Clinical trial NCT04239755: Doxycycline in Acute Traumatic Brain Injury
Official title: Doxycycline Effects on Neurological Outcomes in Patients With Acute Traumatic Brain Injury
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Traumatic Brain Injury
Lead sponsor: Damanhour University
Sponsor class: OTHER
Collaborators: name: Tanta University
First posted: 2020-01-27
Enrollment: 50
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: evaluate the impact of Doxycycline on both clinical outcome and blood levels of NSE in patients with TBI.

Detailed description: 1. Approval will be obtained from Research Ethics Committee of Faculty of Pharmacy, Damnhour University.
2. All Participants agreed to take part in this clinical research and provide informed consent. for unconscious participants, the informed consent was obtained from their legally authorized representative.
3. Patients with moderate to severe TBI will be enrolled from Tanta university hospitals.
4. Serum samples will be collected for measuring the biomarkers.
5. Our design is randomized, controlled study.
6. All enrolled patients will be divided into 2 groups, Group (1) 25 patients that receive doxycycline 100 mg twice daily, either orally or through a nasogastric tube for 5 days, and group (2) will be 25 patients will receive placebo in addition to the standard treatment.
7. All patients will be followed up during ICU period.
8. Statsicial tests appropriate to the study design will be conducted to evaluate the significance of the results.
9. Measuring outcome: the primary outcome is the change in the serum level of acute brain injury biomarkers.
10. Results, conclusions, discussion and recommendations will be given.

Eligibility criteria: Inclusion Criteria:

1. Hospital admission in the first 24 h of injury,
2. 18 to 90 years of age and
3. Both sexes with moderate to severe traumatic brain injury (GCS score ≤ 12).
4. Able to tolerate enteral feeding and drug administration within the first 24 hours of TBI

Exclusion Criteria:

1. Hypersensitivity to tetracyclines
2. Pregnant and breast feeding women,
3. History of autoimmune disease.
4. History of receiving chronic steroid treatment and isotretinoin,
5. Pre-existing hepatic (AST, ALT greater than 3 times the upper limit of normal) or renal failure (BUN/ Creatinine 20:1; creatinine \> 2 mg/dL),
6. Known malignancies

Primary outcomes:
measure: Neuron specific enolase
timeFrame: 7 days
measure: Glasgow Coma Scale (GCS)
timeFrame: 7 days
Secondary outcomes:
Other outcomes:
Locations:
city: Tanta
country: Egypt
facility: Tanta University Hospital
state: El-Gharbia
Study officials:
affiliation: Mansoura University
name: Noha Mansour, Lecturer
role: PRINCIPAL_INVESTIGATOR
References:
citation: Sanchez Mejia RO, Ona VO, Li M, Friedlander RM. Minocycline reduces traumatic brain injury-mediated caspase-1 activation, tissue damage, and neurological dysfunction. Neurosurgery. 2001 Jun;48(6):1393-9; discussion 1399-401. doi: 10.1097/00006123-200106000-00051.
citation: Janata A, Magnet IA, Schreiber KL, Wilson CD, Stezoski JP, Janesko-Feldman K, Kochanek PM, Drabek T. Minocycline fails to improve neurologic and histologic outcome after ventricular fibrillation cardiac arrest in rats. World J Crit Care Med. 2019 Nov 19;8(7):106-119. doi: 10.5492/wjccm.v8.i7.106. eCollection 2019 Nov 19.