Skip to main content
OpenTrials
Recruiting

NCT Number: NCT06359782

Complement Inhibition: Attacking the Overshooting Inflammation @Fter Subarachnoid Hemorrhage (CIAO@SAH)

Aneurysmal subarachnoid hemorrhage (SAH) can lead to devastating outcomes for patients, like cognitive decline. This is caused by early brain injury (EBI) followed by delayed cerebral ischemia (DCI). Neuroinflammation, triggered by the complement system, has been investigated to be a key mediator in the pathophysiology of EBI and DCI. Inhibition of the complement system is therefore considered to be a potentially important new treatment for SAH.

This trial aims to study the safety and efficacy of C1-inhibitor Cinryze, an approved inhibitor of the complement system, compared to placebo in patients with SAH. By temporarily blocking the complement system we hypothesize limitation of delayed cerebral ischemia and a more favourable clinical outcome for SAH patients due to a decrease in the inflammatory response.

Recruiting

Interested in participating?

Request Info

Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Haaglanden Medical Centre

The Hague, South Holland, 2512HH, Netherlands

Location status: Recruiting

Location contact

Daan de Groot, MD

CONTACT

[email protected]

0889797900

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Confirmed diagnosis of aneurysmal subarachnoid hemorrhage on CT-scan;
  • Age ≥ 18 years on admission;
  • WFNS grade 1-5.

Exclusion criteria

  • Subarachnoid hemorrhage deemed most likely of 'peri mesencephalic' origin after consideration of history, clinical examination and radiological findings (including angiographic imaging); (not originated from an aneurysm and patients have by definition a favourable clinical outcome)
  • Subarachnoid hemorrhage deemed most likely of post-traumatic origin after consideration of history, clinical examination and radiological findings (including angiographic imaging); (does not occur spontaneous)
  • Participation in another clinical therapeutic study;
  • Patients with definite infaust prognosis on arrival and/or expected death within 24 hours of admission
  • Patients with a known hereditary complement deficiency (including hereditary angioedema);
  • Patients with a history of sensibility to blood products or C1-inhibitor;
  • Patients with a history of thrombosis (when known at time of inclusion);
  • Pregnant woman

Treatment and study plan

C1 Esterase Inhibitor Injection [Cinryze]

Drug

C1 Esterase Inhibitor Injection [Cinryze]

Other names: Cinryze

Placebo

Drug

Sodium Chloride /physiological saline (0.9%) in equal volume dosed intravenous

Primary outcomes

  1. Number of participants with delayed cerebral ischemia (DCI)

    Time frame: To be determined between day 4 and day 14 of admission

    Defined as either a new focal neurological impairment, or a decrease of at least 2 points on the Glasgow Coma Scale. This should last for at least 1 hour, is not apparent immediately after aneurysm occlusion, and cannot be attributed to other causes by means of clinical assessment, CT or MRI scanning of the brain, and appropriate laboratory studies.

  2. Number of participants with complications during hospitalization.

    Time frame: Up to 1 year after admission

    Complication rate during hospitalization

Secondary outcomes

  1. Number of participants with cerebral infarction on brain CT

    Time frame: at 14 days after admission

  2. Number of participants dying

    Time frame: Up to 1 year after admission

    Mortality rate

  3. Neurological condition measured by Glasgow Coma Scale

    Time frame: During the first 14 days

    Measured daily, minimum value of 3, maximal value of 15, higher scores mean a better outcome

  4. Complement activity markers measured in serum and CSF

    Time frame: Before IV administration of C1-INH or placebo, and after 48 hours and 96 hours after IV administration

    WIESLAB, C3b/C, C4b/C, C5b-9 ELISA assays, CH50/AC50

  5. Inflammatory markers measured in serum and CSF

    Time frame: Before IV administration of C1-INH or placebo, and after 48 hours and 96 hours after IV administration

    TNF-alpha, intraleukins

  6. Number of days in the hospital

    Time frame: Up to 1 year

    Hospital length of stay

  7. Number of ICU days

    Time frame: Up to 1 year

    ICU length of stay

  8. Number of ventilator days

    Time frame: Up to 1 year

    Ventilator days

  9. Clinical outcome

    Time frame: At 6 months

    Modified Ranking Scale, minimum value 0, maximum value 6, higher score means worse outcome

  10. Clinical outcome

    Time frame: At 6 months

    Glasgow Outcome Scale Extended, minimum value 1, maximum value 8, higher score means better outcome

  11. Clinical outcome

    Time frame: At 6 months

    Barthel Index, minimum value 0, maximum value 100, higher score means better outcome

  12. Clinical outcome

    Time frame: At 6 months

    Montreal Cognitive assessment, minimum value 0, maximum value 30, higher score means better outcome

  13. Clinical outcome

    Time frame: At 6 months

    Quality of Life (EQ-5D-5l), minimum value -0.51, maximum value 1, higher score means better outcome

Study contacts

Contact information is provided by the study sponsor or research team.

Daan de Groot, MD

CONTACT

[email protected]

088 979 7900

Sponsors and collaborators

Lead sponsor

Haaglanden Medical Centre

Other

Collaborators

  • Leiden University Medical Center
  • Takeda

Registry information

Official study title

A Phase II Trial on the Safety and Efficacy of C1 Inhibitor for the Acute Management of Subarachnoid Hemorrhage

Acronym: CIAO@SAH

Important dates

Study start
2024
Primary completion
2027
Study completion
2027
First posted
Apr 11, 2024
Registry last updated
Dec 27, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.