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Hodegjeng etter iskemisk slag-trombektomi (HoBIT) (HoBIT)

15. september 2026 oppdatert av: Population Health Research Institute

En pragmatisk, multicentrisk, adaptiv, prospektiv, åpen, blindet endepunkt randomisert klinisk studie som vurderer effekten av hodestilling i seng ved 0 grader kontra 30 grader eller mer på funksjonell bedring etter endovaskulær trombektomi for anterior sirkulasjon storvesselokklusjon hjerneslag.

Endovascular thrombectomy (EVT), also known as clot retrieval, is a procedure that improves recovery for people who suffer a stroke by removing blood clots from large blood vessels in the brain. However, half of the patients undergoing EVT to remove the clot from a brain vessel still face lasting disabilities or even die within three months.

The investigators of the HoBIT trial are trying to find out if the position of the head of bed improves recovery in patients who undergo EVT after suffering from a stroke.

The purpose of this study is to establish the benefit of head of bed positioning at 0-degrees compared with 30-degrees or more after EVT for improving functional outcomes in adults that suffer from a stroke.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

2240

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

  • Navn: Samantha Block, BSc
  • Telefonnummer: 905-521-2100
  • E-post: hobit@phri.ca

Studer Kontakt Backup

  • Navn: Amanda Taylor, BSc
  • Telefonnummer: 905-521-2100
  • E-post: hobit@phri.ca

Studiesteder

    • Ontario
      • Greater Sudbury, Ontario, Canada, P3E5J1
        • Rekruttering
        • Health Sciences North
        • Hovedetterforsker:
          • Aviraj Deshmukh, MD
        • Ta kontakt med:
      • Hamilton, Ontario, Canada, L8L 2X2
        • Rekruttering
        • Hamilton General Hospital
        • Hovedetterforsker:
          • Aristeidis Katsanos, MD
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Age 18 years or older on the date of randomization
  • Endovascular thrombectomy (EVT) for large vessel occlusion (LVO) in the anterior circulation, according to current guidelines and local standards of clinical care. The definition of LVO may include the intracranial segment of the internal carotid artery (ICA), and/ or the M1 segment (proximal, mid, distal) of the middle cerebral artery (M1-MCA), and/ or the proximal M2 segment of the MCA (M2-MCA)
  • Capable of giving signed informed consent either independently, or by a legally authorized representative (LAR), or via a deferred consent process approved by the relevant ethics committee, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.

Exclusion Criteria:

  • Mechanical ventilatory support for acute medical condition prior to procedure (i.e. required for reasons other than procedure)
  • Symptomatic congestive heart failure, chronic obstructive pulmonary disease, or any other medical condition that would make either HoB position inappropriate for patient care in the judgement of the investigator.
  • Any condition, such as but not limited to, agitation/ delirium or severe nausea/ vomiting, that, in the view of the investigator, is expected to significantly impede maintaining the assigned HoB
  • Any condition with life expectancy of less than 3 months
  • Inability to randomize within 1 hour from the end of the EVT

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Annen
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Intervention Arm

Head of bed position of 0-degrees

Flat position with the HoB at 0° elevation for a continuous 24-hour period. Turning to the side (left or right) is permitted, as long as there is no head elevation.

Andre navn:
  • HoB-posisjon på 0 grader
Annen: Control Arm

Head of bed position of 30-degrees or greater

Semi-recumbent position with the HoB to at least 30 degrees for a continuous 24-hour period.

Head and torso must remain elevated at 30 degrees or higher, using the hospital bed's positioning system.

Andre navn:
  • HoB-posisjon på ≥ 30 grader
  • HoB-posisjon på større enn eller lik 30 grader

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Functional disability
Tidsramme: 90±14 days from randomization

Functional disability assessed with the modified Rankin Scale (mRS) score.

