Recombinant Factor VIIa (rFVIIa) for Hemorrhagic Stroke Trial - Part 2

NCT ID: NCT07227246

Last Updated: 2025-11-12

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

350 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-06

Study Completion Date

2029-06-30

Brief Summary

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The objective of the rFVIIa for Acute Hemorrhagic Stroke Administered at Earliest Time (FASTEST) Trial is to establish the first treatment for acute spontaneous intracerebral hemorrhage (ICH) within a time window and subgroup of patients that is most likely to benefit. The central hypothesis is that rFVIIa, administered within 120 minutes from stroke onset with an identified subgroup of patients most likely to benefit, will improve outcomes at 180 days as measured by the Modified Rankin Score (mRS) and decrease ongoing bleeding as compared to standard therapy. FASTEST Part 2 is an extension of the FASTEST Trial where the subgroups include only those treated within 2 hours with a positive spot sign on a baseline CT angiogram.

Detailed Description

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FASTEST Part 2 is a global, Phase III, randomized, double-blind controlled trial of rFVIIa plus best standard therapy vs. placebo and best standard therapy alone. The investigators will include participants with a volume of ICH ≥ 2 and \< 60 cc, no more than a small volume of intraventricular hemorrhage (IVH) (less than 2/3 of one lateral ventricle and less than 1/3 in both lateral ventricles), age ≥ 18 and ≤ 80, Glasgow Coma Scale of ≥ 8, and treated within 120 minutes from stroke onset. All participants in FASTEST Part 2 must have a positive spot sign on a pretreatment CT angiogram. This is based upon data from FASTEST Part 1 from the overall FASTEST Trial where the greatest potential for benefit was demonstrated. To minimize time-to-treatment, the study uses emergency research informed consent procedures (including exception from informed consent (EFIC) in the United States) and mobile stroke units (MSUs), with a goal of ½ of participants treated within 90 minutes, as accomplished in the NINDS t-PA trials. The FASTEST Trial will include approximately 100 hospital sites and at least 15 MSUs in the NINDS-funded StrokeNet and key global institutions with large volumes of ICH patients and the ability to treat them within 120 minutes of stroke onset.

Recruitment of a maximum of 350 participants over approximately 3½ years is planned. Countries participating in the trial include the United States, Canada, Japan, Germany, Spain, Finland, the United Kingdom, and Australia. Involving other countries may be possible in the future depending upon recruitment needs.

Participants will be randomized in a double-blinded fashion to rFVIIa 80 µg/kg dose (maximum 10 mg dose) or placebo. Participants in both arms will receive best standard therapy as per published AHA Guidelines for ICH, including a target systolic blood pressure of 140 mm Hg. The primary outcome (ordinal mRS with the following categories: 0-2, 3, and 4-6) will be determined at 90 days, but participants will be followed by remote assessment at 30 days and 180 days. To measure growth of ICH, all participants will have a standard of care baseline non-contrast CT of the head and a repeat scan at 24 hours. Centralized volumetric measurements of ICH, IVH, and edema will be performed for both time points.

Novo Nordisk A/S will manufacture and supply rFVIIa as a research medication for use in the FASTEST Trial. Novo Nordisk A/S will also manufacture and supply matching placebo that is identical to rFVIIa in appearance and administration.

Conditions

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Intracerebral Hemorrhage

Keywords

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Intracerebral hemorrhage recombinant factor VIIa

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
Blinded study medication

Study Groups

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Recombinant Factor VIIa

rFVIIa given as IV injection over 2 minutes within 120 minutes of stroke onset

Group Type EXPERIMENTAL

Recombinant Factor VIIa

Intervention Type BIOLOGICAL

Participants will be randomized in a double-blinded fashion to rFVIIa 80 µg/kg dose (maximum 10 mg dose) or matching placebo. All participants in FASTEST Part 2 must have a positive spot sign on baseline CTA angiography and be treated within 120 minutes of onset. Participants in both arms will receive best standard therapy as per published AHA Guidelines for ICH, including a target systolic blood pressure of 140 mm Hg.

Placebo

Placebo given as IV injection over 2 minutes within 120 minutes of stroke onset

Group Type PLACEBO_COMPARATOR

Biological/Vaccine: Placebo

Intervention Type BIOLOGICAL

Participants will be randomized in a double-blinded fashion to rFVIIa 80 µg/kg dose (maximum 10 mg dose) or matching placebo. All participants in FASTEST Part 2 must have a positive spot sign on baseline CTA angiography and be treated within 120 minutes or onset. Participants in both arms will receive best standard therapy as per published AHA Guidelines for ICH, including a target systolic blood pressure of 140 mm Hg.

