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TNFα Monoclonal Antibody for Acute Spinal Cord Injury

Primary Purpose

Spinal Cord Injuries

Status
Not yet recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
TNFα Monoclonal Antibody
Methylprednisolone
Saline
Sponsored by
Shanghai Changzheng Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Spinal Cord Injuries

Eligibility Criteria

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

Inclusion Criteria:

  • Patients aged between 18 and 60 years
  • Traumatic spinal cord injury
  • ASIA Impairment Scale A-D
  • The injury must be within two weeks
  • Patients submitted written informed consent

Exclusion Criteria:

  • Traumatic spinal cord injury with brain injury or peripheral nerve injury
  • Patients with severe multiple injuries and unstable vital signs
  • Non-traumatic spinal cord injury caused by spinal tumors, hematoma, myelitis, etc.
  • Patients with central spinal cord injury
  • Patients with a completely transected spinal cord
  • Patients with fever or acute infection
  • Ongoing infectious disease, such as tuberculosis, HIV, hepatitis, syphilis, etc.
  • Patients with malignant tumour
  • Patients with neurodegenerative diseases, or any neuropathies
  • Patients with ankylosing spondylitis
  • Patients with a previous history of spinal surgery

Sites / Locations

  • Shanghai Changzheng Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Placebo Comparator

Arm Label

TNFα monoclonal antibody group

Methylprednisolone group

Control group

Arm Description

Subcutaneous injection of 50mg of TNFα monoclonal antibody immediately after admission before surgery.

Injection of 500mg of methylprednisolone immediately after admission before surgery.

Injection of the same volume of saline immediately after admission before surgery.

Outcomes

Primary Outcome Measures

American Spinal Injury Association Impairment Scale(ASIA)
Change in sensory and motor function as measured by the American Spinal Injury Association Impairment Scale (ASIA). The scale ranked from A to E, A indicates the the most severe spinal cord injury and E indicates no neurological deficit.

Secondary Outcome Measures

Incidence of adverse events
Any abnormal signs, symptoms, findings, or diseases that emerge or worsen relative to baseline in 1 month posttreatment will be recorded as adverse event
Motor Evoked Potentials (MEP) and Somatosensory Evoked Potentials (SSEP) test
Change in sensory and motor function will be measured by SSEP and MED test
Residual urine test
Change in residual urine as measured by ultrasound test

Full Information

First Posted
July 7, 2021
Last Updated
May 4, 2022
Sponsor
Shanghai Changzheng Hospital
Collaborators
The First People's Hospital of Kunshan, Traditional Chinese Medicine Hospital of Kunshan, China, Wuxi 904 Hospital, China, The Sixth People's Hospital of Nantong, China, Zhejiang Provincial Hospital of TCM
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1. Study Identification

Unique Protocol Identification Number
NCT04988425
Brief Title
TNFα Monoclonal Antibody for Acute Spinal Cord Injury
Official Title
Subcutaneous Injection of TNFα Monoclonal Antibody for Treating Traumatic Acute Spinal Cord Injury
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
September 1, 2022 (Anticipated)
Primary Completion Date
August 30, 2023 (Anticipated)
Study Completion Date
August 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Shanghai Changzheng Hospital
Collaborators
The First People's Hospital of Kunshan, Traditional Chinese Medicine Hospital of Kunshan, China, Wuxi 904 Hospital, China, The Sixth People's Hospital of Nantong, China, Zhejiang Provincial Hospital of TCM

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and effectiveness of subcutaneous injection of TNFα monoclonal antibody cells for the treatment of traumatic acute spinal cord injury. Spinal cord injury can be divided into three phases, which are acute (within 2 weeks), sub-acute (2 weeks to 6 months), and chronic (over 6 months). The pathological process of spinal cord injury include primary injury (initial traumatic insult) and a progressive secondary injury cascade characterized by ischemia, proapoptotic signaling, peripheral inflammatory cell infiltration and the release of proinflammatory cytokines. Secondary injury plays a key role in the loss of spinal cord function after trauma. So early treatment to prevent the secondary injury is the key to improve prognosis. TNFα monoclonal antibody is a TNF-α inhibitor that could control inflammatory response, and now widely used in the treatment of Ankylosing spondylitis, Rheumatoid arthritis and other autoimmune diseases. In this study, the investigators will treat patients with acute spinal cord injury with TNFα monoclonal antibody and compare with the control group.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Spinal Cord Injuries

