NCT03696121

Brief Summary

Haemorrhagic stroke, an emergency caused by bleeding in the brain, often leads to death or long-term disability. A quarter of these patients are taking blood-thinning drugs (antiplatelet drugs, such as aspirin) because they are at risk of a heart attack or ischaemic stroke. Patients taking these drugs are more likely to die or be disabled if they have a haemorrhagic stroke. At present, there is no effective treatment for reversing their effects. Desmopressin is a drug which may reverse the effects of antiplatelet drugs and stop bleeding. The investigators would like to run a large randomised trial to see if Desmopressin can reduce the number of people who die or are disabled after haemorrhagic stroke.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
54

participants targeted

Target at P25-P50 for phase_2

Timeline
Completed

Started Apr 2019

Typical duration for phase_2

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

June 8, 2018

Completed
4 months until next milestone

First Posted

Study publicly available on registry

October 4, 2018

Completed
6 months until next milestone

Study Start

First participant enrolled

April 1, 2019

Completed
3.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 30, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2022

Completed
Last Updated

November 15, 2022

Status Verified

November 1, 2022

Enrollment Period

3.2 years

First QC Date

June 8, 2018

Last Update Submit

November 14, 2022

Conditions

Keywords

intracerebral haemorrhage

Outcome Measures

Primary Outcomes (7)

  • Number of eligible patients who received allocated treatment

    Number - higher number indicates feasibility of trial

    90 days

  • Rate of eligible patients randomised

    Shorter period of time to recruit number of patients indicates trial is feasibility;e

    18 months

  • Proportion of eligible patients and randomised

    Are there sufficient numbers of patients to justify a larger trial

    18 months

  • Proportion of participants followed up at 90 days

    Higher number indicates feasibility

    90 days

  • Proportion of patients with full outcome data available, and reasons for non-availability

    Higher number indicates feasibility

    90 days

  • Proportion of eligible patients approached

    Higher number indicates feasibility

    18 months

  • Adherence to intervention

    Higher number indicates feasibility

    18 months

Secondary Outcomes (11)

  • Death or dependency at 90 days

    18 months

  • Number of patients dead or suffered serious adverse events

    Day 28 and 90

  • Change in intracerebral haemorrhage volume at 24 hours

    24 hours

  • Disability - Barthel index

    Day 90

  • Quality of life - EuroQol

    Day 90

  • +6 more secondary outcomes

Study Arms (2)

Intervention

EXPERIMENTAL

Desmopressin injection

Drug: Desmopressin Injection

Control

PLACEBO COMPARATOR

Normal Saline

Drug: Normal saline

Interventions

Single dose 20 micrograms in 50ml Normal Saline as intravenous injection infused over 20 minutes

Intervention

Single dose 50ml Normal Saline as intravenous injection infused over 20 minutes

Control

Eligibility Criteria

Age18 Years - 110 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adults (≥18 years)
  • Confirmed intracerebral haemorrhage on imaging
  • Less than 24 hours from onset of symptoms \[or from when last seen free of stroke symptoms\]
  • Prescribed and thought to be taking a daily oral antiplatelet drug in the preceding seven days (cyclooxygenase inhibitors, phosphodiesterase inhibitors or P2Y12 inhibitors)
  • Signed consent (or waiver of consent).

You may not qualify if:

  • Aneurysmal subarachnoid haemorrhage known at time of enrolment
  • Haemorrhage suspected to be due to transformation of ischaemic stroke
  • Haemorrhage known to be due to thrombolytic drug
  • Haemorrhage known to be due to venous thrombosis
  • Risk/s of fluid retention associated with desmopressin judged clinically significant by the attending physician (for example patients with pulmonary oedema and/or cardiac failure) - - Significant hypotension (systolic blood pressure \<90mmHg)
  • Known drug-eluting coronary artery stent in previous three months
  • Allergy to desmopressin
  • Pregnant or breast-feeding
  • Life expectancy less than four hours, or planned for palliative care only
  • Glasgow coma scale less than 5, mRS \>4.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Nottingham City Hospital

Nottingham, Notts, NG5 1PB, United Kingdom

Location

Related Publications (2)

  • 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.

  • Desborough MJR, Al-Shahi Salman R, Stanworth SJ, Havard D, Brennan PM, Dineen RA, Coats TJ, Hepburn T, Bath PM, Sprigg N. Desmopressin for reversal of Antiplatelet drugs in Stroke due to Haemorrhage (DASH): protocol for a phase II double-blind randomised controlled feasibility trial. BMJ Open. 2020 Nov 10;10(11):e037555. doi: 10.1136/bmjopen-2020-037555.

MeSH Terms

Conditions

StrokeCerebral Hemorrhage

Interventions

Deamino Arginine VasopressinSaline Solution

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular DiseasesIntracranial HemorrhagesHemorrhagePathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Arginine VasopressinVasopressinsPituitary Hormones, PosteriorPituitary HormonesPeptide HormonesHormonesHormones, Hormone Substitutes, and Hormone AntagonistsNeuropeptidesPeptidesAmino Acids, Peptides, and ProteinsOligopeptidesNerve Tissue ProteinsProteinsCrystalloid SolutionsIsotonic SolutionsSolutionsPharmaceutical Preparations

Study Officials

  • Nikola Sprigg

    University of Nottingham

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

June 8, 2018

First Posted

October 4, 2018

Study Start

April 1, 2019

Primary Completion

June 30, 2022

Study Completion

June 30, 2022

Last Updated

November 15, 2022

Record last verified: 2022-11

Locations