Interventions

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Recombinant Factor VIIa

Participants will be randomized in a double-blinded fashion to rFVIIa 80 µg/kg dose (maximum 10 mg dose) or matching placebo. All participants in FASTEST Part 2 must have a positive spot sign on baseline CTA angiography and be treated within 120 minutes of onset. Participants in both arms will receive best standard therapy as per published AHA Guidelines for ICH, including a target systolic blood pressure of 140 mm Hg.

Intervention Type BIOLOGICAL

Biological/Vaccine: Placebo

Participants will be randomized in a double-blinded fashion to rFVIIa 80 µg/kg dose (maximum 10 mg dose) or matching placebo. All participants in FASTEST Part 2 must have a positive spot sign on baseline CTA angiography and be treated within 120 minutes or onset. Participants in both arms will receive best standard therapy as per published AHA Guidelines for ICH, including a target systolic blood pressure of 140 mm Hg.

Intervention Type BIOLOGICAL

Other Intervention Names

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NovoSeven NiaStase

Eligibility Criteria

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Inclusion Criteria

1. Patients aged 18-80 years, inclusive
2. Patients with spontaneous ICH
3. Able to treat with study medication (rFVIIa/placebo) within 120 minutes of stroke onset or last known well with a positive spot sign on pretreatment CT angiography.
4. Efforts to obtain informed consent per EFIC guidelines (U.S.) or adherence to country-specific emergency research informed consent regulations (Canada, Germany, Spain, Finland, U.K., Japan, Australia)

Exclusion Criteria

1. Score of 3 to 7 on the Glasgow Coma Scale
2. Secondary ICH related to known causes (e.g., trauma, aneurysm, arteriovenous malformation (AVM), oral anticoagulant use (vitamin K antagonists or novel oral anticoagulants) within the past 7 days, coagulopathy, etc.)
3. ICH volume \< 2 cc or ≥ 60 cc
4. Blood filling 2/3 or more of one lateral ventricle of the brain, OR, blood filling at least 1/3 of both lateral ventricles.
5. Pre-existing disability (mRS \> 2)
6. Symptomatic thrombotic or vaso-occlusive disease in past 90 days (e.g., cerebral infarction, myocardial infarction, pulmonary embolus, deep vein thrombosis, or unstable angina)
7. Clinical or EKG evidence of ST elevation consistent with acute myocardial ischemia
8. Brainstem location of hemorrhage (patients with cerebellar hemorrhage may be enrolled)
9. Refusal to participate in study by patient, legal representative, or family member
10. Known or suspected thrombocytopenia (unless current platelet count documented above 50,000/μL)
11. Unfractionated heparin use with abnormal PTT
12. Pro-coagulant drugs within 24 hours prior to patient enrollment into the FASTEST trial (example, tranexamic acid or aminocaproic acid)
13. Low-molecular weight heparin use within the previous 24 hours
14. Recent (within 90 days) carotid endarterectomy or coronary or cerebrovascular angioplasty or stenting
15. Advanced or terminal illness or any other condition the investigator feels would pose a significant hazard to the patient if rFVIIa were administered
16. Recent (within 30 days) participation in any investigational drug or device trial or earlier participation in any investigational drug or device trial for which the duration of effect is expected to persist until to the time of FASTEST enrollment
17. Planned withdrawal of care or comfort care measures
18. Patient known or suspected of not being able to comply with trial protocol (e.g., due to alcoholism, drug dependency, or psychological disorder)
19. Known or suspected allergy to trial medication(s), excipients, or related products
20. Contraindications to study medication
21. Previous participation in this trial (previously randomized)
22. Females of childbearing potential who are known to be pregnant or within 12 weeks post-partum and/or lactating at time of enrollment -
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Neurological Disorders and Stroke (NINDS)

NIH

Sponsor Role collaborator

Japan Agency for Medical Research and Development

OTHER_GOV

Sponsor Role collaborator

Novo Nordisk A/S

INDUSTRY

Sponsor Role collaborator

Joseph Broderick, MD

OTHER

Sponsor Role lead

Responsible Party

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Joseph Broderick, MD

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Joseph P Broderick

Role: PRINCIPAL_INVESTIGATOR

University of Cincinnati

Locations

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University of Alabama Hospital

