Aneurysmal Subarachnoid HemorrhagePhase 3CONSCIOUS-3NCT00940095
Clazosentan in Aneurysmal Subarachnoid Hemorrhage
A Phase 3 study testing Clazosentan 5 m/h and Clazosentan 15 mg/h in people with Aneurysmal Subarachnoid Hemorrhage, run by Idorsia Pharmaceuticals Ltd. at 145 sites in 28 countries.
Trial summary
The aim of this study is to demonstrate that clazosentan, administered as a continuous intravenous infusion at either 5 mg/h or 15 mg/h until Day 14 post aneurysmal subarachnoid hemorrhage (aSAH), reduces the incidence of cerebral vasospasm-related morbidity and all-cause mortality within 6 weeks post-aSAH treated by… Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Aneurysmal Subarachnoid Hemorrhage
- What is being tested?
- Clazosentan 5 m/h and Clazosentan 15 mg/h
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 577 participants
- Where
- 145 sitesin 28 countries
- Study dates
- 1 Jul 2009to 1 Jan 2011
- Phase
- Phase 3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Males and females aged 18 to 75 years (inclusive).
- Patients with a ruptured saccular aneurysm, confirmed by angiography (digital subtraction angiography [DSA] or computed tomography angiography [CTA], investigator's assessment), and which has been successfully* secured by endovascular coiling. The time of aneurysm rupture must be known or possible to estimate with a reasonable degree of certainty.
- World Federation of Neurological Surgeons (WFNS) grade I-IV measured prior to the endovascular coiling procedure, and which does not worsen to grade V post-procedure (based on regular Glasgow Coma Scale [GCS])
- Patients with any thick clot (short axis > or = 4 mm) on baseline CT scan (investigator's assessment).
- Women of childbearing potential must have a negative serum pregnancy test and must use a reliable method of contraception during the 12 weeks following study drug discontinuation.
- Written informed consent to participate in the study must be obtained from the patient or a legal representative prior to initiation of any study-mandated procedure and randomization.
Who cannot join
- Subarachnoid hemorrhage (SAH) due to causes other than saccular aneurysm.
- Giant aneurysms (height or width > or = 25 mm).
- Intraventricular or intracerebral blood, in absence of subarachnoid blood, or or with only a thin clot (short axis < 4 mm)
- Cerebral vasospasm on angiography (investigator's assessment) prior to endovascular coiling (intraprocedural cerebral vasospasm is not an exclusion criterion).
- A major complication during the endovascular coiling procedure, such as massive intracranial bleeding, intracranial thromboembolism, coil migration, aneurysm perforation or rupture, arterial dissection, major arterial occlusion, a large territorial cerebral infarct defined as involving > 1/3 of a vascular territory, or a new major neurological deficit post-procedure (e.g., hemiplegia or aphasia lasting > or = 12 hours post-aneurysm coiling)*.
- Current ruptured aneurysm previously secured (successfully or not) by clipping.
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- Coiling material used, which has not been approved by local health authorities.
- Use of liquid embolism aneurysmal treatment or flow diverting device.
- Several aneurysms among which the ruptured one cannot be identified with certainty and which are not all secured during the coiling procedure.
- No end-of-procedure DSA.
- Another securing procedure planned for any aneurysm between randomization and Week 12 post-aSAH.
- Study drug start >56 hours after the aneurysm rupture.
- Known, at time of screening, that certain follow-up, or protocol-mandated imaging assessments will not be feasible.
- Hypotension (systolic blood pressure < or = 90 mmHg) refractory to treatment.
- Aspiration pneumonia.
- Pulmonary edema or severe cardiac failure requiring inotropic support at time of randomization.
- Any severe or unstable concomitant condition or disease (e.g., known significant neurological deficit, cancer, hematological, coronary disease, psychiatric disorder), which would affect assessment of the safety or efficacy of the study drug (investigator's opinion).
- Significant kidney disease defined by plasma creatinine > or = 2.5 mg/dL (221 micromol/l) and/or liver disease defined by total bilirubin > 2-fold Upper Limit of Normal as measured at local laboratory, and/or known diagnosis or clinical suspicion of liver cirrhosis.
