NCT06667999

Brief Summary

Among critically ill patients, many die, and many of the survivors and their family members struggle for years with reduced quality of life. Critically ill patients are treated in intensive care units (ICUs). Here, they receive life support, e.g., mechanical ventilation and advanced support of the circulation (heart and blood vessels) and kidneys. In addition, ICU patients receive many other treatments. It is, however, uncertain if all the treatments provide value for the patients. The desirable effects of many treatments are uncertain, and some may be wasteful or even harmful. Clinical trials are necessary to validly assess the desirable and undesirable effects of different treatments. However, conventional clinical trials have limitations:

  • They typically only assess a single question related to a single comparison of treatments at a time.
  • They are often not very flexible, including with regards to the number of participants needed, and this increases the risk that a trial will end up as inconclusive.
  • There is no or limited re-use or sharing of infrastructure across trials, leading to duplicate work and resource use.
  • Trial participants do usually not benefit from the obtained knowledge before the trial concludes.
  • Involvement of patients, family members, and other stakeholders is typically limited, which may decrease the relevance of the questions addressed. With the Intensive Care Platform Trial (INCEPT), we aim to tackle these challenges by establishing a flexible platform trial that continuously learns from the obtained results. The platform trial may run forever with simultaneous and continuous assessment of many treatments. INCEPT will continuously learn from the accrued data and use these to improve the treatment of both participating and future patients. With INCEPT, we are also building a framework for thorough and extensive involvement of key stakeholders, including patients and family members. INCEPT will improve the way clinical trials are done and increase the probabilities that treatments are improved. This will:
  • Directly improve outcomes for ICU patients.
  • Relieve a strained healthcare system by discarding inefficient or harmful treatments.
  • Ensure that new treatments are beneficial or cost-effective before implementation.
  • Lower the costs and burdens of assessing more treatments in the critically ill.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
10,000

participants targeted

Target at P75+ for phase_4

Timeline
115mo left

Started Jun 2025

Longer than P75 for phase_4

Geographic Reach
1 country

21 active sites

Status
recruiting

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

Study Progress9%
Jun 2025Dec 2035

First Submitted

Initial submission to the registry

October 25, 2024

Completed
6 days until next milestone

First Posted

Study publicly available on registry

October 31, 2024

Completed
8 months until next milestone

Study Start

First participant enrolled

June 26, 2025

Completed
10.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2035

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2035

Last Updated

March 19, 2026

Status Verified

February 1, 2026

Enrollment Period

10.4 years

First QC Date

October 25, 2024

Last Update Submit

March 18, 2026

Conditions

Keywords

Platform trialIntensive careIntensive care unitCritical illnessClinical platform trial

Outcome Measures

Primary Outcomes (3)

  • One of the INCEPT core outcomes (varying between domains)

    Each domain in INCEPT will use one of the core outcomes; 1. All-cause 30-day mortality. 2. All-cause 90-day mortality. 3. All-cause 180-day mortality. 4. Days alive without life support at day 30. 5. Days alive without life support at day 90. 6. Days alive out of hospital at day 30. 7. Days alive out of hospital at day 90. 8. Days free of delirium at day 30. 9. EQ VAS (Health-Related Quality of Life) at day 180. 10. EQ-5D-5L index values (Health-related quality of life) at day 180. 11. Cognitive function at day 180 (all described under "secondary outcomes").

    From randomisation to 30-180 days after randomisation.

  • Days alive without life support at day 30 (Albumin domain)

    Days alive without the use of life support, with life support defined as invasive mechanical ventilation (≥1 hour of ventilation through a cuffed tube), continuous (i.e., ≥1 hour) use of vasopressors/inotropes, use of renal replacement therapy (including any form of in-hospital renal replacement therapy \[e.g., haemodialysis, haemofiltration, or haemodiafiltration\], continuously or intermittently, and including days in between intermittent renal replacement therapy; pauses between renal replacement therapy of up to three days will be considered as days receiving intermittent renal replacement therapy) at hospitals. Integer (0-30 overall; 0-29 in domains with life support at baseline as an eligibility criterion).

    From randomisation to 30 days after randomisation.

  • Days alive and out of hospital at day 30 (Thromboprophylaxis domain)

    Days alive and out of hospital. Rehabilitation facilities and nursing homes do not count as hospitals. Integer 0-29.

    From randomisation to 30 days after randomisation.

Secondary Outcomes (12)

  • All-cause 30-day mortality

    30 days after randomisation.

  • All-cause 90-day mortality

    90 days after randomisation.

  • All-cause 180-day mortality

    180 days after randomisation.

  • Days alive without life support at day 30

    From randomisation to 30 days after randomisation.

