- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT07816159
MMA Infusion of Lidocaine for Treatment of Headache in Patients With Aneurysmal SAH (MIL-SAH)
Middle Meningeal Artery Infusion of Lidocaine for Treatment of Headache in Patients With Aneurysmal Subarachnoid Hemorrhage
Studieoversikt
Status
Intervensjon / Behandling
Detaljert beskrivelse
The MIL-SAH trial is a multicenter, randomized, double-blind, placebo-controlled clinical trial evaluating whether middle meningeal artery (MMA) infusion of lidocaine reduces headache severity in patients with aneurysmal subarachnoid hemorrhage (SAH). Adult patients with SAH undergoing endovascular aneurysm treatment are randomized to receive either bilateral MMA lidocaine infusion or placebo immediately after successful aneurysm securement.
SAH-related headaches are frequently severe, persistent, and difficult to control with current analgesic strategies, which often rely on opioids. Preliminary case series have suggested that MMA lidocaine infusion may reduce headache severity with few adverse effects, but randomized clinical trials to support this is currently lacking. This trial aims to provide robust data on the efficacy and safety of this novel treatment approach.
Studietype
Registrering (Antatt)
Fase
- Fase 2
Kontakter og plasseringer
Studiekontakt
- Navn: Rasmus H Dahl
- Telefonnummer: 0045 35456491
- E-post: rasmus.holmboe.dahl@regionh.dk
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Beskrivelse
Inclusion criteria
- Age ≥ 18 years
- Imaging showing a SAH and intracranial aneurysm
- Undergo endovascular therapy within 72 hours*
- Glasgow coma scale (GCS) score of 14-15
Maximum headache severity of NRS score ≥ 4 at a time > 1 hour after ictus or the ad-ministration of opioids due to headache
Exclusion criteria
- The patient is unable to understand information provided in the national language or English
- Known allergies to amide-type local anesthetics or iodinated contrast media
- Pregnancy or lactation
- Severe hepatic impairment
- History of epilepsy
- History of chronic opioid use
- Renal impairment with eGFR < 30 mL/min/1.73m2
- Current treatment with class III antiarrhythmics (e.g. amiodarone)
- Atrioventricular block of II and III degree
- Unsuccessful endovascular aneurysm securement or procedural complications
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Firemannsrom
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: MMA lidocaine
The participants will receive 50 mg of lidocaine in each middle meningeal artery
|
Participants will receive lidocaine hydrochloride at a dose of 50 mg per side (10 mg/mL; 5 mL).
The infusion is delivered into each MMA over 5 minutes by manual injection, resulting in a total injection time of approximately 10 minutes and a total lidocaine hydrochloride dose of 100 mg.
The trial intervention is performed only during the endovascular treatment session.
There is no repeated dosing of trial medication.
|
|
Placebo komparator: MMA isotonic saline
The participants will receive isotonic saline in each middle meningeal artery
|
Participants will receive 5 mL of isotonic saline per side.
The infusion is delivered into each MMA over 5 minutes by manual injection, resulting in a total injection time of approximately 10 minutes.
The trial intervention is performed only during the endovascular treatment session.
There is no repeated dosing of trial medication.
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Headache Severity
Tidsramme: From 0 to 72 hours postprocedure
|
Daily maximum headache severity over the first 72 hours following the trial intervention
|
From 0 to 72 hours postprocedure
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Headache relief
Tidsramme: From baseline to 2 hours postprocedure
|
Proportion of participants with headache relief (none to mild headache, NRS≤3) at 2 hours following the trial intervention
|
From baseline to 2 hours postprocedure
|
|
Opioid consumption
Tidsramme: From 0-72 hours postprocedure
|
Total opioid consumption (oral morphine equivalents) during the first 72 hours following the trial intervention
|
From 0-72 hours postprocedure
|
|
Patient global assessment
Tidsramme: From 0 to 72 hours postprocedure
|
Patient global assessment (PGA) score at 72 hours following the trial intervention.
Participants will be asked to respond to the question, "Overall, how do you feel about your level of headache control since the treatment?"
using a 5-point scale (poor, fair, good, very good, or excellent).
|
From 0 to 72 hours postprocedure
|
|
Adverse Events Related to Intraarterial Lidocaine Injection
Tidsramme: From 0 to 24 hours postprocedure
|
Proportion of participants with new onset of facial paresis, facial numbness, diplopia, blurry vision, or dizziness during the first 24 hours following the trial intervention
|
From 0 to 24 hours postprocedure
|
Samarbeidspartnere og etterforskere
Sponsor
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
- Smerte
- Nevrologiske manifestasjoner
- Cerebrovaskulære lidelser
- Hjernesykdommer
- Sykdommer i sentralnervesystemet
- Sykdommer i nervesystemet
- Vaskulære sykdommer
- Kardiovaskulære sykdommer
- Patologiske prosesser
- Blødning
- Intrakranielle blødninger
- Patologiske tilstander, tegn og symptomer
- Tegn og symptomer
- Hodepine
- Hjernehinneblødning
- Organiske kjemikalier
- Anilider
- Amides
- Anilinforbindelser
- Aminer
- Acetanilider
- Uorganiske kjemikalier
- Klorforbindelser
- Natriumforbindelser
- Klorider
- Saltsyre
- Lidokain
- Natriumklorid
Andre studie-ID-numre
- p-2026-22097
- E-24086-04 (Annet stipend/finansieringsnummer: Copenhagen University Hospital - Rigshospitalet)
- Pilot Research Grant (Annet stipend/finansieringsnummer: European Society of Minimally Invasive Neurological Therapy)
- 2026-526092-36-00 (Ctis)
Plan for individuelle deltakerdata (IPD)
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