CADASIL Clinical Trial
Official title:
Phase II, Randomized, Crossover, Single Blind, Safety Trial of DABIGATRAN Versus ASA for Preventing Ischaemic Brain Lesions in Patients Affected by CADASIL
This study is a Phase II, randomized, crossover trial designed to compare one fixed dose of dabigatran with open-label use of ASA in patients affected by CADASIL; the study is a safety trial, and the primary objective is to assess that dabigatran is not less safe than ASA in subjects with CADASIL.
The primary endpoint is the number of microbleeds, as measured by MRI, at 90 days of follow
up.
The study is based on the hypothesis that drugs inhibitor of the thrombin is more effective
than ASA in preventing vessel obstruction. The rationale behind the study is based on the
assumption that: a) the formation of microthrombi is relevant to the clinical expression of
the CADASIL disease, and b) thrombin inhibitors are more effective than antiplatelet drugs
in preventing lesions by microvessel obstruction.
Eligible patients will be randomized into one of the 2 treatment groups:
1. One week wash-out (W1), Dabigatran one tablet 100mg twice a day for 12 weeks, a second
one week wash-out (W2), treatment with ASA one tablet of 100mg/day once a day for 12
weeks;
2. The same scheme repeated with reversed sequence No initial wash-out week will be
required for patients in group 2 already treated with ASA.
Clinical and instrumental evaluations will be carried out during the first (W1) and second
wash-out weeks (W2), and at the end of the study (during the week that follows the second
treatment regimen (W3). Each evaluation will consist of physical examination, blood tests
and MRI.
Safety is evaluated on the basis of brain microbleeds and severe haemorrhages.
;
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Crossover Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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