  • Days alive without life support at day 90

    From randomisation to 90 days after randomisation.

  • +7 more secondary outcomes

Other Outcomes (2)

  • Albumin domain-specific safety outcomes

    30 days (matching the primary and guiding outcome) and 90 days (matching the maximum intervention period.

  • Thromboprophylaxis domain-specific safety outcomes

    30 days (matching the primary and guiding outcome) and 90 days (matching the maximum intervention period).

Study Arms (5)

Albumin

EXPERIMENTAL

Use of albumin in ICU during circulatory failure in addition to crystalloids (resuscitation) and for substitution in case of suspected or overt albumin loss or plasma albumin levels ≤25 g/L

Drug: Albumin

No albumin use

OTHER

No albumin is to be used in ICU unless specific events occur

Other: No albumin use

Low-molecular-weight heparin for thromboprophylaxis in weight-adjusted dose

EXPERIMENTAL

Use of low-molecular-weight heparin for thromboprophylaxis in weight-adjusted dose during ICU stay

Drug: LMWH in weight-adjusted dose

Low-molecular-weight heparin for thromboprophylaxis in fixed low dose

ACTIVE COMPARATOR

Use of low-molecular-weight heparin for thromboprophylaxis in fixed low dose during ICU stay

Drug: LMWH in fixed low dose

Low-molecular-weight heparin for thromboprophylaxis in fixed intermediate dose

ACTIVE COMPARATOR

Use of low-molecular-weight heparin for thromboprophylaxis in fixed intermediate dose during ICU stay

Drug: LMWH in fixed intermediate dose

Interventions

Albumin should be used for the following indications: 1. During circulatory failure in addition to crystalloids (resuscitation). 2. For substitution in case of: suspected or overt albumin loss OR P-albumin levels below or equal to 25 g/L. Decisions around timing, volume, and concentration of albumin, and its use for other indications, are at the clinician's discretion. P-albumin should be measured according to local practice.

Albumin

Albumin should not be used. In case of the following special circumstances, albumin may be considered: 1. Large ascites drainage (i.e., equal to or more than 1 L tapped) 2. Spontaneous bacterial peritonitis 3. Hepatorenal syndrome.

No albumin use

Patients with indication for thromboprophylaxis receive low-molecular-weight heparin (LMWH) in a weight-adjusted dose during their ICU stay. The treating clinician may decide to adjust or withhold one or more doses in case of acute and/or chronic kidney injury, renal replacement therapy, thrombocytopenia, invasive procedures, use of thrombolysis, and active (major) bleeding.

Low-molecular-weight heparin for thromboprophylaxis in weight-adjusted dose

Patients with indication for thromboprophylaxis receive low-molecular-weight heparin (LMWH) in a fixed low dose during their ICU stay. The treating clinician may decide to adjust or withhold one or more doses in case of acute and/or chronic kidney injury, renal replacement therapy, thrombocytopenia, invasive procedures, use of thrombolysis, and active (major) bleeding.

Low-molecular-weight heparin for thromboprophylaxis in fixed low dose

Patients with indication for thromboprophylaxis receive low-molecular-weight heparin (LMWH) in a fixed intermediate dose during their ICU stay. The treating clinician may decide to adjust or withhold one or more doses in case of acute and/or chronic kidney injury, renal replacement therapy, thrombocytopenia, invasive procedures, use of thrombolysis, and active (major) bleeding.

Low-molecular-weight heparin for thromboprophylaxis in fixed intermediate dose

Eligibility Criteria

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

You may qualify if:

  • Adult patient (≥18 years old) acutely admitted to the ICU. This includes ICU admissions after emergency surgery, unplanned ICU admissions after elective surgery, and prolonged ICU admissions due to complications after elective surgery (i.e., admissions occurring or being prolonged due to an unexpected, worsened condition, but excluding planned ICU admissions after elective surgery without clinical deterioration).
  • Eligible for at least one active domain.

You may not qualify if:

  • Patient is under coercive measures (e.g., ongoing involuntary hospital stay or under the jurisdiction of correctional authorities).
  • Patients who have previously been included in INCEPT may only be included again during new ICU admissions but may only be randomised to domains in which they have not previously been randomised.
  • DOMAIN-SPECIFIC ELIGIBLE CRITERIA:
  • Each domain may have additional eligibility criteria. Refer to the study website for more information (www.incept.dk).

