Clinical Trials Logo

Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT06138353
Other study ID # HX-A-2023023
Secondary ID
Status Recruiting
Phase Phase 2/Phase 3
First received
Last updated
Start date January 24, 2024
Est. completion date November 30, 2025

Study information

Verified date March 2024
Source Beijing Tiantan Hospital
Contact Jun Yang, doctoral
Phone 010-18911127316
Email yangjun4780@163.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Aneurysmal subarachnoid hemorrhage (SAH) is a frequent worldwide cause for stroke with a mortality of around 30%. Worldwide, almost 500 000 patients have aneurysmal SAH annually.An incidence of 2-16 cases of spontaneous SAH per 100 000 person-years was reported in a recent meta-analysis . Surgical treatment of aneurysms is essential in the acute phase of aSAH patients, either by surgical clipping or by endovascular embolization. Although there are many factors that influence the prognosis of patients with aSAH, cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) are the main factors contributing to the high mortality rate (30-40% within 30 days) and poor long-term functional prognosis of patients after aSAH. Cerebral vasospasm (CVS) is defined as focal or diffuse temporary narrowing of vessel diameter due to contraction of smooth muscle in the arterial wall, which can be detected by digital subtraction angiography (DSA), transcranial ultrasound Doppler (TCD), magnetic resonance (MR), and CT angiography (CTA) or visualised during intraoperative.The prevalence of CVS after aSAH is 67% , with symptomatic patients (symptomatic vasospasm) in 30-40% of them and leading to ischaemic events in 10-45% of patients. It usually begins 3-4 days after bleeding, peaks at 7-10 days and finally resolves at around 14-21 days. There is no effective treatment to prevent cerebral vasospasm events.Shuxuening Injection is a sterilized aqueous solution made by extraction of Ginkgo biloba. The study aims to clarify the clinical study of the efficacy and safety of Shuxuening Injection (10ml/branch) for the prophylactic of cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage.


Description:

This was a randomized, double-blind, placebo-parallel controlled clinical trial. Patients were randomly divided into 2 groups according to 1:1. Group1: Shuxuening injection treatment group (N1=25): Shuxuening injection (specification: 10ml/branch, Lonch Group Wanrong Pharmaceutical Co., Ltd.), 20 ml (2 branches) + 5% dextrose injection 250 ml, intravenously, once a day, from the first day of postoperative, treatment for 1 course of treatment, a total of 10-14 days; Group2: Placebo control group (N2=25): Shuxuening injection simulant (0.9% sodium chloride injection, specification: 10ml/cartridge, Kunming Yusi Pharmaceutical Co., Ltd.), 20 ml (2 cartridges) + 5% dextrose injection 250 ml, intravenously once a day, from the first day of postoperative, treatment for 1 course of treatment, for a total of 10-14 days; both groups received the basal treatment. Basic treatment included nimodipine (oral nimodipine, 60 mg, 4 hours/dose), oxygen inhalation,blood pressure and cardiac monitoring, fluid balance and blood glucose management, etc., in accordance with the "2023 American Heart Association/American Stroke Association (AHA/ASA) Guidelines for the Management of Patients with Aneurysmal Subarachnoid Haemorrhage". Patients will be classified according to the Hunt-Hess grade, with H-H I-II grade placed in the general ward and III-V grade placed in the intensive care unit(ICU).


