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Intravenous tranexamic acid for hyperacute primary intracerebral hemorrhage: Protocol for a randomized, placebo-controlled trial

医学 氨甲环酸 脑出血 随机对照试验 安慰剂 麻醉 临床终点 改良兰金量表 优势比 随机化 外科 内科学 格拉斯哥昏迷指数 病理 替代医学 缺血 失血 缺血性中风
作者
Nikola Sprigg,Katie Robson,Philip M. Bath,Robert A. Dineen,Ian Roberts,Thompson Robinson,Christine Roffe,David J. Werring,Rustam Al‐Shahi Salman,Stuart J. Pocock,Lelia Duley,Timothy J. England,David K. Whynes,Alfonso Ciccone,Ann Charlotte Laska,Hanne Christensen,Şerefnur Öztürk,Rónán Collins,Dániel Bereczki,J.J. Egea-Guerrero,Zhe Kang Law,Anna Członkowska,David Seiffge,Maia Beredzie
出处
期刊:International Journal of Stroke [SAGE Publishing]
卷期号:11 (6): 683-694 被引量:41
标识
DOI:10.1177/1747493016641960
摘要

Rationale Outcome after intracerebral hemorrhage remains poor. Tranexamic acid is easy to administer, readily available, inexpensive, and effective in other hemorrhagic conditions. Aim This randomized trial aims to test the hypothesis that intravenous tranexamic acid given within 8 h of spontaneous intracerebral hemorrhage reduces death or dependency. Design Phase III prospective double-blind randomized placebo-controlled trial. Participants within 8 h of spontaneous intracerebral hemorrhage are randomized to receive either intravenous tranexamic acid 1 g 10 min bolus followed by 1 g 8 h infusion, or placebo. Sample size estimates A trial of 2000 participants (300 from start-up phase and 1700 from main phase) will have 90% power to detect an ordinal shift of the modified Rankin Scale with odds ratio 0.79. Study outcomes The primary outcome is death or dependency measured by ordinal shift analysis of the 7 level mRS at day 90. Secondary outcomes are neurological impairment at day 7 and disability, quality of life, cognition, and mood at day 90. Safety outcomes are death, serious adverse events, thromboembolic events, and seizures. Cost outcomes are length of stay in hospital, readmission, and institutionalization. Discussion This pragmatic trial is assessing efficacy of tranexamic acid after spontaneous intracerebral hemorrhage. Recruitment started in 2013; as of 15th January 2016 1355 participants have been enrolled, from 95 centers in seven countries. Recruitment is due to end in 2017. TICH-2 Trial is registered as ISRCTN93732214.
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