Intracerebral HemorrhagePhase 3ASPIRENCT03907046
Anticoagulation in ICH Survivors for Stroke Prevention and Recovery
A Phase 3 study testing Apixaban and Aspirin in people with Intracerebral Hemorrhage and Atrial Fibrillation, run by Yale University at 187 sites in United States.
Trial summary
Primary Aim: To determine if apixaban is superior to aspirin for prevention of the composite outcome of any stroke (hemorrhagic or ischemic) or death from any cause in patients with recent ICH and atrial fibrillation (AF). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Intracerebral Hemorrhage, Atrial Fibrillation
- What is being tested?
- Apixaban and Aspirin
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 700 participants
- Where
- 187 sitesUnited States
- Study dates
- 28 Jan 2020to Apr 2027
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age at least 18 years
- Intracerebral hemorrhage (ICH) (including primary intraventricular hemorrhage) confirmed by brain CT or MRI
- Can be randomized within 14-180 days after ICH onset
- Non-valvular AF (defined as atrial fibrillation or atrial flutter), documented by electrocardiography or a physician-confirmed history of prior AF
- Provision of signed and dated informed consent form by patient or legally authorized representative
- For females of reproductive potential: use of highly effective contraception
Who cannot join
- Index event is hemorrhagic transformation of a brain infarction or hemorrhage into a tumor
- History of earlier ICH within 12 months preceding index event
- Active infective endocarditis
- Clear indication for anticoagulant drugs (e.g., requires anticoagulation for deep vein thrombosis or pulmonary embolism) or antiplatelet drugs (e.g., requires aspirin or clopidogrel for recent coronary stent).
- Previous or planned left atrial appendage closure
- Clinically significant bleeding diathesis
Show all 15Show fewer
- Serum creatinine ≥2.5 mg/dL
- Active hepatitis or hepatic insufficiency with Child-Pugh score B or C
- Anemia (hemoglobin <8 g/dL) or thrombocytopenia (<100 x 10^9/L) that is chronic in the judgment of the investigator
- Pregnant or breastfeeding
- Known allergy to aspirin or apixaban
- Concomitant participation in a competing trial
- Considered by the investigator to have a condition that precludes safe or active participation in the trial
- Persistent, uncontrolled systolic blood pressure (≥180 mm Hg)
- ICH caused by an arteriovenous malformation (AVM) that has not yet been secured
Trial locations and contacts
187 sites in 1 country. Contact the study team or a site near you to ask about taking part.
187 sites in 1 country
United States187 sites, 142 recruiting
- Recruiting
Jefferson Abington Hospital
Abington, Pennsylvania, 19001
Larami MacKenzie, MD
- Recruiting
Cleveland Clinic Akron General
Akron, Ohio, 44307
Ahmed Itrat, MD
- Recruiting
Albany Medical Center
Albany, New York, 12208
Dylan Jones, MD
- Suspended
University of New Mexico Hospital
Albuquerque, New Mexico, 87106
- Withdrawn
Lehigh Valley Hospital - Cedar Crest
Allentown, Pennsylvania, 18103
- Withdrawn
University of Michigan University Hospital
Ann Arbor, Michigan, 48109
- Recruiting
