ErythroPOietin Alfa to Prevent Mortality and Reduce Severe Disability in Critically Ill TRAUMA Patients

NCT ID: NCT04588311

Last Updated: 2025-07-16

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

2500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-11-09

Study Completion Date

2027-08-31

Brief Summary

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The EPO-TRAUMA study is a prospective, multi-centre, double-blind, phase III, randomised controlled trial evaluating the efficacy of epoetin alfa compared to placebo in reducing mortality and severe disability at six months in critically ill trauma patients.

2500 mechanically ventilated ICU patients admitted with a primary trauma diagnosis presenting to the ICU will be recruited into the study from participating study centres in Australia, New Zealand, Europe, and Saudi Arabia.

Detailed Description

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Trauma can cause many injuries, some of which are life-threatening and require treatment in an intensive care unit (ICU). Despite best available treatment and therapies, people who sustain a critical traumatic injury are at greater risk of death or long-term disability. From 2010 to 2015, approximately 9% of people admitted to an ICU in Australia and New Zealand for treatment of their injuries, did not survive. In Victoria, 6-months post injury, approximately 31% of people who were critically injured developed severe disabilities or died.

Following a traumatic injury, a number of complex pathways are activated by the body. These pathways can occur over hours or weeks and may lead to damage of cells, tissues or blood vessels and may destroy other healthy tissue. The treatment of traumatic injury focuses on trying to minimise further damage that can occur after the initial injury.

Erythropoietin is a glycoprotein hormone essential for erythropoiesis and was first purified in 1977. Its human recombinant analogues known as erythropoiesis stimulating agents (ESAs) are approved for human therapeutic use. However, erythropoietin is also a pleiotropic cytokine with effects beyond just erythropoiesis. Studies in animals have demonstrated the potential protective effects of erythropoietin to organs including the brain, kidney, liver and heart, and anti-inflammatory properties.

Previous research suggests the use of the ESA called epoetin alfa, increases the number of patients surviving severe trauma and reduces the risk of disability in those who survive.

The primary aim of the study is to determine the efficacy of epoetin alfa compared to placebo in reducing mortality and severe disability at six months in critically ill trauma patients.

2500 mechanically ventilated ICU patients admitted with a primary trauma diagnosis presenting to the ICU will be recruited into the study from participating study centres in Australia, New Zealand, Europe, and Saudi Arabia.

Conditions

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Trauma Traumatic Injury Traumatic Brain Injury Wounds and Injuries Penetrating Injury Blunt Injury Major Trauma Multiple Trauma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Erythropoietin (EPO)

Epoetin alfa 40,000 IU (1mL pre-filled syringe) will be given by subcutaneous injection to eligible patients on Study Days 1 and 8 during the intensive care unit stay.

Group Type ACTIVE_COMPARATOR

Epoetin Alfa 40000 UNT/ML

Intervention Type DRUG

Epoetin alfa 40,000IU 1mL pre-filled syringe given as subcutaneous injection.

Placebo

Sodium Chloride 0.9% (1mL in volume) will be given by subcutaneous injection to eligible patients allocated to the placebo arm on Study Days 1 and 8 during the intensive care unit stay.

Group Type PLACEBO_COMPARATOR

Sodium Chloride 0.9%

Intervention Type DRUG

Sodium Chloride 0.9% 1mL in volume given as subcutaneous injection.

Interventions

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Epoetin Alfa 40000 UNT/ML

Epoetin alfa 40,000IU 1mL pre-filled syringe given as subcutaneous injection.

Intervention Type DRUG

Sodium Chloride 0.9%

Sodium Chloride 0.9% 1mL in volume given as subcutaneous injection.

Intervention Type DRUG

Other Intervention Names

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Eprex Binocrit Placebo Saline

Eligibility Criteria

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Inclusion Criteria

* Are ≥ 18 to ≤ 75 years of age
* Are \< 24 hours since primary traumatic injury
* Are invasively mechanically ventilated
* Are expected to stay in the ICU ≥ 48 hours
* Have a haemoglobin not exceeding the upper limit of the applicable normal (ULN) reference range in clinical use at the treating institution
* Have informed consent from a legal surrogate according to local law

Exclusion Criteria

* GCS = 3 and fixed dilated pupils
* Recent history of DVT, PE or other thromboembolic event (within previous 12 months or receiving concomitant anticoagulant treatment for this indication)
* A chronic hypercoagulable disorder, including known malignancy
* Treatment with EPO in the last 30 days
* First dose of study drug unable to be given within 24 hours of primary injury
* Pregnancy or lactation or 3 months postpartum
* Expected to die imminently (\< 24 hours)
* Known sensitivity to mammalian cell derived products
* Known contraindication to epoetin alfa
* End stage renal failure (receives chronic dialysis)
* Severe pre-existing physical or mental disability or severe co-morbidity that may interfere with the assessment of outcome
* The treating physician believes it is not in the best interest of the patient to be randomised to this trial
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University College Dublin

OTHER

Sponsor Role collaborator

Medical Research Institute of New Zealand

OTHER

Sponsor Role collaborator

Medical Research Future Fund

OTHER

Sponsor Role collaborator

Health Research Board, Ireland

OTHER

Sponsor Role collaborator

Health Research Council, New Zealand

OTHER

Sponsor Role collaborator

Irish Critical Care Clinical Trials Network

UNKNOWN

Sponsor Role collaborator

ANZICS Clinical Trials Group

NETWORK

Sponsor Role collaborator

Monash University

OTHER

Sponsor Role collaborator

Australian and New Zealand Intensive Care Research Centre

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Associate Professor Craig French

