Restarting Anticoagulation After Traumatic Intracranial Hemorrhage
NCT04229758 · Status: NOT_YET_RECRUITING · Phase: PHASE3 · Type: INTERVENTIONAL · Enrollment: 1100
Last updated 2021-05-19
Summary
Primary Objective:
To identify the optimal interval to restart oral anticoagulation after traumatic intracranial hemorrhage that will minimize thrombotic events and major bleeding by performing a response adaptive randomized (RAR) PROBE clinical trial of restarting in anticoagulant-associated traumatic intracranial hemorrhage patients, comparing restart at 1 week to restart at 2 weeks or at 4 weeks, with a primary composite outcome of major thrombotic events and bleeding.
Primary Outcome: 60-day composite of thromboembolic events, defined as DVT, pulmonary emboli, myocardial infarctions, ischemic strokes and systemic emboli, and bleeding events defined as non-CNS major bleeding events (modified BARC3 or above) and worsening index tICrH or new intracranial hemorrhage (ICrH).
Secondary objectives of this trial include:
1. To use the Trauma Quality Improvement Program (TQIP) of the American College of Surgeons - Committee on Trauma (ACS-COT), a well-established and highly respected trauma center oversight mechanism, to translate findings of the trial into practice in a closed loop.
2. To establish a relationship between time of restarting and overall secondary events, i.e. a dose response, that favors early restarting (1 week is better than 2 weeks and 2 weeks is better than 4 weeks.
3. To explore patient centered utility weighting of thrombotic versus bleeding composite endpoint components by: A) 60-day Disability Rating Scale (DRS) 24,25 and modified Rankin Scale (mRS)26; B) Trial patient-reported standard gamble utilities including by race, gender and ethnicity.
4. To explore the composite without DVT in the thrombotic component
Conditions
- Hemorrhage
- Intracranial Hemorrhages
- Bleeding
- Trauma
Interventions
- DRUG
-
Anticoagulants
DOAC for the prevention of thromboembolic events in patients with non-valvular AF or VTE.
Sponsors & Collaborators
-
University of Texas at Austin
lead OTHER
Principal Investigators
-
Truman J Milling, MD · Seton Dell Medical School Stroke Institute
Study Design
- Allocation
- RANDOMIZED
- Purpose
- PREVENTION
- Masking
- NONE
- Model
- PARALLEL
Eligibility
- Min Age
- 18 Years
- Sex
- ALL
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2021-10-31
- Primary Completion
- 2026-12-31
- Completion
- 2027-02-28
- FDA Drug
- Yes
Countries
- United States
Study Locations
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