NCH Hospital, Arlington Heights
Arlington Heights, Illinois, 60005
Mohammad Anadani, MD
- Recruiting
Grady Memorial Hospital
Atlanta, Georgia, 30303
Daniel Schachter, MD
- Recruiting
Emory University Hospital
Atlanta, Georgia, 30322
Fadi Nahab, MD
- Recruiting
Augusta University Medical Center
Augusta, Georgia, 30912
Fenwick Nichols, MD
- Recruiting
University of Colorado Hospital
Aurora, Colorado, 80045
Sharon Poisson, MD
- Withdrawn
St. David's Medical Center
Austin, Texas, 78705
- Withdrawn
Eastern Maine Medical Center
Bangor, Maine, 04401
- Recruiting
University of Alabama Hospital
Birmingham, Alabama, 35294
Angela Shapshak, MD
- Recruiting
Saint Alphonsus Regional Medical Center - Boise
Boise, Idaho, 83706
Lukas Clark, MD
- Recruiting
Tufts Medical Center
Boston, Massachusetts, 02111
Emiliya Melkumova, MD
- Recruiting
Massachusetts General Hospital
Boston, Massachusetts, 02114
Mariel Kozberg, MD
- Recruiting
Boston Medical Center
Boston, Massachusetts, 02118
Steven Feske, MD
- Recruiting
Beth Israel Deaconess Medical Center
Boston, Massachusetts, 02215
Magdy Selim, MD
- Recruiting
Kings County Hospital Center
Brooklyn, New York, 11203
Susan Law, MD
- Withdrawn
NewYork-Presbyterian Brooklyn Methodist Hospital
Brooklyn, New York, 11215
- Terminated
Maimonides Medical Center
Brooklyn, New York, 11219
- Recruiting
NYU Langone Hospital - Brooklyn
Brooklyn, New York, 11220
Jennifer Frontera
- Active, not recruiting
Buffalo General Medical Center
Buffalo, New York, 14202
- Recruiting
Lahey Hospital & Medical Center
Burlington, Massachusetts, 01805
Colin James Culbertson, MD
- Recruiting
The University of Vermont Medical Center
Burlington, Vermont, 05401
Chris Commichau
- Recruiting
Mercy San Juan Medical Center
Carmichael, California, 95608
Lucian Maidan
- Withdrawn
Eden Medical Center, Castro Valley
Castro Valley, California, 94546
- Withdrawn
Chandler Regional Medical Center
Chandler, Arizona, 85224
- Recruiting
University of North Carolina Medical Center
Chapel Hill, North Carolina, 27514
Julia Carlson, MD
- Recruiting
Medical University of South Carolina University Hospital
Charleston, South Carolina, 29425
Christine Holmstedt, MD
- Withdrawn
Carolinas Medical Center
Charlotte, North Carolina, 28204
- Recruiting
Presbyterian Medical Center
Charlotte, North Carolina, 28204
Melanie Greenway, MD
- Recruiting
UVA Medical Center
Charlottesville, Virginia, 22908
Brad Worral, MD
- Withdrawn
Erlanger Health System
Chattanooga, Tennessee, 37403
- Recruiting
Rush University Medical Center
Chicago, Illinois, 60612
Alejandro Vargas, MD
- Recruiting
University of Illinois Hospital
Chicago, Illinois, 60612
Ali Alaraj, MD
- Recruiting
University of Chicago Medical Center
Chicago, Illinois, 60637
Rachel Mehendale, MD
- Recruiting
University of Cincinnati Medical Center
Cincinnati, Ohio, 45219
Rob Stanton, MD
- Recruiting
Good Samaritan Hospital
Cincinnati, Ohio, 45220
Chengyuan Feng, MD
- Recruiting
Morton Plant Hospital
Clearwater, Florida, 33756
Ajay Arora, MD
- Recruiting
UH Cleveland Medical Center
Cleveland, Ohio, 44106
Abhishek Ray, MD
- Recruiting
MetroHealth Medical Center
Cleveland, Ohio, 44109
Agnieszka Ardelt, MD
- Recruiting
Cleveland Clinic