- Infusion of i.v. nimodipine or i.v. nicardipine must have these drugs discontinued at least 4 hours prior to initiation of study treatment.
- Infusion of i.v. fasudil within 24-hour period preceding planned start of study drug initiation.
- Start of statins less than 2 weeks prior to admission must have them discontinued prior to study drug initiation.
- Infusion of cyclosporin A or other calcineurin inhibitors (e.g., tacrolimus), or patients for whom it is known at the time of randomization that these medications will be started during the study drug infusion period.
- Intake of an investigational product including investigational coil material within 28 days prior to randomization or those who have already participated in current study or CONSCIOUS-2 (AC-054-301).
- Unlikely event to comply with protocol (e.g., unable to return for follow-up visits).
- Known hypersensitivity to other endothelin receptor antagonists.26.current alcohol or drug abuse/dependence.
- "Large territorial infarct" refers to infarcts detected during the endovascular coiling procedure or immediately post-procedure (i.e., CT performed for suspicion of cerebral infarct or other complication). This does not imply having to wait 24-48 hours post-procedure to perform the protocol-mandated CT scan in order to randomize a patient. Evaluation for a new major neurological deficit post-procedure implies reversal of sedation and performance of a GCS examination (verbal scores in intubated patients may be extrapolated from the eye-opening and motor scores using predefined values). If a new major neurological deficit does not improve within 12 hours after the coiling procedure, the patient cannot be included.
Trial locations and contacts
145 sites in 28 countries.
145 sites in 28 countries
United States29 sites
Massachusetts General Hospital
Boston, Massachusetts, 02114
Boston Medical Centre
Boston, Massachusetts, 02118
Medical University of South Carolina
Charleston, South Carolina, 29425
Univ. of VA Health System
Charlottesville, Virginia, 22908
Rush University Medical Center
Chicago, Illinois, 60612
University of Illnois
Chicago, Illinois, 60612
University of Cincinnati
Cincinnati, Ohio, 45219
University Hospitals Case Medical Center
Cleveland, Ohio, 44106
University of Texas Southwestern Zale Lipshy Hospital
Dallas, Texas, 75390
Duke University Medical Center
Durham, North Carolina, 27710
Colorado Neurological Institute
Englewood, Colorado, 80110
Glendale Adventist Medical Center
Glendale, California, 91206
Yale Univerity School of Medicine
New Haven, Connecticut, 06510
Columbia University Medical Center
New York, New York, 10032
New York Presbyteruan Hospital - Weill Cornell Medical Centre
New York, New York, 10065
Oklahoma University Health Sciences Center
Oklahoma City, Oklahoma, 73104
Thomas Jefferson University School of Medicine
Philadelphia, Pennsylvania, 19107
Temple University Hospital
Philadelphia, Pennsylvania, 19140
Oregon Health & Science University
Portland, Oregon, 97219
Virginia Commonwealth University Medical Centre
Richmond, Virginia, 23284
Virginia Commonwealth University
Richmond, Virginia, 980631
Mayo Clinic
Rochester, Minnesota, 55905
William Beaumont Hospital
Royal Oak, Michigan, 48073
UCSF Medical Centre
San Francisco, California, 94143
Barnes_Jewish Hospital
St Louis, Missouri, 63110
Stanford Hospital and Clinis
Stanford, California, 94305-5327
State University of New York at Stony Brook
Stony Brook, New York, 11794-8122
University of South Florida
