title: Spinal Cord Injury-Assessing Tolerability and Use of Combined Rehabilitation and NeuroAiD (SATURN Study): Protocol of An Exploratory Study In Assessing the Safety and Efficacy of NeuroAiD Amongst People Who Sustain Severe Spinal Cord Injury.
abstract: BACKGROUND
  Spinal cord injury (SCI) is a devastating condition with limited therapeutic options despite decades of research. Current treatment options include use of steroids, surgery, and rehabilitation. Nevertheless, many patients with SCI remain disabled. MLC601 (NeuroAiD), a combination of natural products, has been shown to be safe and to aid neurological recovery after brain injuries and may have a potential role in improving recovery after SCI.
  
  
  OBJECTIVE
  The aim of this study is to evaluate the safety and efficacy of NeuroAiD amongst people who sustain SCI in the study setting.
  
  
  METHODS
  Spinal Cord Injury-Assessing Tolerability and Use of Combined Rehabilitation and NeuroAiD (SATURN) is a prospective cohort study of patients with moderately severe to severe SCI, defined as American Spinal Injury Association (ASIA) Impairment Scale (AIS) A and B. These patients will be treated with open-label NeuroAiD for 6 months in addition to standard care and followed for 24 months. Anonymized data will be prospectively collected at baseline and months 1, 3, 6, 12, 18, and 24 and will include information on demographics; main diagnostics; and neurological and functional state assessed by the Spinal Cord Independence Measure, ASIA-International Standard for Neurological Classification Spinal Cord Injury, and Short Form (SF-8) Health Survey. In addition, NeuroAiD treatment, compliance, concomitant therapies, and side effects, if any, will be collected. Investigators will use a secured online system for data entry. The study is approved by the ethics committee of Hospital University Kebangsaan Malaysia.
  
  
  RESULTS
  The coprimary endpoints are safety, AIS grade, and improvement in ASIA motor score at 6 months. Secondary endpoints are AIS grade, ASIA motor scores and sensory scores, Spinal Cord Independence Measure (SCIM), SF-8 Health Survey, and compliance at other time points.
  
  
  CONCLUSIONS
  SATURN investigates the promising role of NeuroAiD in SCI especially given its excellent safety profile. We described here the protocol and online data collection tool we will use for this prospective cohort study. The selection of moderately severe to severe SCI provides an opportunity to investigate the role of NeuroAiD in addition to standard rehabilitation in patients with poor prognosis. The results will provide important information on the feasibility of conducting larger controlled trials to improve long-term outcome of patients with SCI.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT02537899; https://clinicaltrials.gov/ct2/show/NCT02537899 (Archived by WebCite at http://www.webcitation.org/6m2pncVTG).
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Ramesh
authors.identifier: http://orcid.org/0000-0002-4979-9031
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Ohnmar
authors.identifier: http://orcid.org/0000-0001-6303-9859
authors.initials: O
authors.lastname: Htwe
authors.affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Azmi
authors.identifier: http://orcid.org/0000-0003-1691-9102
authors.initials: A
authors.lastname: Baharudin
authors.affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Mohammad Hisam
authors.identifier: http://orcid.org/0000-0001-5200-8395
authors.initials: MH
authors.lastname: Ariffin
authors.affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Shaharuddin
authors.identifier: http://orcid.org/0000-0002-9810-3184
authors.initials: S
authors.lastname: Abdul Rhani
authors.affiliation: Department of Orthopaedics and Traumatology, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Kamalnizat
authors.identifier: http://orcid.org/0000-0003-3626-2451
authors.initials: K
authors.lastname: Ibrahim
authors.affiliation: Medical Affairs, Moleac, Biopolis Way, Singapore.
authors.forename: Aishah
authors.identifier: http://orcid.org/0000-0002-2356-690X
authors.initials: A
authors.lastname: Rustam
authors.affiliation: Medical Affairs, Moleac, Biopolis Way, Singapore.
authors.forename: Robert
authors.identifier: http://orcid.org/0000-0003-0317-0374
authors.initials: R
authors.lastname: Gan
keywords: MLC601; MLC901; NeuroAiD; efficacy; recovery; safety; spinal cord injury