Spinal Cord Injury
Conditions
Keywords
SCI, spinal cord injury, biologic drug, rho, paralysis, paraplegia, tetraplegia, quadriplegia, trauma, central nervous system, fibrin sealant, neurosurgery, cervical, regeneration, neurotrauma
Brief summary
This is a multicenter, randomized, double-blind, placebo-controlled Phase IIb/III study designed to evaluate the efficacy and safety of Cethrin as a treatment for acute cervical spinal cord injury. During the trial, high and low doses of Cethrin will be compared with placebo.
Interventions
High or low doses of Cethrin administered extradurally in a fibrin sealant during spinal decompression/stabilization surgery.
Fibrin sealant alone administered extradurally during spinal decompression/stabilization surgery.
Sponsors
Study design
Eligibility
Inclusion criteria
* Males or females, ages 18-62, inclusive * Acute cervical spinal cord injury at a neurological level of C4-C6 * AIS Grade A or B * Scheduled to undergo decompression/stabilization surgery within five days of injury * Written or verbal consent from patient or legally authorized representative that patient is able and willing to comply with the study protocol, including follow-up visits
Exclusion criteria
* Participation in any other clinical trial for acute SCI, including previous Cethrin trial * Inability to receive study medication within five days of injury * Acute SCI from gunshot or penetrating/stab wound; peripheral nerve injury; brachial plexus injury; complete spinal cord transection; or multifocal SCI * Significant hemorrhage on MRI/CT scan * Females who are breastfeeding or have a positive serum pregnancy test * Body mass index (BMI) of ≥ 35 kg/m2 at screening * History of an adverse reaction to a fibrin sealant or its human or bovine components * Use of intravenous heparin in previous 48 hours, aspirin-containing products in previous 24 hours, thrombolytics in previous 12 hours * Hemophilia or other bleeding abnormality (platelet level lower than 100 X 109/L, activated partial thromboplastin time or international normalized ratio higher than the upper limit of normal, or baseline hematocrit lower than 0.25) * Unconsciousness or other impairment that precludes reliable ASIA examination * Known immunodeficiency, including human immunodeficiency virus, or use of immunosuppressive or cancer chemotherapeutic drugs * Clinically significant pre-existing neurological, cardiac, respiratory, hepatic, or renal disease
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| American Spinal Injury Association (ASIA) Upper Extremity Motor Score Recovery | Baseline to 6 Months |
Secondary
| Measure | Time frame |
|---|---|
| ASIA Impairment Scale (AIS) Grade Recovery | Baseline to 6 Months |
| Motor Neurological Level Recovery | Baseline to 6 Months |
| ASIA Sensory Score Recovery | Baseline to 6 Months |
| ASIA Total Motor Score Recovery | Baseline to 6 Months |
| Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP) | 6 Months |
| Incidence of Adverse Events | 0-6 Months |
| Spinal Cord Independence Measure (SCIM) III (Total Score, Self-Care Subscore) | 6 Months |