- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT07639892
Antithrombotic Treatment Strategies in Cervical Artery Dissection (TREAT-CAD 2)
Antiplatelet Versus Anticoagulation TREATment Strategies in Cervical Artery Dissection - TREAT-CAD 2 - A Multicenter, Randomized, Two-arm Parallel Group, Open-label, Blinded Endpoint, Pragmatic Trial
The goal of this clinical randomised controlled trial is to compare two treatment strategies - antiplatelet treatment strategy versus anticoagulation treatment strategy - in patients with acute, ischemic Cervical Artery Dissection (CAD). The study population includes patients presenting with any (clinical or imaging) signs of cerebral ischemia due to CAD.
The trial aims to estimate the net effect of antiplatelet versus anticoagulation treatment strategies on the composite primary outcome including recurrent ischemic stroke, major bleeding, or vascular death at 90 days (±2 weeks) after randomization.
Participants will:
- be randomly allocated to antiplatelet treatment strategy or anticoagulation treatment strategy
- receive treatment according to assigned strategy for the study period of 90 days
- be followed up for 90 days (±2 weeks) after randomization
- undergo clinical assessments to monitor for stroke recurrence, bleeding events, and vascular death Participant reported outcomes will be assessed both at 90 days (±2 weeks) and 12 months (± 4 weeks) after enrolment and will also expand to measures of quality of life and mental health outcomes.
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Studientyp
Einschreibung (Geschätzt)
Phase
- Unzutreffend
Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- Written informed consent (according to requirements by national legislation)
Onset/visualization of acute cerebral ischemia (≤ 3 days prior to randomization) attributable to CAD (either)
- CLINICAL ISCHEMIA: onset of acute ischemic stroke (including retinal infarct) or transient ischemic attack (including amaurosis fugax) attributable to CAD OR
- ISCHEMIA WITHOUT CORRESPONDING SYMPTOMS: visualization of acute ischemic lesion on diffusion weighted imaging attributable to CAD
Clinical MRI with suitable sequences for CAD diagnosis
- available OR
- scheduled to be performed before discharge (if not performed before enrolment)
Diagnosis of Cervical Artery Dissection (i.e. extracranial carotid and/or vertebral artery) by MRI/A or CTA based on the presence of the following criteria (at least one)
- Mural hematoma OR
- Long tapering stenosis OR
- Intimal flap OR
- Double lumen OR
- Flame-like occlusion of the dissected artery
Exclusion Criteria:
- Contraindications to either antiplatelets or oral anticoagulation therapy
- Other indication than CAD for full dose oral anticoagulation
- Contraindications for performance of MRI
- Age < 18 years
- Female patients who are either pregnant or breastfeeding (pregnancy testing prior to start of treatment will follow the standard operating procedures of clinical routine at participating sites)
Thrombolysis and/or endovascular treatment (EVT) is/are not considered an exclusion criterion.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Single
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
|
Experimental: Antiplatelet Treatment Strategy
|
Includes aspirin (ASA) or clopidogrel monotherapy or dual antiplatelet therapy (ASA + clopidogrel), at the choice of the treating physician but adhering to latest ESO guideline
|
|
Experimental: Anticoagulation Treatment Strategy
|
Includes vitamin K antagonists (phenprocoumon, acenocoumarol, warfarin) with target INR 2.0-3.0 and heparin/LMWH bridging if needed or DOACs (apixaban, edoxaban, dabigatran, rivaroxaban) - at the choice of the treating physician but adhering to latest ESO guideline
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Net effect of antiplatelet treatment strategy versus anticoagulation treatment strategy
Zeitfenster: From enrollment to day 90 (± 2 weeks)
|
The primary endpoint is a composite of the occurrence of (1) recurrent ischemic stroke, (2) major bleeding (extracranial or intracranial), or (3) vascular death
|
From enrollment to day 90 (± 2 weeks)
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Occurrence of each single component of the primary composite outcome measure
Zeitfenster: From enrollment to day 90 (± 2 weeks)
|
From enrollment to day 90 (± 2 weeks)
|
|
|
- Functional neurological outcome (mRS)
Zeitfenster: From enrollment to day 90 (± 2 weeks)
|
absolute difference and shift in favorable outcome (defined as mRS ≤ 2)
|
From enrollment to day 90 (± 2 weeks)
|
|
All-cause mortality
Zeitfenster: From enrollment to day 90 (± 2 weeks)
|
From enrollment to day 90 (± 2 weeks)
|
|
|
Recurrence of Cervical Artery Dissection
Zeitfenster: From enrollment to day 90 (± 2 weeks)
|
From enrollment to day 90 (± 2 weeks)
|
|
|
Patient-reported outcome measure on global health (PROMIS-10)
Zeitfenster: From enrollment to day 90 (± 2 weeks)
|
From enrollment to day 90 (± 2 weeks)
|
|
|
Health related quality of life (EQ-5D Visual Analog scale)
Zeitfenster: From enrollment to day 90 (± 2 weeks)
|
From enrollment to day 90 (± 2 weeks)
|
Mitarbeiter und Ermittler
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Primärer Abschluss (Geschätzt)
Studienabschluss (Geschätzt)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Andere Studien-ID-Nummern
- 2026-01009
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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