinal cord injury. The site of surgery should be able to accommodate a minimum volume of 2 mL of fibrin sealant.
  • Scheduled to undergo spinal decompression surgery or other interventional spinal surgery (e.g., fixation) within 7 days of injury.
  • ASIA Impairment Scale grade of A (complete, no motor or sensory function present in the sacral segment) as assessed within 12 hours before surgery.
  • Able to communicate effectively to obtain informed consent and to ensure neurological examination.

Exclusion Criteria:

Patients will not be enrolled in this study if they meet one of the following criteria:

  • Use of any experimental drug, or participation in any clinical trial, within 30 days prior to surgery.
  • History of adverse reaction to fibrin sealant.
  • History of hypersensitivity to bovine products.
  • Any medical condition that may interfere with the ASIA assessments.
  • Clinically significant neurological, cardiac, respiratory, hepatic, or renal disease or malignancy.
  • Hemophilia or other bleeding abnormality as defined by:

    • Platelet level lower than 100 X 109/L
    • Activated partial thromboplastin time or international normalized ratio higher than the upper limit of normal
    • Baseline hematocrit lower than 0.25
  • Gunshot wound as the presenting injury, or any evidence of transecting injury to the spinal cord (e.g., by stab wound).
  • Cognitive impairment which may preclude accurate neurological assessments (e.g. traumatic head injury with GCS of less than or equal to 14).
  • Ankylosing Spondylitis.
  • Diabetes mellitus requiring insulin therapy.
  • Known immunodeficiency, including Acquired Immune Deficiency Syndrome or use of immunosuppressive or cancer chemotherapeutic drugs.
  • Pregnancy or breastfeeding during the study. A serum pregnancy test will be performed at Screening for female patients of childbearing potential. In addition, patients who are considered likely to be pregnant may be excluded at th Investigator's discretion.
  • Any condition or situation likely to cause the patient to be unable or unwilling to participate in study procedures or participate in all scheduled study assessments, including follow up through Month 6.
  • Any condition likely to result in the patient's death within the next 6 Months.
  • Any other condition that, in the opinion of the Investigator, would preclude the patient's participation in the study.
  • Previous participation in this study.
  • Use of intravenous heparin in previous 48 hours, thrombolytics and/or aspirin containing products in the previous 10 days.
  • Non-traumatic causes of spinal cord injury (e.g. transverse myelitis, acute disc herniation, etc…).

Sites / Locations

  • St. Joseph's Hospital & Medical Center
  • University of Cincinnati Mayfield Clinic and Spine Institute
  • Thomas Jefferson University Hospital
  • Univ.of Virginia Health System
  • University of Washington Harborview Medical Center
  • Sunnybrooke Health Sciences Centre
  • Toronto Western Hospital
  • Hopital du Sacre-Coeur de Montreal

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

0.3 mg

1 mg

3 mg

6 mg

9 mg

Arm Description

Subjects Receiving 0.3 mg Cethrin

Subjects receiving 1 mg Cethrin

Subjects receiving 3 mg Cethrin

Subjects receiving 6 mg Cethrin

Subjects receiving 9 mg Cethrin

Outcomes

Primary Outcome Measures

The primary goal of this study is to determine the safety and tolerability of Cethrin when administered in conjunction with fibrin sealant to the dura mater of the spinal cord.

Secondary Outcome Measures

Efficacy by AIS

Full Information

First Posted
July 11, 2007
Last Updated
March 15, 2016
Sponsor
Vertex Pharmaceuticals Incorporated
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1. Study Identification

Unique Protocol Identification Number
NCT00500812
Brief Title
A Safety Study for Cethrin (BA-210) in the Treatment of Acute Thoracic and Cervical Spinal Cord Injuries
Official Title
A Phase I/IIa Dose-Ranging Study to Evaluate the Safety, Tolerability, and Pharmacokinetics of BA-210 and the Neurological Status of Patients Following Administration of a Single Extradural Application of Cethrin During Surgery for Acute Thoracic and Cervical Spinal Cord Injury
Study Type
Interventional

2. Study Status

Record Verification Date
May 2012
Overall Recruitment Status
Completed
Study Start Date
February 2005 (undefined)
Primary Completion Date
December 2008 (Actual)
Study Completion Date
February 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Vertex Pharmaceuticals Incorporated

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This trial is a multi-center, open-label, dose-escalation study designed to evaluate the safety, tolerability and pharmacokinetics of Cethrin in two types of spinal cord injury patients: those with a complete cervical injury or a complete thoracic injury. Dose levels from 0.3 mg - 9 mg of Cethrin will be administered.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Spinal Cord Injury
Keywords
biologic drug, transport sequence, rho, spinal cord injury, paralysis, paraplegia, tetraplegia, quadraplegia, trauma, nervous system, fibrin sealant, neurosurgery

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
48 (Actual)