Recruitment information / eligibility

Status Recruiting
Enrollment 50
Est. completion date November 30, 2025
Est. primary completion date November 30, 2025
Accepts healthy volunteers No
Gender All
Age group 18 Years to 99 Years
Eligibility Inclusion Criteria: 1. adult patients (> 18 years of age) 2. patients who were diagnosed with aneurysmal subarachnoid hemorrhage 3. the aneurysms were treated by microsurgery clipping or endovascular coiling 4. Time from onset to surgery is less than or equal to 72 hours; 5. no new hemorrhage or new infarction on first postoperative CT; 6. signed informed consent. Exclusion Criteria: 1. mRS >1 before onset 2. history of microsurgery clipping or endovascular coiling 3. anemia (hemoglobin <10g/dL), thrombocytopenia (platelet count <100×10^9/L), or leukopenia (white blood cell count <3×10^9/L) at randomization 4. patients with chronic liver and kidney dysfunction (including those with alanine aminotransferase (ALT) and aliquot aminotransferase (AST) > 3 times the upper limit of normal, and those with blood creatinine (Scr) > 2 times the upper limit of normal) 5. patients suffering from cardiorespiratory insufficiency disease such as heart failure, severe heart disease, respiratory failure 6. allergy to Shuxuening Injection 7. those who have used Shuxuening Injection before enrolled 8. patients with end-stage disease, those with a life expectancy of less than 3 months 9. women who are prepare for pregnancy in 3 months, pregnant or breastfeeding 10. those who are participating or have participated in other clinical trials within the past 1 month 11. patients are unable to comply with this study due to mental illness, cognitive or emotional disorders, etc. or that the investigator think patients inappropriate for this study

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Shuxuening injection or placebo
Shuxuening injection treatment group : Shuxuening injection (specification: 10ml/branch, Lanzhi Group Wanrong Pharmaceutical Co., Ltd.), 20 ml (2 branches) + 5% dextrose injection 250 ml, intravenously, once a day, from the first day of postoperative, treatment for 1 course of treatment, a total of 10-14 days.

Locations

Country Name City State
China Beijing Tiantan Hospital Beijing Beijing

Sponsors (1)

Lead Sponsor Collaborator
Xiaolin Chen, MD

Country where clinical trial is conducted

China, 

References & Publications (9)

Calapai G, Crupi A, Firenzuoli F, Marciano MC, Squadrito F, Inferrera G, Parisi A, Rizzo A, Crisafulli C, Fiore A, Caputi AP. Neuroprotective effects of Ginkgo biloba extract in brain ischemia are mediated by inhibition of nitric oxide synthesis. Life Sci — View Citation

Dankbaar JW, de Rooij NK, Velthuis BK, Frijns CJ, Rinkel GJ, van der Schaaf IC. Diagnosing delayed cerebral ischemia with different CT modalities in patients with subarachnoid hemorrhage with clinical deterioration. Stroke. 2009 Nov;40(11):3493-8. doi: 10 — View Citation

Geraghty JR, Testai FD. Delayed Cerebral Ischemia after Subarachnoid Hemorrhage: Beyond Vasospasm and Towards a Multifactorial Pathophysiology. Curr Atheroscler Rep. 2017 Oct 23;19(12):50. doi: 10.1007/s11883-017-0690-x. — View Citation

Macdonald RL, Schweizer TA. Spontaneous subarachnoid haemorrhage. Lancet. 2017 Feb 11;389(10069):655-666. doi: 10.1016/S0140-6736(16)30668-7. Epub 2016 Sep 13. — View Citation

Macdonald RL. Delayed neurological deterioration after subarachnoid haemorrhage. Nat Rev Neurol. 2014 Jan;10(1):44-58. doi: 10.1038/nrneurol.2013.246. Epub 2013 Dec 10. — View Citation

Mahadevan S, Park Y. Multifaceted therapeutic benefits of Ginkgo biloba L.: chemistry, efficacy, safety, and uses. J Food Sci. 2008 Jan;73(1):R14-9. doi: 10.1111/j.1750-3841.2007.00597.x. — View Citation

Tulsulkar J, Shah ZA. Ginkgo biloba prevents transient global ischemia-induced delayed hippocampal neuronal death through antioxidant and anti-inflammatory mechanism. Neurochem Int. 2013 Jan;62(2):189-97. doi: 10.1016/j.neuint.2012.11.017. Epub 2012 Dec 7 — View Citation

Vergouwen MD, Vermeulen M, van Gijn J, Rinkel GJ, Wijdicks EF, Muizelaar JP, Mendelow AD, Juvela S, Yonas H, Terbrugge KG, Macdonald RL, Diringer MN, Broderick JP, Dreier JP, Roos YB. Definition of delayed cerebral ischemia after aneurysmal subarachnoid h — View Citation

