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The Second Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2)
This study is not yet open for participant recruitment.
Verified by The George Institute, July 2008
Sponsored by: The George Institute
Information provided by: The George Institute
ClinicalTrials.gov Identifier: NCT00716079
  Purpose

The purpose of this academic lead study is to determine if a treatment strategy of early intensive blood pressure (BP) lowering compared to conservative BP lowering policy in patients with elevated blood pressure within 6 hours of acute intracerebral haemorrhage (ICH) improves the outcome of death and disability at 3 months after onset.


Condition Intervention
Intracerebral Hemorrhage
Stroke
Hypertension
Clinical Trial
Other: Blood pressure management policies

MedlinePlus related topics: High Blood Pressure
Drug Information available for: Metoprolol Metoprolol fumarate Metoprolol succinate Metoprolol Tartrate Clonidine Glycerol Enalapril Enalapril maleate Enalaprilat Phentolamine Phentolamine mesylate Clonidine hydrochloride Hydralazine Hydralazine hydrochloride Nicardipine Nicardipine hydrochloride Labetalol Dilevalol Labetalol hydrochloride Esmolol Asl 8052 Urapidil
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study
Official Title: An International Randomised Controlled Trial to Establish the Effects of Early Intensive Blood Pressure Lowering in Patients With Intracerebral Haemorrhage.

Further study details as provided by The George Institute:

Primary Outcome Measures:
  • A composite of death or dependency, with dependency being defined by a score of 3 to 5 on the modified Rankin Scale (mRS) [ Time Frame: 90 days ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • death and dependency in patients treated <4 hours; death; dependency; HRQoL; physical function; recurrent vascular events; days of hospitalisation; permanent residential care [ Time Frame: 90 days ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 2800
Study Start Date: September 2008
Estimated Study Completion Date: December 2011
Estimated Primary Completion Date: December 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Intensive
Intensive Blood pressure (BP) lowering therapy is given via an intravenous drip for 24 hours. The target is to reach a systolic BP <140mmHg within 1 hour.
Other: Blood pressure management policies
The trial is an assessment of BP lowering management strategies, using routinely available drugs. There is some flexibility in the use of particular BP lowering agents to achieve BP targets.
Conservative
Patients will receive management of BP that is based on a standard guideline, as published by the American Heart Association (AHA). The attending clinician may consider commencing BP treatment if the systolic level is greater than 180 mmHg, however and the first line treatment will be oral (including nasogastric if required) and/or transdermal routes. Should control of systolic BP not be achieved via these routes, intravenous treatment may be started until the target systolic BP of 180 mmHg is achieved.
Other: Blood pressure management policies
The trial is an assessment of BP lowering management strategies, using routinely available drugs. There is some flexibility in the use of particular BP lowering agents to achieve BP targets.

Detailed Description:

Intracerebral haemorrhage (ICH) is one of the most serious subtypes of stroke, affecting over a million people worldwide each year, most of whom live in Asia. About one third of people with ICH die early after onset and the majority of survivors are left with major long-term disability. Despite the magnitude of the disease burden and cost on healthcare resources, there remains uncertainty about the role of surgery for ICH and no acute medical therapies have been shown to definitely alter outcome in ICH.

The INTERACT2 study follows the recently completed initial pilot study vanguard phase) which established the feasibility of the protocol, safety of early intensive BP lowering, and effects on haematoma expansion within 6 hours of onset of ICH. Having established 'proof-of-concept' that BP lowering may improve outcome by reducing haematoma expansion, INTERACT2 aims to establish the effects of the treatment on major clinical endpoints in patients with ICH recruited from an expanding clinical network around the world.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with CT-confirmed spontaneous Intracerebral Haemorrhage (ICH)
  • Elevated systolic blood pressure (>150mmHg and <220mmHg)
  • Capacity to commence randomly assigned treatment within 6 hours of onset of ICH.
  • Able to be 'actively' treated and admitted to a monitored facility

