Safety Study of Nicardipine to Treat Cerebral Vasospasm

Status Terminated

Clinical Trial Summary

The purpose of this study is to determine if intrathecal nicardipine is safe for the treatment of cerebral vasospasm.

Clinical Trial Description

Subarachnoid hemorrhage accounts for approximately 5% of all strokes and affects 30,000 Americans per year. Poor outcome from aneurysmal subarachnoid hemorrhage (SAH) occurs in 50 to 75% of patients, and this is attributed to secondary ischemia in approximately 30% of patients. This delayed cerebral ischemia has been attributed to the anatomic narrowing of arteries in the cerebral vasculature which occurs following SAH.

Because of this relationship between cerebral vasospasm, cerebral ischemia, and poor outcome, there has been significant effort to establish treatments that decrease the incidence of vasospasm after SAH. Currently, medications and hemodynamic maneuvers are used as standard of care for the treatment of vasospasm and to improve outcome after SAH.

The calcium channel blocker, nimodipine, is one of the few treatments for vasospasm that has been shown to be of proven benefit. Nicardipine is another calcium channel blocker that has been evaluated in several studies via an intravenous administration route. These studies did show significant improvements in symptomatic and angiographic vasospasm, although a benefit in outcome was not seen. However, the intravenous administration of nicardipine was associated with significant systemic side effects that may have affected outcome including hypotension, pulmonary edema, and azotemia.

The administration of nicardipine via an intrathecal route avoids the systemic complications associated with intravenous dosing since the direct cerebrospinal fluid dosing is much lower. The result is that the systemic concentration will remain low avoiding systemic side effects, and central nervous system concentration will remain high. We propose that this difference may improve outcomes while minimizing complication related effects on patient outcomes. ;

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT01810302
Study type	Interventional
Source	University of Florida
Contact
Status	Terminated
Phase	Phase 2
Start date	August 2013
Completion date	January 2014

View Details

See also
Status	Clinical Trial	Phase
Completed	`NCT02275949` - Acupuncture for Cerebral Vasospasm After Subarachnoid Hemorrhage	N/A
Completed	`NCT02389634` - Identification of Novel Molecular Markers for Vasospasm
Completed	`NCT00962546` - Computed Tomographic (CT) Perfusion and CT Angiography as Screening Tools for Vasospasm Following Subarachnoid Hemorrhage	N/A
Not yet recruiting	`NCT04512859` - Stellate Ganglion Block in Preventing Cerebral Vasospasm Secondary to Subarachnoid Hemorrhage	N/A
Completed	`NCT01024972` - Safety Study of Dantrolene in Subarachnoid Hemorrhage	Phase 1/Phase 2
Completed	`NCT00692744` - Quality of Life in Elderly After Aneurysmal Subarachnoid Hemorrhage (SAH)	N/A
Completed	`NCT04208477` - "The Effect of Stellate Ganglion Block in Severe Brain Injury"	N/A
Recruiting	`NCT06303349` - Predictive Model for the Occurrence of Cerebral Vasospasm Complicating Subarachnoid Haemorrhage by Combined Analysis of the Kinetics of a Panel of Biomarkers.	N/A
Recruiting	`NCT02129413` - Safety Study of Carotid Body Neurostimulation to Treat Cerebral Vasospasm	N/A
Terminated	`NCT00487461` - Use of Simvastatin for the Prevention of Vasospasm in Aneurysmal Subarachnoid Hemorrhage	N/A
Terminated	`NCT00582868` - Use of Brain Oxygen Tension Level and Cleaved-tau Protein to Detect Vasospasm After SAH	N/A
Withdrawn	`NCT01878136` - Effect of Intraventricular tPA Following Aneurysmal Subarachnoid Hemorrhage	Phase 1/Phase 2
Withdrawn	`NCT01091870` - Sildenafil for Prevention of Cerebral Vasospasm	Phase 2
Completed	`NCT03214705` - Role of CT Perfusion in Predicting Poor Outcome After Subarachnoid Hemorrhage
Recruiting	`NCT05150002` - Cervical Spinal Cord Stimulation in Patients With Cerebral Vasospasm After Subarachnoid Haemorrhage: VasoStim Study	N/A
Completed	`NCT01187420` - Bilateral Bispectral Index (BIS) Study	N/A
Enrolling by invitation	`NCT05230134` - Cervical Sympathetic Block in Patients With Cerebral Vasospasm	N/A
Withdrawn	`NCT02426827` - Cervical Spinal Cord Stimulation in Cerebral Vasospasm	N/A
Withdrawn	`NCT00871065` - Safety Study of Sildenafil in Treatment of Cerebral Aneurysm Vasospasm	Phase 2
Recruiting	`NCT04691271` - Stellate Ganglion Block and Cerebral Vasospasm	N/A

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.