Tampa, Florida, 33606
Capital Health System Inc. d/b/a The Stroke and Cerebrovascular Center of New Jersey
Trenton, New Jersey, 08638
Germany14 sites
Universitatsklinikum Augsburg Clinic for Diagnostic Radiology and Neuroradiology
Augsburg, 86156
Charite Universitatsmedzin Berlin
Berlin, D-13353
Universitatsklinikum Bonn
Bonn, 53105
University of Bonn Medical Center
Bonn, 53105
Klinik imd Poliklinik fur Neurochirurgie
Dresden, 1307
Universitaet Erlangen-Nuerberg Klinik fur Neurologie
Erlangen, 91054
University Hospital of Essen
Essen, 45122
Universitatsklinik Frankfurt, Klinik und Poliklinik f. Neurochirurgie
Frankfurt, 60528
Neuroradiologie der Universitatsklinik Freiburg
Freiburg im Breisgau, D-79106
Universitatsklinikum Hamburg-Eppendorf
Hamburg, 20246
Neurochirurggische Universitatsklinik des Heidelberg
Heidelberg, 69120
Klinik und Poliklinik fur Neurochirurgie
Leipzig, 04103
Thechnical University - Klinikum rechts der Isar
Munich, 81675
University Regensburg
Regensburg, 93053
Canada9 sites
University of Calgary - Foothills Medical Center
Calgary, Alberta, T2N 1M9
University of Alberta Hospital
Edmonton, Alberta, T6G 2B7
QEII Heath Sciences Center - Halifax Infirmary
Halifax, Nova Scotia, B3H 3A7
CHUM Hospital - Notre Dame
Montreal, Quebec, H2L 4M1
Hopital de I'Enfant-Jesus
Québec, G1J 1Z4
Royal University Hospital
Saskatoon, Saskatchewan, S7N 0W8
Hamilton General Hospital
Toronto, Ontario, L8L 2X2
St. Michael's Hospital, University of Toronto
Toronto, Ontario, M5C 3G7
Vancouver Hospital & Health Sciences
Vancouver, British Columbia, V5Z 1M9
Czechia8 sites
Fakultni nemocnice Bmo
Brno, 625 00
Nemocnice Ceske Budejovice
České Budějovice, 370 87
Fakultní nemocnice Ostrava
Ostrava, 169 02
Fakultni nemocnice Ostrava
Ostrava, 708 52
Nemocnice Na Homolce
Prague, 150 30
ÚVN Praha
Prague, 16902
Fakultni nemocnice Homoice
Prague, 500 05
Masarykova nemocnice Usti n. Labem
Ústí nad Labem, 401 13
France8 sites
CHU d'Angers
Angers, 49933
Hopital Pellegrin
Bordeaux, 33076
Hopital neurologique et Neuro-Chirurgical Pierre Wertheimer
Bron, 69677
Hopital Henru Mondor
Créteil, 94010
Hopital General
Dijon, 21033
Hopital de la Timone - CHU de Marseille
Marseille, 13385
Hopital Gui de Chauliac
Montpellier, 34295
Hopital central
Nancy, 54035
Belgium7 sites
UZ Antwerpen
Antwerp, 2650
ULB Erasme
Brussels, 1070
UZ Brussels
Brussels, 1090
UCL Saint-Luc
Brussels, 1200
UZ Brussels
Brussels
UZ Gent
Ghent, 9000
UZ Gasthuisberg
Leuven, 3000
Brazil7 sites
Hospital das Clinicas da UFMG
Belo Horizonte, 30110-934
Hospital de Clinicas da Universidade Federal do Parana
Curitiba, 80060-900
Clinica de Neurologia de
Joinville, 89202-000
Hospital de Clínicas de Niteroí
Niteroí, 24020-090
Hospital Moinhos de Vento
Porto Alegre, 90035-001
Hospital Santa Marcelina
São Paulo, 08270-070
Santa Case de Misericordia de Sobral
Sobral, 62010-550
Australia5 sites
Royal Brisbane & Women's Hosptal
Brisbane, QLD 4029
Royal Prince Alfred Hosptial
Camperdown, NSW 2050
Monash Medical Centre
Clayton, VIC 3168
Gold Coast Hospital
Southport, Queensland, 4215
Princess Alexandra Hospital
Woolloongabba, QLD 4102
Chile5 sites
Hospital Regional de Concepción
Concepción, 4070038
Institute de Neurocirugia
Santiago, 7500691
Hospital Clinico Pontificia Universidad Católica de Chile
Santiago, 8330024
Clinica Davila
Santiago, 8431657
Hospital Carlos Van Buren
Valparaíso, 2352499
Spain5 sites
Hospital Vali d' Hebron
Barcelona, 08035
Hospital Universitari de Bellvitge
Barcelona, 08907
