Overview
Restart TICrH Alpha Pilot Protocol, Restarting DOACs After Traumatic Intracranial Hemorrhage
Status:
Not yet recruiting
Not yet recruiting
Trial end date:
2023-07-01
2023-07-01
Target enrollment:
0
0
Participant gender:
All
All
Summary
Randomized pilot trial of restarting DOACs at 1 week versus 4 weeks after traumatic intracranial hemorrhagePhase:
Phase 3Accepts Healthy Volunteers?
NoDetails
Lead Sponsor:
University of Texas at AustinCollaborator:
University of KansasTreatments:
Apixaban
Dabigatran
Edoxaban
Rivaroxaban
Criteria
Inclusion Criteria:1. Acute traumatic intracranial hemorrhage on anticoagulation for Atrial Fibrillation
(AF) or Venous Thromboembolism (VTE)
2. 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)
3. 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 Criteria:
1. Mechanical Valve or Ventricular Assist Device (VAD)
2. SDH >8 mm maximum width or any midline shift at any time point or more than one SDH
3. Physician plan to start/restart antiplatelet therapy during trial period
4. Abbreviated Injury Scale other than head >3
5. Pregnancy
6. Inability to understand need for adherence to study protocol
7. Renal function below DOAC label exclusions
8. Any active pathological bleeding (e.g. no acute blood on most recent CT)
9. Hypersensitivity to drug or other label contraindication
10. Any bleeding that the investigator deems unsafe to restart DOAC at 1 week post injury,
or conversely unsafe to hold DOAC to 4 weeks
11. Completion of DOAC therapy expected prior to 60 day primary endpoint, e.g. 3-6 month
VTE treatment
12. Concomitant need for strong inducers/inhibitors of p-gp and CYP3A4
13. Low body weight (<45kg)
14. Inability to swallow