- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03640949
Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrest (VAM-IHCA)
Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrest - A Randomized, Double-Blind, Placebo-Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Locations
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Aalborg, Denmark
- Aalborg University Hospital
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Aarhus, Denmark
- Aarhus University Hospital
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Copenhagen, Denmark
- Copenhagen University Hospital - Rigshospitalet
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Hellerup, Denmark
- Copenhagen University Hospital - Gentofte
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Herlev, Denmark
- Copenhagen University Hospital - Herlev
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Horsens, Denmark
- Horsens Regional Hospital
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Køge, Denmark
- Zealand University Hospital - Køge
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Odense, Denmark
- Odense University Hospital
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Randers, Denmark
- Randers Regional Hospital
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Viborg, Denmark
- Viborg Regional Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- In-hospital cardiac arrest
- Age ≥ 18 years
- Received at least one dose of adrenaline during cardiopulmonary resuscitation
Exclusion Criteria:
- Clearly documented "do-not-resuscitate" order prior to the cardiac arrest
- Prior enrollment in the trial
- Invasive mechanical circulatory support at the time of the cardiac arrest
- Known or suspected pregnancy at the time of the cardiac arrest
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Vasopressin and methylprednisolone
The study drugs will consist of 40 mg methylprednisolone (Solu-medrol®, Pfizer) and 20 IU of vasopressin (Empressin®, Amomed Pharma GmbH) given as soon as possible after the first dose of adrenaline.
Additional doses of vasopressin (20 IU) will be administered after each adrenaline dose for a maximum of four doses (80 IU).
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20 IE of vasopressin per dose for a maximum of four doses (80 IU)
40 mg methylprednisolone once
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Placebo Comparator: Placebo
The placebo for vasopressin will consist of 1 mL of 9 mg/mL NaCl ("normal saline") from 2 mL ampules identical to the vasopressin ampules.
The placebo for methylprednisolone will also consist of 1 mL of 9 mg/mL NaCl.
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Placebo
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Return of Spontaneous Circulation
Time Frame: During the cardiac arrest, an average of 20 minutes
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Return of spontaneous circulation is defined as spontaneous circulation with no further need for chest compressions sustained for at least 20 minutes
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During the cardiac arrest, an average of 20 minutes
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants That Survived 30 Days
Time Frame: At 30 days
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At 30 days
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Number of Participants With a Favorable Neurological Outcome at 30 Days
Time Frame: At 30 days
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A favorable neurological outcome will be defined as a cerebral performance category score of 1 or 2. The cerebral performance category score is a 5-point scale assessing neurological/functional outcomes after brain damage with higher scores indicating worse neurological/functional outcomes.
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At 30 days
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Vasopressor-free Days
Time Frame: 7 days
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Vasopressor-free days will be defined as the number of days within the first 7 days after the cardiac arrest where the patient is not receiving vasopressors and is alive.
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7 days
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Invasive Ventilation-free Days
Time Frame: 7 days
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Invasive ventilation-free days will be defined as the number of days within the first 7 days after the cardiac arrest where the patient is not receiving invasive ventilation and is alive.
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7 days
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Sequential Organ Failure Assessment (SOFA) Score at 24, 48 and 72 Hours
Time Frame: 24, 48 and 72 hours
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The SOFA score is a validated and widely used measure of organ failure assessing the respiratory, nervous, cardiovascular, hepatic, coagulation, and renal systems.
We will assess both the cardiovascular sub score as well as the overall SOFA score.
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24, 48 and 72 hours
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Hospital Disposition
Time Frame: At hospital discharge, up to 1 year
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Hospital disposition (e.g.
home, rehabilitation, nursing home, hospice) will be defined at the time of discharge from the initial acute care hospital.
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At hospital discharge, up to 1 year
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Survival
Time Frame: At 90 days, 180 days, and 1 year
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At 90 days, 180 days, and 1 year
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Favorable Neurological Outcome
Time Frame: At 90 days, 180 days, and 1 year
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A favorable neurological outcome will be defined as a cerebral performance category score of 1 or 2. The cerebral performance category score is a 5-point scale assessing neurological/functional outcomes after brain damage with higher scores indicating worse neurological/functional outcomes.