8. Arms, Groups, and Interventions

Arm Title
0.3 mg
Arm Type
Experimental
Arm Description
Subjects Receiving 0.3 mg Cethrin
Arm Title
1 mg
Arm Type
Experimental
Arm Description
Subjects receiving 1 mg Cethrin
Arm Title
3 mg
Arm Type
Experimental
Arm Description
Subjects receiving 3 mg Cethrin
Arm Title
6 mg
Arm Type
Experimental
Arm Description
Subjects receiving 6 mg Cethrin
Arm Title
9 mg
Arm Type
Experimental
Arm Description
Subjects receiving 9 mg Cethrin
Intervention Type
Drug
Intervention Name(s)
Cethrin
Other Intervention Name(s)
(BA-210)
Primary Outcome Measure Information:
Title
The primary goal of this study is to determine the safety and tolerability of Cethrin when administered in conjunction with fibrin sealant to the dura mater of the spinal cord.
Time Frame
Prestudy, 24-72 hrs, 6 weeks, 3, 6 & 12 months
Secondary Outcome Measure Information:
Title
Efficacy by AIS
Time Frame
Pre-study, 24-72 hrs, 6 weeks, 3, 6 & 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
16 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients will be enrolled in this study only if they meet all of the following criteria: Informed Consent Form signed by the patient or patient's legal representative. Male or female, aged 16-70 years, inclusive. For Group 1, patients with acute thoracic (T2-T12) spinal cord injury; for Group 2, patients with acute cervical (C4-T1) spinal cord injury. The site of surgery should be able to accommodate a minimum volume of 2 mL of fibrin sealant. Scheduled to undergo spinal decompression surgery or other interventional spinal surgery (e.g., fixation) within 7 days of injury. ASIA Impairment Scale grade of A (complete, no motor or sensory function present in the sacral segment) as assessed within 12 hours before surgery. Able to communicate effectively to obtain informed consent and to ensure neurological examination. Exclusion Criteria: Patients will not be enrolled in this study if they meet one of the following criteria: Use of any experimental drug, or participation in any clinical trial, within 30 days prior to surgery. History of adverse reaction to fibrin sealant. History of hypersensitivity to bovine products. Any medical condition that may interfere with the ASIA assessments. Clinically significant neurological, cardiac, respiratory, hepatic, or renal disease or malignancy. Hemophilia or other bleeding abnormality as defined by: Platelet level lower than 100 X 109/L Activated partial thromboplastin time or international normalized ratio higher than the upper limit of normal Baseline hematocrit lower than 0.25 Gunshot wound as the presenting injury, or any evidence of transecting injury to the spinal cord (e.g., by stab wound). Cognitive impairment which may preclude accurate neurological assessments (e.g. traumatic head injury with GCS of less than or equal to 14). Ankylosing Spondylitis. Diabetes mellitus requiring insulin therapy. Known immunodeficiency, including Acquired Immune Deficiency Syndrome or use of immunosuppressive or cancer chemotherapeutic drugs. Pregnancy or breastfeeding during the study. A serum pregnancy test will be performed at Screening for female patients of childbearing potential. In addition, patients who are considered likely to be pregnant may be excluded at th Investigator's discretion. Any condition or situation likely to cause the patient to be unable or unwilling to participate in study procedures or participate in all scheduled study assessments, including follow up through Month 6. Any condition likely to result in the patient's death within the next 6 Months. Any other condition that, in the opinion of the Investigator, would preclude the patient's participation in the study. Previous participation in this study. Use of intravenous heparin in previous 48 hours, thrombolytics and/or aspirin containing products in the previous 10 days. Non-traumatic causes of spinal cord injury (e.g. transverse myelitis, acute disc herniation, etc…).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael J. Fehlings, MD, PhD, FRCSC, FACS
Organizational Affiliation
Univestity Health Network, Toronto Western
Official's Role
Principal Investigator
Facility Information:
Facility Name
St. Joseph's Hospital & Medical Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85013
Country
United States
Facility Name
University of Cincinnati Mayfield Clinic and Spine Institute
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45267
Country
United States
Facility Name
Thomas Jefferson University Hospital
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
Univ.of Virginia Health System
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Facility Name
University of Washington Harborview Medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States
Facility Name
Sunnybrooke Health Sciences Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M4N3M5
Country
Canada
Facility Name
Toronto Western Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5T2S8
Country
Canada
Facility Name
Hopital du Sacre-Coeur de Montreal
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H4J1C5
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
23844986
Citation
McKerracher L, Anderson KD. Analysis of recruitment and outcomes in the phase I/IIa Cethrin clinical trial for acute spinal cord injury. J Neurotrauma. 2013 Nov 1;30(21):1795-804. doi: 10.1089/neu.2013.2909. Epub 2013 Oct 1.
Results Reference
result
PubMed Identifier
21381984
Citation
Fehlings MG, Theodore N, Harrop J, Maurais G, Kuntz C, Shaffrey CI, Kwon BK, Chapman J, Yee A, Tighe A, McKerracher L. A phase I/IIa clinical trial of a recombinant Rho protein antagonist in acute spinal cord injury. J Neurotrauma. 2011 May;28(5):787-96. doi: 10.1089/neu.2011.1765.
Results Reference
result
Links:
URL
http://www.bioaxonebio.com
Description
Sponsor
URL
http://www.ncbi.nlm.nih.gov/pubmed?term=mckerracher%20Fehlings
Description
Publication

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A Safety Study for Cethrin (BA-210) in the Treatment of Acute Thoracic and Cervical Spinal Cord Injuries

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