Cleveland, Ohio, 44195
Blake Buletko
- Recruiting
Arrowhead Regional Medical Center
Colton, California, 92324
Dan Miulli, MD
- Recruiting
University of Missouri Health Care
Columbia, Missouri, 65212
Farhan Siddiq, MD
- Recruiting
OSU Wexner Medical Center
Columbus, Ohio, 43210
Yousef Hannawi, MD
- Recruiting
Riverside Methodist Hospital
Columbus, Ohio, 43214
Vivek Rai, MD
- Withdrawn
UT Southwestern Medical Center
Dallas, Texas, 75390
- Suspended
Danbury Hospital
Danbury, Connecticut, 06810
- Withdrawn
Geisinger Medical Center
Danville, Pennsylvania, 17822
- Withdrawn
Henry Ford Hospital
Detroit, Michigan, 48202
- Suspended
Rancho Los Amigos National Rehabilitation Center
Downey, California, 90242
- Recruiting
Duke University Hospital
Durham, North Carolina, 27710
Dylan Ryan, MD
- Recruiting
JFK Medical Center
Edison, New Jersey, 08820
Navid Tabibzadeh, MD
- Recruiting
NYC Health + Hospitals/Elmhurst
Elmhurst, New York, 11373
Hazem Shoirah, MD
- Recruiting
Evanston Hospital
Evanston, Illinois, 60201
Mohammad Anadani, MD
- Recruiting
Inova Fairfax Hospital
Falls Church, Virginia, 22042
Saqib Chaudhry, MD
- Withdrawn
McLaren Flint
Flint, Michigan, 48532
- Recruiting
Kaiser Permanente Fontana Medical Center
Fontana, California, 92335
Vaninder Chhabra
- Recruiting
Broward Health Medical Center
Fort Lauderdale, Florida, 33316
Mehdi Mehdi, MD
- Recruiting
Community Regional Medical Center of Fresno
Fresno, California, 93720
Mellekate Vishwas, MD
- Recruiting
St. Jude Medical Center
Fullerton, California, 92835
Ashish Nanda, MD
- Withdrawn
St. Mary's Medical Center
Grand Junction, Colorado, 81501
- Withdrawn
Trinity Health Saint Mary's
Grand Rapids, Michigan, 49503
- Recruiting
Trinity Health Saint Mary's
Grand Rapids, Michigan, 49503
Muhammad Farooq, MD
- Recruiting
Moses H. Cone Memorial Hospital
Greensboro, North Carolina, 27401
Pramod Sethi, MD
- Recruiting
ECU Health Medical Center
Greenville, North Carolina, 27834
Shailesh Male, MD
- Recruiting
Greenville Hospital System
Greenville, South Carolina, 29605
Sanjeev Sivakumar, MD
- Recruiting
Hackensack University Medical Center
Hackensack, New Jersey, 07601
Kaitlin Reilly-Kit, MD
- Recruiting
Hartford Hospital
Hartford, Connecticut, 06102
Mark Alberts, MD
- Recruiting
Penn State Hershey Medical Center
Hershey, Pennsylvania, 17033
Nandakumar Nagaraja, MD
- Recruiting
The Queen's Medical Center
Honolulu, Hawaii, 96813
Kazuma Nakagawa, MD
- Withdrawn
Baylor College of Medicine Medical Center
Houston, Texas, 77030
- Recruiting
Houston Methodist Hospital
Houston, Texas, 77030
Britz Britz, MD
- Recruiting
Memorial Hermann Texas Medical Center
Houston, Texas, 77030
Andrew Barreto, MD
- Recruiting
IU Health Methodist Hospital
Indianapolis, Indiana, 46202
Lisa Nobel, MD
- Recruiting
University of Iowa Medical Center
Iowa City, Iowa, 52242
Amir Shaban, MD
- Withdrawn
University of Mississippi Medical Center
Jackson, Mississippi, 39216
- Recruiting
UF Health Jacksonville
Jacksonville, Florida, 32209
Kimberly McPhearson, MD
- Terminated
Mayo Clinic
Jacksonville, Florida, 32224
- Recruiting
University of Kansas Hospital
Kansas City, Kansas, 66160
Kyle Carpenter, MD
- Recruiting
Fort Sanders Regional Medical Center
Knoxville, Tennessee, 37916
S. Arthur Moore, MD
- Recruiting
Baptist Health Lexington
Lexington, Kentucky, 40503
Murali Kolikonda, MD
- Recruiting
University of Kentucky Hospital
Lexington, Kentucky, 40536
Suhas Gangadhara, MD
- Withdrawn
UAMS Medical Center
Little Rock, Arkansas, 77205
- Recruiting
Cooperman Barnabas Medical Center
Livingston, New Jersey, 07052
Steven Shapiro, MD
- Withdrawn
Long Beach Memorial Medical Center
Long Beach, California, 90806
- Recruiting
Los Alamitos Medical Center
Los Alamitos, California, 90720
Nirav Patel, MD
- Recruiting
Kaiser Permanente Los Angeles Medical Center
Los Angeles, California, 90027
Harsimran Brara, MD
- Recruiting
Cedars-Sinai Medical Center
Los Angeles, California, 90048
Konrad Schlick, MD
- Recruiting
Ronald Reagan UCLA Medical Center
Los Angeles, California, 90095
Latisha Sharma, MD
- Recruiting
University of Louisville Hospital
Louisville, Kentucky, 40202
Isaac Abecassis, MD
- Recruiting
North Shore University Hospital
Manhasset, New York, 11030
Rohan Arora, MD
- Recruiting
WellStar Kennestone Hospital
Marietta, Georgia, 30060
Christopher Horn, MD
- Recruiting
Loyola University Medical Center
Maywood, Illinois, 60153
Sarkis Morales-Vidal, MD
- Recruiting
Methodist University Hospital
Memphis, Tennessee, 38104
Balaji Krishnaiah, MD
- Recruiting
Semmes Murphey Main Campus
Memphis, Tennessee, 38120
Neha Kumar, MD
- Recruiting
Jackson Memorial Hospital
Miami, Florida, 33136
Sebastian Koch
- Withdrawn
Froedtert Hospital
Milwaukee, Wisconsin, 53226
- Recruiting
Abbott Northwestern Hospital
Minneapolis, Minnesota, 55407
Ganesh Asaithambi, MD
- Recruiting
M Health Fairview University of Minnesota Medical Center
Minneapolis, Minnesota, 55455
Oladi Bentho, MD
- Recruiting
University of South Alabama University Hospital
Mobile, Alabama, 36604
Taha Nisar, MD
- Recruiting
Doctors Medical Center Modesto, Modesto, CA
Modesto, California, 95350
James Jaffe, MD
- Recruiting
J.W. Ruby Memorial Hospital
Morgantown, West Virginia, 26506
Amelia Adcock, MD
- Terminated
McLaren Macomb
Mount Clemens, Michigan, 48043
- Recruiting
Vanderbilt University Hospital
Nashville, Tennessee, 37232
Deborah Kerrigan, MD
- Recruiting
Jersey Shore University Medical Center
Neptune City, New Jersey, 07753
Ephrem Teklemariam, MD
- Recruiting
Yale New Haven Hospital
New Haven, Connecticut, 06511
Guido Falcone, MD
- Recruiting
Ochsner Medical Center - Main Campus
New Orleans, Louisiana, 70121
Richard Zweifler
- Recruiting
Mount Sinai West
New York, New York, 10019
Neha Dangayach, MD
- Recruiting
The Mount Sinai Hospital
New York, New York, 10029
Neha Dangayach, MD
- Recruiting
NYP Columbia University Medical Center
New York, New York, 10032
Imama Naqvi, MD
- Recruiting
NYP Weill Cornell Medical Center
New York, New York, 10065
Hooman Kamel, MD
- Withdrawn
Hoag Hospital Newport Beach
Newport Beach, California, 92663
- Recruiting
OU Medical Center
Oklahoma City, Oklahoma, 73104
Evgeny Sidorov
- Recruiting
Mercy Hospital Oklahoma City
Oklahoma City, Oklahoma, 73120
Jeffrey Craig, MD
- Recruiting
University of Nebraska Medical Center
Omaha, Nebraska, 68105
Pierre Fayad, MD
- Recruiting
UC Irvine Medical Center
Orange, California, 92868
