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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04797156
Other study ID # GCO 19-1137
Secondary ID
Status Recruiting
Phase Early Phase 1
First received
Last updated
Start date March 3, 2021
Est. completion date December 2024

Study information

Verified date November 2023
Source Icahn School of Medicine at Mount Sinai
Contact Daniel Amor, MD
Phone (973) 897-8540
Email daniel.amor@mountsinai.org
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is a randomized study. The purpose of this study is to evaluate the effect of tranexamic acid in patients undergoing multilevel spine surgery. 75 patients undergoing multi-level spine surgery will be enrolled at Mount Sinai West. Study participation will last from the time of pre-operative evaluation to the time of discharge from hospital. Specifically, the study team will compare tranexamic acid given only intravenously vs. given both topically and intravenously vs. given only intravenously but at a higher dosage. The study team hypothesizes that patient who received combined topical and intravenous TXA (low dose) have similar or decreased overall blood loss postoperatively compared to patient who received high or low dose intravenous TXA alone.


Description:

Prospective triple-blinded randomized control trial. The surgeon will provide study information (protocol, consent, general information) to patients in the surgeon's office. Recruitment will be done through a coordination of the operating schedule and the surgeon's office. Patients presenting for preoperative visits at the surgeon's office or the preoperative joint clinic will be approached. On the day of the surgery, the subject will meet the research team in the holding area. The team will finalize participation and ask the subject about the signed consent forms and answer any additional questions. All patients will be provided with copies of the IRB protocol and consent if they wish to have it. Copy of the consent form will be sent in a secured email to the potential subject. The email will be secured by entering in [SECURE] in the e-mail subject line. Once recruited blinding assessments will be done by the study team. Patients will be assigned randomly using a computer-generated table of numbers to one of the three groups: 1) High Dose Intravenous TXA (hTXA group), 2) Low Dose Intravenous TXA (lTXA group), or 3) Combined Intravenous and Topical TXA group (cTXA group). Surgical team will perform the required spine procedure. Study personnel will make the medication which will be labelled as study drug for surgical and anesthesia team to give during the procedure. Patients assigned to hTXA group will receive 50mg/kg IV TXA loading dose with a 5mg/kg/hr maintenance dose, and normal saline poured over 5 minutes at the wound prior to closure. Patients assigned to lTXA group will receive 20mg/kg IV TXA loading dose with a 5mg/kg/hr maintenance dose, and normal saline poured over 5 minutes at the wound prior to closure. Patients assigned to cTXA group will received 20mg/kg V TXA loading dose with a 5mg/kg/hr maintenance dose, and 2g topical TXA poured over 5 minutes at the would prior to closure. Otherwise, the patient, surgeon, and anesthesiologist in the case will be blinded.


Recruitment information / eligibility

Status Recruiting
Enrollment 65
Est. completion date December 2024
Est. primary completion date November 2024
Accepts healthy volunteers No
Gender All
Age group 18 Years to 80 Years
Eligibility Inclusion Criteria: - Adults 18-80 years old - Undergo major multilevel spine surgery (2-8 levels) - Male or female Exclusion Criteria: - ASA class V - Urgent or emergent surgery, - Morbid obesity - Patients with known coagulopathy disorder, hx of thromboembolic event <1 year, renal insufficiency, hepatic dysfunction, serious cardiac disease - Patients with known allergy to TXA or receiving antiplatelet and/or anticoagulant drugs - Religious or other belief that limit blood transfusion, - Surgery duration more than 6 hours - Patient refusal or inability to consent

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
High Dose Tranexamic acid
50mg/kg IV TXA
Low Dose Tranexamic acid
20mg/kg IV TXA
Tranexamic acid Topical
2g topical TXA
Normal saline
Normal saline poured on wound

Locations

Country Name City State
United States Mount Sinai West Hospital New York New York

Sponsors (1)

Lead Sponsor Collaborator
Icahn School of Medicine at Mount Sinai

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change in Hematocrit level The amount of post-operative blood loss during the first 24, 48 and 72 hours in patients undergoing multilevel spine surgery. Specifically, the hematocrit number difference between baseline and post-operative day 1, 2 and 3. Baseline and Post-operative day 1, 2 and 3
Secondary Post-operative drain output The amount of post-operative drain output (ml) during the first 24, 48 and 72 hours in patients undergoing multilevel spine surgery. Post-operative day 1, 2 and 3
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