Scores:

0 - No symptoms

  1. - No significant difficulty despite symptoms; able to carry out all usual duties and activities
  2. - Slight disability; unable to carry out all previous activities, but able to look after own affairs without assistance
  3. - Moderate disability; requiring some help, but able to walk without assistance
  4. - Moderately severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance
  5. - Severe disability; bedridden, incontinent and requiring constant nursing care and attention
  6. - Dead
90±14 days from randomization

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Absolute difference in NIHSS score
Tidsramme: Between randomization and 36±12 hours from randomization

Absolute difference in the National Institutes of Health Stroke Scale (NIHSS) scores

Scores:

0 - No stroke symptoms 1-4 - Minor stroke 5-15 - Moderate stroke 16-20 - Moderate to severe stroke 21-42 - Severe stroke

Between randomization and 36±12 hours from randomization
Early neurological improvement
Tidsramme: 36±12 hours from randomization, compared with randomization

Early neurological improvement, defined as an absolute decrease of the National Institutes of Health Stroke Scale (NIHSS) score by 4 points or more

Scores:

0 - No stroke symptoms 1-4 - Minor stroke 5-15 - Moderate stroke 16-20 - Moderate to severe stroke 21-42 - Severe stroke

36±12 hours from randomization, compared with randomization
Functional impairment
Tidsramme: Day 7 from randomization or discharge if happens first

Functional impairment assessed with the Modified Rankin Score (mRS)

Scores:

0 - No symptoms

  1. - No significant difficulty despite symptoms; able to carry out all usual duties and activities
  2. - Slight disability; unable to carry out all previous activities, but able to look after own affairs without assistance
  3. - Moderate disability; requiring some help, but able to walk without assistance
  4. - Moderately severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance
  5. - Severe disability; bedridden, incontinent and requiring constant nursing care and attention
  6. - Dead
Day 7 from randomization or discharge if happens first
Functional independence
Tidsramme: Day 7 from randomization or discharge if happens first and 90±14 days from randomization

Functional independence defined as Modified Rankin Score (mRS) of 2 or less

Scores:

0 - No symptoms

  1. - No significant difficulty despite symptoms; able to carry out all usual duties and activities
  2. - Slight disability; unable to carry out all previous activities, but able to look after own affairs without assistance
  3. - Moderate disability; requiring some help, but able to walk without assistance
  4. - Moderately severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance
  5. - Severe disability; bedridden, incontinent and requiring constant nursing care and attention
  6. - Dead
Day 7 from randomization or discharge if happens first and 90±14 days from randomization
Quality of life assessment
Tidsramme: 90±14 days from randomization

Quality of life assessed with the EuroQol 5-Dimension 5-Level (EQ-5D-5L) Scores range from 1 (full health) to 0 (dead), with negative values indicating states that are "worse than dead".

90±14 days from randomization
Intervention adherence
Tidsramme: First 24 hours from randomization

Adherence to the assigned HoB position for 24 hours from randomization, defined as >80% of total time spent in the assigned HoB

First 24 hours from randomization
Total time spent
Tidsramme: First 24 hours from randomization

Total time spent in the assigned HoB position

First 24 hours from randomization
Infarct volume
Tidsramme: 24 +/- 12 hours from randomization and 5-7 days from randomization

Infarct volume on the brain imaging (CT/ MRI) performed as part of standard clinical care

24 +/- 12 hours from randomization and 5-7 days from randomization

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Etterforskere

  • Hovedetterforsker: Aristeidis Katsanos, MD, Population Health Research Institute
  • Hovedetterforsker: Mike Sharma, MD, Population Health Research Institute

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

3. september 2026

Primær fullføring (Antatt)

1. april 2029

Studiet fullført (Antatt)

1. mai 2029

Datoer for studieregistrering

Først innsendt

17. januar 2026

Først innsendt som oppfylte QC-kriteriene

17. januar 2026

Først lagt ut (Faktiske)

26. januar 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

18. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

15. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • HoBIT

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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