Wengui Yu, MD
- Recruiting
Desert Regional Medical Center
Palm Springs, California, 92262
Kevin Attenhofer, MD
- Withdrawn
Huntington Memorial Hospital
Pasadena, California, 91105
- Recruiting
Ascension Sacred Heart Pensacola
Pensacola, Florida, 32504
Terry Neill, MD
- Recruiting
OSF St. Francis Medical Center
Peoria, Illinois, 61637
Arun Talkad
- Recruiting
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, 19104
Aaron Rothstein, MD
- Withdrawn
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, 19107
- Recruiting
Temple University Hospital
Philadelphia, Pennsylvania, 19140
Paul Katz, MD
- Withdrawn
St. Joseph's Hospital and Medical Center
Phoenix, Arizona, 85013
- Recruiting
UPMC Presbyterian Hospital
Pittsburgh, Pennsylvania, 15213
Marcelo Rocha
- Recruiting
Cleveland Clinic Tradition Hospital
Port Saint Lucie, Florida, 34987
Marc Babi, MD
- Recruiting
Maine Medical Center
Portland, Maine, 04102
Teresa May, MD
- Recruiting
Oregon Health & Science University Hospital
Portland, Oregon, 92739
Wayne Clark
- Recruiting
Providence St. Vincent Medical Center
Portland, Oregon, 97213
John Zurasky
- Terminated
Vassar Brothers Medical Center
Poughkeepsie, New York, 12601
- Terminated
Rhode Island Hospital
Providence, Rhode Island, 02903
- Recruiting
Kaiser Permanente Redwood City Medical Center, Redwood City, CA
Redwood City, California, 94063
Sheila Chan, MD
- Recruiting
Bon Secours St. Mary's Hospital
Richmond, Virginia, 23226
Amandeep Sangha, MD
- Suspended
VCU Medical Center
Richmond, Virginia, 23298
- Recruiting
Strong Memorial Hospital
Rochester, New York, 14642
Curtis Benesch, MD
- Withdrawn
Javon Bea Hospital - Riverside
Rockford, Illinois, 61114
- Recruiting
UC Davis Medical Center
Sacramento, California, 95817
Kwan Ng, MD
- Recruiting
Kaiser Permanente Sacramento Medical Center
Sacramento, California, 95825
Yekaterina Axelrod, MD
- Recruiting
St. Cloud Hospital
Saint Cloud, Minnesota, 56303
Muhammad Fareed Suri, MD
- Active, not recruiting
HealthPartners Methodist Hospital
Saint Louis Park, Minnesota, 55426
- Terminated
Regions Hospital
Saint Paul, Minnesota, 55101
- Withdrawn
United Hospital, St. Paul
Saint Paul, Minnesota, 55102
- Recruiting
University of Utah Healthcare
Salt Lake City, Utah, 84112
Nabeel Chauhan, MD
- Recruiting
University of Texas Health Science Center San Antonio
San Antonio, Texas, 78229
Reza Behrouz, MD
- Recruiting
San Francisco General Hospital
San Francisco, California, 94110
Claude Hemphill, MD
- Recruiting
Santa Barbara Cottage Hospital
Santa Barbara, California, 93105
Brian Walcott, MD
- Withdrawn
Virginia Mason Medical Center
Seattle, Washington, 98101
- Recruiting
Harborview Medical Center
Seattle, Washington, 98104
David Tirschwell, MD
- Withdrawn
Swedish Medical Center - Cherry Hill Campus
Seattle, Washington, 98122
- Recruiting
Avera Research Institute
Sioux Falls, South Dakota, 57108
Jonathon Cooke, MD
- Withdrawn
St. John's Hospital
Springfield, Illinois, 62769
- Recruiting
Baystate Medical Center
Springfield, Massachusetts, 01199
Gottfried Schlaug, MD
- Recruiting
Mercy Hospital Springfield
Springfield, Missouri, 65804
Brenton Coger, MD
- Recruiting
Cox Medical Center South
