NCT01143064

Brief Summary

The SyNAPSe trial will study if giving intravenous (i.v.) progesterone within 8 hours of the injury for a total of 120 hours to severe traumatic brain injury patients improves their recovery.

Trial Health

98
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Strong global presence with extensive site network
Enrollment
1,195

participants targeted

Target at P75+ for phase_3

Timeline
Completed

Started Jun 2010

Typical duration for phase_3

Geographic Reach
21 countries

156 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2010

Completed
9 days until next milestone

First Submitted

Initial submission to the registry

June 10, 2010

Completed
4 days until next milestone

First Posted

Study publicly available on registry

June 14, 2010

Completed
3.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2014

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2014

Completed
10.6 years until next milestone

Results Posted

Study results publicly available

October 2, 2024

Completed
Last Updated

October 2, 2024

Status Verified

September 1, 2024

Enrollment Period

3.8 years

First QC Date

June 10, 2010

Results QC Date

May 23, 2022

Last Update Submit

September 5, 2024

Conditions

Keywords

Brain InjuryTrauma

Outcome Measures

Primary Outcomes (1)

  • Glasgow Outcome Scale (GOS)

    The GOS assesses mortality and disability in traumatic brain injury (TBI) patients according to the designation: Good Recovery, Moderate Disability, Severe Disability, Vegetative State or Dead.

    6 months

Secondary Outcomes (6)

  • Mortality at Month 1

    1 month post injury

  • Mortality at Month 6

    6 months post injury

  • Glasgow Outcome Scale at 3 Months

    Month 3

  • Glasgow Outcome Scale - Extended (GOS-E)

    3 months and 6 months post injury

  • Short Form (36) Health Survey (SF-36)

    3 months and 6 months post injury

  • +1 more secondary outcomes

Study Arms (2)

Progesterone

ACTIVE COMPARATOR
Drug: Progesterone

Lipid emulsion without progestrone

PLACEBO COMPARATOR
Drug: Lipid emulsion without progesterone

Interventions

Intravenous administration of 0.71mg/kg/hr for 1hr followed by 0.5mg/kg/hr administered intravenously for an additional 119 hrs.

Also known as: BHR-100
Progesterone

Intravenous administration equal to 0.71mg/kg/hr for 1hr followed by 0.5mg/kg/hr administered intravenously for an additional 119 hrs.

Lipid emulsion without progestrone

Eligibility Criteria

Age16 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Male or female patients between the age of 16 and 70 years, inclusive
  • Weight from 45 to 135 kg, inclusive
  • Sustained a closed head trauma no more than 8 hours before start of study drug infusion
  • TBI diagnosed by history and clinical examination
  • Post-resuscitation Glasgow Coma Scale (GCS) score between 3 to 8, inclusive
  • At least one reactive pupil (pinpoint pupils due to opioid pain treatment are considered reactive)
  • Evidence of TBI confirmed by abnormalities consistent with trauma on CT scan upon admission (diffuse injury II-IV, evacuated and non-evacuated mass lesion, Marshall's CT Classification)
  • Indication for ICP monitoring

You may not qualify if:

  • Life expectancy of less than 24 hours as determined by the Investigator
  • Prolonged and/or uncorrectable hypoxia (Pa02\< 60 mmHg) or hypotension (systolic blood pressure \< 90 mmHg) at the time of randomization
  • Any spinal cord injury
  • Pregnancy
  • Penetrating head injury
  • Bilaterally fixed dilated pupils at the time of randomization
  • Coma suspected to be primarily due to other causes (e.g. alcohol)
  • Pure epidural hematoma
  • Preexisting clinically significant disease or chronic condition that can be ascertained at the time of admission and could affect functional outcome
  • Severe cardiac or hemodynamic instability prior to randomization
  • Known treatment with another investigational drug therapy or procedure within 30 days of injury
  • A history of allergic reaction to progesterone and related drugs or any of the components of the infusion
  • Any disease, in the opinion of the Investigator, that is unstable or which could jeopardize the safety of the patient and his/her compliance in the study.
  • Patients who, in the opinion of the Investigator, would not be able or willing to comply with the protocol through the final visit (6 months post-injury)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (156)

