E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Severe acute brain injury caused by aneurysmal subarachnoid hemorrhage, spontaneous intracerebral hemorrhage or traumatic brain injury. |
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E.1.1.1 | Medical condition in easily understood language |
Severe brain injury after a brain hemorrhage caused by either trauma to the head, rupture of a brain aneurysm, or a spontaneous bleeding in the brain tissue. |
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E.1.1.2 | Therapeutic area | Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Anesthesia and Analgesia [E03] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10018061 |
E.1.2 | Term | General anesthesia |
E.1.2 | System Organ Class | 100000004865 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10070731 |
E.1.2 | Term | Electrocorticography |
E.1.2 | System Organ Class | 100000004865 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10056389 |
E.1.2 | Term | Brain damage |
E.1.2 | System Organ Class | 100000004852 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10019529 |
E.1.2 | Term | Hemorrhage brain |
E.1.2 | System Organ Class | 100000004852 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
This pilot and feasibility trial – the KETA-BID trial – aims investigate the efficacy and safety of S-ketamine on the occurrence of cortical spreading depolarisations and the feasibility of the setup. More specifically, the KETA-BID trial investigates the efficacy of S-ketamine in those where cortical spreading depolarisations persist despite physiological optimisation. |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives of this trial is investigate the safety of using S-ketamine for patients with severe acute brain injury by investigating the rate of adverse events and adverse reactions after randomisation and throughout the intervention period, and to examine functional outcome at 6 months after ictus of brain injury. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Age ≥ 18 years. • Admitted to the NICU with a diagnosis of traumatic brain injury, aneurysmal subarachnoid hemorrhage or spontaneous intracerebral hemorrhage. • Planned for surgery with a craniotomy or craniectomy. • Expected to continue sedation and mechanical ventilation after surgery. |
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E.4 | Principal exclusion criteria |
• Patient and next of kin do not read or understand spoken Danish. • Known allergy to S-ketamine (the active pharmaceutical ingredient or the excipients). • Wake-up call to occur immediatly after surgery. • Pregnancy (all female participants aged ≤ 50 years will have a blood hCG to control for pregnancy). • Active anti-psychotic treatment before admission. • Current abuse of ketamine. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Occurrence of cortical spreading depolarisations per hour of ECoG monitoring after randomisation. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
From randomisation (i.e. start of treatment with S-ketamine or placebo) until end of ECoG monitoring. |
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E.5.2 | Secondary end point(s) |
• Rate of adverse events and adverse reactions • Functional outcome (using modified Rankin Scale) at 6 months after ictus of brain injury.
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Rate of adverse events and adverse reactions: from randomisation and throughout the intervention period. Functional outcome (using modified Rankin Scale): at 6 months after ictus of brain injury. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |