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Brain Injuries, TraumaticPhase 4BIKeNCT05097261

Ketamine in Acute Brain Injury Patients.

A Phase 4 study testing Ketamine in people with Brain Injuries, Traumatic, run by Geert Meyfroidt, MD, PhD at 8 sites in Belgium.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Although, in the past years, an increasing use of ketamine in Traumatic Brain injury (TBI) has been reported as an adjunct to other sedatives, there is no evidence from randomized clinical trial to support this practice. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Brain Injuries, Traumatic
What is being tested?
Ketamine
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
100 participants
Where
8 sitesBelgium
Study dates
6 Sep 2021to 30 Jun 2026
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Traumatic brain injury patients
  • Age >= 18 years
  • Admitted to the ICU
  • Within 72 hours after admission to the initial hospital:
  • ICP monitoring in place (parenchymal probe, ventricular catheter, or both)
  • Requiring sedation

Who cannot join

  • Known pregnancy and/or lactation
  • Imminent or actual brain death upon inclusion
  • Allergy or intolerance to the study medication
  • Pre-existing neurocognitive disorders, pre-existing congenital or non-congenital brain dysfunction.
  • Inability to obtain informed consent
  • Inclusion in an interventional randomised controlled trial of which the PI indicates that co-inclusion specifically in the BIKe study is prohibited.
Show all 9Show fewer
  • Therapy restriction code upon inclusion.
  • Porphyria
  • Glaucoma

Trial locations and contacts

8 sites in 1 country.

Liese Mebis, PhD contact

003216343125

liese.mebis@uzleuven.be

8 sites in 1 country

Belgium8 sites, 8 recruiting
  • Imelda Bonheiden

    Bonheiden

    Emmanuel Van Der Hauwaert, MD

    Recruiting
  • AZ Sint-Jan

    Bruges

    Marc Bourgeois, MD

    Recruiting
  • Jessa Ziekenhuis

    Hasselt, 3500

    Jasperina Dubois, MD, jasperina.dubois@jessazh.be

    Recruiting
  • UZLeuven

    Leuven, 3001

    Liese Mebis, PhD, MSc, +3216343125, liese.mebis@uzleuven.be

    Geert JP Meyfroidt, MD, PhD

    Recruiting
  • CHR de la Citadelle Liège

    Liège

    Hugues Maréchal, MD

    Recruiting
  • CHU de Liège

    Liège

    Didier Ledoux, MD

    Recruiting
  • AZ Delta

    Roeselare

    Peiter Lormans, MD

    Recruiting
  • AZ Turnhout

    Turnhout

    Eva Boonen, MD, PhD

    Recruiting

Other trials in Belgium

About this study

Official title: Brain Injury and Ketamine: a Prospective, Randomized Controlled Double Blind Clinical Trial to Study the Effects of Ketamine on Sedative Sparing and Intracranial Pressure in Traumatic Brain Injury Patients.

Although, in the past years, an increasing use of ketamine in Traumatic Brain injury (TBI) has been reported as an adjunct to other sedatives, there is no evidence from randomized clinical trial to support this practice.

The BIKe (Brain Injury and Ketamine) study is a double-blind placebo controlled randomized multicenter clinical trial to examine the safety and feasibility of using ketamine as an adjunct to a standard sedative strategy in TBI patients.

Read the detailed description

In this study the effects of ketamine as an adjunct to an standard sedation regime in adult TBI patients will be investigated on the therapy intensity level and intracranial pressure. All patients will receive propofol for sedation to control ICP, to a maximum dose of 4 mg/kg/h. If the ICP is not controlled at the maximum dose of propofol, midazolam will be added, to a maximum dose of 0.3 mg/kg/h, as part of the current standard of care in the Participating Sites. All patients will receive remifentanil, fentanyl or sufentanil infusions for pain relief. The study medication (ketamine or placebo) will be started after randomization.

As part of the current standard of care in the Participating Sites, the decision for decompressive craniectomy and/or barbiturate coma will be taken after multidisciplinary consultation between the treating intensivist and neurosurgeon.

