Efficacy and Safety of Factor VIIa on Rebleeding After Surgery for Spontaneous Intracerebral Hemorrhage (ICH) (PRE-SICH)
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Purpose
Although the role of surgical treatment is still controversial, surgical evacuation of intracerebral hematoma is a frequent practice. Rebleeding is a frequent complication in patients submitted to hematoma evacuation. It has been reported that smaller postoperative volume of hematoma is associated with a better outcome. The investigators hypothesize that the administration of Factor VIIa (Eptacog alfa) immediately after surgical evacuation of the hematoma can reduce postoperative rebleeding.
Aims of the Study:
This study will investigate:
- The efficacy of Eptacog alfa in preventing or reducing rebleeding after surgery for spontaneous supratentorial ICH; and
- The safety of product administration
| Condition | Intervention | Phase |
|---|---|---|
|
Intracerebral Hemorrhage |
Drug: rFactor VIIa (Eptacog alfa, NovoNordisk) Drug: rFVIIa Other: Sodiun chloride 0.9% |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Investigator) Primary Purpose: Treatment |
| Official Title: | Efficacy and Safety of Factor VIIa (Eptacog Alfa) on Rebleeding After Surgery for Spontaneous Supratentorial Intracerebral Hemorrhage. A Randomized, Controlled, Open-Label, Investigator-Blinded Pilot Study |
- Evaluate the efficacy of Factor VIIa (Eptacog alfa) in preventing or reducing rebleeding after surgery for spontaneous supratentorial ICH [ Time Frame: 4 years ] [ Designated as safety issue: Yes ]
- Safety of product administration [ Time Frame: 4 years ] [ Designated as safety issue: Yes ]
| Enrollment: | 30 |
| Study Start Date: | January 2005 |
| Study Completion Date: | December 2008 |
| Primary Completion Date: | December 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1
Patients treated with recombinant FVIIa
|
Drug: rFactor VIIa (Eptacog alfa, NovoNordisk)
rFVIIa will be admistered as single bolus at the dosage of 100 mcg/Kg b.w.
Drug: rFVIIa
Patients with spontaneous supratentorial ICH will be treated with rFVII after hematoma evacuation
|
|
Placebo Comparator: 2
Patients with spontaneous supratentorial ICH included in this arm will be treated with placebo
|
Other: Sodiun chloride 0.9%
Bolus injection of sodium chloride 0.9% after surgical hematoma removal
|
Detailed Description:
The primary endpoint is the evaluation of efficacy of Factor VIIa (Eptacog alfa, NovoSeven, Novo Nordisk) on rebleeding after surgery for primary supratentorial ICH. All patients included in the study will perform a CT scan within 3 hours before surgery, then immediately after surgery, and 18-30 hours after surgery. The hematoma volume will be evaluated by a multi-slice CT scan. All CT scan images will be sent to the Coordinating Center where the hematoma volume will be evaluated by a dedicated software by the same investigator who will be unaware of the treatment (investigator- blinded study).
SAFETY EVALUATION:
Seventeen episodes of thrombotic spontaneous adverse events have been reported after administration of 480,000 standard doses of Eptacog alfa in hemophilic patients. These episodes include myocardial infarction, acute cerebrovascular thrombosis, disseminated intravascular coagulation (DIC), deep venous thrombosis (DVT) and pulmonary embolism.
Before and after hematoma removal will be evaluated ECG, myocardiac enzymes, coagulation profile, CT scan (looking for ischemic events) and venous echodoppler ultrasound of lower extremities.
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female, aged 18-75 years inclusive
- Intraparenchymal primary supratentorial intracerebral hemorrhage requiring surgical evacuation
- Any Glasgow Coma Score (GCS) score
- Surgery expected to be performed within 24 hours from symptoms onset
Exclusion Criteria:
- Age below 18
- Intraparenchymal hematoma secondary to rupture of cerebral aneurysm or bleeding of arteriovenous (A-V) malformation or cerebral tumors
- Contemporary involvement in another study
- Pregnancy
- Myocardial infarction in the six months preceding enrolment
- Coronary or carotid stents positioned in the six months preceding enrolment
- Solid organ transplant patients (e.g., heart, lung, liver, kidney)
- Pregnancy
- Myocardial infarction in the six months preceding enrolment
- Coronary and carotid stents positioned in the six months preceding enrolment
- Solid organ transplant patients (e.g., heart, lung, liver, kidney)
Contacts and Locations| Italy | |
| Azienda Ospedaliera S. Croce e Carle | |
| Cuneo, Italy, 12100 | |
| Azienda Ospedaliera "Maggiore della Carità" | |
| Novara, Italy, 28100 | |
| II Dpt Anesthesiology&Critical Care Medicine - IRCCS Policlinico S. Matteo | |
| Pavia, Italy, 27100 | |
| Principal Investigator: | Roberto Imberti, M.D. | IRCCS Policlinico S. Matteo - Pavia - Italy |
More Information
Publications:
| Responsible Party: | Roberto Imberti, M.D., Fondazione IRCCS Policlinico S. Matteo |
| ClinicalTrials.gov Identifier: | NCT00128050 History of Changes |
| Other Study ID Numbers: | NS-SICH-2005 |
| Study First Received: | August 8, 2005 |
| Last Updated: | February 3, 2009 |
| Health Authority: | Italy: National Monitoring Centre for Clinical Trials - Ministry of Health |
Keywords provided by IRCCS Policlinico S. Matteo:
|
Spontaneous intracerebral hemorrhage ICH intracerebral rebleeding cerebral hematoma evacuation cerebral hematoma volume |
Additional relevant MeSH terms:
|
Hemorrhage Cerebral Hemorrhage Pathologic Processes Intracranial Hemorrhages Cerebrovascular Disorders |
Brain Diseases Central Nervous System Diseases Nervous System Diseases Vascular Diseases Cardiovascular Diseases |
ClinicalTrials.gov processed this record on May 21, 2013