Complejo Hospotalario Virgen de las Nieves-Hospital de Rehabilitacion y Traumatologia
Granada, 18012
Hospital Universitario 12 se Octubre
Madrid, 28041
Hospital de Son Dureta
Palma de Mallorca, 07014
Austria4 sites
Landeskrankenhaus und Medizinische Universitat
Graz, A-8036
Medizinsche Universitat Innsbruck
Innsbruck, 6020
University Fur Neurochirurgie, SALK, Christian Doppler Hospital
Salzburg, 5020
AKH University of Vienna, Medical Univ. Of Neurosurgery
Vienna, 1090
Italy4 sites
Osepedale Maggiore Bellaria
Bologna, 40139
Azienda Ospedaliera di Careggi
Florence, 50141
Azienda Osepedaliera San Giovanni - Addolorata
Rome, 184
Ospedale Maggiore
Verona, 37126
Switzerland4 sites
Kantonsspital Aarau
Aarau, 5001
Universitatsklinik Bern
Bern, 3010
Geneva University Hospital
Geneva, 1211
Universitatsspital Zurich
Zurich, 8091
Argentina3 sites
Hospital Aleman
Buenos Aires, C1118AAT
Clinica De Sol
Buenos Aires, C1425DQI
ENERI
Buenos Aires, C1426ENF
Denmark3 sites
The Neuroscience Center, Copenhagen University Hospital
Copenhagen, 2100
Glostrup Hospital
Glostrup Municipality, 2600
Odense University Hospital
Odense, DK 5000
Hungary3 sites
Borsod-Abauj-Zemplen County Hospital and University Teaching Hospital
Miskolc, Borsod-Abauj Zemplen county
University of Pecs, Faculty of Medicine Neurosurgery Clinic
Pécs, 7623
University of Szeged, Faculty of Medicine
Pécs
India3 sites
Post Graduate Institute of Medical Education and Research
Chandigarh, 160012
CARE Hospital
Hyderabad, 5-4-199
King Edward Memorial Hospital
Pune, 411011
Israel3 sites
Rambam Medical Centre
Haifa, 31096
Hadassah Universtity Medical Center
Jerusalem, 91120
Sheba Medical Centre
Tel HaShomer, 52621
Norway3 sites
Haukeland University Hospital, Helse Bergen HF
Bergen, 5021
Ulleval Univ Hosp
Oslo, 0407
Universitetssykehuset Nord-Norge
Tromsø, N9038
Sweden3 sites
Sahlgrenska University Hospital
Gothenburg, 41345
Linkoping University Hospital
Linköping, 58185
Lund University Hospital
Lund, 22185
Finland2 sites
Helsinki University Central Hospital
Helsinki, Fin-00029 HUS
Tampere University Central Hospital (TAYS)
Tampere, 33520
Hong Kong2 sites
Queen Mary Hospital
Hong Kong
Prince od Wales Hospital
Shatin
Mexico2 sites
Instituto Nacional de Neurologia y Neurocirugia
Mexico City, 14269
Hospital Universitario "Dr. Jose Eleuterio Gonzalez" Universidad Autonoma de Nuevo Leon
Monterrey, 64460
Poland2 sites
Szpital Akademii Medycznej w Gdansku
Gdansk, 80-952
Samodzielny Publiczny Centralny Szpital Kliniczy w Warszawie
Warsaw, 02-097
Singapore2 sites
National University Hospital
Singapore, 119074
National Neuroscience Institute
Singapore, 308433
Slovenia2 sites
University Clinical Centre Ljubljana
Ljubljana, 1525
General Hospital Maribor
Maribor, 2000
Taiwan2 sites
National Taiwan University Hospital
Taipei, 100
Taipei Veterans General Hospital
Taipei, 112
About this study
Official title: A Prospective, Multi-center, Double-blind, Randomized, Placebo-controlled, Parallel-group Study to Assess the Efficacy and Safety of Clazosentan in Reducing Vasospasm-related Morbidity and All-cause Mortality in Adult Patients With Aneurysmal Subarachnoid Hemorrhage Treated by Endovascular Coiling.
The aim of this study is to demonstrate that clazosentan, administered as a continuous intravenous infusion at either 5 mg/h or 15 mg/h until Day 14 post aneurysmal subarachnoid hemorrhage (aSAH), reduces the incidence of cerebral vasospasm-related morbidity and all-cause mortality within 6 weeks post-aSAH treated by endovascular coiling.
