- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning 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
Studieöversikt
Status
Intervention / Behandling
Detaljerad beskrivning
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.
Studietyp
Inskrivning (Beräknad)
Fas
- Fas 2
Kontakter och platser
Studiekontakt
- Namn: Rasmus H Dahl
- Telefonnummer: 0045 35456491
- E-post: rasmus.holmboe.dahl@regionh.dk
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Beskrivning
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
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Fyrdubbla
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: 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-jämförare: 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.
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Headache Severity
Tidsram: 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
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Headache relief
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
|
Samarbetspartners och utredare
Sponsor
Studieavstämningsdatum
Studera stora datum
Studiestart (Beräknad)
Primärt slutförande (Beräknad)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
- Smärta
- Neurologiska manifestationer
- Cerebrovaskulära störningar
- Hjärnsjukdomar
- Sjukdomar i centrala nervsystemet
- Sjukdomar i nervsystemet
- Kärlsjukdomar
- Hjärt-kärlsjukdomar
- Patologiska processer
- Blödning
- Intrakraniella blödningar
- Patologiska tillstånd, tecken och symtom
- Tecken och symtom
- Huvudvärk
- Subaraknoidal blödning
- Organiska kemikalier
- Anilider
- Amider
- Anilinföreningar
- Aminer
- Acetanilider
- Oorganiska kemikalier
- Klorföreningar
- Natriumföreningar
- Klorider
- Saltsyra
- Lidokain
- Natriumklorid
Andra studie-ID-nummer
- p-2026-22097
- E-24086-04 (Annat bidrag/finansieringsnummer: Copenhagen University Hospital - Rigshospitalet)
- Pilot Research Grant (Annat bidrag/finansieringsnummer: European Society of Minimally Invasive Neurological Therapy)
- 2026-526092-36-00 (Ctis)
Plan för individuella deltagardata (IPD)
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