Antisecretory factor in severe traumatic brain injury (AFISTBI): protocol for an exploratory randomized placebo-controlled trial

Abstract Background Despite recent advances in neuroimaging and neurocritical care, severe traumatic brain injury (TBI) is still a major cause of severe disability and mortality, with increasing incidence worldwide. Antisecretory factor (AF), commercially available as Salovum®, has been shown to low...

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Main Authors: Linus Réen, David Cederberg, Niklas Marklund, Edward Visse, Peter Siesjö
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Trials
Online Access:https://doi.org/10.1186/s13063-025-08760-7
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author Linus Réen
David Cederberg
Niklas Marklund
Edward Visse
Peter Siesjö
author_facet Linus Réen
David Cederberg
Niklas Marklund
Edward Visse
Peter Siesjö
author_sort Linus Réen
collection DOAJ
description Abstract Background Despite recent advances in neuroimaging and neurocritical care, severe traumatic brain injury (TBI) is still a major cause of severe disability and mortality, with increasing incidence worldwide. Antisecretory factor (AF), commercially available as Salovum®, has been shown to lower intracranial pressure (ICP) in experimental models of, e.g., TBI and herpes encephalitis. The aim of this study is to assess the effect of antisecretory factors in adult patients with severe TBI on ICP and inflammatory mediators in extracellular fluid and plasma. Methods/design This is a single-center, randomized, placebo-controlled clinical phase 2 trial, investigating the clinical superiority of Salovum® given as a food supplement during 5 days to adults with severe TBI (Glasgow Coma Scale (GCS) < 9), admitted to the neurocritical intensive care unit (NICU) at Skane university hospital, Lund, Sweden. All patients with GCS < 9 and clinical indication for insertion of ICP-monitor and microdialysis catheter will be screened for inclusion and assigned to either the treatment group (n = 10) or placebo group (n = 10). In both groups, the primary outcome will be ICP (mean values and change from baseline during intervention), registered from high-frequency data monitoring for 5 days. Secondary outcomes will be inflammatory mediators in plasma and intracerebral microdialysis perfusate days 1, 3, and 5 during trial treatment. Trial registration ClinicalTrials.gov NCT04117672. Registered on September 17, 2017. Protocol version 6 from October 24, 2023.
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spelling doaj-art-92e08494fa4c4b4899547e60dfe9392d2025-02-09T12:53:16ZengBMCTrials1745-62152025-02-012611810.1186/s13063-025-08760-7Antisecretory factor in severe traumatic brain injury (AFISTBI): protocol for an exploratory randomized placebo-controlled trialLinus Réen0David Cederberg1Niklas Marklund2Edward Visse3Peter Siesjö4Department of Clinical Sciences Lund, Neurosurgery, Lund UniversityDepartment of Clinical Sciences Lund, Neurosurgery, Lund UniversityDepartment of Clinical Sciences Lund, Neurosurgery, Lund UniversityDepartment of Clinical Sciences Lund, Neurosurgery, Lund UniversityDepartment of Clinical Sciences Lund, Neurosurgery, Lund UniversityAbstract Background Despite recent advances in neuroimaging and neurocritical care, severe traumatic brain injury (TBI) is still a major cause of severe disability and mortality, with increasing incidence worldwide. Antisecretory factor (AF), commercially available as Salovum®, has been shown to lower intracranial pressure (ICP) in experimental models of, e.g., TBI and herpes encephalitis. The aim of this study is to assess the effect of antisecretory factors in adult patients with severe TBI on ICP and inflammatory mediators in extracellular fluid and plasma. Methods/design This is a single-center, randomized, placebo-controlled clinical phase 2 trial, investigating the clinical superiority of Salovum® given as a food supplement during 5 days to adults with severe TBI (Glasgow Coma Scale (GCS) < 9), admitted to the neurocritical intensive care unit (NICU) at Skane university hospital, Lund, Sweden. All patients with GCS < 9 and clinical indication for insertion of ICP-monitor and microdialysis catheter will be screened for inclusion and assigned to either the treatment group (n = 10) or placebo group (n = 10). In both groups, the primary outcome will be ICP (mean values and change from baseline during intervention), registered from high-frequency data monitoring for 5 days. Secondary outcomes will be inflammatory mediators in plasma and intracerebral microdialysis perfusate days 1, 3, and 5 during trial treatment. Trial registration ClinicalTrials.gov NCT04117672. Registered on September 17, 2017. Protocol version 6 from October 24, 2023.https://doi.org/10.1186/s13063-025-08760-7
spellingShingle Linus Réen
David Cederberg
Niklas Marklund
Edward Visse
Peter Siesjö
Antisecretory factor in severe traumatic brain injury (AFISTBI): protocol for an exploratory randomized placebo-controlled trial
Trials
title Antisecretory factor in severe traumatic brain injury (AFISTBI): protocol for an exploratory randomized placebo-controlled trial
title_full Antisecretory factor in severe traumatic brain injury (AFISTBI): protocol for an exploratory randomized placebo-controlled trial
title_fullStr Antisecretory factor in severe traumatic brain injury (AFISTBI): protocol for an exploratory randomized placebo-controlled trial
title_full_unstemmed Antisecretory factor in severe traumatic brain injury (AFISTBI): protocol for an exploratory randomized placebo-controlled trial
title_short Antisecretory factor in severe traumatic brain injury (AFISTBI): protocol for an exploratory randomized placebo-controlled trial
title_sort antisecretory factor in severe traumatic brain injury afistbi protocol for an exploratory randomized placebo controlled trial
url https://doi.org/10.1186/s13063-025-08760-7
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