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
Participant
Masking Description
Random grouping
Allocation
Randomized
Enrollment
90 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
TNFα monoclonal antibody group
Arm Type
Experimental
Arm Description
Subcutaneous injection of 50mg of TNFα monoclonal antibody immediately after admission before surgery.
Arm Title
Methylprednisolone group
Arm Type
Active Comparator
Arm Description
Injection of 500mg of methylprednisolone immediately after admission before surgery.
Arm Title
Control group
Arm Type
Placebo Comparator
Arm Description
Injection of the same volume of saline immediately after admission before surgery.
Intervention Type
Drug
Intervention Name(s)
TNFα Monoclonal Antibody
Intervention Description
Subcutaneous injection of 50mg of TNFα monoclonal antibody immediately after admission before surgery.
Intervention Type
Drug
Intervention Name(s)
Methylprednisolone
Intervention Description
Injection of 500mg of methylprednisolone immediately after admission before surgery.
Intervention Type
Drug
Intervention Name(s)
Saline
Intervention Description
Injection of the same volume of saline immediately after admission before surgery
Primary Outcome Measure Information:
Title
American Spinal Injury Association Impairment Scale(ASIA)
Description
Change in sensory and motor function as measured by the American Spinal Injury Association Impairment Scale (ASIA). The scale ranked from A to E, A indicates the the most severe spinal cord injury and E indicates no neurological deficit.
Time Frame
baseline, 1 month, 3 months, 6 months and 12 months post-treatment
Secondary Outcome Measure Information:
Title
Incidence of adverse events
Description
Any abnormal signs, symptoms, findings, or diseases that emerge or worsen relative to baseline in 1 month posttreatment will be recorded as adverse event
Time Frame
1 month post-treatment
Title
Motor Evoked Potentials (MEP) and Somatosensory Evoked Potentials (SSEP) test
Description
Change in sensory and motor function will be measured by SSEP and MED test
Time Frame
baseline, 3 months, 6 months and 12 months post-treatment
Title
Residual urine test
Description
Change in residual urine as measured by ultrasound test
Time Frame
baseline, 3 months, 6 months and 12 months post-treatment

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 Criteria: Patients aged between 18 and 60 years Traumatic spinal cord injury ASIA Impairment Scale A-D The injury must be within two weeks Patients submitted written informed consent Exclusion Criteria: Traumatic spinal cord injury with brain injury or peripheral nerve injury Patients with severe multiple injuries and unstable vital signs Non-traumatic spinal cord injury caused by spinal tumors, hematoma, myelitis, etc. Patients with central spinal cord injury Patients with a completely transected spinal cord Patients with fever or acute infection Ongoing infectious disease, such as tuberculosis, HIV, hepatitis, syphilis, etc. Patients with malignant tumour Patients with neurodegenerative diseases, or any neuropathies Patients with ankylosing spondylitis Patients with a previous history of spinal surgery
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Xuhua Lu, M.D.
Phone
+862181885793
Email
xuhualu@hotmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Bangke Zhang, M.D.
Phone
+8618301783716
Email
zbk12345@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xuhua Lu, M.D.
Organizational Affiliation
Shanghai Changzheng Hospotal
Official's Role
Principal Investigator
Facility Information:
Facility Name
Shanghai Changzheng Hospital
City
Shanghai
ZIP/Postal Code
200003
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
IPD will be available through email when requested

Learn more about this trial

TNFα Monoclonal Antibody for Acute Spinal Cord Injury

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