Birmingham, Alabama, United States

Site Status RECRUITING

St. Joseph's Hospital and Medical Center

Phoenix, Arizona, United States

Site Status RECRUITING

Kaiser Permanente Baldwin Park Medical Center

Baldwin Park, California, United States

Site Status RECRUITING

Mills Peninsula Medical Center

Burlingame, California, United States

Site Status RECRUITING

Kaiser Permanente Downey Medical Center

Downey, California, United States

Site Status RECRUITING

Kaiser Permanente Fontana Medical Center

Fontana, California, United States

Site Status RECRUITING

Kaiser Permanente South Bay Medical Center

Harbor City, California, United States

Site Status RECRUITING

UCSD Health La Jolla

La Jolla, California, United States

Site Status RECRUITING

Kaiser Permanente Los Angeles Medical Center

Los Angeles, California, United States

Site Status RECRUITING

Kaiser Permanente West Los Angeles Medical Center

Los Angeles, California, United States

Site Status RECRUITING

Ronald Reagan UCLA Medical Center

Los Angeles, California, United States

Site Status RECRUITING

UC Irvine Medical Center,

Orange, California, United States

Site Status RECRUITING

Kaiser Permanente Riverside Medical Center

Riverside, California, United States

Site Status RECRUITING

UC Davis Medical Center

Sacramento, California, United States

Site Status RECRUITING

UCSD Medical Center - Hillcrest Hospital

San Diego, California, United States

Site Status RECRUITING

San Francisco General Hospital

San Francisco, California, United States

Site Status RECRUITING

UF Health Shands Hospital

Gainesville, Florida, United States

Site Status RECRUITING

Mayo Clinic

Jacksonville, Florida, United States

Site Status RECRUITING

Grady Memorial Hospital

Atlanta, Georgia, United States

Site Status RECRUITING

WellStar Kennestone Hospital

Marietta, Georgia, United States

Site Status RECRUITING

The Queen's Medical Center

Honolulu, Hawaii, United States

Site Status RECRUITING

Northwestern Memorial Hospital

Chicago, Illinois, United States

Site Status RECRUITING

University of Chicago Medical Center

Chicago, Illinois, United States

Site Status RECRUITING

Central DuPage Hospital

Winfield, Illinois, United States

Site Status RECRUITING

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status RECRUITING

UMass Memorial Medical Center

Worcester, Massachusetts, United States

Site Status RECRUITING

Henry Ford Hospital

Detroit, Michigan, United States

Site Status RECRUITING

M Health Fairview Ridges Hospital,

Burnsville, Minnesota, United States

Site Status RECRUITING

M Health Fairview Southdale Hospital

Edina, Minnesota, United States

Site Status RECRUITING

M Health Fairview St. John's Hospital

Maplewood, Minnesota, United States

Site Status RECRUITING

M Health Fairview University of Minnesota Medical Center Hospital,

Minneapolis, Minnesota, United States

Site Status RECRUITING

Mayo Clinic Saint Marys Campus

Rochester, Minnesota, United States

Site Status RECRUITING

Barnes Jewish Hospital

St Louis, Missouri, United States

Site Status RECRUITING

North Shore University Hospital

Manhasset, New York, United States

Site Status RECRUITING

Mount Sinai West

New York, New York, United States

Site Status RECRUITING

The Mount Sinai Hospital

New York, New York, United States

Site Status RECRUITING

Stony Brook University Hospital

Stony Brook, New York, United States

Site Status RECRUITING

University of Cincinnati Medical Center

Cincinnati, Ohio, United States

Site Status RECRUITING

OSU Wexner Medical Center

Columbus, Ohio, United States

Site Status RECRUITING

Riverside Methodist Hospital

Columbus, Ohio, United States

Site Status RECRUITING

St. John Medical Center

Tulsa, Oklahoma, United States

Site Status RECRUITING

Providence St. Vincent Medical Center

Portland, Oregon, United States

Site Status RECRUITING

Temple University Hospital

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Medical University of South Carolina University Hospital