The decision to stop or reduce sedation, lies with the treating physician, based on the level of ICP control, the absence of clinical or radiological signs of deterioration of the neurologic state. In the case of barbiturate coma, the study drug will be discontinued. During and following decompressive craniectomy, the sedative regime (propofol/midazolam/study drug/ opioids) will be continued. In case of suspected or threatening Propofol-Related Infusion syndrome, propofol will be stopped and switched to midazolam. In case of hypertriglyceridemia >200 mg/dL, propofol will be reduced and if necessary, midazolam will be associated to allow control of sedation. During surgical procedures related to the traumatic brain injury or not, the study drug will not be discontinued. The use of open label administration of ketamine is not allowed during the course of the trial, i.e until hospital discharge.

Being tested
Ketamine, Placebo
Medical subject headings
Brain Injuries, Traumatic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • KetamineDrug

    Also called Ketalar

    Racemic ketamine® will be administered by continuous infusion in a prefilled 50 ml syringe at a concentration of 50 mg/ml, undiluted. The ketamine dose is 1 mg/kg/h, to a maximum dose of 120 mg/hour, which corresponds to an infusion rate of 0.02 ml/kg/h to a maximum rate of 2.4 ml/h.

  • PlaceboDrug

    Also called Saline

    Placebo (NaCl 0.9%) will be provided in the same type syringes and administered at the same infusion rate as the IMP (0.02 ml/kg/h to a maximum rate of 2.4 ml/h).

Study groups in NCT05097261
Study groupRoleWhat they receive
KetamineExperimentalRacemic ketamine® will be administered by continuous infusion in a prefilled 50 ml syringe at a concentration of 50 mg/ml, undiluted. The ketamine dose is 1 mg/kg/h, to a maximum dose of 120 mg/hour, which corresponds to an infusion rate of 0.02 ml/kg/h to a maximum rate of 2.4 ml/h. Study patients weighing over 120 kg will not exceed the maximum dose of 120mg/kg of ketamine. The study medication will be started within 6 hours after randomization. The IMP, ketamine, will be provided directly to each Participating Site by the official supplier of ketamine for Belgium (Pfizer).
Receives: Drug: Ketamine
PlaceboActive comparatorThe placebo (NaCl 0.9%) will be provided in the same type syringes and administered at the same infusion rate as the IMP (0.02 ml/kg/h to a maximum rate of 2.4 ml/h).
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in therapeutic intensity of intracranial pressure (ICP) reducing measures, assessed by the TIL score (Therapy Intensity Level)

    The primary efficacy endpoint will be the reduction in daily Therapy Intensity Level (TIL) score, based on the highest score in each item per day until study drug discontinuation (calculated every day on the available data at 7:00 AM). Scales for TIL score range from 0 (minimum) to 38 (maximum). Higher scores are related to worse outcome.

    Measured: From date of randomization (and start study drug) until study drug discontinuation or date of death from any cause, whichever came first, assessed up to 6 months.

Secondary outcomes (16)
  1. Intracranial pressure (ICP)

    The average of hourly validated intracranial pressure (mmHg) measurements per 24 hours

    Measured: From date of randomization until study drug discontinuation or or date of death from any cause, whichever came first, assessed up to 6 months.

  2. Duration of sedation

    Total duration of the first period of sedative treatments (propofol, midazolam and/or dexmedetomidine)

    Measured: defined as the start of the first infusion of either propofol, midazolam and/or dexmedetomidine to the cessation of the last uninterrupted infusion of either propofol, midazolam, opioids and/or dexmedetomidine, assessed up to 6 months.

  3. Propofol

    Total dose of propofol in mg per 24 hours

    Measured: From date of randomization until study drug discontinuation or date of death from any cause, whichever came first, assessed at ICU discharge, assessed up to 6 months.

  4. Mechanical ventilation

    Total duration of mechanical ventilation, defined as all types of ventilation where positive end expiratory pressure is applied, expressed in cm H2O (5 cm H2O minimum).

    Measured: From date of randomization until study drug discontinuation or date of death from any cause, whichever came first, assessed up to 6 months.

  5. Midazolam

    Total dose of midazolam in mg per 24 hours

    Measured: From date of randomization until study drug discontinuation or date of death from any cause, whichever came first, assessed up to 6 months.

  6. ICU length of stay

    Length of stay (number of days) in ICU

    Measured: From ICU admission until ICU discharge (end of stay is defined as application for discharge in the hospital computer system, or death), assessed up to 6 months.

