PROphylaxis for Venous ThromboEmbolism in Severe Traumatic Brain Injury (PROTEST)

NCT ID: NCT03559114

Last Updated: 2024-09-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

1100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-07-19

Study Completion Date

2027-12-31

Brief Summary

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This is a phase III, multi-centre, double blind, randomized controlled trial of patients with traumatic brain injury (TBI).

Detailed Description

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Patients with severe brain injury are at risk for developing blood clots in their legs, which can travel to the lungs. This potentially serious complication is known as venous thromboembolism (VTE). Anticoagulants are commonly used to prevent VTE in hospital patients. However, in patients with major head injury, anticoagulant prevention is commonly delayed for the fear that it can potentially lead to further bleeding in the brain. Another method that aims to prevent blood clots involves the use of sequential compression device (SCD) that compress the legs and increase the flow of blood in the leg veins.

This study will compare results from patients who receive the SCDs only to those who receive both SCD and anticoagulants. The outcome of this study will provide information about how best to prevent blood clots while not increase brain bleeding after head injury.

Conditions

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Traumatic Brain Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Anticoagulant

Dalteparin sodium (at a dose of 5000 IU once daily by subcutaneous injection) for 7 days upon randomization after hospital admission.

Group Type ACTIVE_COMPARATOR

Dalteparin

Intervention Type DRUG

Dalteparin in prophylactic doses administered daily if screening criteria are satisfied.

Saline

Saline (0.2 mL) once daily by subcutaneous injection for 7 days upon randomization after hospital admission.

Group Type PLACEBO_COMPARATOR

Saline

Intervention Type DRUG

Saline in prophylactic doses administered daily if screening criteria are satisfied.

Interventions

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Dalteparin

Dalteparin in prophylactic doses administered daily if screening criteria are satisfied.

Intervention Type DRUG

Saline

Saline in prophylactic doses administered daily if screening criteria are satisfied.

Intervention Type DRUG

Other Intervention Names

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Fragmin Sodium Chloride

Eligibility Criteria

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Inclusion Criteria

i) Patients with severe TBI defined as GCS of ≤8, or

ii) Patients with moderate TBI defined as GCS = 9-12, admitted to ICU, with at least some ICB present on initial CT scan and any of the following:

1. Requiring invasive mechanical ventilation at the time of screening
2. Increased ICB on repeat CT scan compared to initial CT scan

iii) Upon randomization the patient will be able to receive the first dose of study drug in the first 3 calendar days from the time of injury

iv) ≥ 18 years of age

Exclusion Criteria

i) Known Hypersensitivity to FRAGMIN (Dalteparin), or its constituents including benzyl alcohol or to other low molecular weight heparins and/or heparins or pork products

ii) Known history of confirmed or suspected immunologically-mediated heparin-induced thrombocytopenia (delayed-onset severe thrombocytopenia), and/or in patients with a known history of a positive in vitro platelet-aggregation test in the presence of FRAGMIN (Dalteparin) is positive

iii) Known septic endocarditis

iv) Uncontrollable active bleeding

v) Known major blood clotting disorders

vi) Known acute gastroduodenal ulcer (with active bleeding)

vii) Severe uncontrolled hypertension (i.e. BP\>210 despite medications)

viii) Known diabetic or hemorrhagic retinopathy

ix) Anticipated to be unable to receive SCD on at least one lower extremity due to nature of injuries for duration of intervention period

x) Presence of another confounding factor that can adequately explain the poor GCS at time of presentation (e.g. drug toxicity, seizure)

xi) Known presence of irreversible coagulopathies

xii) Known Pregnancy

xiii) Participants extremely low weight (\<45 kg), or extremely high weight (\>120kg)

xiv) Not expected to survive more than 48 hours from admission
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sunnybrook Research Institute

OTHER

Sponsor Role collaborator

Sunnybrook Health Sciences Centre

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Farhad Pirouzmand, MD, MSc, FRCSC

Role: PRINCIPAL_INVESTIGATOR

Sunnybrook Health Sciences Centre

Damon Scales, MD, PhD, FRCPC

Role: PRINCIPAL_INVESTIGATOR

Sunnybrook Health Sciences Centre

Locations

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Foothills Medical Centre

Calgary, Alberta, Canada

Site Status RECRUITING

Royal Alexandra Hospital

Edmonton, Alberta, Canada

Site Status RECRUITING

University of Alberta Hospital

Edmonton, Alberta, Canada

Site Status RECRUITING

Vancouver General Hospital

Vancouver, British Columbia, Canada

Site Status RECRUITING

Queen Elizabeth II Health Sciences Centre

Halifax, Nova Scotia, Canada

Site Status RECRUITING

Hamilton Health Sciences Centre

Hamilton, Ontario, Canada

Site Status RECRUITING

Kingston General Hospital

Kingston, Ontario, Canada

Site Status RECRUITING

The Ottawa Hospital

Ottawa, Ontario, Canada

Site Status RECRUITING

Sunnybrook Health Science Centre

Toronto, Ontario, Canada

Site Status RECRUITING

Unity Health Toronto

Toronto, Ontario, Canada

Site Status RECRUITING

Hopital de L'Enfant-Jesus

Québec, Quebec, Canada

Site Status RECRUITING

Royal University Hospital

Saskatoon, Saskatchewan, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Farhad Pirouzmand, MD, MSc, FRCSC

Role: CONTACT

416-480-6100 ext. 5263

Kanthi Kavikondala, CCRP

Role: CONTACT

416-480-6100 ext. 87546

Facility Contacts

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Olesya Dmitrieva

Role: primary

Andreas Kramer, MD

Role: backup

Patrica Thompson

Role: primary

Tayne Hewer

Role: backup

Jim Kutsogiannis, MD, MHS, FRCPC

Role: backup

Patrica Thompson

Role: primary

Tayne Hewer

Role: backup

Jim Kutsogiannis, MD, MHS, FRCPC

Role: backup

Rebecca Grey

Role: primary

Donald Griesdale, MD, MPH, FRCPC

Role: backup

Laura-Lee Magennis

Role: primary

Lisa Julien

Role: backup

Sean Christie, MD, FRCSC

Role: backup

Laurel Murphy, MD

Role: backup

Amanda Martyniuk

Role: primary

Sunjay Sharma, MD, MSc, FRCSC, FACS

Role: backup

Paul Engels, MD

Role: backup

Tracy Boyd

Role: primary

Gordon Boyd, MD, PhD, FRCPC

Role: backup

Rebecca Porteous

Role: primary

Sydney Mietzitis

Role: backup

Shane English, MD, MSc, FRCPC

Role: backup

Farhad Pirouzmand, MD, MSc, FRCSC

Role: primary

Damon Scales, MD, PhD, FRCPC

Role: backup

Marlene Santos, MD, MSc

Role: primary

Michael Cusimano, MD, MHPE, FRCS, PhD

Role: backup

David Bellemare

Role: primary

Alexis Turgeon-Fournier, MD

Role: backup

Emily Junk

Role: primary

Gary Hunter, MD, FRCPC, CSCN (EEG)

Role: backup

Other Identifiers

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0785

Identifier Type: -

Identifier Source: org_study_id

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