Desmopressin for Reversal of Antiplatelet Drugs in Stroke Due to Haemorrhage
Condition: Stroke, Acute
MeSH terms: Stroke; Hemorrhage
Study type: Interventional
Phase: Phase 2

Summary: 
      Haemorrhagic stroke, an emergency caused by bleeding in the brain, often leads to death or
      long-term disability. A quarter of these patients are taking blood-thinning drugs
      (antiplatelet drugs, such as aspirin) because they are at risk of a heart attack or ischaemic
      stroke. Patients taking these drugs are more likely to die or be disabled if they have a
      haemorrhagic stroke. At present, there is no effective treatment for reversing their effects.
      Desmopressin is a drug which may reverse the effects of antiplatelet drugs and stop bleeding.
      The investigators would like to run a large randomised trial to see if Desmopressin can
      reduce the number of people who die or are disabled after haemorrhagic stroke.
    

Detailed description: 
      Intracerebral haemorrhage is a medical emergency, caused by a blood vessel bleeding directly
      into the brain. Outcome is directly related to the amount of bleeding that occurs. Many
      patients die early and others are left with significant disability. A quarter of all people
      with intracerebral haemorrhage are taking an antiplatelet drug, which is associated with
      larger volumes of brain haemorrhage and significantly worse outcomes. Four to five million
      people are taking antiplatelet drugs in the UK and use continues to rise in an ageing
      population.

      Despite advances in treatment of ischaemic stroke, there is no effective drug treatment for
      intracerebral haemorrhage. Treatment for intracerebral haemorrhage has been identified as a
      priority area by Stroke Association and stroke survivors.

      Desmopressin is a drug that reverses blood thinning effects of antiplatelet drugs, by
      indirectly increasing platelet adhesion, which the investigators hypothesise will minimise
      the devastating consequences of intracerebral haemorrhage associated with antiplatelet drugs.
      Desmopressin is commonly used in patients with inherited platelet dysfunction disorders and
      is an appealing treatment for antiplatelet-associated intracerebral haemorrhage. A recent
      systematic review did not find any randomised controlled trials evaluating desmopressin for
      antiplatelet-associated intracerebral haemorrhage. Desmopressin is affordable, available and
      could be implemented clinically across the UK and worldwide in the next five years with
      immediate benefit for stroke patients, their families and society.
    

Intervention name(s): Desmopressin Injection; Normal saline
Intervention type(s): Drug; Drug
Intervention description(s): Single dose 20 micrograms in 50ml Normal Saline as intravenous injection infused over 20 minutes; Single dose 50ml Normal Saline as intravenous injection infused over 20 minutes
Intervention MeSH terms: Deamino Arginine Vasopressin
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: intracerebral haemorrhage