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| ID | Type | Description | Link |
|---|---|---|---|
| 2017-005159-10 | EudraCT Number |
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| Name | Class |
|---|---|
| NeuroScios GmbH | UNKNOWN |
| Data Magik Limited | UNKNOWN |
| Pharm-Analyt Labor GmbH | UNKNOWN |
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This study of NicaPlant® is conducted in patients who have a subarachnoid haemorrhage. Patients will be randomized in two treatment groups. Both groups will receive the standard of care and the investigational group will receive in addition NicaPlant®. NicaPlant® is tested to reduce the long-term complications of aneurysmal subarachnoid haemorrhage (aSAH).
This is a safety, tolerability, efficacy and pharmacokinetic study of NicaPlant® in subarachnoid haemorrhage patients involving two treatment groups. Both treatment groups will receive standard of care and patients randomised to the investigational group will receive in addition NicaPlant® .
NicaPlant® is a nicardipine modified-release formulation. It is presented in the form of a rod-shaped implant with a 4 mg nicardipine load. Following aneurysm clip ligation, 10 NicaPlant® implants will be placed into the basal cisterns in direct contact with the exposed cerebral blood vessel walls.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NicaPlant® | Experimental | 10 NicaPlant® implants (total 40 mg nicardipine) will be placed after clip ligation into the basal cisterns in direct contact with the exposed cerebral blood vessel walls. In addition patients will receive standard of care for aneurysmal subarachnoid haemorrhage patients according to the treatment guidelines. |
|
| Control | Other | Standard of care for aneurysmal subarachnoid haemorrhage patients according to the treatment guidelines. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nicardipine | Drug | 10 NicaPlant® implants releasing 4 mg nicardipine each. |
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| Measure | Description | Time Frame |
|---|---|---|
| Incidence of moderate to severe cerebral angiographic vasospasm assessed by digital subtraction angiography | Fishers Exact test | day 8 ± 1 after aneurysm rupture |
| Safety by adverse event recording | Descriptive summary | trough study completion, an average of 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of new cerebral infarcts on computer tomography (CT) of the brain versus post-intervention CT scan | Fishers exact test | up to day 14 ± 1 after aneurysm rupture |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of vasospasm-related morbidity/mortality | Fishers exact test | within 21 days post aneurysm rupture |
| Pharmacokinetic profile of NicaPlant® in plasma | AUC for multiple plasma samples |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Claudius Thomé, Prof.Dr. | Universitätsklinik Innsbruck, Universitätsklinik für Neurochirurgie | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universitätsklinik Innsbruck, Universitätsklinik für Neurochirurgie | Innsbruck | 6020 | Austria | |||
| Kepler Universitätsklinikum, Universitätsklinik für Neurochirurgie |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39158893 | Derived | Wessels L, Wolf S, Adage T, Breitenbach J, Thome C, Kerschbaumer J, Bendszus M, Gmeiner M, Gruber A, Mielke D, Rohde V, Wostrack M, Meyer B, Gempt J, Bavinzski G, Hirschmann D, Vajkoczy P, Hecht N. Localized Nicardipine Release Implants for Prevention of Vasospasm After Aneurysmal Subarachnoid Hemorrhage: A Randomized Clinical Trial. JAMA Neurol. 2024 Oct 1;81(10):1060-1065. doi: 10.1001/jamaneurol.2024.2564. |
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The clinical trial is defined as a single-blind study. For ethical reasons, no placebo implants will be used and therefore the surgeon cannot be blinded. All investigators/surgeons who have not been involved in the operation of a patient will remain blinded for this particular patient.
| Standard of care | Other | Both arms receive the usual standard of care. |
|
| within 21 days post aneurysm rupture or within hospitalisation if shorter |
| Nicardipine levels in cerebrospinal fluid (CSF) (only in patients provided with an external ventricular drain (EVD) at time of CSF removal for medical reasons) | Average concentration (Cav) for single CSF samples if sufficient CSF data is obtained. | within 21 days post aneurysm rupture or within hospitalisation if shorter |
| Length of hospital stay | ANOVA | week 52 ± 2 after aneurysm rupture |
| Modified Rankin Scale | Cochran-Mantel-Haenzel (CMH) test (with modified ridits) minimum value: 0, maximum value: 6, higher scores mean a worse outcome | week 12 ± 1 after aneurysm rupture |
| Modified Rankin Scale | Cochran-Mantel-Haenzel (CMH) test (with modified ridits) minimum value: 0, maximum value: 6, higher scores mean a worse outcome | week 52 ± 2 after aneurysm rupture |
| Glasgow Outcome Scale Extended | Cochran-Mantel-Haenzel (CMH) test (with modified ridits) minimum value: 1, maximum value: 8, higher scores mean a better outcome | week 12 ± 1 after aneurysm rupture |
| Glasgow Outcome Scale Extended | Cochran-Mantel-Haenzel (CMH) test (with modified ridits) minimum value: 1, maximum value: 8, higher scores mean a better outcome | week 52 ± 2 after aneurysm rupture |
| Montreal Cognitive Assessment | ANOVA minimum value: 0, maximum value: 30, higher scores mean a better outcome | week 12 ± 1 after aneurysm rupture |
| Montreal Cognitive Assessment | ANOVA minimum value: 0, maximum value: 30, higher scores mean a better outcome | week 52 ± 2 after aneurysm rupture |
| EQ-5D-5L | ANOVA | week 12 ± 1 after aneurysm rupture |
| EQ-5D-5L | ANOVA | week 52 ± 2 after aneurysm rupture |
| SF36 | ANOVA | week 12 ± 1 after aneurysm rupture |
| SF36 | ANOVA | week 52 ± 2 after aneurysm rupture |
| Linz |
| 4020 |
| Austria |
| Medizinische Universität Wien, Universitätsklinik für Neurochirurgie | Vienna | 1090 | Austria |
| Charité Universitätsmedizin Berlin, Klinik für Neurochirurgie mit Arbeitsbereich pädiatrische Neurochirurgie | Berlin | 10117 | Germany |
| Universitätsklinikum Göttingen, Neurochirurgische Klinik | Göttingen | 37075 | Germany |
| Klinikum Rechts der Isar, Neurochirurgische Klinik und Poliklinik | Munich | 81675 | Germany |
| ID | Term |
|---|---|
| D013345 | Subarachnoid Hemorrhage |
| ID | Term |
|---|---|
| D020300 | Intracranial Hemorrhages |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D009529 | Nicardipine |
| D059039 | Standard of Care |
| ID | Term |
|---|---|
| D004095 | Dihydropyridines |
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D019984 | Quality Indicators, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |
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