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (21)

Anaesthesia, Hospital Sønderjylland

Aabenraa, 6200, Denmark

NOT YET RECRUITING

Department of Anaesthesia and Intensive Care, Aalborg University Hospital

Aalborg, 9000, Denmark

RECRUITING

Department of Intensive Care Nord , Aarhus University Hospital

Aarhus, 8200, Denmark

RECRUITING

Department of Intensive Care Øst, Aarhus University Hospital

Aarhus, 8200, Denmark

RECRUITING

Department of Cardiothoracic Anaesthesia and Intensive care, Copenhagen Universisty Hospital - Rigshospitalet

Copenhagen, 2100, Denmark

NOT YET RECRUITING

Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet

Copenhagen, 2100, Denmark

RECRUITING

Neuroanaesthesiology, Copenhagen University Hospital - Rigshospitalet

Copenhagen, 2100, Denmark

NOT YET RECRUITING

Department of anesthesiology and intensive care, Bispebjerg-Frederiksberg Hospital

Copenhagen, 2400, Denmark

RECRUITING

Esbjerg Hospital

Esbjerg, 6700, Denmark

NOT YET RECRUITING

Department of Anesthesiology and Intensive Care, Copenhagen University Hospital Herlev

Herlev, 2730, Denmark

NOT YET RECRUITING

Department of Anaesthesiology and Intensive Care, Gødstrup Hospital

Herning, 7400, Denmark

RECRUITING

Department of Anaesthesia and Intensive Care Medicine, Copenhagen University Hospital - North Zealand

Hillerød, 3400, Denmark

RECRUITING

Anaesthesiology and Intensive Care, Amager and Hvidovre Hospital

Hvidovre, 2650, Denmark

RECRUITING

Department of Anesthesia and intensive care medicine, Kolding Hospital

Kolding, 6000, Denmark

RECRUITING

Department of Anesthesia, Zealand University Hospital

Køge, 4600, Denmark

RECRUITING

Anesthesiology (ICU), Zealand University Hospital, Nykøbing Falster

Nykøbing Falster, 4800, Denmark

NOT YET RECRUITING

Department of Anesthesiology and Intensive Care, Odense University Hospital

Odense, 5000, Denmark

RECRUITING

Operation og Intensiv, Regional Hospital Randers

Randers, 8930, Denmark

RECRUITING

Intensive care, Slagelse Hospital

Slagelse, 4200, Denmark

RECRUITING

Department. of Anesthesiology and Intensive Care Medicine

Svendborg, 5700, Denmark

RECRUITING

Department of Anaesthesiology and Intensive Care, Regional Hospital Viborg

Viborg, 8800, Denmark

RECRUITING

Related Links

MeSH Terms

Conditions

Critical Illness

Interventions

AlbuminsHeparin, Low-Molecular-Weight

Condition Hierarchy (Ancestors)

Disease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

ProteinsAmino Acids, Peptides, and ProteinsHeparinGlycosaminoglycansPolysaccharidesCarbohydrates

Study Officials

  • Anders Perner, Professor

    Copenhagen University Hospital - Rigshospitalet, Department of Intensive Care

    STUDY CHAIR
  • Anders Granholm, MD

    Copenhagen University Hospital - Rigshospitalet, Department of Intensive Care

    PRINCIPAL INVESTIGATOR
  • Morten H Moeller, Professor

    Copenhagen University Hospital - Rigshospitalet, Department of Intensive Care

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Anders Perner, Professor

CONTACT

Morten H Moeller, Professor

CONTACT

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
NONE
Masking Details
Domains may be open-label or blinded (masked). Outcome assessment of health-related quality of life and cognitive function will always be blinded.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Randomised, embedded, multifactorial, adaptive, primarily Bayesian, domain-based platform trial.
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Professor, senior staff specialist

Study Record Dates

First Submitted

October 25, 2024

First Posted

October 31, 2024

Study Start

June 26, 2025

Primary Completion (Estimated)

December 1, 2035

Study Completion (Estimated)

December 1, 2035

Last Updated

March 19, 2026

Record last verified: 2026-02

Data Sharing

IPD Sharing
Will share

An anonymised version of the final dataset (without personal, identifiable information, with timestamps replaced by relative time differences with respect to the time of randomisation, and other measures as deemed relevant) in each domain may be shared with other researchers following a reasonable request (i.e., a research proposal outlining the objectives, methodologies, and plans for data usage) and subsequent approval by the platform and domain management committees. Any sharing of data that is not considered anonymised will be after the necessary approvals; alternatively, aggregation, scrambling, or synthetic datasets (i.e., datasets with similar structure and attempts to preserve the overall relationships between variables as the original dataset) may be shared.

Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
Time Frame
For each domain, data will generally only be shared after a grace period of at least 9 months following initial publication of results based on the data. Approved researchers will sign appropriate agreements to ensure compliance with the approved purpose and ethical and eventual legal requirements.
Access Criteria
Described in the core protocol which will be available at www.incept.dk once the trial has been approved.
More information

Locations