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Ghrelin (OXE--103) for Acute Concussion Management

Primary Purpose

Concussion, Brain, Traumatic Brain Injury

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Ghrelin (OXE-103)
Placebo
Sponsored by
Michael Rippee, MD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Concussion, Brain

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

INCLUSION AND EXCLUSION:

In Part A (post-acute), subjects must be consented within 28 days post injury. In Part B (acute), subjects must be consented, randomized, and start treatment within 24 hours of presentation to the University of Kansas Health System Trauma Unit.

Subjects in both Part A and B will have a symptom severity score of at least 20 at the time of randomization in order to reduce the expected degree (number and severity) of spontaneous symptom resolution prior to study completion.

Subjects with pre-existing neurologic conditions other than mTBI (including cognitive dysfunction) will be excluded.

Subjects with concurrent long bone fractures or orbital fractures will be excluded.

Subjects receiving, or planning to receive, a continuous ketamine infusion while enrolled in study will be excluded.

Subjects with these known endocrinological abnormalities at baseline will be excluded from study: diabetes mellitus, excess or deficiency of growth hormone, cortisol, or prolactin. Exclusion from study for any other endocrinological abnormalities or diagnoses existing at baseline are ultimately up to the discretion of the study physician.

Significant abnormalities in serum creatinine (>2.5 mg/dL), or alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3 times the upper limit of normal, or bilirubin (>2.5 mg/dL) will exclude subjects from participation.

Subjects with any abnormal findings noted on imaging, such as hemorrhage, will be excluded from the study. Subjects who meet criteria for moderate or severe TBI will also be excluded.

Subjects who are known to be pregnant will be excluded. Subjects who do not agree to double-barrier contraception or abstinence (for female subjects of child-bearing potential or male subjects who are sexually active with a female of child-bearing potential) until the day following last dose (total of at least 5 half-lives) will be excluded.

In Part A subjects receiving other concomitant medications, physical therapy, or other treatments related to their current mTBI will be eligible if they meet the inclusion criteria.

Subjects (or household members) who are not able to inject themselves or the subject will be excluded.

For both Part A and Part B, subjects are not allowed to be concurrently enrolled in another therapeutic intervention clinical trial while participating in this study. Any subjects currently enrolled in such a separate therapeutic intervention clinical trial, for any condition, will be excluded from participating in this study. For clarification, this does not include observational clinical trials or registries.

Ultimately study subject participation will be at the discretion of the study physician.

Sites / Locations

  • University of Kansas Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Ghrelin (OXE-103)

Arm Description

Placebo (40ug/kg) will be self-administered twice daily for 14 days. ONLY THE PART B (ACUTE) SUBJECTS WILL BE RANDOMIZED AND MAY RECEIVE PLACEBO.

OXE-103 (40ug/kg) will be self-administered twice daily for 14 days. PART A (POST-ACUTE) SUBJECTS WILL BE OFFERED EXPERIMENTAL TREATMENT WITHOUT RANDOMIZATION. PART B (ACUTE) SUBJECTS WILL BE DOUBLE-BLIND RANDOMIZED TO EXPERIMENTAL OR PLACEBO TREATMENT.

Outcomes

Primary Outcome Measures

Symptom Management - Post Concussion Symptom Scale
The primary goal is to describe the change in number of symptoms and/or severity of symptoms in sub-acute concussion with treatment with OXE-103 using the Post Concussion Symptom Scale questionnaire during the intervention period at days 1 and 15 as well as during the post-treatment period at days 21 and 44. The Post Concussion Symptom Scale questionnaire consists of 23 common concussion symptoms which are assigned a ranking of severity on a scale from 0 (no symptom) to 6 (severe symptom). This tool is used to capture both severity of concussion symptoms as well as the number of symptoms.