The primary endpoint of the study is the occurrence of cerebral vasospasm-related morbidity, and mortality of all-causes within 6 weeks post-aSAH, defined by at least one of the following:
Read more
- Death (all causes).
- New cerebral infarct(s) due to cerebral vasospasm as either the primary or relevant contributing cause, or not adjudicated to be entirely due to causes other than vasospasm.
- Delayed ischemic neurological deficit (DIND) due to cerebral vasospasm as either the primary or relevant contributing cause, or not adjudicated to be entirely due to causes other than vasospasm.
- Administration of a valid rescue therapy in the presence of confirmed cerebral vasospasm on angiography (DSA or CTA).
An independent Critical Events Committee (CEC) will adjudicate whether or not patients meet the primary endpoint and its individual morbidity components.
- Conditions
- Aneurysmal Subarachnoid Hemorrhage
- Being tested
- Clazosentan 5 m/h, Clazosentan 15 mg/h, Placebo
- Keywords
- Subarachnoid, Aneurysmal, surgical clipping, PIVLAZ, vasospasm, cerebral vasospasm, clazosentan, Actelion, Hemorrhage
- Medical subject headings
- Subarachnoid Hemorrhage, Vasospasm, Intracranial, Hemorrhage
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Clazosentan 5 m/hDrug
Also called ACT-108475 (AXV-034343)
Continuous intravenous infusion of clazosentan (5 mg/h)
Clazosentan 15 mg/hDrug
Also called ACT-108475 (AXV-034343)
Continuous intravenous infusion of clazosentan clazosentan (15 mg/h)
PlaceboDrug
Continuous intravenous infusion of placebo-matching clazosentan
| Study group | Role | What they receive |
|---|---|---|
| Clazosentan 5 mg/h | Experimental | Continuous intravenous infusion of clazosentan (5 mg/h) started within 56 hours post-aSAH and scheduled to continue until Day 14 post-aSAH, or at least until Day 10 post-aSAH, for patients discharged before Day 14 Receives: Drug: Clazosentan 5 m/h |
| Clazosentan 15 mg/h | Experimental | Continuous intravenous infusion of clazosentan (15 mg/h) started within 56 hours post-aSAH and scheduled to continue until Day 14 post-aSAH, or at least until Day 10 post-aSAH, for patients discharged before Day 14 Receives: Drug: Clazosentan 15 mg/h |
| Placebo | Placebo comparator | Continuous intravenous infusion of placebo matching clazosentan started within 56 hours post-aSAH and scheduled to continue until Day 14 post-aSAH, or at least until Day 10 post-aSAH, for patients discharged before Day 14 Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Cerebral vasospasm-related morbidity and mortality of all-causes as defined by the protocol
Measured: Within 6 weeks post-aSAH
Secondary outcomes (1)
Glasgow Outcome Scale Extended (GOSE) at Week 12 post-aSAH, dichotomized into good (score > 4) and poor (score ≤ 4) outcome.
Measured: Week 12 post-aSAH
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Jul 2009 (estimated)
- Study start1 Jul 2009
- Primary completion1 Oct 2010
- Study completion1 Jan 2011
Why it stopped: Lack of efficacy data from the Phase 3 clinical study (AC-054-301; CONSCIOUS-2)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Aneurysmal Subarachnoid HemorrhageStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 577 participants (actual)
Sponsor and investigators
- Lead sponsor
- Idorsia Pharmaceuticals Ltd.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Sebastien Roux, MD, Study director, Actelion
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00940095
- Sponsor's protocol ID
- AC-054-302
- Acronym
- CONSCIOUS-3
- Status last verified
- Jul 2018
- First submitted
- 13 Jul 2009
- Last updated
- 9 Jul 2018
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Macdonald RL, Higashida RT, Keller E, Mayer SA, Molyneux A, Raabe A, Vajkoczy P, Wanke I, Bach D, Frey A, Nowbakht P, Roux S, Kassell N. Randomized trial of clazosentan in patients with aneurysmal subarachnoid hemorrhage undergoing endovascular coiling. Stroke. 2012 Jun;43(6):1463-9. doi: 10.1161/STROKEAHA.111.648980. Epub 2012 Mar 8.
