Efficacy and safety of cerebrolysin in neurorecovery after moderate-severe traumatic brain injury: results from the CAPTAIN II trial

Mureșanu, Dafin F.; Florian, Ștefan Ioan; Hömberg, V.; Matula, Christian; Steinbüchel, Nicole von; Vos, Pieter E.; Wild, K. von; Bîrle, Codruța; Mureșanu, Ioana; Slăvoacă, Dana; Rosu, Olivia Verisezan; Strilciuc, Ștefan; Vester, Johannes

doi:10.1007/s10072-019-04181-y

Cited by 40 publications

(57 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the CAPTAIN II study [ 17 ], an ensemble of scales measuring global function outcome and the neurocognitive outcome was used to prove the statistically significant effect of Cerebrolysin in the first primary endpoint (Day 90). Therefore, the predictive value of age and BPRS significantly influenced by the treatment in our current study.…”

Section: Discussionmentioning

confidence: 99%

“…Data were extracted from the CAPTAIN II Study database [ 17 ]. CAPTAIN II is a single-center, prospective, randomized, double-blind, placebo-controlled clinical trial.…”

Section: Methodsmentioning

confidence: 99%

“…The Baseline Prognostic Risk Score (BPRS), developed by Hukklehoven et al, estimates the risk of mortality and unfavorable outcome at six months [ 15 ]. In the CAPTAIN I [ 16 ] and CAPTAIN II [ 17 ] studies, this scale was used to assess the heterogeneity of the study population.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Effect of Cerebrolysin on the Predictive Value of Baseline Prognostic Risk Score in Moderate and Severe Traumatic Brain Injury

et al. 2020

View full text Add to dashboard Cite

Cognitive dysfunction is a significant complaint among patients after moderate to severe traumatic brain injury (TBI), with devastating consequences on functional recovery and quality of life. Prognostic models allow a better assessment and management of neurotrauma patients. The aim of the study was to demonstrate the predictive value of the Baseline Prognostic Risk Score (BPRS) in moderate to severe TBI, in a sample of patients treated with neurotrophic factors. Eighty patients with moderate-severe TBI from the CAPTAIN II study were included in secondary data analysis. Patients received active treatment with Cerebrolysin, 50 mL per day for ten days, followed by two treatment cycles with 10 mL per day for ten days. BPRS was determined on admission; the age was recorded, and patients were evaluated using the following neurocognitive tests: Mini-Mental State Essay (MMSE), Wechsler Adult Intelligence Scale-Third Edition Processing Speed Index (WAIS-III PSI) and Stroop Colour Word Test-Victoria Version at 10, 30 and 90 days. Hierarchical regression analysis was performed to investigate the unique predictive value of BPRS on cognitive evolution, independent of age. BPRS independently predicted scores on the WAIS-III PSI DSCales and the Word subscale of the Stroop Colour Word Test at 90 days. Age was a significant predictor for all the investigated scales at 10, 30, and 90 days. This study demonstrates the predictive value of a validated prognostic model (BPRS) for medium-term neurocognitive outcomes in a sample of moderate-severe traumatic brain injury treated with neurotrophic factors.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Data were extracted from the CAPTAIN II Study database [ 17 ]. CAPTAIN II is a single-center, prospective, randomized, double-blind, placebo-controlled clinical trial.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Cerebrolysin on the Predictive Value of Baseline Prognostic Risk Score in Moderate and Severe Traumatic Brain Injury

et al. 2020

View full text Add to dashboard Cite

show abstract

“…A subgroup of 62 patients was selected from a total group of 132 patients with moderate-severe TBI (GCS 7-12) included in the CAPTAIN II trial [ 15 ]. The study was approved by the Ethics Committee of the University of Medicine and Pharmacy in Cluj-Napoca, Romania (No.…”

Section: Methodsmentioning

confidence: 99%

“…The evaluations performed at 10 and 90 days were selected from the CAPTAIN II dataset [ 15 ]. At both visits, the following scales were assessed:…”