Secondary Outcome Measures

Quality of Life - QOLIBRI-OS
A secondary goal is to examine change in quality of life with treatment of sub-acute concussion using the Quality of Life after Brain Injury - Overall Scale questionnaire. The Quality of Life after Brain Injury - Overall Scale questionnaire consists of six questions which address satisfaction of life after injury. Responses are assigned a ranking on a scale from "not at all" to "very."
Quality of Life - PGAS
A secondary goal is to examine change in quality of life with treatment of sub-acute concussion using a Patient Global Assessment Scale, which is measured using a visual analogue scale. The range is from 0 (no impact) to 10 (greatest impact). This tool asks how concussion symptoms impact ability to function or perform daily activities.

Full Information

First Posted
September 3, 2020
Last Updated
May 30, 2023
Sponsor
Michael Rippee, MD
Collaborators
University of Kansas Health System, University of Kansas Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT04558346
Brief Title
Ghrelin (OXE--103) for Acute Concussion Management
Official Title
Ghrelin (OXE--103) for Acute Concussion Management
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
October 20, 2020 (Actual)
Primary Completion Date
October 30, 2022 (Actual)
Study Completion Date
October 30, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Michael Rippee, MD
Collaborators
University of Kansas Health System, University of Kansas Medical Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Concussions are the leading form of mild traumatic brain injury. Management of concussions and mild traumatic brain injury is a high priority medical focus, social concern, and research topic. Currently, there are no FDA approved treatments for acute concussion. The current standard of care is rest followed by gradual return to normal activity. The purpose of this study is to show improvement in the way patients feel or function after a concussion. OXE-103 is a protein hormone produced in the laboratory which identical to the hormone ghrelin that is secreted by the stomach. This study will investigate the use of this hormone as treatment for symptoms of acute concussion. The goal of this study is to show improvement in the way study participants feel or function after concussion. An OXE-103 (ghrelin) agonist is already FDA approved for another condition, but not for concussion. For concussion, it is considered investigational. This study will examine, if ghrelin is taken every day for two weeks, if the brain will heal faster and help improve or resolve symptoms. The study will also include a placebo arm and a non-treatment group (for those who wish to participate but do not want to receive any treatment). The OXE-103 and placebo will be self-administered through injections using needles.
Detailed Description
All consenting participants will be screened for eligibility. The study has two Parts: Part A: Post-Acute (within 28 days of injury) Part B: Acute (within 24 hours of injury) Part A does not include randomization and all enrolling subjects will be offered treatment with OXE-103. Enrolling subjects in this Part A will also have the option to choose participation in a non-treatment control group if they do not want treatment. Part B participation includes double-blinded randomization to receive either OXE-103 or placebo. There is no option to choose participation in a non-treatment control group. For Part B, consenting and eligible participants will either be randomized to receive study drug (OXE-103) or placebo. The study team will also be blinded to the assigned treatment, so they will not know which treatment participants have been assigned to take. Consenting participants must be willing to commit to the following: give themselves subcutaneous injections twice a day (for the treatment groups) attend several study visits, which require both in-person and phone-only visits complete various questionnaires and testing have blood drawn have ECG's performed undergo a pregnancy test (if of childbearing potential) and use contraception while on study (for the treatment groups) tell the study team about any side effects they might experience from the study drug during study participation Total participation for the treatment groups will last about 7 weeks, which includes screening, 14 days of taking the study drug, and 4 weeks of follow-up. Participation for the non-treatment group will last the same amount of time.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Concussion, Brain, Traumatic Brain Injury