Westermaier T, Jauss A, Eriskat J, Kunze E, Roosen K. Acute vasoconstriction: decrease and recovery of cerebral blood flow after various intensities of experimental subarachnoid hemorrhage in rats. J Neurosurg. 2009 May;110(5):996-1002. doi: 10.3171/2008. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Other modified Rankin scale(mRS) modified Rankin scale(mRS) ranged from a minimum of 0 to a maximum of 5, with higher scores representing a worse outcome. modified Rankin scale(mRS) within 14 days and 90 days
Primary Number of Participants with cerebral vasospasm(CVS) The prevalence of CVS after aSAH is 67% , with symptomatic patients (symptomatic vasospasm) in 30-40% of them and leading to ischemic events in 10-45% of patients. It usually begins 3-4 days after rupture bleeding, peaks at 7-10 days and finally resolves at around 14-21 days. Cerebral vasospasm events within 14 days
Secondary Rate of Delayed Cerebral Ischemic(DCI) Delayed cerebral ischemic events within 14 days Delayed cerebral ischemic events within 14 days
See also
  Status Clinical Trial Phase
Recruiting NCT06032533 - Remote Ischemic Conditioning in Aneurysmal SAH N/A
Completed NCT05131295 - Dapsone Use in Patients With Aneurysmal Subarachnoid Hemorrhage. Phase 3
Recruiting NCT04583163 - Variability in Transcranial Doppler Technique in Neuro-Critical Care Patients
Recruiting NCT06006975 - Early Warning of Delayed Cerebral Ischemia
Terminated NCT02893826 - Safety/Pharmacokinetic Study Comparing Intracisternal EG-1962 to Standard of Care Enteral Nimodipine in Adults With aSAH Phase 1
Unknown status NCT01567449 - Risk Factors for Aneurysm Rebleeding N/A
Recruiting NCT05095857 - The Anesthetic Ketamine as Treatment for Patients With Severe Acute Brain Injury Phase 4
Not yet recruiting NCT04512859 - Stellate Ganglion Block in Preventing Cerebral Vasospasm Secondary to Subarachnoid Hemorrhage N/A
Recruiting NCT05103566 - Safety, Feasibility, and Efficacy of Non-invasive Vagus Nerve Stimulation (nVNS) in the Treatment of Aneurysmal Subarachnoid Hemorrhage N/A
Not yet recruiting NCT04696523 - Effect of Xenon on Brain Injury After Aneurysmal Subarachnoid Hemorrhage Phase 2
Completed NCT04415736 - Artificial Intelligence in Subarachnoid Hemorrhage
Recruiting NCT05925478 - Pterygopalatine Fossa Block in Aneurysmal Subarachnoid Hemorrhage Early Phase 1
Recruiting NCT04649398 - Cerebral Nimodipine Concentrations Following Oral, Intra-venous and Intra-arterial Administration
Recruiting NCT02995928 - Trial of Prophylactic Decompressive Craniectomy for Poor-grade Aneurysmal Subarachnoid Hemorrhage N/A
Recruiting NCT04945603 - Poor Grade Aneurysmal Subarachnoid Hemorrhage Study Group
Active, not recruiting NCT06239142 - Understanding Mental Fatigue After Subarachnoid Hemorrhage
Completed NCT03318783 - Subarachnoid Hemorrhage and Soluble Epoxide Hydrolase Inhibition Trial Phase 1/Phase 2
Terminated NCT05686265 - Cerebral Nitrosative/Oxidative Stress in Aneurysmal Subarachnoid Haemorrhage
Not yet recruiting NCT06359782 - Complement Inhibition: Attacking the Overshooting Inflammation @Fter Subarachnoid Hemorrhage (CIAO@SAH) Phase 2
Not yet recruiting NCT06057155 - Intracranial Pressure and Optic Nerve Sheath Diameter With CLOSED Bundle