Section: Methodsmentioning

confidence: 99%

Prediction of Neurocognitive Outcome after Moderate-Severe Traumatic Brain Injury Using Serum Neuron-Specific Enolase and S100 biomarkers

et al. 2020

View full text Add to dashboard Cite

Seric biomarkers have been tested in a large number of studies on traumatic brain injuries (TBI) patients in order to predict severity, especially related to the short-term outcome. However, TBI patients have a high risk of developing long-term complications such as physical disability, cognitive impairment, psychiatric pathology, epilepsy, and others. The aim of this study was to assess the correlation between protein biomarkers S100 and neuron-specific enolase (NSE) and neurocognitive status at 10- and 90-days post-injury. Both biomarkers were tested in the first 4h and after 72h post-injury in 62 patients with moderate-severe TBI. The patients were evaluated by a series of neurocognitive tests: Early Rehabilitation Barthel Index (ERBI), Glasgow Outcome Scale-Extended (GOSE), The Mini-Mental State Examination (MMSE), Processing Speed Index (PSI), and Stroop Test, at 10 and 90 days post-injury and supplementary by the Hospital Anxiety and Depression Scale at 90 days. For evaluating the whole neurocognitive status instead of every scale separately, we used Structural Equation Modeling (SEM), while for anxiety and depressive symptoms, we used multiple regression analyses. SEM showed that NSE values at 4 hours were significant predictors of the cognitive status at 10 (p=0.034) and 90 days (p= 0.023). Also, there were found significant correlations between NSE at 4h and the anxiety level. This study demonstrated a significant correlation between NSE at 4h and short and medium-term neuropsychological outcomes, which recommends using this biomarker for selecting patients with a higher risk of cognitive dysfunction.

show abstract

A novel pharmacological treatment concept for neuroprotection in severe traumatic brain injury—Two case reports

Trimmel

Herzer

Derdak

et al. 2022

Clinical Case Reports

View full text Add to dashboard Cite

Severe traumatic brain injury (sTBI) is a major cause of death and disability worldwide, resulting in a significant individual and socioeconomic burden. Current treatment guidelines do not include any recommendations for neuroprotective or neuoregenerative drugs. Here, we present a combined treatment with Cerebrolysin and Citicoline in two cases. Both drugs are experimentally better than clinically proven in their own effectiveness, but there is almost no clinical data on the combination of the two. Our case study hints at a promising approach that may improve neurological outcome after sTBI. The first patient was a 29 years male motorcyclist suffered polytrauma in a high-speed accident. He had severe bilateral chest trauma and fractures in both thighs and an sTBI. In addition to surgical and standard neurocritical care according to the evidence-based guidelines, he was given neuroprotective therapy with Cerebrolysin (50 ml/day) and Citicoline (3 g/day), by continuous intravenous infusion (IV), for 21 days.The second patient was a 30 years male ski mountaineer who had suffered a fall over 300 m in open terrain. In addition to the sTBI, he had fractures in the cervical spine, ribs, pelvis, and lower extremities, as well as lung contusions and massive soft tissue trauma. After initial treatment in a local hospital, he was transferred to our department and received the same neuroprotective drugs, like all of our patients with sTBI. Considering the severity of the injuries (Injury Severity Score[ISS]: 43/50, Revised Trauma Score [RTS: 5.0304, 2.7794]) and the unfavorable outcome probability (Hukkelhoven Score) of 93.1% and 82.6%, the outcomes of both patients are surprisingly encouraging 1 year after the accident. They achieved a Glasgow Outcome Score of 6 and 5 and grades 2 and 4 on the modified Rankin Scale, respectively. Currently, both are able to take care of themselves in activities of daily life to a large extent. Neuroprotective drugs may improve the regeneration of cell membranes, improve blood brain barrier integrity, and reduce neuroinflammation leading to secondary damage to the injured brain.How to cite this article: Trimmel H, Herzer G, Derdak C, Kettenbach J, Grgac I. A novel pharmacological treatment concept for neuroprotection in severe traumatic brain injury-Two case reports.

show abstract

Efficacy and safety of cerebrolysin in neurorecovery after moderate-severe traumatic brain injury: results from the CAPTAIN II trial

Cited by 40 publications

References 58 publications

The Effect of Cerebrolysin on the Predictive Value of Baseline Prognostic Risk Score in Moderate and Severe Traumatic Brain Injury

The Effect of Cerebrolysin on the Predictive Value of Baseline Prognostic Risk Score in Moderate and Severe Traumatic Brain Injury

Prediction of Neurocognitive Outcome after Moderate-Severe Traumatic Brain Injury Using Serum Neuron-Specific Enolase and S100 biomarkers

A novel pharmacological treatment concept for neuroprotection in severe traumatic brain injury—Two case reports

Contact Info

Product

Resources

About