Desmopressin for Reversal of Antiplatelet Drugs in Stroke Due to Haemorrhage

• Status: Recruiting
• Trial end date: 2022-01-14
• Target enrollment: 0
• Participant gender: All

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.

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University of Nottingham
• Collaborator: National Institute for Health Research, United Kingdom
• Treatments: Deamino Arginine Vasopressin; Platelet Aggregation Inhibitors

Criteria

Inclusion Criteria:

• 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).

Exclusion Criteria:

• 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.