rFVIIa in ICH in Patients Treated With Anticoagulants or Anti-Platelets

NCT ID: NCT00222625

Last Updated: 2006-09-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-09-30

Study Completion Date

2006-09-30

Brief Summary

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Evaluation of efficacy and safety of recombinant factor VIIa versus standard therapy in preventing early haematoma growth in spontaneous acute intracerebral haemorrhage in patients treated with oral anticoagulants or antiplatelets agents

Detailed Description

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Intracerebral hemorrhage (ICH) is the deadliest, most disabling, and least treatable form of stroke. Approximately 40% of patients die within 1 month of ICH onset, and two-thirds of survivors never regain functional independence. Though guidelines for supportive care exist, there is currently no treatment that has been shown in a randomized-controlled trial to definitely improve outcome after ICH. Hematoma volume is a critical determinant of mortality and functional outcome after ICH, and early hematoma growth may be an important cause of early neurological deterioration.

Considerable clinical interest has been given to the relationship between antiplatelet and antithrombotic treatment and ICH.

The reported incidence of major bleeding events in patients undergoing antithrombotic treatment is 5-11/1,000 patients/year, while the overall range of hemorrhages is about 62/1,000 patients/year.In the patients treated with antithrombotic drugs (oral anticoagulants or antiplatelets agent) the incidence rate of ICH has been shown higher than in the general population. Moreover, the mortality rate for both spontaneous and post-traumatic events is higher in antithrombotic treated patients than in controls. \[14,15\] rFVIIa has been successfully used to control ICH in patients with hemophilia or other coagulation disorders, and can arrest intraoperative bleeding and reverse coagulopathies in patients undergoing neurosurgical procedures.\[19\] rFVIIa has also been reported to prevent or minimize refractory bleeding in non-coagulopathic patients.

Conditions

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Intracerebral Hemorrhage

Keywords

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Intracerebral Hemorrhage Oral Anticoagulants Antiplatelet Agents Recombinant Activated Factor VII

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Interventions

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rFVIIa + (vit K in AO patients)

Intervention Type DRUG

FFP or aPCC+ vit K in AO treated patients

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* ICH in patient on treatment with one of the following:
* a)oral anticoagulant (INR upper than 1,4 at enrollment
* b) aspirin, whatever dosage
* Male or female subjects, age \> 18 years.
* Informed consent

Exclusion Criteria

* INR below 1.4 for patients on oral anticoagulants.
* Patients with secondary ICH related to infarction, tumor, cerebrovenous thrombosis, thrombolysis.
* Planned neurosurgical intervention.
* Any history of haemophilia or other congenital or acquired coagulopathy requiring specific antihemorrhagic treatment.
* Acute myocardial ischaemia or acute thrombotic stroke (within one year).
* Septicemia, intravascular disseminated coagulation.
* Pregnancy.
* Limb amputation due to vascular disease or claudication within last 30 days.
* Known or suspected allergy to the trial product or related products.
* Participation in other trials within the previous year.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Of Perugia

OTHER

Sponsor Role lead

Principal Investigators

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Alfonso Iorio

Role: PRINCIPAL_INVESTIGATOR

University Of Perugia

Locations

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A.O.R.N. San Sebastiano

Caserta, , Italy

Site Status RECRUITING

Emergency Room

Forlì, , Italy

Site Status RECRUITING

Emergency Department - S.Martino Hospital

Genoa, , Italy

Site Status RECRUITING

Emergency Room - University of Messina

Messina, , Italy

Site Status RECRUITING

Internal and Vascular Medicine - Stroke Unit - University of Perugia

Perugia, , Italy

Site Status RECRUITING

Divisione di Neurologia

Piacenza, , Italy

Site Status RECRUITING

Emergency Room

Ravenna, , Italy

Site Status RECRUITING

Emergency Room

Reggio Emilia, , Italy

Site Status RECRUITING

Stroke Unit - Policlinico Universitario Umberto I

Rome, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Alfonso Iorio, MD

Role: CONTACT

Phone: 075 578 4306

Email: [email protected]

Facility Contacts

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Tiscione Vitagliano

Role: primary

Alberto Randelli

Role: primary

Fiorella Altomonte, MD

Role: primary

Maria Gioffrè, Professor

Role: primary

Agnelli Giancarlo, Professor

Role: primary

Donata Guidetti, MD

Role: primary

Raffaele Nocenti

Role: primary

Angelo Ghirarduzzi

Role: primary

Danilo Toni, Professor

Role: primary

References

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Eilertsen H, Menon CS, Law ZK, Chen C, Bath PM, Steiner T, Desborough MJ, Sandset EC, Sprigg N, Al-Shahi Salman R. Haemostatic therapies for stroke due to acute, spontaneous intracerebral haemorrhage. Cochrane Database Syst Rev. 2023 Oct 23;10(10):CD005951. doi: 10.1002/14651858.CD005951.pub5.

Reference Type DERIVED
PMID: 37870112 (View on PubMed)

Iorio A. Iatrogenic causes of an ICH: OAT therapy. Eur J Anaesthesiol Suppl. 2008;42:8-11. doi: 10.1017/S0265021507003171.

Reference Type DERIVED
PMID: 18289410 (View on PubMed)

Other Identifiers

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04 MICV AI 04

Identifier Type: -

Identifier Source: secondary_id

2005-002155-40

Identifier Type: -

Identifier Source: org_study_id