Charleston, South Carolina, United States

Site Status RECRUITING

Prisma Health Greenville Memorial Hospital

Greenville, South Carolina, United States

Site Status RECRUITING

Memorial Hermann Memorial City Medical Center

Houston, Texas, United States

Site Status RECRUITING

Memorial Hermann-Texas Medical Center

Houston, Texas, United States

Site Status RECRUITING

University of Utah Healthcare

Salt Lake City, Utah, United States

Site Status RECRUITING

VCU Medical Center

Richmond, Virginia, United States

Site Status RECRUITING

University of Calgary - Foothills Medical Centre

Calgary, Alberta, Canada

Site Status RECRUITING

University of Alberta Hospital

Edmonton, Alberta, Canada

Site Status RECRUITING

Vancouver General Hospital

Vancouver, British Columbia, Canada

Site Status RECRUITING

Health Sciences Centre Winnipeg

Winnipeg, Manitoba, Canada

Site Status RECRUITING

Hamilton General Hospital

Hamilton, Ontario, Canada

Site Status RECRUITING

Ottawa Hospital Research Institute

Ottawa, Ontario, Canada

Site Status RECRUITING

Sunnybrook Health Sciences Center

Toronto, Ontario, Canada

Site Status RECRUITING

St. Michaels Hospital

Toronto, Ontario, Canada

Site Status RECRUITING

University of Montreal Hospital

Montreal, Quebec, Canada

Site Status RECRUITING

University Hospital Heidelberg

Heidelberg, Baden-Wurttemberg, Germany

Site Status RECRUITING

University Hospital Erlangen

Erlangen, Bavaria, Germany

Site Status RECRUITING

Clinic Frankfurt Hoechst

Frankfurt am Main, Hesse, Germany

Site Status RECRUITING

University Hospital Augsburg

Augsburg, , Germany

Site Status RECRUITING

Charite University Medicine Berlin

Berlin, , Germany

Site Status RECRUITING

University Medical Center Hamburg

Hamburg, , Germany

Site Status RECRUITING

University Hospital Tuebingen

Tübingen, , Germany

Site Status RECRUITING

National Cerebral and Cardiovascular Center

Suita, Osaka, Japan

Site Status RECRUITING

Kyushu Medical Center

Fukuoka, , Japan

Site Status RECRUITING

Gifu University Hospital

Gifu, , Japan

Site Status RECRUITING

Kagoshima City Hospital

Kagoshima, , Japan

Site Status RECRUITING

Kobe City Medical Center General Hospital

Kobe, , Japan

Site Status RECRUITING

Japanese Red Cross Kyoto Daini Hospital

Kyoto, , Japan

Site Status RECRUITING

Iwate Prefectural Central Hospital

Morioka, , Japan

Site Status RECRUITING

Niigata City General Hospital

Niigata, , Japan

Site Status RECRUITING

KMU University Hospital

Osaka, , Japan

Site Status RECRUITING

NHO Osaka National Hospital

Osaka, , Japan

Site Status RECRUITING

Nakamura Memorial Hospital

Sapporo, , Japan

Site Status RECRUITING

Jichi Medical University Hospital

Shimotsuke, , Japan

Site Status RECRUITING

Kyorin University Hospital

Tokyo, , Japan

Site Status RECRUITING

Toranomon Hospital

Tokyo, , Japan

Site Status RECRUITING

Hospital Universitari Germans Trias i Pujol

Badalona, Barcelona, Spain

Site Status RECRUITING

Vall d'Hebron University Hospital (VHUH)

Horta, Barcelona, Spain

Site Status RECRUITING

Bellvitge University Hospital,

L'Hospitalet de Llobregat, Barcelona, Spain

Site Status RECRUITING

Santa Creu and Sant Pau Hospital

Barcelona, Catalonia, Spain

Site Status RECRUITING

Girona University Hospital

Girona, Catalonia, Spain

Site Status RECRUITING

Arnau de Vilanova University Hospital

Lleida, Catalonia, Spain

Site Status RECRUITING

Valladolid University Hospital

Valladolid, , Spain

Site Status RECRUITING

John Radcliffe Hospital

Oxford, Oxfordshire, United Kingdom

Site Status RECRUITING

Royal Stoke University Hospital

Stoke-on-Trent, Staffordshire, United Kingdom

Site Status RECRUITING

Royal Victoria Infirmary

Newcastle upon Tyne, , United Kingdom

Site Status RECRUITING

Queens Medical Centre

Nottingham, , United Kingdom

Site Status RECRUITING

Countries

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United States Canada Germany Japan Spain United Kingdom

Central Contacts

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Joseph P Broderick, MD

Role: CONTACT

Phone: 15139195404

Email: [email protected]

James Grotta, MD

Role: CONTACT

Phone: (281) 387-2329

Email: [email protected]

