Could Progesterone Improve Outcomes After Traumatic Brain Injury?

In patients with traumatic brain injury (TBI), progesterone did not improve favorable outcomes, according to 2 recent studies.

In one of the studies, researchers assigned 1195 patients (16 to 79 years) with severe TBI to receive intravenous progesterone or a placebo. They began dosages within 8 hours after the injury occurred. Treatment was continued for 120 hours.^{1
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The study showed that progesterone use yielded a 50.4% favorable outcome compared to 50.5% with the placebo. Investigators noted that death rates were similar in the 2 groups and there were no differences in safety.

In the other study, researchers assigned 882 participants (mean age: 35 years) with moderate, moderate-to-severe, or severe TBI to intravenous progesterone or a placebo. Researchers initiated the treatment within 4 hours of the initial injury and continued for a total of 96 hours.²

Researchers found no significant difference in favorable outcome between the placebo group and the progesterone group. The mean Injury Severity Score was 24.4 on a scale from 0-75.²

The complete studies are published in the December issue of The New England Journal of Medicine.

-Michelle Canales

References:

1. Skolnick BE, Maas AI, Narayan RK, et al. A clinical trial of progesterone for severe traumatic brain injury. NEJM. 2014 December [epub ahead of print] doi: 10.1056/NEJMoa1411090.

2. Wright DW, Yeatts S, Silbergleit, et al. Very early administration of progesterone for acute traumatic brain injury. JAMA Neurol. 2014 December [epub ahead of print] doi: 10.1056/NEJMoa1404304.