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Efficacy Study of NH001 in Vegetative State & Minimally Conscious State Following a Traumatic Brain Injury (NH001-2)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT00761228
Recruitment Status : Suspended
First Posted : September 29, 2008
Last Update Posted : March 31, 2017
Information provided by (Responsible Party):

Study Description
Brief Summary:
The purpose of this study is to test the drug apomorphine in subjects who are in a Vegetative State or a Minimally Conscious State.

Condition or disease Intervention/treatment Phase
Brain Injury Drug: Apomorphine Drug: Placebo Phase 2

Detailed Description:
This is a prospective, multi-center, randomized, double-blind, placebo-controlled study of the safety and efficacy of NH001 to improve the functional outcome of patients in a vegetative state or minimally conscious state following a severe traumatic brain injury (TBI).

Study Design

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 76 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Double-blind, Placebo-controlled, Randomized Study of the Safety and Efficacy of NH001 in Improving the Functional Outcome of Patients in a Vegetative State or Minimally Conscious State Following a Severe Traumatic Brain Injury
Study Start Date : July 2010
Estimated Primary Completion Date : December 2018
Estimated Study Completion Date : December 2018

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arms and Interventions

Arm Intervention/treatment
Active Comparator: Apomorphine
Patients will receive an ascending dosing schedule to reach a maximum infusion rate of up to 6 mg/hour for 12 hours a day.
Drug: Apomorphine
Patients will receive an ascending dosing schedule of continuous subcutaneous apomorphine to reach a maximum infusion rate of up to 6 mg/hour for 12 hours a day.
Placebo Comparator: Placebo
Patients will receive a continues subcutaneous infusion of saline solution.
Drug: Placebo
Patients will receive a continues subcutaneous infusion of saline solution.

Outcome Measures

Primary Outcome Measures :
  1. Presence or absence of meaningful responses to external commands based on Coma Recovery Scale-Revised [ Time Frame: Day 42 or the day that the drug treatment is discontinued, whichever happens earlier. ]

Secondary Outcome Measures :
  1. Coma/Near Coma Scale (CNC) Disability Rating Scale (DRS), Glasgow Outcome Scale Extended (GOS-E), ability to participate in 3 hours a day of active rehabilitation, and a clinical impression of change. [ Time Frame: Baseline, weekly during drug treatment and at follow up visits of days 90,180 and 360. ]

Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 50 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Patient is between 18 and 50 years of age, inclusive.
  2. Male or non-pregnant female (females of child-bearing potential will be required to have undergone a pregnancy test with negative results prior to entry to the study).
  3. Patients will have sustained a severe closed head injury within one to four months.
  4. Patients will have remained in a vegetative or minimally conscious state between one and four months after injury.
  5. Patients will have reached a stabilized clinical state prior to admission to the study (e.g. afebrile, haemodynamic and electrolyte stability).
  6. Patients will have a mean DRS score between 17 and 29, when measured twice a day over two consecutive days.
  7. Informed consent from a legal representative will have been obtained, according to the procedures outlined in Section 8.1.2.
  8. Patients who, according to the investigator's opinion, are likely to be available for the required 180-day follow up evaluation.

Exclusion Criteria:

  1. Patients who are not clinically stable at the time of entry into the study (infections, cardiovascular decompensation, etc.)
  2. Patients who require mechanical respiratory assistance.
  3. Patients who show signs of progressive neurological deterioration post-TBI.
  4. Patients with a known history of medically relevant substance abuse.
  5. Patients with history of cardiac disease.
  6. Patients who suffered an anoxic event.
  7. Patients who have received an investigational drug within 30 days of the study.
  8. Patients who have previously used NH001, other dopaminergic agent (e.g. levodopa, amantadine, domperidone) or any known neuro-stimulant (e.g. methylphenidate, amphetamines, atomoxetine, modafinil) within the last 7 days days.
  9. Patients who are receiving dopamine blockers (e.g. risperidone, haloperidol, chlorpromazine, flupenthixol, clozapine, olanzapine, quetiapine)
  10. Patients who are receiving drugs of the 5HT3 antagonist class, including, for example, ondansetron, granisetron, dolasetron, palonosetron and alosetron.
  11. Patients who are receiving tricyclic antidepressants drugs
  12. Patients who are receiving type I antiarrhythmics (i.e. quinidine).
  13. Patients who have a known history of cardiac arrhythmias or congenital QTc prolongation.
  14. Patients who have a known history of previous neurological functional impairment (e.g. stroke, spinal cord injury, dementia, epilepsy, psychiatric diseases).
  15. Patients who experienced seizures within the first week post injury or have ongoing seizures.
  16. Patients receiving prophylactic anti-convulsive medications.
  17. Patients with known allergies to apomorphine, morphine, sulfites or trimethobenzamide.
  18. Patients who are receiving nitrates or other vasodilators.
  19. Patients receiving CNS acting agents such as barbiturates, morphine, belladonna, opiates.
  20. For male patients, patients who are receiving trazodone or any other drug that is known to produce priapism.
  21. Patients without a relative or legal guardian to consent to the study.
  22. Patients who, according to the investigator's opinion, are unlikely to be available for the required 180-day follow up evaluation.
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00761228

United States, Massachusetts
Spaulding Rehabilitation Hospital
Boston, Massachusetts, United States, 02114
Sponsors and Collaborators
NeuroHealing Pharmaceuticals Inc.
FDA Office of Orphan Products Development
Principal Investigator: Elkan R Gamzu, PhD NeuroHealing Pharmaceuticals Inc.
Principal Investigator: Ross D Zafonte, DO Spaulding Rehabilitation Hospital
More Information

Responsible Party: NeuroHealing Pharmaceuticals Inc.
ClinicalTrials.gov Identifier: NCT00761228     History of Changes
Other Study ID Numbers: 3337
First Posted: September 29, 2008    Key Record Dates
Last Update Posted: March 31, 2017
Last Verified: March 2017

Keywords provided by NeuroHealing Pharmaceuticals Inc.:
Vegetative State
Minimally Conscious State
Traumatic Brain Injury

Additional relevant MeSH terms:
Wounds and Injuries
Brain Injuries
Brain Injuries, Traumatic
Persistent Vegetative State
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Craniocerebral Trauma
Trauma, Nervous System
Brain Damage, Chronic
Consciousness Disorders
Neurobehavioral Manifestations
Neurologic Manifestations
Signs and Symptoms
Physiological Effects of Drugs
Autonomic Agents
Peripheral Nervous System Agents
Gastrointestinal Agents
Dopamine Agonists
Dopamine Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action