PubMed 22403047Mayer SA, Aldrich EF, Bruder N, Hmissi A, Macdonald RL, Viarasilpa T, Marr A, Roux S, Higashida RT. Thick and Diffuse Subarachnoid Blood as a Treatment Effect Modifier of Clazosentan After Subarachnoid Hemorrhage. Stroke. 2019 Oct;50(10):2738-2744. doi: 10.1161/STROKEAHA.119.025682. Epub 2019 Aug 9.
PubMed 31394993
Study at a glance
From the registry record, last updated by the sponsor on 9 Jul 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Prospective, Multi-center, Double-blind, Randomized, Placebo-controlled, Parallel-group Study to Assess the Efficacy and Safety of Clazosentan in Reducing Vasospasm-related Morbidity and All-cause Mortality in Adult Patients With Aneurysmal Subarachnoid Hemorrhage Treated by Endovascular Coiling.
- ClinicalTrials.gov ID
- NCT00940095
- Acronym / sponsor ID
- CONSCIOUS-3 / AC-054-302
- Conditions
- Aneurysmal Subarachnoid Hemorrhage
- Keywords
- Subarachnoid, Aneurysmal, surgical clipping, PIVLAZ, vasospasm, cerebral vasospasm, clazosentan, Actelion
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Lack of efficacy data from the Phase 3 clinical study (AC-054-301; CONSCIOUS-2)
- Enrolment
- 577 participants (actual)
- Lead sponsor
- Idorsia Pharmaceuticals Ltd.Industry (pharma, biotech, devices)
- Study start
- 1 Jul 2009
- Primary completion
- 1 Oct 2010 (actual)
- Study completion
- 1 Jan 2011 (actual)
- First posted
- 15 Jul 2009 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this study is to demonstrate that clazosentan, administered as a continuous intravenous infusion at either 5 mg/h or 15 mg/h until Day 14 post aneurysmal subarachnoid hemorrhage (aSAH), reduces the incidence of cerebral vasospasm-related morbidity and all-cause mortality within 6 weeks post-aSAH treated by endovascular coiling.
The primary endpoint of the study is the occurrence of cerebral vasospasm-related morbidity, and mortality of all-causes within 6 weeks post-aSAH, defined by at least one of the following:
- Death (all causes).
- New cerebral infarct(s) due to cerebral vasospasm as either the primary or relevant contributing cause, or not adjudicated to be entirely due to causes other than vasospasm.
- Delayed ischemic neurological deficit (DIND) due to cerebral vasospasm as either the primary or relevant contributing cause, or not adjudicated to be entirely due to causes other than vasospasm.
- Administration of a valid rescue therapy in the presence of confirmed cerebral vasospasm on angiography (DSA or CTA).
An independent Critical Events Committee (CEC) will adjudicate whether or not patients meet the primary endpoint and its individual morbidity components.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Clazosentan 5 mg/h | Experimental | Drug: Clazosentan 5 m/hContinuous intravenous infusion of clazosentan (5 mg/h) started within 56 hours post-aSAH and scheduled to continue until Day 14 post-aSAH, or at least until Day 10 post-aSAH, for patients discharged before Day 14 |
| Clazosentan 15 mg/h | Experimental | Drug: Clazosentan 15 mg/hContinuous intravenous infusion of clazosentan (15 mg/h) started within 56 hours post-aSAH and scheduled to continue until Day 14 post-aSAH, or at least until Day 10 post-aSAH, for patients discharged before Day 14 |
| Placebo | Placebo comparator | Drug: PlaceboContinuous intravenous infusion of placebo matching clazosentan started within 56 hours post-aSAH and scheduled to continue until Day 14 post-aSAH, or at least until Day 10 post-aSAH, for patients discharged before Day 14 |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Males and females aged 18 to 75 years (inclusive).
- Patients with a ruptured saccular aneurysm, confirmed by angiography (digital subtraction angiography [DSA] or computed tomography angiography [CTA], investigator's assessment), and which has been successfully* secured by endovascular coiling. The time of aneurysm rupture must be known or possible to estimate with a reasonable degree of certainty.
