Neurology Central

Traumatic brain injury and circulating biomarkers: the CREACTIVE trial, an interview with Guido Bertolini

Guido Bertolini is the head of the Laboratory of Clinical Epidemiology at the Mario Negri Institute (Milan, Italy). He is also a clinical epidemiologist and coordinator of the CREACTIVE study – a large network of ICUs across seven countries in Europe focused on treating traumatic brain injury (TBI) patients.
In this interview, Guido speaks to us about the first results from the CREACTIVE trial, including the short- and long-term implications of this research. He also provides his opinion on where the field may be in 10 years’ time.

You’ve presented a talk on circulating biomarkers for TBI prognostication, where you presented the first results from the CREACTIVE trial. Could you tell us more about this?

CREACTIVE is quite a large study and we are hoping to recruit approximately 7000 patients. We have several substudies in progress and right now we’re close to the end of the project, with more than 6000 patients in our database at the present time.

Here at Frontiers in TBI (5–6 July, London, UK), I presented a substudy of CREACTIVE on biomarkers. Currently, there are only 21 out of the total 74 ICUs participating in this and they are collecting samples, such as serum and plasma, from their TBI patients at day one (the day of trauma) and day five.

I presented some very preliminary and exploratory analyses on the first 80 patients. At the moment, we have 1500 patients in total but our first assessment of possible biomarkers started on 80 patients. We tested 107 biomarkers within this cohort and identified the most promising candidates with the idea of improving prognostication of the outcome at 6 months. By outcome I am referring to the resulting disability, not just the mortality.

We found some very interesting preliminary data revealing that there may be several potentially useful biomarker candidates. However, the idea is not just to rely on one molecule but rather to find a combination of different biomarkers that can provide added value to the capability of making a prognosis on patients.

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