APEX-STROKE EAGLE Domain (EAGLE) (EAGLE)
2026年8月24日 更新者：Fudan University
Early Surgical Bundle for Intracerebral Hemorrhage (EAGLE) Domain of the APEX-STROKE Adaptive Platform Trial
In this domain of APEX-STROKE, participants with acute spontaneous supratentorial intracerebral haemorrhage (ICH) who meet the domain-specific eligibility criteria will be randomised to either an early surgical bundle or guideline-based standard care.
Intervention: Early minimally invasive surgery (MIS) shall be initiated within 8 hours of symptom onset; intensive systolic blood pressure control (target range: 130-140 mmHg) shall be achieved within 1 hour post-randomization and maintained for 72 hours post-randomization; tranexamic acid (TXA) hemostatic therapy: A 1-g loading dose shall be intravenously infused over 10 minutes, followed by an 8-hour continuous intravenous infusion of a 1-g maintenance dose; the entire regimen must be initiated within 30 minutes post-randomization.
Control condition: All patient management shall strictly adhere to local institutional guidelines for intracerebral hemorrhage (ICH) diagnosis and treatment; MIS is recommended to be prohibited within 12 hours of symptom onset (except for emergency life-saving surgery); blood pressure management shall be conducted in accordance with local guidelines; the use of TXA is not recommended.
調査の概要
状態
まだ募集していません
研究の種類
介入
入学 (推定)
878
段階
- フェーズ 3
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
いいえ
説明
Inclusion Criteria:
- Age ≥ 18 years;
- Confirmed diagnosis of spontaneous supratentorial intracerebral hemorrhage (ICH) via cerebral imaging;
- Randomization completed within 6 hours of symptom onset (or last known normal state), with the ability to initiate MIS within 8 hours of ICH onset;
- Hematoma volume ranging from 20 to 80 mL;
- National Institutes of Health Stroke Scale (NIHSS) score ≥ 8;
- Glasgow Coma Scale (GCS) score ≥ 8;
- Provision of written informed consent (or signed by an authorized representative).
Exclusion Criteria:
- Secondary causes of hemorrhage (e.g., structural abnormalities including arteriovenous malformations, cerebral aneurysms, tumors, trauma) or hemorrhagic transformation of acute ischemic stroke;
- Isolated intraventricular hemorrhage, or brainstem/cerebellar hemorrhage;
- Severe chronic kidney disease or liver failure;
- High risk of mortality within 7 days, or poor adherence to study treatment or follow-up;
- Severe comorbidities (e.g., cancer, chronic obstructive pulmonary disease, heart failure, significant pre-stroke disability [modified Rankin Scale (mRS) score 3-5]) that may confound outcome assessment;
- Other conditions judged by the investigator to be unsuitable for MIS (e.g., brain herniation, etc.);
- Definite indications or contraindications for antihypertensive therapy of different intensities;
- Specific contraindications to any component of the planned antihypertensive medications (e.g., patients with allergy or hypersensitivity to any ingredient);
- Patients with contraindications to tranexamic acid (TXA), including: those allergic or hypersensitive to TXA or its excipients, patients with active thrombotic disorders, individuals with hereditary or acquired thrombophilia, patients with subarachnoid hemorrhage, and those with upper urinary tract bleeding complicated by gross hematuria, etc.;
- Patients known at enrollment to be receiving therapeutic anticoagulation with warfarin or low-molecular-weight heparin (users of direct oral anticoagulants are eligible for inclusion and not excluded).
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的：Experimental: Early Surgical Bundle
Participants in this arm receive an early surgical bundle consisting of minimally invasive surgery (MIS), intensive blood pressure management, and tranexamic acid (TXA) haemostatic therapy, in addition to guideline-based standard care for acute spontaneous supratentorial intracerebral haemorrhage.
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アクティブコンパレータ：Active Comparator: Guideline-Based Standard Care
Participants in this arm receive guideline-based standard care for acute spontaneous supratentorial intracerebral haemorrhage.
Clinical assessment, investigations, monitoring, blood pressure management, surgical decisions, and supportive treatment are determined by the treating clinical team according to local institutional guidelines.
TXA should be avoided.
If surgery is required, it should generally be initiated ≥12 hours after ICH symptom onset unless emergency life-saving surgery is clinically necessary.
Surgery is not recommended for participants with a haematoma volume of 20-30 mL.
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Guideline-based standard care for acute intracerebral haemorrhage is provided according to local institutional guidelines.
Treatment decisions, including monitoring, blood pressure management, neurosurgical intervention, vasoactive support, mechanical ventilation, fluid therapy, and other supportive care, are determined by the treating clinical team.
TXA should be avoided.
If surgery is clinically required, it should generally be initiated ≥12 hours after ICH symptom onset unless emergency life-saving surgery is necessary.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Utility-Weighted Modified Rankin Scale (UW-mRS) Score at 6 Months
時間枠：180 days
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Functional outcome will be assessed using the utility-weighted modified Rankin Scale (UW-mRS) by a trained central assessor blinded to treatment allocation.
The UW-mRS incorporates the functional health states represented by the modified Rankin Scale into a utility-weighted measure of overall functional outcome.
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180 days
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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National Institutes of Health Stroke Scale (NIHSS) Score
時間枠：24 hours after randomization, 7 days after randomization or earlier at hospital discharge
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Neurological impairment will be assessed using the National Institutes of Health Stroke Scale (NIHSS).
Higher scores indicate greater neurological impairment.
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24 hours after randomization, 7 days after randomization or earlier at hospital discharge
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Rebleeding
時間枠：Within 7 days after randomization or earlier at hospital discharge
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The occurrence of rebleeding will be assessed during the early post-randomization period.
The outcome will be reported as the number and proportion of participants experiencing a rebleeding event.
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Within 7 days after randomization or earlier at hospital discharge
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Poor Functional Outcome
時間枠：180 days
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Poor functional outcome will be defined as a modified Rankin Scale (mRS) score of 3-6.
The outcome will be reported as the number and proportion of participants with mRS scores of 3-6.
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180 days
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Mortality
時間枠：180 days
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Mortality will be assessed as the number and proportion of participants who have died from any cause during follow-up.
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180 days
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Disability
時間枠：180 days
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Disability will be defined as a modified Rankin Scale (mRS) score of 3-5 and will be reported as the number and proportion of participants meeting this criterion.
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180 days
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Health-Related Quality of Life Assessed by EQ-5D-5L
時間枠：180 days
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Health-related quality of life will be assessed using the EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L).
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180 days
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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (推定)
2026年9月1日
一次修了 (推定)
2029年6月30日
研究の完了 (推定)
2030年2月28日
試験登録日
最初に提出
2026年8月24日
QC基準を満たした最初の提出物
2026年8月24日
最初の投稿 (実際)
2026年8月27日
学習記録の更新
投稿された最後の更新 (実際)
2026年8月27日
QC基準を満たした最後の更新が送信されました
2026年8月24日
最終確認日
2026年8月1日
詳しくは
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