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This is an open-label, dose-escalation study on the safety, tolerability and preliminary efficacy for preventing stroke-associated pneumonia of propranolol in patients with intracerebral hemorrhage. Propranolol is administered via intravenous pump continuously for 7 days.
The accelerated titration (ATD) incorporated with Bayesian Optimal Interval design (BOIN) will be used to assess the DLT, safety and tolerability. Eligible patients will be enrolled in the ascending dose until MTD is established.The total number of patients is estimated to be approximately 30 patients for dose escalation, but the final total number of patients will depend upon the number of dose cohorts to reach MTD and patient number at each dose level. The preliminary efficacy of continuous intravenous infusion of propranolol for preventing stroke-associated pneumonia (SAP) in patients with severe intracerebral hemorrhage will be evaluated by analyzing the incidence and timing of SAP within 7 days of onset. Throughout the study period, all subjects receiving the investigational drug will undergo lymphocyte subset analysis and abdominal CT scans (to measure splenic volume) to exploratorily assess the impact of intravenous propranolol infusion on the immune function of these patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Propranolol administered via intravenous pump for successive 7 days. | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intravenous Pump-Delivered Propranolol | Drug | During the dose escalation phase, the proposed five dose levels of intravenous pump infusion of propranolol hydrochloride injection are as follows:
|
| Measure | Description | Time Frame |
|---|---|---|
| Maximum tolerated Dose (MTD) | Determine MTD of intravenous pump-delivered propranolol in patients with intracerebral hemorrhage | up to 7 days |
| Adverse events assessed according to NCI-CTCAE V6.0 | Evaluate the safety of intravenous pump-delivered propranolol in patients with intracerebral hemorrhage | up to 7 days |
| Dose limiting toxicities (DLT) | Evaluate the tolerability of intravenous pump-delivered propranolol in patients with intracerebral hemorrhage | up to 7 days |
| Measure | Description | Time Frame |
|---|---|---|
| The incidence of SAP within 7 days post-onset. | Incidence of stroke-associated pneumonia within 7 days after onset of ICH | up to 7 days |
| Time to first diagnosis of SAP after onset. | Time to first diagnosis of SAP after onset of ICH |
| Measure | Description | Time Frame |
|---|---|---|
| Change in immunology function | Use the flow cytometry to measure the change of ratio and number of CD4+、CD8+、NK 、B cells at baseline, 3 days, 7 days | up to 7 days |
| Spleen volume | Spleen volume calculated based on Abdominal CT. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yan Qu, M.D. | Contact | +86-18629074363 | yanqu0123@icloud.com | |
| Shunnan Ge, M.D. | Contact | +86-18165295569 | gesn8561@163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Neurosurgery , Tangdu Hospital, Fourth Military Medical University | Xi'an | Shaanxi | 710038 | China |
The study protocol,statistical analysis plan(SAP),informed consent form(ICF),clinical study report(CSR),analytic code will be shared with other researchers.
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|
| up to 7 days |
| up to 7 days |
| ID | Term |
|---|---|
| D002543 | Cerebral 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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