Impact of Amantadine on Traumatic Brain Injury
Primary Purpose
Trauma, Brain
Status
Completed
Phase
Phase 4
Locations
Egypt
Study Type
Interventional
Intervention
Amantadine (100mg) as add on therapy.
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Trauma, Brain focused on measuring traumatic brain injury (TBI), Interleukin-18 (IL-18), Neuron specific enolase (NSE), Neurotensin (NT)
Eligibility Criteria
Inclusion criteria
•Adult patients will be enrolled if they present with clinical signs of trauma brain injury
Exclusion criteria
- Age lower than 18
- Females with positive pregnancy test
- Known congestive heart failure or ischemic heart disease
- Any injury disturbs the examination (high cervical cord injury or locked-in syndrome, could be a source of bias)
- Penetrating head trauma
- Need for any operation (laparotomy or craniotomy)
- Severe brain disease (For example CVA history or brain tumour)
- Renal failure with GFR lower than 60 ml/min
- Patients with unknown identity
Sites / Locations
- Tanta University Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Amantadine Group
Placebo Group
Arm Description
Group, I are patients who will receive amantadine (100mg) as add on therapy to the standard regimen.
Group II are patients who will be managed with the standard regimen.
Outcomes
Primary Outcome Measures
Neurotensin pg/ml
Neurotensin pg/ml by ELISA Kit
Neuron specific enolase (NSE) ng/mL
Neuron specific enolase (NSE) by ELISA Kit
interleukin-18 (IL-18) pg/ml
interleukin-18 (IL-18) by ELISA Kit
ICU stay (days)
ICU stay (days)
Secondary Outcome Measures
(GCS) Total Glasgow Coma Scale score: (Severe: GCS 8 or less- Moderate: GCS 9-12- Mild: GCS 13-15).
number of GCS to describe the level of consciousness in a person following a traumatic brain injury.
GCS-E
The Glasgow Outcome Scale-Extended (GOS-E)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04527289
Brief Title
Impact of Amantadine on Traumatic Brain Injury
Official Title
Potential Impact of Amantadine on Traumatic Brain Injury Outcomes
Study Type
Interventional
2. Study Status
Record Verification Date
April 2023
Overall Recruitment Status
Completed
Study Start Date
September 30, 2020 (Actual)
Primary Completion Date
October 1, 2021 (Actual)
Study Completion Date
October 30, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Damanhour University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The aim of this study is to evaluate whether the addition of amantadine to the management regimen of traumatic brain injury patients would have a favorable effect on recovery and neurological complications in association with prognosis biomarkers Interleukin-18 (IL-18), Neuron-specific enolase (NSE) and (Neurotensin).
Detailed Description
Proposal Steps
Approval will be obtained from Research Ethics Committee of Faculty of Pharmacy, Damanhour University.
All participants agreed to take part in this clinical study and provide informed consent.
Patients will be enrolled if they present with clinical signs of trauma, from Emergency department at Tanta University Hospital
Complete physical, laboratory, radiological assessment will be done for all patients
Serum samples will be collected for measuring the biomarkers.
All enrolled 50 patients will be divided into two groups; Group I are patients who will receive amantadine as added on therapy. Group II are patients who will be managed with the standard regimen.
All patients will be followed up during 6 weeks period.
At the end of 6 weeks, prognosis biomarkers will be withdrawn.
Statistical tests appropriate to the study design will be conducted to evaluate the significance of the results.
Measuring outcome: The primary outcome is to compare the effect of adding amantadine on recovery rate and neurological complications in trauma patients.
Results, conclusion, discussion and recommendations will be given.
Methodology
50 Patients will be randomized equally to the assigned study groups
Prognosis biomarkers (IL-18, NSE and Neurotensin) will be measured using ELISA
Conventional routine tests (including renal function tests) will be assessed
Patients will be evaluated clinically (such as Glasgow score…) for recovery rate for neurological complications.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Trauma, Brain
Keywords
traumatic brain injury (TBI), Interleukin-18 (IL-18), Neuron specific enolase (NSE), Neurotensin (NT)
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Model Description
All enrolled 50 patients will be divided into two groups; Group I are patients who will receive amantadine as add on therapy. Group II are patients who will be managed with the standard regimen.