Role: STUDY_CHAIR

Western Health; ANZIC Research Centre

Professor Alistair Nichol

Role: STUDY_CHAIR

University College Dublin

Locations

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Royal Prince Alfred Hospital

Camperdown, New South Wales, Australia

Site Status RECRUITING

St Vincent's Hospital Sydney

Darlinghurst, New South Wales, Australia

Site Status ACTIVE_NOT_RECRUITING

St George Hospital

Kogarah, New South Wales, Australia

Site Status RECRUITING

Liverpool Hospital

Liverpool, New South Wales, Australia

Site Status RECRUITING

John Hunter Hospital

New Lambton Heights, New South Wales, Australia

Site Status RECRUITING

Royal North Shore Hospital

Saint Leonards, New South Wales, Australia

Site Status RECRUITING

Westmead Hospital

Westmead, New South Wales, Australia

Site Status RECRUITING

Royal Darwin Hospital

Tiwi, Northern Territory, Australia

Site Status NOT_YET_RECRUITING

Cairns Hospital

Cairns, Queensland, Australia

Site Status WITHDRAWN

Royal Brisbane and Women's Hospital

Herston, Queensland, Australia

Site Status RECRUITING

Gold Coast University Hospital

Southport, Queensland, Australia

Site Status RECRUITING

Princess Alexandra Hospital

Woolloongabba, Queensland, Australia

Site Status RECRUITING

Royal Adelaide Hospital

Adelaide, South Australia, Australia

Site Status RECRUITING

Flinders Medical Centre

Adelaide, South Australia, Australia

Site Status NOT_YET_RECRUITING

The Alfred Hospital

Melbourne, Victoria, Australia

Site Status RECRUITING

Royal Melbourne Hospital

Melbourne, Victoria, Australia

Site Status RECRUITING

Royal Perth Hospital

Perth, Western Australia, Australia

Site Status RECRUITING

Cliniques Universitaires Saint-Luc

Brussels, , Belgium

Site Status NOT_YET_RECRUITING

HUB Hopital Erasme

Brussels, , Belgium

Site Status NOT_YET_RECRUITING

CHU-Charleroi Chimay

Charleroi, , Belgium

Site Status RECRUITING

Ziekenhuis Oost-Limburg

Genk, , Belgium

Site Status NOT_YET_RECRUITING

Ghent University Hospital

Ghent, , Belgium

Site Status NOT_YET_RECRUITING

CHR de la Citadelle de LIEGE

Liège, , Belgium

Site Status NOT_YET_RECRUITING

Helsinki University Hospital (HUS)

Helsinki, , Finland

Site Status RECRUITING

Kuopio University Hospital

Kuopio, , Finland

Site Status RECRUITING

Turku University Hospital

Turku, , Finland

Site Status RECRUITING

University Hospital Münster

Münster, , Germany

Site Status RECRUITING

Beaumont Hospital

Beaumont, , Ireland

Site Status RECRUITING

Cork University Hospital

Cork, , Ireland

Site Status RECRUITING

St Vincent's University Hospital

Dublin, , Ireland

Site Status RECRUITING

Auckland City Hospital

Grafton, Auckland, New Zealand

Site Status RECRUITING

Christchurch Hospital

Christchurch, Christchurch, New Zealand

Site Status RECRUITING

Middlemore Hospital

Auckland, Otahuhu, New Zealand

Site Status RECRUITING

Waikato Hospital

Hamilton, Waikato Region, New Zealand

Site Status RECRUITING

Wellington Hospital

Newtown, Wellington Region, New Zealand

Site Status RECRUITING

King Abdulaziz Medical City

Riyadh, , Saudi Arabia

Site Status RECRUITING

University Medical Centre Ljubljana

Ljubljana, , Slovenia

Site Status RECRUITING

University Medical Centre Maribor

Maribor, , Slovenia

Site Status RECRUITING

University Hospital Bern

Bern, , Switzerland

Site Status RECRUITING

Lucerne Cantonal Hospital

Lucerne, , Switzerland

Site Status NOT_YET_RECRUITING

St. Gallen Cantonal Hospital

Sankt Gallen, , Switzerland

Site Status RECRUITING

Countries

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Australia Belgium Finland Germany Ireland New Zealand Saudi Arabia Slovenia Switzerland

Central Contacts

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Vicki Papanikolaou

Role: CONTACT

+61 409 142 695

Sian Donnelly

Role: CONTACT

+353 (1) 716 5810

Facility Contacts

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Dr Dieter Linde

Role: primary

Prof Michael Piagnerelli

Role: primary

References

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Nichol A, French C, Little L, Haddad S, Presneill J, Arabi Y, Bailey M, Cooper DJ, Duranteau J, Huet O, Mak A, McArthur C, Pettila V, Skrifvars M, Vallance S, Varma D, Wills J, Bellomo R; EPO-TBI Investigators; ANZICS Clinical Trials Group. Erythropoietin in traumatic brain injury (EPO-TBI): a double-blind randomised controlled trial. Lancet. 2015 Dec 19;386(10012):2499-506. doi: 10.1016/S0140-6736(15)00386-4. Epub 2015 Oct 6.

Reference Type BACKGROUND
PMID: 26452709 (View on PubMed)

Other Identifiers

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U1111-1242-3694

Identifier Type: REGISTRY

Identifier Source: secondary_id

2020-003388-24

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

ANZIC-RC/CF001

Identifier Type: -

Identifier Source: org_study_id

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