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用于院外心脏骤停后神经保护的胰高血糖素样肽-1类似物:一项随机对照试验的研究方案

GLP-1 analogues for neuroprotection after out-of-hospital cardiac arrest: study protocol for a randomized controlled trial.

作者信息

Wiberg Sebastian, Hassager Christian, Thomsen Jakob Hartvig, Frydland Martin, Høfsten Dan Eik, Engstrøm Thomas, Køber Lars, Schmidt Henrik, Møller Jacob Eifer, Kjaergaard Jesper

机构信息

Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

Department of Anaesthesiology and Intensive care, Odense University Hospital, 5000, Odense C, Denmark.

出版信息

Trials. 2016 Jun 30;17(1):304. doi: 10.1186/s13063-016-1421-2.

Abstract

BACKGROUND

Attenuating the neurological damage occurring after out-of-hospital cardiac arrest is an ongoing research effort. This dual-centre study investigates the neuroprotective effects of the glucagon-like-peptide-1 analogue Exenatide administered within 4 hours from the return of spontaneous circulation to comatose patients resuscitated from out-of-hospital cardiac arrest.

METHODS/DESIGN: This pilot study will randomize a total of 120 unconscious patients with sustained return of spontaneous circulation after out-of-hospital cardiac arrest undergoing targeted temperature management in a blinded one-to-one fashion to a 6-hour and 15-minute infusion of either Exenatide or placebo. Patients are eligible for inclusion if resuscitated from cardiac arrest with randomization from 20 minutes to 240 minutes after return of spontaneous circulation. The co-primary endpoint is feasibility, defined as the initiation of treatment within the inclusion window in more than 90 % of participants, and efficacy, defined as the area under the neuron-specific enolase curve from 0 to 72 hours after admission. Secondary endpoints include all-cause mortality at 30 days and Cerebral Performance Category as well as a modified Rankin Score at 180 days. The study has been approved by the Danish National Board of Health and the local Ethics Committee and is monitored by Good Clinical Practice units. The study is currently enrolling.

DISCUSSION

This paper presents the methods and planned statistical analyses used in the GLP-1 trial and aims to minimize bias and data-driven reporting of results.

TRIAL REGISTRATION

  1. Danish National Board of Health, EudraCT 2013-004311-45. Registered on 25 March 2014. 2) Videnskabsetisk komité C, Region Hovedstaden, No. 45728. Registered on 29 January 2014. 3) Clinicaltrial.gov, NCT02442791 . Registered on 25 of January 2015.
摘要

背景

减轻院外心脏骤停后发生的神经损伤是一项正在进行的研究工作。这项双中心研究调查了胰高血糖素样肽-1类似物艾塞那肽在自主循环恢复后4小时内给予院外心脏骤停复苏后昏迷患者的神经保护作用。

方法/设计:这项初步研究将总共120名院外心脏骤停后自主循环持续恢复且正在接受目标温度管理的昏迷患者以盲法一对一的方式随机分为接受6小时15分钟的艾塞那肽或安慰剂输注。如果患者从心脏骤停中复苏且在自主循环恢复后20分钟至240分钟内随机分组,则符合纳入条件。共同主要终点是可行性,定义为超过90%的参与者在纳入窗口内开始治疗,以及有效性,定义为入院后0至72小时神经元特异性烯醇化酶曲线下面积。次要终点包括30天全因死亡率、脑功能分类以及180天时的改良Rankin评分。该研究已获得丹麦国家卫生委员会和当地伦理委员会的批准,并由良好临床实践单位进行监测。该研究目前正在招募患者。

讨论

本文介绍了GLP-1试验中使用的方法和计划的统计分析,旨在尽量减少偏倚和结果的数据驱动报告。

试验注册

1)丹麦国家卫生委员会,EudraCT 2013-004311-45。于2014年3月25日注册。2)哥本哈根大区科学伦理委员会,编号45728。于2014年1月29日注册。3)Clinicaltrial.gov,NCT02442791。于2015年1月25日注册。

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Targeted temperature management at 33°C versus 36°C after cardiac arrest.心脏骤停后 33°C 与 36°C 的目标温度管理。
N Engl J Med. 2013 Dec 5;369(23):2197-206. doi: 10.1056/NEJMoa1310519. Epub 2013 Nov 17.

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