NCT04062097

Brief Summary

This multicenter, prospective, observational, non-interventional study investigates patients with intracranial hemorrhage under effective anticoagulation with dabigatran or vitamin-K antagonist (VKA). Routine data will be collected during hospitalization. Patients aged 18 years or older under effective therapy with dabigatran and symptomatic intracranial bleeding confirmed by cerebral imaging and treated with idarucizumab will be compared to patients under effective treatment with VKA at the time of onset of the intracranial bleeding. Ninety-five dabigatran patients who provided written informed consent for data transmission will be included. As control group retrospective and anonymized data of 285 VKA patients patients under VKA treatment and admitted to RIC-ICH study centers will be used. For each patient receiving idarucizumab, three patients with intracranial hemorrhage under effective treatment with VKA, will be included (retrospective) in the study. In addition, data of VKA patients will be transferred from the RASUNOA-PRIME and the "Erlanger Hirnblutungs-Register".

Trial Health

87
On Track

Trial Health Score

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

Enrollment
104

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Sep 2019

Typical duration for all trials

Geographic Reach
1 country

33 active sites

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

August 8, 2019

Completed
12 days until next milestone

First Posted

Study publicly available on registry

August 20, 2019

Completed
1 month until next milestone

Study Start

First participant enrolled

September 19, 2019

Completed
2.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2021

Completed
Last Updated

December 9, 2024

Status Verified

April 1, 2022

Enrollment Period

2.3 years

First QC Date

August 8, 2019

Last Update Submit

December 4, 2024

Conditions

Keywords

intracranial/intracerebral bleedingstroketransient ischemic attack (TIA)myocardial infarctionanticoagulationdabigatranidarucizumabvitamin-k antagonists

Outcome Measures

Primary Outcomes (1)

  • Intra-hospital mortality rate

    Intra-hospital mortality rate

    From study inclusion until hospital discharge or 30 days after index event, whichever came first.

Secondary Outcomes (5)

  • Change in National Institutes of Health Stroke Scale (NIHSS)

    At hospital admission, 24 hours after admission and 72 hours after admission.

  • Intracranial bleeding

    Between 24 and 72 hours after initial CT.

  • Stroke severity

    72 hours after hospital admission

  • Functional status

    At hospital discharge or 30 days after index event, whichever came first.

  • Mortality rate

    7 and 30 days after index event.

Study Arms (2)

dabigatran-group

Patients with the anticoagulating therapy dabigatran and onset of clinically symptomatic intracranial hemorrhage, that is treated with idarucizumab.

Drug: Dabigatran Etexilate Oral Capsule [Pradaxa]Drug: Idarucizumab 2.5 GM/50 ML Intravenous Solution [PRAXBIND]

VKA-group

Patients under effective treatment with VKA and with intracranial hemorrhage.

Drug: Vitamin K antagonist

Interventions

Dabigatran is the most frequently used direct thrombin inhibitor in secondary stroke prevention in patients with atrial fibrillation.

dabigatran-group

Idarucizumab is the current standard therapy in patients with intracranial bleeding under anticoagulation with dabigatran.

dabigatran-group

This drug group includes the active substances phenprocoumon and warfarin.

VKA-group

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Patients with the anticoagulating therapy dabigatran admitted with a clinically symptomatic intracranial bleeding will be included in the study, if they have been treated with idarucizumab (dabigatran-group). It is assumed that some of these patients will have been given an antiplatelet drug as co-medication. As reference population, patients with intracranial hemorrhage under effective treatment with VKA (INR ≥ 1,7) treated in the same center will be used (VKA-group). These patients usually have been treated with some antagonist to VKA (or no reversal therapy at all).

You may qualify if:

  • Age ≥18 years at enrollment
  • Patients willing and able to provide written informed consent for data transmission (exceptions/special cases for patients who are not legally competent to sign informed consent for data transmission).
  • Patients with primary intracranial hemorrhage as confirmed with CT.
  • Patients under effective anticoagulation treatment with dabigatran at the time of admission (TT\>60 sec. or last intake of medication \<24hours).
  • Patients treated with Idarucizumab (2x2.5 g recommended) may still be included the day after the administration of Praxbind, or on the following working day if treatment was carried out on the weekend.
  • \- Patients with intracranial hemorrhage under effective anticoagulation treatment with VKA (INR ≥ 1,7) having been initially treated in the past in the study center.

