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Efficacy Study of NH001 in Vegetative State & Minimally Conscious State Following a Traumatic Brain Injury (NH001-2)

Primary Purpose

Brain Injury

Status
Suspended
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Apomorphine
Placebo
Sponsored by
NeuroHealing Pharmaceuticals Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Brain Injury focused on measuring Vegetative State, Minimally Conscious State, Coma, Traumatic Brain Injury

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patient is between 18 and 50 years of age, inclusive.
  2. Male or non-pregnant female (females of child-bearing potential will be required to have undergone a pregnancy test with negative results prior to entry to the study).
  3. Patients will have sustained a severe closed head injury within one to four months.
  4. Patients will have remained in a vegetative or minimally conscious state between one and four months after injury.
  5. Patients will have reached a stabilized clinical state prior to admission to the study (e.g. afebrile, haemodynamic and electrolyte stability).
  6. Patients will have a mean DRS score between 17 and 29, when measured twice a day over two consecutive days.
  7. Informed consent from a legal representative will have been obtained, according to the procedures outlined in Section 8.1.2.
  8. Patients who, according to the investigator's opinion, are likely to be available for the required 180-day follow up evaluation.

Exclusion Criteria:

  1. Patients who are not clinically stable at the time of entry into the study (infections, cardiovascular decompensation, etc.)
  2. Patients who require mechanical respiratory assistance.
  3. Patients who show signs of progressive neurological deterioration post-TBI.
  4. Patients with a known history of medically relevant substance abuse.
  5. Patients with history of cardiac disease.
  6. Patients who suffered an anoxic event.
  7. Patients who have received an investigational drug within 30 days of the study.
  8. Patients who have previously used NH001, other dopaminergic agent (e.g. levodopa, amantadine, domperidone) or any known neuro-stimulant (e.g. methylphenidate, amphetamines, atomoxetine, modafinil) within the last 7 days days.
  9. Patients who are receiving dopamine blockers (e.g. risperidone, haloperidol, chlorpromazine, flupenthixol, clozapine, olanzapine, quetiapine)
  10. Patients who are receiving drugs of the 5HT3 antagonist class, including, for example, ondansetron, granisetron, dolasetron, palonosetron and alosetron.
  11. Patients who are receiving tricyclic antidepressants drugs
  12. Patients who are receiving type I antiarrhythmics (i.e. quinidine).
  13. Patients who have a known history of cardiac arrhythmias or congenital QTc prolongation.
  14. Patients who have a known history of previous neurological functional impairment (e.g. stroke, spinal cord injury, dementia, epilepsy, psychiatric diseases).
  15. Patients who experienced seizures within the first week post injury or have ongoing seizures.
  16. Patients receiving prophylactic anti-convulsive medications.
  17. Patients with known allergies to apomorphine, morphine, sulfites or trimethobenzamide.
  18. Patients who are receiving nitrates or other vasodilators.
  19. Patients receiving CNS acting agents such as barbiturates, morphine, belladonna, opiates.
  20. For male patients, patients who are receiving trazodone or any other drug that is known to produce priapism.
  21. Patients without a relative or legal guardian to consent to the study.
  22. Patients who, according to the investigator's opinion, are unlikely to be available for the required 180-day follow up evaluation.

Sites / Locations

  • Spaulding Rehabilitation Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Apomorphine

Placebo

Arm Description

Patients will receive an ascending dosing schedule to reach a maximum infusion rate of up to 6 mg/hour for 12 hours a day.

Patients will receive a continues subcutaneous infusion of saline solution.

Outcomes

Primary Outcome Measures

Presence or absence of meaningful responses to external commands based on Coma Recovery Scale-Revised

Secondary Outcome Measures

Coma/Near Coma Scale (CNC) Disability Rating Scale (DRS), Glasgow Outcome Scale Extended (GOS-E), ability to participate in 3 hours a day of active rehabilitation, and a clinical impression of change.

Full Information

First Posted
September 26, 2008
Last Updated
March 29, 2017
Sponsor
NeuroHealing Pharmaceuticals Inc.
Collaborators
FDA Office of Orphan Products Development
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1. Study Identification

Unique Protocol Identification Number
NCT00761228
Brief Title
Efficacy Study of NH001 in Vegetative State & Minimally Conscious State Following a Traumatic Brain Injury
Acronym
NH001-2
Official Title
A Double-blind, Placebo-controlled, Randomized Study of the Safety and Efficacy of NH001 in Improving the Functional Outcome of Patients in a Vegetative State or Minimally Conscious State Following a Severe Traumatic Brain Injury
Study Type
Interventional