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At 90 days, 180 days, and 1 year
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Modified Rankin Scale (mRS)
Time Frame: At 30 days, 90 days, 180 days, and 1 year
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The mRS is a 7-point scale, ranging from 0 (no symptoms) to 6 (dead), assessing the degree of disability and dependence after a neurological injury such as stroke or cardiac arrest.
A good outcome will be defined as a mRS of 0 to 3 and a poor outcome as 4 to 6.
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At 30 days, 90 days, 180 days, and 1 year
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Glasgow Outcome Scale Extended (GOSE)
Time Frame: At 30 days, 90 days, 180 days, and 1 year
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The GOSE is a 8-point scale that is an extension of the Glasgow Outcomes Scale (which is identical to the CPC, only with inverse scores) where the scores 1, 2 and 3 from the CPC score is divided into two.
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At 30 days, 90 days, 180 days, and 1 year
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Health-related Quality of Life (EQ-5D-5L)
Time Frame: At 30 days, 90 days, 180 days, and 1 year
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The EQ-5D-5L is a well-established measure of health-related quality of life that is quantified as a utility (i.e. a measure of quality of life between 0 and 1).
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At 30 days, 90 days, 180 days, and 1 year
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Lars W Andersen, MD, MPH, PhD, DMSc, Aarhus University Hospital
Publications and helpful links
General Publications
- Andersen LW, Isbye D, Kjaergaard J, Kristensen CM, Darling S, Zwisler ST, Fisker S, Schmidt JC, Kirkegaard H, Grejs AM, Rossau JRG, Larsen JM, Rasmussen BS, Riddersholm S, Iversen K, Schultz M, Nielsen JL, Lofgren B, Lauridsen KG, Solling C, Paelestik K, Kjaergaard AG, Due-Rasmussen D, Folke F, Charlot MG, Jepsen RMHG, Wiberg S, Donnino M, Kurth T, Hoybye M, Sindberg B, Holmberg MJ, Granfeldt A. Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2021 Oct 26;326(16):1586-1594. doi: 10.1001/jama.2021.16628.
- Andersen LW, Sindberg B, Holmberg M, Isbye D, Kjærgaard J, Zwisler ST, Darling S, Larsen JM, Rasmussen BS, Løfgren B, Lauridsen KG, Pælestik KB, Sølling C, Kjærgaard AG, Due-Rasmussen D, Folke F, Charlot MG, Iversen K, Schultz M, Wiberg S, Jepsen RMHG, Kurth T, Donnino M, Kirkegaard H, Granfeldt A. Vasopressin and methylprednisolone for in-hospital cardiac arrest - Protocol for a randomized, double-blind, placebo-controlled trial. Resusc Plus. 2021 Jan 30;5:100081. doi: 10.1016/j.resplu.2021.100081. eCollection 2021 Mar.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Heart Diseases
- Cardiovascular Diseases
- Heart Arrest
- Physiological Effects of Drugs
- Autonomic Agents
- Peripheral Nervous System Agents
- Anti-Inflammatory Agents
- Antiemetics
- Gastrointestinal Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Neuroprotective Agents
- Protective Agents
- Natriuretic Agents
- Hemostatics
- Coagulants
- Vasoconstrictor Agents
- Antidiuretic Agents
- Methylprednisolone
- Vasopressins
- Arginine Vasopressin
Other Study ID Numbers
- 00001
- 2017-004773-13 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Six months after the publication of the last results, all de-identified individual patient data will be made available for data sharing. Procedures, including re-coding of key variables, will be put in place to allow for complete de-identification of the data. Data will be completely anonymized according to Danish law.
All relevant trial-related documents, including the protocol, data dictionary, and the main statistical code, will be shared along with the data. There will be no predetermined end date for the data sharing.
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- Study Protocol
- Statistical Analysis Plan (SAP)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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