Recombinant Factor VIIa (rFVIIa) for Hemorrhagic Stroke Trial

Description

The objective of the rFVIIa for Acute Hemorrhagic Stroke Administered at Earliest Time (FASTEST) Trial is to establish the first treatment for acute spontaneous intracerebral hemorrhage (ICH) within a time window and subgroup of patients that is most likely to benefit. The central hypothesis is that rFVIIa, administered within 120 minutes from stroke onset with an identified subgroup of patients most likely to benefit, will improve outcomes at 180 days as measured by the Modified Rankin Score (mRS) and decrease ongoing bleeding as compared to standard therapy.

Conditions

Intracerebral Hemorrhage

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Study Overview

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Study Details

Study overview

The objective of the rFVIIa for Acute Hemorrhagic Stroke Administered at Earliest Time (FASTEST) Trial is to establish the first treatment for acute spontaneous intracerebral hemorrhage (ICH) within a time window and subgroup of patients that is most likely to benefit. The central hypothesis is that rFVIIa, administered within 120 minutes from stroke onset with an identified subgroup of patients most likely to benefit, will improve outcomes at 180 days as measured by the Modified Rankin Score (mRS) and decrease ongoing bleeding as compared to standard therapy.

Recombinant Factor VIIa (rFVIIa) for Acute Hemorrhagic Stroke Administered at Earliest Time (FASTEST) Trial

Recombinant Factor VIIa (rFVIIa) for Hemorrhagic Stroke Trial

Condition
Intracerebral Hemorrhage
Intervention / Treatment

-

Contacts and Locations

Birmingham

University of Alabama Hospital, Birmingham, Alabama, United States, 35233

Phoenix

St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States, 85013

Baldwin Park

Kaiser Permanente Baldwin Park Medical Center, Baldwin Park, California, United States, 91706

Burlingame

Mills Peninsula Medical Center, Burlingame, California, United States, 94010

Downey

Kaiser Permanente Downey Medical Center, Downey, California, United States, 90242

Fontana

Kaiser Permanente Fontana Medical Center, Fontana, California, United States, 92335

Harbor City

Kaiser Permanente South Bay Medical Center, Harbor City, California, United States, 90710

La Jolla

UCSD Health La Jolla, La Jolla, California, United States, 92037

Los Angeles

Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, United States, 90027

Los Angeles

Kaiser Permanente West Los Angeles Medical Center, Los Angeles, California, United States, 90034

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • 1. Patients aged 18-80 years, inclusive
  • 2. Patients with spontaneous ICH
  • 3. Able to treat with study medication (rFVIIa/placebo) within 120 minutes of stroke onset or last known well
  • 4. Efforts to obtain informed consent per EFIC guidelines (U.S.) or adherence to country-specific emergency research informed consent regulations (Canada, Germany, Spain, U.K., Japan)
  • 1. Score of 3 to 7 on the Glasgow Coma Scale
  • 2. Secondary ICH related to known causes (e.g., trauma, aneurysm, arteriovenous malformation (AVM), oral anticoagulant use (vitamin K antagonists or novel oral anticoagulants) within the past 7 days, coagulopathy, etc.)
  • 3. ICH volume \< 2 cc or ≥ 60 cc
  • 4. Blood filling 2/3 or more of one lateral ventricle of the brain, OR, blood filling at least 1/3 of both lateral ventricles.
  • 5. Pre-existing disability (mRS \> 2)
  • 6. Symptomatic thrombotic or vaso-occlusive disease in past 90 days (e.g., cerebral infarction, myocardial infarction, pulmonary embolus, deep vein thrombosis, or unstable angina)
  • 7. Clinical or EKG evidence of ST elevation consistent with acute myocardial ischemia
  • 8. Brainstem location of hemorrhage (patients with cerebellar hemorrhage may be enrolled)
  • 9. Refusal to participate in study by patient, legal representative, or family member
  • 10. Known or suspected thrombocytopenia (unless current platelet count documented above 50,000/μL)
  • 11. Unfractionated heparin use with abnormal PTT
  • 12. Pro-coagulant drugs within 24 hours prior to patient enrollment into the FASTEST trial (example, tranexamic acid or aminocaproic acid)
  • 13. Low-molecular weight heparin use within the previous 24 hours
  • 14. Recent (within 90 days) carotid endarterectomy or coronary or cerebrovascular angioplasty or stenting
  • 15. Advanced or terminal illness or any other condition the investigator feels would pose a significant hazard to the patient if rFVIIa were administered
  • 16. Recent (within 30 days) participation in any investigational drug or device trial or earlier participation in any investigational drug or device trial for which the duration of effect is expected to persist until to the time of FASTEST enrollment
  • 17. Planned withdrawal of care or comfort care measures
  • 18. Patient known or suspected of not being able to comply with trial protocol (e.g., due to alcoholism, drug dependency, or psychological disorder)
  • 19. Known or suspected allergy to trial medication(s), excipients, or related products
  • 20. Contraindications to study medication
  • 21. Previous participation in this trial (previously randomized)
  • 22. Females of childbearing potential who are known to be pregnant or within 12 weeks post-partum and/or lactating at time of enrollment

Ages Eligible for Study

18 Years to 80 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Joseph Broderick, MD,

Joseph Broderick, MD, PRINCIPAL_INVESTIGATOR, University of Cincinnati

Study Record Dates

2028-01-01