- World Federation of Neurological Surgeons (WFNS) grade I-IV measured prior to the endovascular coiling procedure, and which does not worsen to grade V post-procedure (based on regular Glasgow Coma Scale [GCS])
- Patients with any thick clot (short axis > or = 4 mm) on baseline CT scan (investigator's assessment).
- Women of childbearing potential must have a negative serum pregnancy test and must use a reliable method of contraception during the 12 weeks following study drug discontinuation.
Key exclusion criteria (26 listed)
- Subarachnoid hemorrhage (SAH) due to causes other than saccular aneurysm.
- Giant aneurysms (height or width > or = 25 mm).
- Intraventricular or intracerebral blood, in absence of subarachnoid blood, or or with only a thin clot (short axis < 4 mm)
- Cerebral vasospasm on angiography (investigator's assessment) prior to endovascular coiling (intraprocedural cerebral vasospasm is not an exclusion criterion).
- A major complication during the endovascular coiling procedure, such as massive intracranial bleeding, intracranial thromboembolism, coil migration, aneurysm perforation or rupture, arterial dissection, major arterial occlusion, a large territorial cerebral infarct defined as involving > 1/3 of a vascular territory, or a new major neurological deficit post-procedure (e.g., hemiplegia or aphasia lasting > or = 12 hours post-aneurysm coiling)*.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Clazosentan 5 m/hAlso: ACT-108475 (AXV-034343)Continuous intravenous infusion of clazosentan (5 mg/h) | Drug | Clazosentan 5 mg/h |
| Clazosentan 15 mg/hAlso: ACT-108475 (AXV-034343)Continuous intravenous infusion of clazosentan clazosentan (15 mg/h) | Drug | Clazosentan 15 mg/h |
| PlaceboContinuous intravenous infusion of placebo-matching clazosentan | Drug | Placebo |
Primary outcome
Cerebral vasospasm-related morbidity and mortality of all-causes as defined by the protocol
Time frame: Within 6 weeks post-aSAH
1 secondary outcome
Glasgow Outcome Scale Extended (GOSE) at Week 12 post-aSAH, dichotomized into good (score > 4) and poor (score ≤ 4) outcome.
Time frame: Week 12 post-aSAH
Results and safety
The study was stopped early (reason given: Lack of efficacy data from the Phase 3 clinical study (AC-054-301; CONSCIOUS-2)). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Jul 2018.
- Results publication: PubMed 22403047Macdonald RL, Higashida RT, Keller E, Mayer SA, Molyneux A, Raabe A, Vajkoczy P, Wanke I, Bach D, Frey A, Nowbakht P, Roux S, Kassell N. Randomized trial of clazosentan in patients with aneurysmal subarachnoid hemorrhage undergoing endovascular coiling. Stroke. 2012 Jun;43(6):1463-9. doi: 10.1161/STROKEAHA.111.648980. Epub 2012 Mar 8.
- Derived from this study: PubMed 31394993Mayer SA, Aldrich EF, Bruder N, Hmissi A, Macdonald RL, Viarasilpa T, Marr A, Roux S, Higashida RT. Thick and Diffuse Subarachnoid Blood as a Treatment Effect Modifier of Clazosentan After Subarachnoid Hemorrhage. Stroke. 2019 Oct;50(10):2738-2744. doi: 10.1161/STROKEAHA.119.025682. Epub 2019 Aug 9.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Sebastien Roux, MD study director
Actelion
145 sites in 28 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Clazosentan 5 m/h and Clazosentan 15 mg/h in people with Aneurysmal Subarachnoid Hemorrhage, run by Idorsia Pharmaceuticals Ltd. at 145 sites in 28 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 26 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 9 Jul 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 145 sites in United States, Germany, Canada, Czechia, France and 23 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study was stopped early (reason given: Lack of efficacy data from the Phase 3 clinical study (AC-054-301; CONSCIOUS-2)). Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Cerebral vasospasm-related morbidity and mortality of all-causes as defined by the protocol (time frame: Within 6 weeks post-aSAH). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00940095, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jul 2018.