2. Study Status

Record Verification Date
March 2017
Overall Recruitment Status
Suspended
Study Start Date
July 2010 (undefined)
Primary Completion Date
December 2018 (Anticipated)
Study Completion Date
December 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NeuroHealing Pharmaceuticals Inc.
Collaborators
FDA Office of Orphan Products Development

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to test the drug apomorphine in subjects who are in a Vegetative State or a Minimally Conscious State.
Detailed Description
This is a prospective, multi-center, randomized, double-blind, placebo-controlled study of the safety and efficacy of NH001 to improve the functional outcome of patients in a vegetative state or minimally conscious state following a severe traumatic brain injury (TBI).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain Injury
Keywords
Vegetative State, Minimally Conscious State, Coma, 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
76 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Apomorphine
Arm Type
Active Comparator
Arm Description
Patients will receive an ascending dosing schedule to reach a maximum infusion rate of up to 6 mg/hour for 12 hours a day.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Patients will receive a continues subcutaneous infusion of saline solution.
Intervention Type
Drug
Intervention Name(s)
Apomorphine
Intervention Description
Patients will receive an ascending dosing schedule of continuous subcutaneous apomorphine to reach a maximum infusion rate of up to 6 mg/hour for 12 hours a day.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Patients will receive a continues subcutaneous infusion of saline solution.
Primary Outcome Measure Information:
Title
Presence or absence of meaningful responses to external commands based on Coma Recovery Scale-Revised
Time Frame
Day 42 or the day that the drug treatment is discontinued, whichever happens earlier.
Secondary Outcome Measure Information:
Title
Coma/Near Coma Scale (CNC) Disability Rating Scale (DRS), Glasgow Outcome Scale Extended (GOS-E), ability to participate in 3 hours a day of active rehabilitation, and a clinical impression of change.
Time Frame
Baseline, weekly during drug treatment and at follow up visits of days 90,180 and 360.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient is between 18 and 50 years of age, inclusive. Male or non-pregnant female (females of child-bearing potential will be required to have undergone a pregnancy test with negative results prior to entry to the study). Patients will have sustained a severe closed head injury within one to four months. Patients will have remained in a vegetative or minimally conscious state between one and four months after injury. Patients will have reached a stabilized clinical state prior to admission to the study (e.g. afebrile, haemodynamic and electrolyte stability). Patients will have a mean DRS score between 17 and 29, when measured twice a day over two consecutive days. Informed consent from a legal representative will have been obtained, according to the procedures outlined in Section 8.1.2. Patients who, according to the investigator's opinion, are likely to be available for the required 180-day follow up evaluation. Exclusion Criteria: Patients who are not clinically stable at the time of entry into the study (infections, cardiovascular decompensation, etc.) Patients who require mechanical respiratory assistance. Patients who show signs of progressive neurological deterioration post-TBI. Patients with a known history of medically relevant substance abuse. Patients with history of cardiac disease. Patients who suffered an anoxic event. Patients who have received an investigational drug within 30 days of the study. Patients who have previously used NH001, other dopaminergic agent (e.g. levodopa, amantadine, domperidone) or any known neuro-stimulant (e.g. methylphenidate, amphetamines, atomoxetine, modafinil) within the last 7 days days. Patients who are receiving dopamine blockers (e.g. risperidone, haloperidol, chlorpromazine, flupenthixol, clozapine, olanzapine, quetiapine) Patients who are receiving drugs of the 5HT3 antagonist class, including, for example, ondansetron, granisetron, dolasetron, palonosetron and alosetron. Patients who are receiving tricyclic antidepressants drugs Patients who are receiving type I antiarrhythmics (i.e. quinidine). Patients who have a known history of cardiac arrhythmias or congenital QTc prolongation. Patients who have a known history of previous neurological functional impairment (e.g. stroke, spinal cord injury, dementia, epilepsy, psychiatric diseases). Patients who experienced seizures within the first week post injury or have ongoing seizures. Patients receiving prophylactic anti-convulsive medications. Patients with known allergies to apomorphine, morphine, sulfites or trimethobenzamide. Patients who are receiving nitrates or other vasodilators. Patients receiving CNS acting agents such as barbiturates, morphine, belladonna, opiates. For male patients, patients who are receiving trazodone or any other drug that is known to produce priapism. Patients without a relative or legal guardian to consent to the study. Patients who, according to the investigator's opinion, are unlikely to be available for the required 180-day follow up evaluation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elkan R Gamzu, PhD
Organizational Affiliation
NeuroHealing Pharmaceuticals Inc.
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Ross D Zafonte, DO
Organizational Affiliation
Spaulding Rehabilitation Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Spaulding Rehabilitation Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Efficacy Study of NH001 in Vegetative State & Minimally Conscious State Following a Traumatic Brain Injury

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