Recombinant Factor VIIa (rFVIIa) for Hemorrhagic Stroke Trial

Overview

About this study

The purpose of the rFVIIa for Acute Hemorrhagic Stroke Administered at Earliest Time (FASTEST) trial is to establish the first treatment for acute spontaneous intracerebral hemorrhage (ICH) within a time window and subgroup of patients that is most likely to benefit. The central hypothesis is that rFVIIa, administered within 120 minutes from stroke onset with an identified subgroup of patients most likely to benefit, will improve outcomes at 180 days as measured by the Modified Rankin Score (mRS) and decrease ongoing bleeding as compared to standard therapy.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

1. Patients aged 18-80 years, inclusive.

2. Patients with spontaneous ICH.

3. Able to treat with study medication (rFVIIa/placebo) within 120 minutes of stroke
onset or last known well.

4. Efforts to obtain informed consent per EFIC guidelines (U.S.) or adherence to
country-specific emergency research informed consent regulations (Canada, Germany,
Spain, U.K., Japan).

Exclusion Criteria:

1. Score of 3 to 7 on the Glasgow Coma Scale.

2. Secondary ICH related to known causes (e.g., trauma, aneurysm, arteriovenous
malformation (AVM), oral anticoagulant use (vitamin K antagonists or novel oral
anticoagulants) within the past 7 days, coagulopathy, etc.).

3. ICH volume < 2 cc or ≥ 60 cc.

4. IVH score > 7.

5. Pre-existing disability (mRS > 2).

6. Symptomatic thrombotic or vaso-occlusive disease in past 90 days (e.g., cerebral
infarction, myocardial infarction, pulmonary embolus, deep vein thrombosis, or
unstable angina).

7. Clinical or EKG evidence of ST elevation consistent with acute myocardial ischemia.

8. Brainstem location of hemorrhage (patients with cerebellar hemorrhage may be enrolled).

9. Refusal to participate in study by patient, legal representative, or family member.

10. Known or suspected thrombocytopenia (unless current platelet count documented above
50,000/µL).

11. Unfractionated heparin use with abnormal PTT.

12. Low-molecular weight heparin use within the previous 24 hours.

13. Recent (within 90 days) carotid endarterectomy or coronary or cerebrovascular
angioplasty or stenting.

14. Advanced or terminal illness or any other condition the investigator feels would pose
a significant hazard to the patient if rFVIIa were administered.

15. Recent (within 30 days) participation in any investigational drug or device trial or
earlier participation in any investigational drug or device trial for which the
duration of effect is expected to persist until to the time of FASTEST enrollment.

16. Planned withdrawal of care or comfort care measures.

17. Patient known or suspected of not being able to comply with trial protocol (e.g., due
to alcoholism, drug dependency, or psychological disorder).

18. Known or suspected allergy to trial medication(s), excipients, or related products.

19. Contraindications to study medication.

20. Previous participation in this trial (previously randomized).

21. Females of childbearing potential who are known to be pregnant or within 12 weeks
post-partum and/or lactating at time of enrollment.

Eligibility last updated 8/1/22. Questions regarding updates should be directed to the study team contact.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Jacksonville, Fla.

Mayo Clinic principal investigator

Lauren Ng, M.D.

Open for enrollment

Contact information:

Lauren Ng M.D.

(904) 956-3041

Ng.Lauren@mayo.edu

More information

Publications

Publications are currently not available
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CLS-20545020

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