Masking
ParticipantInvestigator
Masking Description
double blind
Allocation
Randomized
Enrollment
50 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Amantadine Group
Arm Type
Experimental
Arm Description
Group, I are patients who will receive amantadine (100mg) as add on therapy to the standard regimen.
Arm Title
Placebo Group
Arm Type
Placebo Comparator
Arm Description
Group II are patients who will be managed with the standard regimen.
Intervention Type
Drug
Intervention Name(s)
Amantadine (100mg) as add on therapy.
Other Intervention Name(s)
PK-merz
Intervention Description
Amantadine (100mg) as add on therapy to the management regimen of traumatic brain injury - 100mg twice daily Oral or feeding tube
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
patients will be managed with placebo as add on to the standard regimen.
Primary Outcome Measure Information:
Title
Neurotensin pg/ml
Description
Neurotensin pg/ml by ELISA Kit
Time Frame
2 weeks
Title
Neuron specific enolase (NSE) ng/mL
Description
Neuron specific enolase (NSE) by ELISA Kit
Time Frame
2 Weeks
Title
interleukin-18 (IL-18) pg/ml
Description
interleukin-18 (IL-18) by ELISA Kit
Time Frame
2 Weeks
Title
ICU stay (days)
Description
ICU stay (days)
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
(GCS) Total Glasgow Coma Scale score: (Severe: GCS 8 or less- Moderate: GCS 9-12- Mild: GCS 13-15).
Description
number of GCS to describe the level of consciousness in a person following a traumatic brain injury.
Time Frame
6 weeks
Title
GCS-E
Description
The Glasgow Outcome Scale-Extended (GOS-E)
Time Frame
6 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria
•Adult patients will be enrolled if they present with clinical signs of trauma brain injury
Exclusion criteria
Age lower than 18
Females with positive pregnancy test
Known congestive heart failure or ischemic heart disease
Any injury disturbs the examination (high cervical cord injury or locked-in syndrome, could be a source of bias)
Penetrating head trauma
Need for any operation (laparotomy or craniotomy)
Severe brain disease (For example CVA history or brain tumour)
Renal failure with GFR lower than 60 ml/min
Patients with unknown identity
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rehab H Werida, Lecturer
Organizational Affiliation
Damanhour University
Official's Role
Study Director
Facility Information:
Facility Name
Tanta University Hospital
City
Tanta
State/Province
Elgarbia
ZIP/Postal Code
31527
Country
Egypt
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
26165872
Citation
Stelmaschuk S, Will MC, Meyers T. Amantadine to Treat Cognitive Dysfunction in Moderate to Severe Traumatic Brain Injury. J Trauma Nurs. 2015 Jul-Aug;22(4):194-203; quiz E1-2. doi: 10.1097/JTN.0000000000000138.
Results Reference
background
PubMed Identifier
23542317
Citation
Bharosay A, Bharosay VV, Varma M, Saxena K, Sodani A, Saxena R. Correlation of Brain Biomarker Neuron Specific Enolase (NSE) with Degree of Disability and Neurological Worsening in Cerebrovascular Stroke. Indian J Clin Biochem. 2012 Apr;27(2):186-90. doi: 10.1007/s12291-011-0172-9. Epub 2011 Nov 8.
Results Reference
background
PubMed Identifier
24080899
Citation
Ciaramella A, Della Vedova C, Salani F, Viganotti M, D'Ippolito M, Caltagirone C, Formisano R, Sabatini U, Bossu P. Increased levels of serum IL-18 are associated with the long-term outcome of severe traumatic brain injury. Neuroimmunomodulation. 2014;21(1):8-12. doi: 10.1159/000354764. Epub 2013 Sep 26.
Results Reference
background
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Impact of Amantadine on Traumatic Brain Injury
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