University of South Alabama Medical Center

Mobile, Alabama, 36617, United States

Location

LAC+USC Medical Center

Los Angeles, California, 90033, United States

Location

University of California San Diego Medical Center

San Diego, California, 92103, United States

Location

Denver Health Medical Center

Denver, Colorado, 80204, United States

Location

Christiana Care Health System Hospital

Newark, Delaware, 19718, United States

Location

Delray Medical Center

Delray Beach, Florida, 33431, United States

Location

Tallahassee Memorial Healthcare

Tallahassee, Florida, 32308, United States

Location

Tampa General Hospital

Tampa, Florida, 33606, United States

Location

Saint Alphonsus Regional Medical Center

Boise, Idaho, 83706, United States

Location

John H. Stroger Jr. Hospital of Cook County

Chicago, Illinois, 60612, United States

Location

Advocate Lutheran General Hospital

Park Ridge, Illinois, 60068, United States

Location

Saint John's Hospital

Springfield, Illinois, 62769, United States

Location

Wishard Health Services

Indianapolis, Indiana, 46202, United States

Location

Methodist Hospital

Indianapolis, Indiana, 46206, United States

Location

Mercy Medical Center

Des Moines, Iowa, 50314, United States

Location

University of Iowa Hospitals and Clinics

Iowa City, Iowa, 52242, United States

Location

University of Kansas Medical Center

Kansas City, Kansas, 66160, United States

Location

University of Louisville Hospital

Louisville, Kentucky, 40202, United States

Location

LSU Health - Shreveport

Shreveport, Louisiana, 71103, United States

Location

Eastern Maine Medical Center

Bangor, Maine, 04401, United States

Location

Maine Medical Center

Portland, Maine, 04102, United States

Location

Baystate Medical Center

Springfield, Massachusetts, 01199, United States

Location

University of Massachusetts Memorial Medical Center

Worcester, Massachusetts, 01655, United States

Location

Bronson Methodist Hospital

Kalamazoo, Michigan, 49007, United States

Location

St. Mary's of Michigan

Saginaw, Michigan, 48604, United States

Location

University of Missouri Health Care

Columbia, Missouri, 65212, United States

Location

Truman Medical Center Hospital Hill

Kansas City, Missouri, 64108, United States

Location

Lester E. Cox Memorial Hospital

Springfield, Missouri, 65804, United States

Location

The Nebraska Medical Center

Omaha, Nebraska, 68198, United States

Location

Robert Wood Johnson University Hospital

New Brunswick, New Jersey, 08903, United States

Location

Albany Medical Center Hospital

Albany, New York, 12208, United States

Location

Westchester Medical Center

Valhalla, New York, 10595, United States

Location

Mission Hospital

Asheville, North Carolina, 28801, United States

Location

