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The Second Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2)
This study is currently recruiting participants.
Verified by The George Institute, March 2009
First Received: July 14, 2008   Last Updated: March 19, 2009   History of Changes
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

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.

Resource links provided by NLM:


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 Recruiting
Concord, New South Wales, Australia, 2138
Contact: Rosie Portley         rosie.portley@email.cs.nsw.gov.au    
Principal Investigator: Alastair Corbett            
Gosford Hospital Recruiting
Gosford, New South Wales, Australia, 2250
Contact: Margaret Webb         mmwebb@nsccahs.health.nsw.gov.au    
Principal Investigator: Jonathan Sturm            
John Hunter Hospital Recruiting
Newcastle, New South Wales, Australia, 2310
Contact: Andrea Moore     +61 2 4921 1211     Andrea.Moore@mater.health.nsw.gov.au    
Principal Investigator: Christopher Levi            
Royal Prince Alfred Hospital Recruiting
Sydney, New South Wales, Australia, 2050
Contact: Nadia Schweizer, RN     +61-2-9515-5513     nadia.schweizer@email.cs.nsw.gov.au    
Principal Investigator: Craig Anderson            
Australia, Victoria
Royal Melbourne Hospital Recruiting
Melbourne, Victoria, Australia, 3050
Contact: Gillian McCarthy     +61-3-9342-7743     gillian.mccarthy@mh.org.au    
Principal Investigator: Stephen Davis            
Austin Health Recruiting
Melbourne, Victoria, Australia
Contact: Dennis Young     +61 0394962648     dyoung@nsri.org.au    
Principal Investigator: Helen Dewey            
Box Hill Hospital Recruiting
Melbourne, Victoria, Australia, 3128
Contact: Kelly Coughlan     +61-3-8892-3609     kelly.coughlan@easternhealth.org.au    
Principal Investigator: Christopher Bladin            
Alfred Hospital Recruiting
Melbourne, Victoria, Australia, 3181
Principal Investigator: Richard Gerraty, PhD FRACP            
Australia, Western Australia
Sir Charles Gairdner Hospital Recruiting
Perth, Western Australia, Australia, 6009
Contact: David Blacker, MBBS         David.Blacker@health.wa.gov.au    
Contact: Ellen Baker         ellen.baker@health.wa.gov.au    
Principal Investigator: David Blacker            
Austria
Medizinische Universitat Innsbruck Not yet recruiting
Innsbruck, Austria, A-6020
Contact: Erich Schmutzhard     +43 512 23853     erich.schmutzhard@i-med.ac.at    
Principal Investigator: Erich Schmutzhard            
Landesklinikum Donauregion Tulln Not yet recruiting
Tulln, Austria, 3430
Contact: Michael Brainin     43 (0) 2272 601 10721     michael.brainin@donau-uni.ac.at    
Principal Investigator: Michael Brainin            
Allgemeines Krankenhaus Linz Not yet recruiting
Linz, Austria, 4020
Contact: Franz Gruber     + 43 732 7806 6815     franz.gruber@akh.linz.at    
Principal Investigator: Franz Gruber            
Krankenhaus Barmherzige Bruder Not yet recruiting
Vienna, Austria, A-1020
Contact: Wilfried Lang     + 43 (0) 1-21121-3241     wilfried.lang@bbwien.at    
Principal Investigator: Wilfried Lang            
China
Regional Coordinating and Monitoring Centre: Centre for Epidemiological Studies and Clinical Trials, Ruijin Hospital, Shanghai Institute of Hypertension, Shanghai Second Medical University Recruiting
Shanghai, China, 200025
Contact: Jiguang Wang, Professor     +86 21 64662193        
Principal Investigator: Jiguang Wang, Professor            
Regional Coordinating Centre China: The George Institute China Recruiting
Beijing, China, 100088
Contact: Jian Sun     +86 1082800577 ext 205     sjian@george.org    
Principal Investigator: Yinging Huang, PhD            
France
Regional Coordinating Centre Europe: Hospital Lariboisiere Not yet recruiting
Paris, France, 75475
Contact: Serge Merchand     +33 1 4995 6946        
Principal Investigator: Christian Stapf            
India, Andhra Pradesh
Regional Coordinating Centre India: The George Institute India Not yet recruiting
Hyderabad, Andhra Pradesh, India, 500 033
Contact: Hemalata Boyini     +914023558091 ext 205     h.boyini@george.org.in    
Principal Investigator: Subash Kaul            
Sponsors and Collaborators
The George Institute
Investigators
Principal Investigator: Craig Anderson, PhD The George Institute
  More Information

Additional Information:
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: March 19, 2009
ClinicalTrials.gov Identifier: NCT00716079     History of Changes
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:
Vasodilator Agents
Neurotransmitter Agents
Cerebral Hemorrhage
Cerebral Infarction
Adrenergic Agents
Hydralazine
Intracranial Hemorrhages
Brain Diseases
Hemorrhage
Cerebrovascular Disorders
Urapidil
Labetalol
Enalapril
Adrenergic beta-Antagonists
Anti-Arrhythmia Agents
Stroke
Clonidine
Vascular Diseases
Central Nervous System Diseases
Adrenergic alpha-Antagonists
Cardiovascular Agents
Metoprolol
Antihypertensive Agents
Phentolamine
Glycerol
Enalaprilat
Esmolol
Metoprolol succinate
Adrenergic Antagonists
Peripheral Nervous System Agents

Additional relevant MeSH terms:
Vasodilator Agents
Cerebral Hemorrhage
Neurotransmitter Agents
Adrenergic Agents
Molecular Mechanisms of Pharmacological Action
Hydralazine
Physiological Effects of Drugs
Intracranial Hemorrhages
Brain Diseases
Hemorrhage
Cerebrovascular Disorders
Labetalol
Pathologic Processes
Therapeutic Uses
Adrenergic beta-Antagonists
Cardiovascular Diseases
Anti-Arrhythmia Agents
Sympatholytics
Nervous System Diseases
Stroke
Vascular Diseases
Central Nervous System Diseases
Adrenergic alpha-Antagonists
Cardiovascular Agents
Antihypertensive Agents
Metoprolol
Pharmacologic Actions
Phentolamine
Autonomic Agents
Adrenergic Antagonists

ClinicalTrials.gov processed this record on September 10, 2009