Status:

UNKNOWN

Restart TICrH Alpha Pilot Protocol, Restarting DOACs After Traumatic Intracranial Hemorrhage

Lead Sponsor:

University of Texas at Austin

Collaborating Sponsors:

University of Kansas

Conditions:

Anticoagulants; Increased

Eligibility:

All Genders

55+ years

Phase:

PHASE3

Brief Summary

Randomized pilot trial of restarting DOACs at 1 week versus 4 weeks after traumatic intracranial hemorrhage

Detailed Description

Restart TICrH two-center pilot trial will assign patients with anticoagulant-associated traumatic intracranial hemorrhage to restart anticoagulation at 1 week or 4 weeks. Entry into the trial is prima...

Eligibility Criteria

Inclusion

  • Acute traumatic intracranial hemorrhage on anticoagulation for Atrial Fibrillation (AF) or Venous Thromboembolism (VTE)
  • Patient is higher risk for stroke or other thrombotic events as witnessed by having a CHA2DS2-VASc score of \> 3 (at least 3 of the following risk factors: age greater than 65, (age \> 75 counts for 2 points), history of stroke or TIA (2 points), history of heart failure, history of diabetes, history of atherosclerotic vascular disease, female biological sex, history of hypertension)
  • DOAC prescribed at label dose with creatinine clearance adjustments. DOAC at continuation dose, i.e., not initial therapy high doses in the setting of VTE

Exclusion

  • Mechanical Valve or Ventricular Assist Device (VAD)
  • SDH \>8 mm maximum width or any midline shift at any time point or more than one SDH
  • Physician plan to start/restart antiplatelet therapy during trial period
  • Abbreviated Injury Scale other than head \>3
  • Pregnancy
  • Inability to understand need for adherence to study protocol
  • Renal function below DOAC label exclusions
  • Any active pathological bleeding (e.g. no acute blood on most recent CT)
  • Hypersensitivity to drug or other label contraindication
  • Any bleeding that the investigator deems unsafe to restart DOAC at 1 week post injury, or conversely unsafe to hold DOAC to 4 weeks
  • Completion of DOAC therapy expected prior to 60 day primary endpoint, e.g. 3-6 month VTE treatment
  • Concomitant need for strong inducers/inhibitors of p-gp and CYP3A4
  • Low body weight (\<45kg)
  • Inability to swallow

Key Trial Info

Start Date :

July 1 2021

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

July 1 2023

Estimated Enrollment :

100 Patients enrolled

Trial Details

Trial ID

NCT04891861

Start Date

July 1 2021

End Date

July 1 2023

Last Update

May 19 2021

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