  7. Hospital length of stay

    Length of stay in hospital (days)

    Measured: From admission to hospital until end of stay in hospital (dead or alive), assessed up to 6 months.

  8. Richmond Agitation-Sedation scale (RASS)

    Average daily RASS. Scale ranges from +4 (combative) until -5 (Unarousable).

    Measured: From date of randomization until study drug discontinuation or date of death from any cause, whichever came first, assessed up to 6 months.

  9. Delirium

    Number of delirium-free days, assessed 3 times per day with the Intensive Care Delirium Screening Checklist (ICDSC) or Confusion Assessment Method for the ICU (CAM-ICU delirium scale).

    Measured: From date of randomization until study drug discontinuation or date of death from any cause, whichever came first, assessed up to 6 months.

  10. eGOS

    extended Glasgow Outcome Scale (eGOS)

    Measured: 6 months after the onset of TBI

  11. ICU mortality

    Mortality during ICU stay

    Measured: From date of randomization until ICU discharge, assessed up to 6 months.

  12. In-hospital mortality

    Mortality during hospital stay

    Measured: From date of randomization until hospital discharge, assessed up to 6 months.

  13. Barbiturate coma incidence

    The incidence of barbiturate coma

    Measured: From date of randomization until study drug discontinuation or date of death from any cause, whichever came first, assessed up to 6 months.

  14. Barbiturate coma duration

    The duration of barbiturate coma

    Measured: From date of randomization until study drug discontinuation or date of death from any cause, whichever came first, assessed up to 6 months.

  15. Decompressive craniectomy

    The incidence of decompressive craniectomy

    Measured: From date of randomization until study drug discontinuation or date of death from any cause, whichever came first, assessed up to 6 months, assessed up to 6 months.

  16. Propofol Infusion Syndrome (PRIS)

    Incidence of PRIS documented and diagnosed by the attending physician and defined as:

    • Cardiac manifestations, not explained by a coronary ischemic event:
    • Acute refractory bradycardia leading to asystole, or
    • ECG: widening of QRS-complex, or Brugada-syndrome-like patterns (particularly Type 1: Coved-type ST-segment elevation >2mm in >1 of V1-V3 followed by a negative T-wave), or ventricular tachy-arrhythmias
    • Combined with one or more of the following:
    • Unexplained metabolic acidosis (base deficit > 10 mmol/L)
    • Rhabdomyolysis (Creatinine kinase at least five times the upper limit of normal)
    • Hyperlipidaemia (triglyceride levels > 150 mg/dl)
    • Enlarged or fatty liver, apparent on CT or echography
    • All occurring in patients receiving propofol for > 24h
    • Diagnosed by the attending physician

    Measured: From date of randomization until study drug discontinuation or date of death from any cause, whichever came first, assessed up to 6 months.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Oct 2021
  2. Study start6 Sep 2021
  3. Primary completion31 Dec 2025 (estimated)
  4. Study completion30 Jun 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Care provider
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05097261
Sponsor's protocol ID
S60859
Other IDs
2017-004698-15, 2017
Acronym
BIKe
Status last verified
Aug 2024
First submitted
8 Sep 2020
Last updated
22 Aug 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • De Sloovere V, Mebis L, Wouters P, Guiza F, Boonen E, Bourgeois M, Dubois J, Ledoux D, Lormans P, Marechal H, Van der Hauwaert E, Depreitere B, Meyfroidt G. Brain Injury and Ketamine study (BIKe): a prospective, randomized controlled double blind clinical trial to study the effects of ketamine on therapy intensity level and intracranial pressure in severe traumatic brain injury patients. Trials. 2025 May 28;26(1):177. doi: 10.1186/s13063-025-08835-5.

    PubMed 40437634

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Ketamine in people with Brain Injuries, Traumatic, run by Geert Meyfroidt, MD, PhD at 8 sites in Belgium.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 22 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Liese Mebis, PhD (003216343125, liese.mebis@uzleuven.be), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in therapeutic intensity of intracranial pressure (ICP) reducing measures, assessed by the TIL score (Therapy Intensity Level) (time frame: From date of randomization (and start study drug) until study drug discontinuation or date of death from any cause, whichever came first, assessed up to 6 months.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05097261, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Aug 2024; AzTrials last refreshed its copy on 6 Nov 2026.

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