Facility Contacts

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Elizabeth Liptrap, MD

Role: primary

Supreet Kaur, MD

Role: primary

Navdeep Sangha, MD

Role: primary

Ilana Spokoyny, MD

Role: primary

Navdeep Sangha, MD

Role: primary

Navdeep Sangha, MD

Role: primary

Navdeep Sangha, MD

Role: primary

Brett Meyer, MD

Role: primary

Navdeep S Sangha, MD

Role: primary

Navdeep Sangha, MD

Role: primary

May Nour, MD, PhD

Role: primary

Jay Shah, MD

Role: primary

Navdeep S Sangha, MD

Role: primary

Lara L Zimmermann, MD

Role: primary

Brett Meyer, MD

Role: primary

Vineeta Singh, MD

Role: primary

Anna Y Khanna, MD

Role: primary

Lauren K Ng, MD

Role: primary

Digvijaya Navalkele, MD, MPH

Role: primary

Raisa C. Martinez, MD

Role: primary

Chung-Huan Sun, MD

Role: primary

Babak S. Jahromi, MD, PhD

Role: primary

Ali Mansour, MD

Role: primary

Harish N. Showkeen, MD

Role: primary

Pierre Borczuk, MD

Role: primary

Adalia H. Jun-O'Connell, MD

Role: primary

Christopher A Lewandowski, MD

Role: primary

Christopher Streib, MD

Role: primary

Christopher Streib, MD

Role: primary

Christopher Streib, MD

Role: primary

Christopher Streib, MD

Role: primary

Eugene L. Scharf, M.D.

Role: primary

Peter D Panagos, MD

Role: primary

Richard Elias Temes, MD

Role: primary

John W Liang, MD

Role: primary

John Liang, MD

Role: primary

Jason Mathew, DO

Role: primary

Kyle Walsh, MD

Role: primary

Yousef Hannawi, MD

Role: primary

William J Hicks, MD

Role: primary

Errol L Gordon, MD

Role: primary

Ted J Lowenkopf, MD

Role: primary

Nina T Gentile, MD

Role: primary

Christine Holmstedt, MD

Role: primary

Sanjeev Sivakumar, MD

Role: primary

Ritvij Bowry, MD

Role: primary

James Grotta, MD

Role: primary

Ramesh Grandhi, MD, MS

Role: primary

Dennis J. Rivet, MD

Role: primary

Andrew M Demchuk, MD, PhD

Role: primary

Brian H. Buck, MD, FRCPC

Role: primary

Ming Yin Dominic TSE, MD

Role: primary

Nishita Singh, MD, DM, MSc

Role: primary

Ashkan Shoamanesh, MD

Role: primary

Dar Dowlatshahi, MD

Role: primary

Houman Khosravani, MD PhD FRCPC

Role: primary

Alexandra Muccilli, MD

Role: primary

Laura C Gioia, MD, MSc

Role: primary

Jan C Purrucker, MD

Role: primary

Stefan T Gerner, MD

Role: primary

Thorsten Steiner, MD

Role: primary

Hauke Schneider, Dr. med.

Role: primary

Christian Nolte, MD

Role: primary

Götz Thomalla, MD

Role: primary

Sven Poli, Dr. med.

Role: primary

Kazunori Toyoda, MD,PhD,FAHA

Role: primary

Yasushi Okada, MD

Role: primary

Toru Iwama, MD

Role: primary

Fumio Miyashita, MD

Role: primary

Nobuyuki Sakai, MD

Role: primary

Yoshinari Nagakane, MD

Role: primary

Naoto Kimura, MD

Role: primary

Kenichi Morita, MD, PhD

Role: primary

Yusuke Yakushiji, MD

Role: primary

Toshiyuki Fujinaka, MD

Role: primary

Kenji Kamiyama, MD

Role: primary

Shigeru Fujimoto, MD, PhD

Role: primary

Teruyuki Hirano, MD, PhD

Role: primary

Takayuki Hara, MD

Role: primary

Alejandro Bustamante Rangel, MD

Role: primary

Carlos A. Molina, MD, PhD

Role: primary

Pere Cardona Portela, MD

Role: primary

Joan Martí-Fàbregas, MD,PhD

Role: primary

Yolanda Silva Blas, MD, PhD

Role: primary

Francisco Purroy Garcia, MD PhD

Role: primary

Juan F Arenillas Lara, MD

Role: primary

Philip Mathieson, MD

Role: primary

Indira Natarajan, FRCP, MSc

Role: primary

Tudor Gheorghiu, MD

Role: primary

Ganesh Subramanian, MB, FRCP, M Ed, M Res

Role: primary

Related Links

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Other Identifiers

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U01NS110772-04

Identifier Type: NIH

Identifier Source: secondary_id

View Link

Ucincinnatifastestpart2

Identifier Type: -

Identifier Source: org_study_id