Carolinas Medical Center

Charlotte, North Carolina, 28203, United States

Location

Duke University Medical Center

Durham, North Carolina, 27710, United States

Location

Wake Forest University-Baptist Medical Center

Winston-Salem, North Carolina, 27157, United States

Location

Summa Health System

Akron, Ohio, 44304, United States

Location

MetroHealth Medical Center

Cleveland, Ohio, 44109, United States

Location

Miami Valley Hospital

Dayton, Ohio, 45409, United States

Location

St. Elizabeth Health Center

Youngstown, Ohio, 44501, United States

Location

OU Medical Center

Oklahoma City, Oklahoma, 73104, United States

Location

Legacy Emanuel Hospital & Health Center

Portland, Oregon, 97227, United States

Location

Allegheny General Hospital

Pittsburgh, Pennsylvania, 15212, United States

Location

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, 15213, United States

Location

Medical University of South Carolina

Charleston, South Carolina, 29425, United States

Location

University of South Carolina School of Medicine

Columbia, South Carolina, 29203, United States

Location

Johnson City Medical Center

Johnson City, Tennessee, 37604, United States

Location

Vanderbilt University Medical Center

Nashville, Tennessee, 37212, United States

Location

Texas Tech University Health Sciences Center

El Paso, Texas, 79905, United States

Location

University of Virginia Health System

Charlottesville, Virginia, 22908, United States

Location

Marshall University Joan C. Edwards School of Medicine

Huntington, West Virginia, 25701, United States

Location

West Virginia University Hospital

Morgantown, West Virginia, 26506, United States

Location

University of Wisconsin Hospital and Clinics

Madison, Wisconsin, 53792, United States

Location

Hospital Francisco Lopez Lima

General Roca, Río Negro Province, Argentina

Location

Hospital de Emergencias Clemente Alvarez (HECA)

Rosario, Santa Fe Province, Argentina

Location

Hospital Nacional "Profesor Alejandro Posadas"

Buenos Aires, Argentina

Location

Hospital Regional De Comodoro Rivadavia (HRCR)

Comodoro Rivadavia, Argentina

Location

Hospital Central de Mendoza

Mendoza, Argentina

Location

Hospital San Martin

Paraná, Argentina

Location

Hospital Dr. José Maria Cullen

Santa Fé, Argentina

Location

Medizinische Universität Graz

Graz, Austria

Location

Medizinische Universität Innsbruck

Innsbruck, Austria

Location

Unfallkrankenhaus Salzburg

Salzburg, Austria

Location

Landesklinikum Wiener Neustadt

Vienna, Austria

Location

ULB Erasme

Brussels, Belgium

Location

Ziekenhuis Oost-Limburg, Location Sint Jan

Genk, Belgium

Location

Universitair Ziekenhuis Gent

Ghent, Belgium

Location

University Hospital of the Free University Brussels (UZ Brussel)

