Antithrombotic treatment after stroke due to intracerebral haemorrhage.
Alexia Cochrane, Chen Chen, Jacqueline Stephen...
https://pubmed.ncbi.nlm.nih.gov/36700520/Actively Recruiting
Led by Yale University · Updated on 2026-05-08
700
Participants Needed
187
Research Sites
N/A
Total Duration
Researchers are evaluating the use of apixaban compared to aspirin to prevent stroke or death in patients who have had a recent intracerebral hemorrhage ICH and also have atrial fibrillation AF. This phase III randomized, double-blinded trial aims to determine if apixaban is superior in preventing any type of stroke or death, as well as if it leads to better functional recovery measured by the modified Rankin Scale. The study will enroll 700 patients and follow them for 12 to 36 months to assess these outcomes. Participants will be randomly assigned to receive either apixaban or aspirin. Apixaban dosing is typically 5 mg twice daily, with a reduced dose of 2.5 mg twice daily for those meeting specific criteria such as older age, lower body weight, or certain medication use. Aspirin is given once daily at a dose of 81 mg. The study includes a treatment period after recent ICH, with careful monitoring for safety and efficacy. During the study, participants will undergo regular assessments including evaluation of stroke occurrence, death, and changes in functional status using the modified Rankin Scale. Safety and adherence will be monitored throughout the follow-up period, which ranges from 12 months up to 3 years. The research team will collect data to understand the benefits and risks of apixaban versus aspirin in this patient population.
CONDITIONS
Anticoagulation in ICH Survivors for Stroke Prevention and Recovery
K
Kevin N Sheth, MD
H
Hooman Kamel, MD
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Yale University
Lead Sponsor
National Institute of Neurological Disorders and Stroke (NINDS)
Collaborating Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Apixaban (Factor Xa inhibitor) | Aspirin (Antiplatelet) |
|---|---|---|
| What it is | Apixaban is an oral anticoagulant that blocks Factor Xa to reduce blood clot formation. | Aspirin is an oral antiplatelet medication that reduces blood clot formation by inhibiting platelet aggregation. |
| Role in the trial | Investigational intervention in this randomized parallel trial. | Active comparator in the randomized trial. |
| Primary use | Being evaluated for the prevention of stroke and improvement of recovery after intracerebral hemorrhage in patients with atrial fibrillation. | Being compared for the prevention of stroke and improvement of recovery after intracerebral hemorrhage in patients with atrial fibrillation. |
| How it is given or performed | Apixaban is taken orally by mouth at the dose assigned in the study. | Aspirin is taken orally by mouth following the study protocol. |
| Evidence status | Ongoing randomized clinical trial; published evidence for use of direct oral anticoagulants (DOACs) like apixaban in patients with recent ICH and atrial fibrillation remains limited, and further high-quality evidence is being sought. | Ongoing randomized clinical trial; published evidence does not establish aspirin as a standard of care for stroke prevention in ICH survivors with atrial fibrillation and notes concerns about bleeding risk. |
| Important limitations | The safety and effectiveness of apixaban for stroke prevention in ICH survivors with atrial fibrillation are not yet established, and concerns remain about bleeding risk and uncertainty in optimal management. The study is limited by the absence of published randomized outcome data for this indication as of now. | The use of aspirin in ICH survivors with atrial fibrillation is also not established; there are significant concerns about bleeding risk and a lack of high-quality randomized data. This arm is a comparator rather than representing proven standard care. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Up to 3 years
Participants receive either Apixaban or Aspirin to prevent stroke and improve recovery after intracerebral hemorrhage.
Regular visits throughout treatment duration
Duration - Up to 3 years total follow-up from enrollment
Participants are monitored for stroke occurrence, death, and changes in recovery status after treatment ends.
Periodic visits during follow-up
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
PREVENTION
Number of Arms
2
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Alexia Cochrane, Chen Chen, Jacqueline Stephen...
https://pubmed.ncbi.nlm.nih.gov/36700520/Yale University
Lead Sponsor
National Institute of Neurological Disorders and Stroke (NINDS)
Collaborating Sponsor