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Oral Anticoagulation After Stroke With Prior ICH in Subjects With AF (OASIS-AF)

20. mai 2026 oppdatert av: Min Lou, Second Affiliated Hospital, School of Medicine, Zhejiang University

A Prospective, Multicenter, Randomized Controlled Trial of Anticoagulation Therapy After Ischemic Stroke in Patients With Previous Intracerebral Hemorrhage and Atrial Fibrillation

This prospective, multicenter, randomized controlled trial aims to evaluate the efficacy and safety of initiating direct oral anticoagulants (DOACs) in patients with a history of spontaneous intracerebral hemorrhage (ICH) and non-valvular atrial fibrillation (AF) who have recently suffered an acute ischemic stroke. Existing evidence regarding the optimal antithrombotic strategy for this specific high-risk "double-jeopardy" population remains largely undefined. Eligible participants will be randomized in a 1:1 ratio to either receive oral anticoagulation therapy or a non-anticoagulation standard of care. The primary objective is to assess the incidence of a composite endpoint consisting of recurrent ischemic stroke and recurrent ICH over a 12-month follow-up period.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

852

Fase

  • Fase 4

Kontakter og plasseringer

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

Studiekontakt

  • Navn: Min Lou, PhD, MD
  • Telefonnummer: 8613958007213
  • E-post: lm99@zju.edu.cn

Studer Kontakt Backup

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

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  1. Age ≥ 18 years.
  2. Diagnosis of acute ischemic stroke, with no evidence of hemorrhagic transformation confirmed by acute neuroimaging (MRI and CT).
  3. Documented history of spontaneous intracerebral hemorrhage (ICH).
  4. Confirmed non-valvular atrial fibrillation (including paroxysmal, persistent, or permanent subtypes).
  5. Provision of written informed consent by the patient or a legally authorized representative.

Exclusion Criteria:

  1. Severe baseline disability, defined as a pre-stroke Modified Rankin Scale (mRS) score > 4.
  2. Intracerebral hemorrhage definitively caused by underlying structural vascular lesions (e.g., AVM, aneurysm) or systemic diseases.
  3. Severe, uncontrolled hypertension refractory to medical therapy.
  4. Severe renal impairment, defined as an estimated Creatinine Clearance (CrCl) < 30 mL/min.
  5. Clinical indications necessitating continuous oral anticoagulation therapy other than atrial fibrillation (e.g., mechanical prosthetic heart valves, deep vein thrombosis, pulmonary embolism).
  6. Documented contraindications to direct oral anticoagulants according to the product summary of characteristics (excluding the previous spontaneous ICH), including but not limited to hypersensitivity, active clinically significant bleeding, high-risk bleeding lesions, or hepatic disease associated with coagulopathy and clinically relevant bleeding risk.
  7. Prior deployment of, or planned procedure for, a left atrial appendage occlusion (LAAO) device.
  8. Women who are pregnant, breastfeeding, or planning to become pregnant during the trial period.
  9. Estimated life expectancy of less than 1 year due to concomitant terminal illness.

Studieplan

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

Hvordan er studiet utformet?

Designdetaljer

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

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Anticoagulation Therapy
Participants in this arm will receive early initiation of direct oral anticoagulants (DOACs) following an individualized clinical assessment. Initiation is contingent upon the exclusion of hemorrhagic transformation via head CT/SWI within 24 hours prior to treatment.
Legemiddel: Direct Oral Anticoagulants (DOACs)
Administration of approved DOACs (e.g., apixaban, rivaroxaban, edoxaban, or dabigatran) at standard stroke prevention dosages.
Aktiv komparator: Non-Anticoagulation Therapy
Participants will not receive oral anticoagulation therapy during the study period. Patients may be prescribed single antiplatelet therapy (e.g., aspirin or clopidogrel) or no antithrombotic therapy, strictly at the discretion of the treating physician based on current clinical guidelines and individual patient risk profiles.
Legemiddel: Antiplatelet Therapy or No Antithrombotic Therapy
Administration of single antiplatelet agents or avoidance of antithrombotic therapy, representing the current variable standard of care.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Incidence of the Composite Endpoint of Recurrent Stroke
Tidsramme: Up to 12 months
Proportion of participants experiencing a recurrent ischemic stroke or a recurrent intracerebral hemorrhage (ICH). Events will be adjudicated by independent, blinded clinical assessors.
Up to 12 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Incidence of Recurrent Ischemic Stroke
Tidsramme: Up to 12 months.
Proportion of participants experiencing a recurrent acute ischemic stroke.
Up to 12 months.
Incidence of Recurrent Intracerebral Hemorrhage (ICH)
Tidsramme: Up to 12 months.
Proportion of participants experiencing a recurrent spontaneous ICH.
Up to 12 months.
Time to First Occurrence of Recurrent Ischemic Stroke
Tidsramme: Up to 12 months
Time interval from randomization to the confirmed diagnosis of a recurrent ischemic stroke.
Up to 12 months
Time to First Occurrence of Recurrent Intracerebral Hemorrhage (ICH)
Tidsramme: Up to 12 months
Time interval from randomization to the confirmed diagnosis of a recurrent ICH.
Up to 12 months
Incidence of Vascular Death
Tidsramme: Up to 12 months
Proportion of participants who die from vascular causes (e.g., fatal stroke, fatal myocardial infarction).
Up to 12 months
All-Cause Mortality Rate
Tidsramme: Up to 12 months
Proportion of participants who die from any cause during the follow-up period.
Up to 12 months
Incidence of Major Bleeding Events
Tidsramme: Up to 12 months
Proportion of participants experiencing a major bleeding event, defined strictly according to the International Society on Thrombosis and Haemostasis (ISTH) criteria.
Up to 12 months
Incidence of Clinically Relevant Non-Major (CRNM) Bleeding
Tidsramme: Up to 12 months
Proportion of participants experiencing bleeding events that do not meet the ISTH criteria for major bleeding but result in medical intervention, hospitalization, or discontinuation of the study drug.
Up to 12 months

Samarbeidspartnere og etterforskere

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

Sponsor

Second Affiliated Hospital, School of Medicine, Zhejiang University

Etterforskere

  • Hovedetterforsker: Min Lou, PhD, MD, Second Affiliated Hospital, School of Medicine, Zhejiang University

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 (Antatt)

1. juni 2026

Primær fullføring (Antatt)

1. juni 2029

Studiet fullført (Antatt)

1. september 2029

Datoer for studieregistrering

Først innsendt

20. mai 2026

Først innsendt som oppfylte QC-kriteriene

20. mai 2026

Først lagt ut (Faktiske)

27. mai 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

27. mai 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

20. mai 2026

Sist bekreftet

1. mai 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • OASIS-AF

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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