Jette, Belgium

Location

University Hospital Gasthuisberg

Leuven, Belgium

Location

Chengdu Military General Hospital

Chengdu, China

Location

The First Affiliated Hospital of Fujian Medical University

Fuzhou, China

Location

The 2nd Affiliated Hospital of Zhejiang University

Hangzhou, China

Location

The Second Hospital of Shandong University

Jinan, China

Location

Huashan Hospital of Fudan University

Shanghai, China

Location

Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine

Shanghai, China

Location

General Hospital of Tianjin Medical University

Tianjin, China

Location

The Affiliated Hospital of Xuzhou Medical College

Xuzhou, China

Location

Fakultní nemocnice Brno Neurochirurgická klinika

Brno, Czechia

Location

Fakultní nemocnice u sv. Anny v Brnĕ, Neurochirurgická klinika

Brno, Czechia

Location

Fakultní Nemocnice Plzeň, Neurochirurgicé Oddĕlení

Pilsen, Czechia

Location

Fakultní nemocnice Kralovske Vinohrady

Prague, Czechia

Location

Tampere University Hospital

Tampere, Finland

Location

Groupe Hospitalier Pellegrin

Bordeaux, France

Location

Hôpital Pierre Wertheimer

Bron, France

Location

Centre Hospitalier Universitaire de Grenoble- Hópital Michallon

La Tronche, France

Location

CHRU de Lille- Hópital Roger Salengro

Lille, France

Location

Centre Hospitalier Universitaire de Limoges

Limoges, France

Location

Centre Hospitalier Universitaire Hôpital Nord

Marseille, France

Location

Hópital Central - CHU de Nancy

Nancy, France

Location

Groupe Hospitalier La Salpêtrière

Paris, France

Location

Charité - Universitätsmedizin Berlin

Berlin, Germany

Location

Krankenhaus Merheim

Cologne, Germany

Location

Klinikum der J.W. Goethe-Universität

Frankfurt, Germany

Location

Universitätsmedizin Göttingen

Göttingen, Germany

Location

Berufsgenossenschaftliche Kliniken

Halle, Germany

Location

Universitätsklinikum Hamburg-Eppendorf

Hamburg, Germany

Location

Universitätsklinikum Heidelberg

Heidelberg, Germany

Location

Universitätsklinikum Gießen und Marburg gGmbH

Marburg, Germany

Location

Klinikum Nürnberg

Nuremberg, Germany

Location

Niels-Stensen-Kliniken

Osnabrück, Germany

Location

Universitätsklinikum Ulm

Ulm, Germany

Location

Honvédelmi Minisztérium Állami Egészségügyi Központ

Budapest, Hungary

Location

Pécsi Tudományegyetem Általános Orvostudományi Kar

Pécs, Hungary

Location

Szegedi Tudományegyetem Szent-Györgyi Albert Klinikai Központ

Szeged, Hungary

Location

Rambam Medical Center

Haifa, Israel

Location

Hadassah Medical Organization

Jerusalem, Israel

Location

Rabin Medical Center

Petah Tikva, Israel

Location

Tel Aviv Sourasky Medical Center

Tel Aviv, Israel

Location

Chaim Sheba Medical Center

Tel Litwinsky, Israel

Location

Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena

Milan, Italy

Location

Fondazione San Raffaele del Monte Tabor

Milan, Italy

Location

Azienda Ospedaliera San Gerardo

Monza, Italy

Location

Azienda Ospedaliero Universitaria Maggiore della Caritá

Novara, Italy

Location

Azienda Ospedaliera San Camillo Forlanini

Rome, Italy

Location

Azienda Ospedaliero Universitaria Integrata di Verona

Verona, Italy

Location

Hospital Raja Permaisuri Bainun

Ipoh, Malaysia

Location

Hospital Kuala Lumpur

Kuala Lumpur, Malaysia

Location

University Malaya Medical Centre

Kuala Lumpur, Malaysia

Location

Hospital Tengku Ampuan Afzan

Kuantan, Malaysia

Location

Sarawak General Hospital

Kuching, Malaysia

Location

VU Medisch Centrum

Amsterdam, Netherlands

Location

Universitair Medisch Centrum Groningen

Groningen, Netherlands

Location

Spitalul Clinic Judetean de Urgenta Timisoara

Timișoara, Romania

Location

State Budget Educational Institution of Higher Professional Education "Kemerovskaya State Medical Academy of Federal Agency of Healthcare and Social Development"

Kemerovo, Russia

Location

State Professional Institution of High Professional Education "Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky of Ministry of Health and Social Development"

Krasnoyarsk, Russia

Location

State Institution "Burdenko Neurosurgical Institute of RAMS"

Moscow, Russia

Location

State Healthcare Facility "Murmansk Regional Clinical Hospital n.a. Bayandin"

Murmansk, Russia

Location

Saint Petersburg Healthcare Institution "City Mariinsky Hospital"

Saint Petersburg, Russia

Location

State Institution of Health Care "Sverdlovsk Regional Clinical Hospital #1"

