Ondansetron for Pediatric Mild Traumatic Brain Injury
Status:
Completed
Trial end date:
2014-02-01
Target enrollment:
Participant gender:
Summary
Background: Most patients suffering from mild Traumatic Brain Injury (mTBI) present
persistent symptoms at one week post injury. A systematic review showed a paucity of studies
for short term outcomes following mTBI. Among potential treatments for mTBI, ondansetron has
shown promising results based on clinical experience and a single retrospective study.
Objectives: The primary objective of this pilot study is to determine the feasibility of a
randomized controlled trial evaluating the effect of ondansetron to decrease post concussion
symptoms at one week following mTBI in children. More specifically, this pilot study will
evaluate the proportion of participants who complete assessment at one week following
intervention. Method: This will be a randomized, double blinded, controlled trial performed
among children aged between 8 and 17 years old who sustained a mTBI in the previous 24 hours.
Participants visiting the emergency department will be randomized to receive one dose of
either ondansetron or placebo. The primary outcome of interest is defined as an increase from
pre-concussion baseline of at least 3 symptoms from the Post Concussion Symptom Inventory
(PCSI) one week following trauma. Secondary outcomes will include time to full recovery, mean
PCSI score, and outcomes at one month following head trauma. The primary analysis will
compare the proportion of participants with persistence of symptoms at one week in both
groups. The full study sample size was calculated to have 90% power to detect a decrease in
the proportion of persistence of symptoms from 50% to 30% with an alpha value of 0.05.
Approximately 126 patients will therefore be recruited in each arm. The investigators plan to
recruit 30 participants (10% of the final population) for the pilot study. Expected results:
This pilot study should confirm the feasibility of the randomized controlled trial by showing
that 90% of the recruited participants provide data on the primary outcome at one week
following intervention. On the long term, the investigator expect that ondansetron will
decrease the proportion of patients sustaining persistent symptoms of concussion from 50% to
lower than 30%.