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo (40ug/kg) will be self-administered twice daily for 14 days. ONLY THE PART B (ACUTE) SUBJECTS WILL BE RANDOMIZED AND MAY RECEIVE PLACEBO.
Arm Title
Ghrelin (OXE-103)
Arm Type
Experimental
Arm Description
OXE-103 (40ug/kg) will be self-administered twice daily for 14 days. PART A (POST-ACUTE) SUBJECTS WILL BE OFFERED EXPERIMENTAL TREATMENT WITHOUT RANDOMIZATION. PART B (ACUTE) SUBJECTS WILL BE DOUBLE-BLIND RANDOMIZED TO EXPERIMENTAL OR PLACEBO TREATMENT.
Intervention Type
Drug
Intervention Name(s)
Ghrelin (OXE-103)
Intervention Description
40ug/kg twice daily by self-injection
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
40ug/kg twice daily by self-injection
Primary Outcome Measure Information:
Title
Symptom Management - Post Concussion Symptom Scale
Description
The primary goal is to describe the change in number of symptoms and/or severity of symptoms in sub-acute concussion with treatment with OXE-103 using the Post Concussion Symptom Scale questionnaire during the intervention period at days 1 and 15 as well as during the post-treatment period at days 21 and 44. The Post Concussion Symptom Scale questionnaire consists of 23 common concussion symptoms which are assigned a ranking of severity on a scale from 0 (no symptom) to 6 (severe symptom). This tool is used to capture both severity of concussion symptoms as well as the number of symptoms.
Time Frame
Days 1-44
Secondary Outcome Measure Information:
Title
Quality of Life - QOLIBRI-OS
Description
A secondary goal is to examine change in quality of life with treatment of sub-acute concussion using the Quality of Life after Brain Injury - Overall Scale questionnaire. The Quality of Life after Brain Injury - Overall Scale questionnaire consists of six questions which address satisfaction of life after injury. Responses are assigned a ranking on a scale from "not at all" to "very."
Time Frame
Days 1-44
Title
Quality of Life - PGAS
Description
A secondary goal is to examine change in quality of life with treatment of sub-acute concussion using a Patient Global Assessment Scale, which is measured using a visual analogue scale. The range is from 0 (no impact) to 10 (greatest impact). This tool asks how concussion symptoms impact ability to function or perform daily activities.
Time Frame
Days 1-44

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION AND EXCLUSION: In Part A (post-acute), subjects must be consented within 28 days post injury. In Part B (acute), subjects must be consented, randomized, and start treatment within 24 hours of presentation to the University of Kansas Health System Trauma Unit. Subjects in both Part A and B will have a symptom severity score of at least 20 at the time of randomization in order to reduce the expected degree (number and severity) of spontaneous symptom resolution prior to study completion. Subjects with pre-existing neurologic conditions other than mTBI (including cognitive dysfunction) will be excluded. Subjects with concurrent long bone fractures or orbital fractures will be excluded. Subjects receiving, or planning to receive, a continuous ketamine infusion while enrolled in study will be excluded. Subjects with these known endocrinological abnormalities at baseline will be excluded from study: diabetes mellitus, excess or deficiency of growth hormone, cortisol, or prolactin. Exclusion from study for any other endocrinological abnormalities or diagnoses existing at baseline are ultimately up to the discretion of the study physician. Significant abnormalities in serum creatinine (>2.5 mg/dL), or alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3 times the upper limit of normal, or bilirubin (>2.5 mg/dL) will exclude subjects from participation. Subjects with any abnormal findings noted on imaging, such as hemorrhage, will be excluded from the study. Subjects who meet criteria for moderate or severe TBI will also be excluded. Subjects who are known to be pregnant will be excluded. Subjects who do not agree to double-barrier contraception or abstinence (for female subjects of child-bearing potential or male subjects who are sexually active with a female of child-bearing potential) until the day following last dose (total of at least 5 half-lives) will be excluded. In Part A subjects receiving other concomitant medications, physical therapy, or other treatments related to their current mTBI will be eligible if they meet the inclusion criteria. Subjects (or household members) who are not able to inject themselves or the subject will be excluded. For both Part A and Part B, subjects are not allowed to be concurrently enrolled in another therapeutic intervention clinical trial while participating in this study. Any subjects currently enrolled in such a separate therapeutic intervention clinical trial, for any condition, will be excluded from participating in this study. For clarification, this does not include observational clinical trials or registries. Ultimately study subject participation will be at the discretion of the study physician.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Rippee, MD
Organizational Affiliation
University of Kansas Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Ghrelin (OXE--103) for Acute Concussion Management

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