Yekaterinburg, Russia

Location

National Neuroscience Institute

Singapore, Singapore

Location

National University Hospital

Singapore, Singapore

Location

Singapore General Hospital

Singapore, Singapore

Location

Hospital Universitario Germans Trias i Pujol

Badalona, Barcelona, Spain

Location

Hospital Parc Taulí

Sabadell, Barcelona, Spain

Location

Hospital General Universitario de Alicante

Alicante, Spain

Location

Hospital Universitario de Bellvitge

Barcelona, Spain

Location

Hospital Universitario Vall Hebrón

Barcelona, Spain

Location

Hospital Universitario de Girona Dr. Josep Trueta

Girona, Spain

Location

Hospital Universitario de Gran Canaria Dr. Negrín

Las Palmas de Gran Canaria, Spain

Location

Hospital Universitario 12 de Octubre

Madrid, Spain

Location

Hospital Universitari Son Espases

Palma de Mallorca, Spain

Location

Hospital Universitario Virgen del Rocio

Seville, Spain

Location

Hospital Clínico Universitario De Valencia

Valencia, Spain

Location

Hospital Universitari i Politecnic La Fé de Valencia

Valencia, Spain

Location

Taichung Veterans General Hospital

Taichung, Taiwan

Location

National Taiwan University Hospital

Taipei, Taiwan

Location

Chiang Mai University

Chiang Mai, Thailand

Location

Faculty of Medicine, Prince of Songkla University

Hat Yai, Thailand

Location

Khon Kaen Hospital

Khon Kaen, Thailand

Location

Royal Preston Hospital

Fulwood, Preston, United Kingdom

Location

Queen Elizabeth Hospital

Birmingham, United Kingdom

Location

University Hospital Coventry

Coventry, United Kingdom

Location

Leeds Teaching Hospitals NHS, Leeds General Infirmary

Leeds, United Kingdom

Location

The Royal London Hospital

London, United Kingdom

Location

The James Cook University Hospital

Middlesbrough, United Kingdom

Location

Southampton University Hospital

Southampton, United Kingdom

Location

Related Publications (3)

  • Wright DW, Kellermann AL, Hertzberg VS, Clark PL, Frankel M, Goldstein FC, Salomone JP, Dent LL, Harris OA, Ander DS, Lowery DW, Patel MM, Denson DD, Gordon AB, Wald MM, Gupta S, Hoffman SW, Stein DG. ProTECT: a randomized clinical trial of progesterone for acute traumatic brain injury. Ann Emerg Med. 2007 Apr;49(4):391-402, 402.e1-2. doi: 10.1016/j.annemergmed.2006.07.932. Epub 2006 Sep 29.

    PMID: 17011666BACKGROUND
  • Xiao G, Wei J, Yan W, Wang W, Lu Z. Improved outcomes from the administration of progesterone for patients with acute severe traumatic brain injury: a randomized controlled trial. Crit Care. 2008;12(2):R61. doi: 10.1186/cc6887. Epub 2008 Apr 30.

    PMID: 18447940BACKGROUND
  • Skolnick BE, Maas AI, Narayan RK, van der Hoop RG, MacAllister T, Ward JD, Nelson NR, Stocchetti N; SYNAPSE Trial Investigators. A clinical trial of progesterone for severe traumatic brain injury. N Engl J Med. 2014 Dec 25;371(26):2467-76. doi: 10.1056/NEJMoa1411090. Epub 2014 Dec 10.

Related Links

MeSH Terms

Conditions

Brain InjuriesWounds and Injuries

Interventions

Progesterone

Condition Hierarchy (Ancestors)

Brain DiseasesCentral Nervous System DiseasesNervous System DiseasesCraniocerebral TraumaTrauma, Nervous System

Intervention Hierarchy (Ancestors)

PregnenedionesPregnenesPregnanesSteroidsFused-Ring CompoundsPolycyclic CompoundsCorpus Luteum HormonesGonadal HormonesHormonesHormones, Hormone Substitutes, and Hormone AntagonistsProgesterone CongenersGonadal Steroid Hormones

Limitations and Caveats

Treatment Emergent Adverse Events with Incidence of \>5% by System Organ Class and Preferred Term (Safety Population) data was reported in the Other (Not Including Serious) Adverse Events section. Adverse events were reported for the modified Intention-to-Treat (mITT) population which includes all subjects who were randomized and in whom treatment with study drug was initiated (analyzed according to randomized treatment).

Results Point of Contact

Title
Global Chief Medical Officer
Organization
Besins Healthcare Ireland Ltd

Study Officials

  • Neta R. Nelson, MPH

    BHR Pharma, LLC

    STUDY DIRECTOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

June 10, 2010

First Posted

June 14, 2010

Study Start

June 1, 2010

Primary Completion

March 1, 2014

Study Completion

March 1, 2014

Last Updated

October 2, 2024

Results First Posted

October 2, 2024

Record last verified: 2024-09

Locations