Exclusion Criteria:

  • Clear indication or contraindication to intensive BP lowering.
  • Evidence ICH secondary to a structural abnormality
  • Use of thrombolytic agent
  • Previous ischaemic stroke within 30 days
  • A very high likelihood that the patient will die within the next 24 hours on the basis of clinical and/or radiological criteria
  • Score of 3-5 on the Glasgow Coma Scale (indicating deep coma)
  • Significant pre-stroke disability or advanced dementia
  • Planned early neurological intervention
  • Participation in another clinical trial.
  • A high likelihood that the patient will not adhere to the study treatment and follow-up regimen.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00716079

Contacts
Contact: Emma Heeley, PhD +61299934561 eheeley@george.org.au

Locations
Australia, New South Wales
Concord Hospital
Concord, New South Wales, Australia, 2138
Gosford Hospital
Gosford, New South Wales, Australia, 2250
John Hunter Hospital
Newcastle, New South Wales, Australia, 2310
Royal Prince Alfred Hospital
Sydney, New South Wales, Australia, 2050
St Vincent's Hospital
Sydney, New South Wales, Australia, 2010
Westmead Hospital
Westmead, New South Wales, Australia, 2145
Australia, Victoria
Alfred Hospital
Melbourne, Victoria, Australia, 3181
Austin Health
Melbourne, Victoria, Australia
Box Hill Hospital
Melbourne, Victoria, Australia, 3128
Monash Medical Centre
Melbourne, Victoria, Australia
Royal Melbourne Hospital
Melbourne, Victoria, Australia, 3050
Australia, Western Australia
Sir Charles Gairdner Hospital
Perth, Western Australia, Australia, 6009
China
Regional Coordinating Centre: Centre for Epidemiological Studies and Clinical Trials, Ruijin Hospital, Shanghai Institute of Hypertension, Shanghai Second Medical University
Shanghai, China, 200025
Hospitals in China c/o The George Institute China
Beijing, China
France
Lariboisiere Hospital
Paris, France, 75475
Sponsors and Collaborators
The George Institute
Investigators
Principal Investigator: Craig Anderson, PhD The George Institute
  More Information

Further information on INTERACT2 is available on the George Institute for International health's website.  This link exits the ClinicalTrials.gov site

Publications:
Responsible Party: The George Institute for International Health ( Porfessor Craig Anderson )
Study ID Numbers: NHMRC-571281
Study First Received: July 14, 2008
Last Updated: July 14, 2008
ClinicalTrials.gov Identifier: NCT00716079  
Health Authority: Australia: National Health and Medical Research Council

Keywords provided by The George Institute:
Cerebral Hemorrhage
Stroke
antihypertensive drugs
blood pressure
disability
clinical trial
outcomes

Study placed in the following topic categories:
Cerebral Hemorrhage
Cerebral Infarction
Hydralazine
Clonidine
Stroke
Vascular Diseases
Central Nervous System Diseases
Intracranial Hemorrhages
Hemorrhage
Brain Diseases
Metoprolol
Cerebrovascular Disorders
Urapidil
Labetalol
Phentolamine
Enalapril
Glycerol
Esmolol
Enalaprilat
Metoprolol succinate
Nicardipine
Hypertension

Additional relevant MeSH terms:
Vasodilator Agents
Sympatholytics
Neurotransmitter Agents
Adrenergic Agents
Molecular Mechanisms of Pharmacological Action
Nervous System Diseases
Physiological Effects of Drugs
Adrenergic alpha-Antagonists
Cardiovascular Agents
Antihypertensive Agents
Pharmacologic Actions
Pathologic Processes
Autonomic Agents
Therapeutic Uses
Adrenergic beta-Antagonists
Cardiovascular Diseases
Adrenergic Antagonists
Peripheral Nervous System Agents
Anti-Arrhythmia Agents

ClinicalTrials.gov processed this record on January 16, 2009