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Antioxidant and NMDA Receptor Blocker Wins Anoxic Brain Damage of KorEa OHCA Patients

A Phase II, Double-blind, Randomized, Placebo-controlled, Multicenter Trial to Assess the Efficacy and Safety of Neu2000KWL in Patients Who Resuscitated After Out-of-hospital Cardiac Arrest Patient and Receiving Therapeutic Hypothermia

Status
UNKNOWN
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03651557
Acronym
AWAKE
Enrollment
150
Registered
2018-08-29
Start date
2018-11-29
Completion date
2021-05-31
Last updated
2019-03-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Cardiac Arrest

Keywords

Neu2000KWL, cerebral performance category, out-of-hospital cardiac arrest, neuroprotection, glutamate, N-Methyl-D-aspartate (NMDA) receptor antagonist, Anti-oxidant, free radical

Brief summary

This study aims to investigate the efficacy and safety of Neu2000KWL, a neuroprotectant, in patients resuscitated from out-of-hospital cardiac arrest and receiving therapeutic hypothermia.

Detailed description

Lack of good neurological recovery is the biggest hurdle in the treatment of out-of-hospital cardia arrest. Neu2000KWL, a N-Methyl-D-aspartate (NMDA) receptor antagonist and an antioxidant, attenuated cerebral neuronal death and reduced hypoxic injury of brain in preclinical studies. Phase I clinical study has revealed that Neu2000KWL is very safe for treating human. In current study, the investigators will assess the efficacy of Neu2000KWL to compare the neurological biomarker, brain imaging, and clinical outcomes of patients successfully resuscitated from out-of-cardiac arrest treated by 3-day infusion of Neu2000KWL with patients assigned to placebo arm.

Interventions

DRUGNeu2000KWL High-dose group

1st infusion of 1500mg in patients within 4 hours following sudden cardiac arrest onset followed by 5 consecutive infusions of 750 mg at intervals of 12 hours(Total drug dosage is 5250mg.)

DRUGNeu2000KWL Low-dose group

1st infusion of 750mg in patients within 4 hours following sudden cardiac arrest onset followed by 5 consecutive infusions of 500 mg at intervals of 12 hours (Total drug dosage is 3250mg.)

DRUGPlacebo

1st infusion of the same volume of saline in patients within 4 hours following sudden cardiac arrest onset followed by 5 consecutive infusions of the same volume of saline at intervals of 12 hours

Sponsors

Samsung Medical Center
CollaboratorOTHER
Chonnam National University Hospital
CollaboratorOTHER
Gangnam Severance Hospital
CollaboratorOTHER
Kyungpook National University Hospital
CollaboratorOTHER
Pusan National University Hospital
CollaboratorOTHER
Soonchunhyang University Hospital
CollaboratorOTHER
GNT Pharma
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)

Masking description

Double Blind (Subject, Caregiver, Investigator)

Eligibility

Sex/Gender
ALL
Age
19 Years to 80 Years
Healthy volunteers
No

Inclusion criteria

1. 19 Years to 80 Years (Adult) 2. Out-of-hospital cardiac arrest caused by non-perfusing cardiac rhythm 3. Successful resuscitation accompanied by ROSC time of more than 20 min 4. Therapeutic hypothermia is planned or initiated 5. The first infusion is planned within 4 hours after ROSC 6. Informed consent is obtained from patient or family member(s) 7. No concern with previous cardiovascular surgery

Exclusion criteria

1. Hypersensitivity to aspirin or sulfasalazine 2. Unwitnessed cardiac arrest 3. CPR time \> 60 min 4. Therapeutic hypothermia is not planned 5. Use of extracorporeal membrane oxygenation (ECMO) at initiation of in-hospital resuscitation (E-CPR) 6. Very poor prognosis is expected: patients with (A) non-cardiac or respiratory arrest, (B) poor basal neurological status (C) secondary cardiac arrest caused by trauma, major bleeding, acute neurologic disease including stroke or tumor, (D) multiorgan failure or advanced malignancy 7. Pregnant or lactating women 8. Participated in other clinical studies within 90 days before randomization; or participating in other clinical trials at present 9. Intracranial bleeding verified by first brain CT imaging 10. The investigators consider the patients are not suitable for this trial

Design outcomes

Primary

MeasureTime frameDescription
Verification of difference between of Neuron specific enolase (NSE) value at after 4th infusion of Neu2000KWL.The 3rd day of study (which corresponds to finished 4th infusion of Neu2000KWL).Blood concentration of neuron specific enolase (NSE)

Secondary

MeasureTime frameDescription
Verification of the difference between groups of Change in NSE values at after the 2nd infusion of Neu2000KWL and after the 6th infusionAt the 24 hours and 72 hours after the first infusion of Neu2000KWL.The difference of blood neuron specific enolase (NSE) between 24 hour (day 1) and 72 hour (day 3) after the first infusion of Neu2000KWL.
Verification of difference between the cumulative of neuron specific enolase (NSE) values at after 6th infusion of Neu2000KWLThe 4th day of study (which corresponds to finished 6th infusion of Neu2000KWL).Cumulative Blood concentration of neuron specific enolase (NSE)
Verification of difference between each group of NSE values at after 6th infusion after 1st infusion of Neu2000KWL and 24 hours after end of last infusionThe 4th and 5th day of study (which corresponds to the timepoint of finished treatment using Neu2000KWL and 24 hour after finished treatment using Neu2000KWL).The difference of blood neuron specific enolase (NSE) between day 4 and day 5
Verification of difference between groups of Neurological function evaluated by cerebral performance category (CPC) and modified Rankin Scale (mRS) at 5 day, 14 day, or discharge within 14 days, and 90 days after 1st infusion of Neu2000KWL.5 day, 14 day, or discharge within 14 days, and 90 days after 1st infusion of Neu2000KWLNeurological function evaluated by cerebral performance category (CPC), which ranges 1 to 5 (1: best, 5: worst), and neurological function evaluated by modified Rankin Scale (mRS), which ranges 0 to 6 (0:best, 6: worst)
Verification of difference between groups of Cumulative value of blood S100beta from 6th infusion after 1st infusion of Neu2000KWL.The 4th day of study (which corresponds to finished 6th infusion of Neu2000KWL).Cumulative blood concentration of S100beta .
Verification of difference between the cerebral infarction at analysis of brain MRI's Apparent Diffusion Coefficient(ADC) images within 48 hours of the last infusion of Neu2000KWLThe 5th day of study (which corresponds to 48 hours after finished treatment using Neu2000KWL).Blood neuron specific enolase (NSE) at day 5

Other

MeasureTime frameDescription
Serious adverse event90 daysSafety Outcome Measure Number of participants with treatment-related adverse events assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0
Mortality within 90 days90 daysSafety Outcome Measure

Countries

South Korea

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 14, 2026