TRACK-TBI Precision Medicine Part 3 - Option II

NCT ID: NCT06790095

Last Updated: 2025-12-22

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

ENROLLING_BY_INVITATION

Clinical Phase

PHASE2

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-31

Study Completion Date

2027-05-31

Brief Summary

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The purpose of this study is to determine if experimental drug treatment improves recovery after TBI as compared to a control (placebo) group. Changes in recovery will be measured throughout the study. The study drug listed below is approved by the U.S. Food and Drug Administration (FDA) but is being used "off-label" in this study. This means that the drug is not currently approved to treat TBI.

Detailed Description

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Conditions

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Traumatic Brain Injury

Keywords

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Traumatic Brain Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Cyclosporine (CsA)

Intravenous (IV) injection, 2.5 mg/kg loading dose given over 2 hours, followed by a 3-day (72-hour) constant IV infusion of 5 mg/kg/day.

Group Type ACTIVE_COMPARATOR

Cyclosporine (CsA)

Intervention Type DRUG

Intravenous (IV) injection, loading dose of 2.5 mg/kg (diluted in 0.9% NaCl to a final volume of 50 ml) given over 2 hours, immediately followed by a continuous IV infusion of of 5 mg/kg/day (diluted in 0.9% NaCl to a final volume of 250 ml) for 3 days (72-hour).

Matching Placebo

Intravenous (IV) injection of 0.9% NaCl over 74 hours.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Intravenous (IV) injection of 0.9% NaCl with the same dosing strategy as CsA: "loading dose" given over 2 hours, immediately followed by a continuous IV infusion for 3 days (72-hour).

Interventions

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Cyclosporine (CsA)

Intravenous (IV) injection, loading dose of 2.5 mg/kg (diluted in 0.9% NaCl to a final volume of 50 ml) given over 2 hours, immediately followed by a continuous IV infusion of of 5 mg/kg/day (diluted in 0.9% NaCl to a final volume of 250 ml) for 3 days (72-hour).

Intervention Type DRUG

Placebo

Intravenous (IV) injection of 0.9% NaCl with the same dosing strategy as CsA: "loading dose" given over 2 hours, immediately followed by a continuous IV infusion for 3 days (72-hour).

Intervention Type DRUG

Other Intervention Names

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Sandimmune®

Eligibility Criteria

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Inclusion Criteria

1. Adults (18-65 years of age, inclusive)
2. Presents to a participating enrollment site and is able to receive treatment within 24 hours of head injury warranting clinical evaluation with a non- contrast cranial CT based on American College of Emergency Physicians (ACEP) Centers for Disease Control and Prevention (CDC) clinical policy for TBI imaging.
3. Closest, prior to randomization GCS score of 3 to 8
4. Evidence of TBI on cranial CT, confirmed by:

* Evidence of contusion and/or
* Evidence of traumatic axonal microvascular injury (TAMVI)
5. Initial GFAP blood level \>1000 pg/mL ≤ 15000 pg/mL determined using a for Research Use Only (RUO) assay(s) or an Investigation Use Only (IUO) assay(s)
6. Participants able to undergo Magnetic Resonance Imaging (MRI) scans, no contraindications
7. Legally Authorized Representative (LAR) willing and able to provide informed consent
8. Participant/LAR able to read, speak, and understand English or Spanish (participating site dependent, where available), including the Informed Consent Form (ICF)

Exclusion Criteria

1. Isolated epidural hematoma
2. Bilaterally fixed dilated pupils in the absence of paralytic medications, or evidence of herniation on cranial CT
3. Pre-existing conditions including disabling developmental, neurologic, psychiatric, medical disorder that continues to produce functional disability up to the time of injury; or imminent death based on clinical judgement
4. Order for comfort care placed prior to enrollment
5. Current enrollment in another interventional study
6. Currently pregnant or currently breastfeeding or planning on becoming pregnant in the next 6M
7. Current incarceration or in custody
8. On psychiatric hold (e.g. Codes 5150, 5250)
9. Ongoing pre-injury therapy with the Investigational Product (IP), currently receiving immunosuppressive therapy or any contraindicated medications (see CsA Drug contraindications/caution table in Manual of Procedures)
10. Current or medical history of any allergic reactions and/or anaphylactic reactions towards CsA and cremophor (also known as kolliphor®)
11. Severe polytrauma or previous conditions that would preclude conducting any study activities
12. Any spinal cord injury of grade A to D on the American Spinal Injury Association (ASIA) Impairment Scale
13. Primary diagnosis at the enrolling facility of ischemic or hemorrhagic stroke
14. Body Mass Index (BMI) \>35
15. Hemodynamic instability, per participating site physician investigator clinical judgement
16. Current or medical history of renal dysfunction, significant renal failure, or high-risk for renal failure, defined as:

* Creatinine Clearance (CrCl) or estimated Glomerular Filtration Rate (eGFR) (\<60 mL/minute/1.73 m2)
* Major rhabdomyolysis with creatine kinase \> 5,000 IU/L
17. Current or medical history of hepatic disease or serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) value \>3 times the upper limit of normal lab value at the screening/baseline visit
18. Current or medical history of serious chronic viral or fungal infection
19. Current or medical history of active mycobacterial infection or anti- tuberculous treatment
20. Medical history of human immunodeficiency virus, hepatitis B surface antigen, or hepatitis C virus antibody
21. Any significant disease or disorder (including abnormal laboratory tests) which, in the opinion of the participating site investigator, may either put the patient at risk because of participation in the study, or may influence the results of the study
22. Low likelihood of follow up or study compliance, or any other reason, in the opinion of the participating site investigator, the participants should not participate in the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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U.S. Army Medical Research and Development Command

FED

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Geoffrey Manley, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Locations

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University of California, San Francisco

San Francisco, California, United States

Site Status

Countries

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United States

Related Links

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Other Identifiers

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PM-003

Identifier Type: -

Identifier Source: org_study_id