You may not qualify if:

  • Additional therapy with PCC, aPCC or factor VII (in patients under dabigatran).
  • \- Start of symptoms of initial ICH event \> 24 h before admission to hospital.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (33)

Klinikum Schön Klinik Bad Aibling SE & Co. KG

Bad Aibling, 83043, Germany

Location

Hochtaunuskliniken GmbH

Bad Homburg, 61352, Germany

Location

Rhön Klinikum Campus Bad Neustadt

Bad Neustadt an der Saale, 97616, Germany

Location

Vivantes Klinikum Auguste Viktoria

Berlin, 12157, Germany

Location

Vivantes Klinikum Neukölln

Berlin, 12351, Germany

Location

Vivantes Humboldt Klinikum

Berlin, 13509, Germany

Location

Evangelisches Klinikum Bethel gGmbH

Bielefeld, 33617, Germany

Location

Katholisches Klinikum Bochum gGmbH, St. Josef Hospital

Bochum, 44791, Germany

Location

Universitätsklinkum Bonn

Bonn, 53127, Germany

Location

Klinikum Allgemeines Krankenhaus Celle

Celle, 29223, Germany

Location

Carl-Thiem-Klinikum Cottbus gGmbH

Cottbus, 03048, Germany

Location

Krankenhaus St. Elisabeth gGmbH

Damme, 49401, Germany

Location

Albert-Ludwigs-Universität Freiburg

Freiburg im Breisgau, 79106, Germany

Location

SHR Wald-Klinikum Gera GmbH

Gera, 07548, Germany

Location

Georg-August-Universität Göttingen, Universitätsmedizin

Göttingen, 37075, Germany

Location

Klinikum Martha Maria

Halle, 06120, Germany

Location

Asklepios Klinik Wandsbek

Hamburg, 22043, Germany

Location

Asklepios Klinik Barmbek

Hamburg, 22291, Germany

Location

Universitätsklinikum Hamburg-Eppendorf

Hamburg, 22307, Germany

Location

Klinikum Agatharied GmbH

Hausham, 83734, Germany

Location

Universitätsklinikum Heidelberg

Heidelberg, 69120, Germany

Location

BDH-Klinik Hessisch Oldendorf

Hessisch Oldendorf, 31840, Germany

Location

Universitätsklinikum Schleswig-Holstein, Campus Kiel

Kiel, 24105, Germany

Location

Universität Leipzig

Leipzig, 04103, Germany

Location

Klinikum Main-Spessart Lohr

Lohr, 97816, Germany

Location

Universitätsklinikum Schleswig-Holstein, Campus Lübeck

Lübeck, 23538, Germany

Location

Universitätsmedizin der Johannes-Guttenberg-Universität Mainz

Mainz, 55131, Germany

Location

Klinikum Osnabrück

Osnabrück, 49076, Germany

Location

Klinikum Vest Knappschaftskrankenhaus

Recklinghausen, 45657, Germany

Location

Klinikum Nordwest Krankenhaus Sande

Sanderbusch, 26452, Germany

Location

Klinikum der Landeshauptstadt Stuttgart gKAöR

Stuttgart, 70174, Germany

Location

Universitätsklinikum Tübingen

Tübingen, 72076, Germany

Location

Sana HANSE-Klinikum Wismar GmbH

Wismar, 23966, Germany

Location

MeSH Terms

Conditions

Intracranial HemorrhagesStrokeIschemic Attack, TransientMyocardial Infarction

Interventions

Dabigatranidarucizumabacarboxyprothrombin

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular DiseasesHemorrhagePathologic ProcessesPathological Conditions, Signs and SymptomsBrain IschemiaMyocardial IschemiaHeart DiseasesInfarctionIschemiaNecrosis

Intervention Hierarchy (Ancestors)

PyridinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsBenzimidazolesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-Ring

Study Officials

  • Hans Diener, Prof. Dr.

    University Hospital, Essen

    STUDY DIRECTOR

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Senior Professor of Clinical Neurosciences

Study Record Dates

First Submitted

August 8, 2019

First Posted

August 20, 2019

Study Start

September 19, 2019

Primary Completion

December 31, 2021

Study Completion

December 31, 2021

Last Updated

December 9, 2024

Record last verified: 2022-04

Locations