Desmopressin for reversal of Antiplatelet drugs in Stroke due to Haemorrhage (DASH) : protocol for a phase II double-blind randomised controlled feasibility trial

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ..

INTRODUCTION: Intracerebral haemorrhage (ICH) can be devastating and is a common cause of death and disability worldwide. Pre-ICH antiplatelet drug use is associated with a 27% relative increase in 1 month case fatality compared with patients not using antithrombotic drugs. We aim to assess the feasibility of conducting a randomised controlled testing the safety and efficacy of desmopressin for patients with antiplatelet-associated ICH.

METHODS AND ANALYSIS: We aim to include 50 patients within 24 hours of spontaneous ICH onset, associated with oral antiplatelet drug(s) use in at least the preceding 7 days. Patients will be randomised (1:1) to receive intravenous desmopressin 20 µg in 50 mL sodium chloride 0.9% infused over 20 min or matching placebo. We will mask participants, relatives and outcome assessors to treatment allocation. Feasibility outcomes include proportion of patients approached being randomised, number of patients receiving allocated treatment, rate of recruitment and adherence to treatment and follow-up. Secondary outcomes include change in ICH volume at 24 hours; hyponatraemia at 24 hours, length of hospital stay, discharge destination, early death less than 28 days, death or dependency at day 90, death up to day 90, serious adverse events (including thromboembolic events) up to day 90; disability (Barthel index, day 90), quality of life (EuroQol 5D (EQ-5D), day 90), cognition (telephone mini-mental state examination day 90) and health economic assessment (EQ-5D).

ETHICS AND DISSEMINATION: The Desmopressin for reversal of Antiplatelet drugs in Stroke due to Haemorrhage (DASH) trial received ethical approval from the East Midlands-Nottingham 2 research ethics committee (18/EM/0184). The DASH trial is funded by National Institute for Health and Care Research RfPB grant: PB-PG-0816-20011. Trial results will be published in a peer reviewed academic journal and disseminated through academic conferences and through patient stroke support groups. Reporting will be in compliance with Consolidated Standards of Reporting Trials recommendations.

TRIAL REGISTRATION NUMBERS: NCT03696121; ISRCTN67038373; EudraCT 2018-001904-12.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:10

Enthalten in:

BMJ open - 10(2020), 11 vom: 10. Nov., Seite e037555

Sprache:

Englisch

Beteiligte Personen:

Desborough, Michael J R [VerfasserIn]
Al-Shahi Salman, Rustam [VerfasserIn]
Stanworth, Simon J [VerfasserIn]
Havard, Diane [VerfasserIn]
Brennan, Paul M [VerfasserIn]
Dineen, Robert A [VerfasserIn]
Coats, Timothy J [VerfasserIn]
Hepburn, Trish [VerfasserIn]
Bath, Philip M [VerfasserIn]
Sprigg, Nikola [VerfasserIn]

Links:

Volltext

Themen:

Anticoagulation
Bleeding disorders & coagulopathies
Clinical Trial Protocol
Clinical trials
Deamino Arginine Vasopressin
ENR1LLB0FP
Journal Article
Platelet Aggregation Inhibitors
Research Support, Non-U.S. Gov't
Stroke
Stroke medicine

Anmerkungen:

Date Completed 14.05.2021

Date Revised 20.03.2024

published: Electronic

ClinicalTrials.gov: NCT03696121

ISRCTN: ISRCTN67038373

EudraCT: 2018-001904-12

Citation Status MEDLINE

doi:

10.1136/bmjopen-2020-037555

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM31740590X