Last updated on December 2018

Apixaban After Anticoagulation-associated Intracerebral Haemorrhage in Patients With Atrial Fibrillation

Are you eligible to participate in this study?

You may be eligible for this study if you meet the following criteria:

  • Conditions: Atrial Fibrillation | Cerebral Hemorrhage
  • Age: Between 18 - 100 Years
  • Gender: Male or Female

Inclusion Criteria:

  • Intracerebral haemorrhage (including including isolated spontaneous intraventricular haemorrhage), documented with CT or MRI, during treatment with anticoagulation (VKA, any direct thrombin inhibitor, any factor Xa inhibitor, or (low molecular weight) heparin at a therapeutic dose).
  • The haemorrhage has occurred between 7 and 90 days before randomization.
  • Diagnosis of (paroxysmal) non-valvular AF, documented on electrocardiography.
  • A CHA2DS2-VASc score 2.
  • Score on the modified Rankin scale (mRS)4.
  • Equipoise regarding the optimal medical treatment for the prevention of stroke.
  • Age 18 years.
  • Written informed consent by the patient or by a legal representative

Exclusion Criteria:

  • Conditions other than atrial fibrillation for which the patient requires long-term anticoagulation
  • A different clinical indication for the use of an antiplatelet drug even if treated with apixaban, such as clopidogrel for recent coronary stenting.
  • Mechanical prosthetic heart valve (biological prosthetic heart valves are allowed) or rheumatic mitral valve disease.
  • Serious bleeding event in the previous 6 months, except for intracerebral haemorrhage.
  • High risk of bleeding (e.g., active peptic ulcer disease, a platelet count of <100,000.mL-1 or haemoglobin level of <6.2 mMol.L-1, ischaemic stroke in the previous 7 days (patients are eligible thereafter), documented haemorrhagic tendencies, or blood dyscrasias).
  • Current alcohol or drug abuse.
  • Life expectancy of less than 1 year.
  • Severe renal insufficiency (a serum creatinine level of more than 221 mol per liter or a calculated creatinine clearance of <15 ml per minute).
  • Alanine aminotransferase or aspartate aminotransferase level greater than 2 times the upper limit of the normal range or a total bilirubin more than 1.5 times the upper limit of the normal range, unless a benign causative factor (e.g. Gilbert's syndrome) is known or identified.
  • Allergy to apixaban.
  • Use of strong cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp) inhibitors (e.g. systemic azole-antimycotics as ketoconazole or HIV protease inhibitors such as ritonavir).
  • Pregnancy or breastfeeding.
  • Women of childbearing potential: any woman who has begun menstruation and is not postmenopausal or otherwise permanently unable to conceive. A postmenopausal woman is defined as a woman who is over the age of 45 and has not had a menstrual period for at least 12 months.

Recruitment Status: Open

Brief Description Eligibility Contact Research Team

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