Springfield, Missouri, 65807
Benjamin Lisle, MD
- Recruiting
PeaceHealth Sacred Heart Medical Center - RiverBend
Springfield, Oregon, 97477
Mariam Tsikvadze, MD
- Recruiting
Barnes Jewish Hospital
St Louis, Missouri, 63110
Yan Wang, MD
- Recruiting
Mercy Hospital South
St Louis, Missouri, 63128
Venkat Chintapally-Rao, MD
- Recruiting
Mercy Hospital St. Louis
St Louis, Missouri, 63141
Nida Jamal, MD
- Recruiting
Stanford University Medical Center
Stanford, California, 94304
Chitra Venkat, MD
- Withdrawn
Staten Island University Hospital - North Campus
Staten Island, New York, 10305
- Recruiting
Stony Brook University Hospital
Stony Brook, New York, 11794
Jason Mathew, MD
- Recruiting
Overlook Medical Center
Summit, New Jersey, 07901
Marianna Atiya, MD
- Recruiting
SUNY Upstate Medical University
Syracuse, New York, 13210
Julius-Gene Latorre, MD
- Recruiting
Tampa General Hospital
Tampa, Florida, 33606
Swetha Renati, MD
- Recruiting
St. Joseph's Hospital
Tampa, Florida, 33607
Abilash Haridas, MD
- Recruiting
Montefiore Medical Center
The Bronx, New York, 10467
Kathryn Kirchoff-Torres, MD
- Recruiting
Munson Medical Center
Traverse City, Michigan, 49684
Ramiro Castro-Apolo, MD
- Withdrawn
Capital Health Regional Medical Center
Trenton, New Jersey, 08638
- Recruiting
Banner University Medical Center
Tucson, Arizona, 85719
Firas Kaddouh, MD
- Recruiting
Ascension St. John Medical Center
Tulsa, Oklahoma, 74104
Rahul Rahangdale, MD
- Recruiting
St. John Medical Center
Tulsa, Oklahoma, 74104
Rahul Rahangdale, MD
- Recruiting
Westchester Medical Center
Valhalla, New York, 10595
Stephan Mayer, MD
- Recruiting
MedStar Georgetown University Hospital
Washington D.C., District of Columbia, 20007
Douglas Mayson, MD
- Withdrawn
MedStar Washington Hospital Center
Washington D.C., District of Columbia, 20010
- Recruiting
George Washington University Hospital
Washington D.C., District of Columbia, 20037
Fernando Mayor Basto, MD
- Recruiting
Burke Rehabilitation Center
White Plains, New York, 10605
Kathryn Kirchoff-Torres, MD
- Recruiting
PIH Health Hospital - Whittier
Whittier, California, 90602
Gautam Ganguly, MD
- Recruiting
New Hanover Regional Medical Center
Wilmington, Delaware, 28403
James McKinney, MD
- Recruiting
New Hanover Regional Medical Center
Wilmington, North Carolina, 28403
Amanda Pardon, MD
- Recruiting
Central DuPage Hospital
Winfield, Illinois, 60190
Dhruvil Pandya, MD
- Recruiting
Forsyth Medical Center
Winston-Salem, North Carolina, 27103
Mitchell Hargis, MD
- Recruiting
Wake Forest Baptist Medical Center
Winston-Salem, North Carolina, 27157
Stacey Wolfe, MD
- Recruiting
UMass Memorial Medical Center
Worcester, Massachusetts, 01655
Majaz Moonis, MD
- Withdrawn
Metro Health Hospital
Wyoming, Michigan, 49519
About this study
Official title: Anticoagulation in Intracerebral Hemorrhage (ICH) Survivors for Stroke Prevention and Recovery
Primary Aim: To determine if apixaban is superior to aspirin for prevention of the composite outcome of any stroke (hemorrhagic or ischemic) or death from any cause in patients with recent ICH and atrial fibrillation (AF).
Secondary Aim: To determine if apixaban, compared with aspirin, results in better functional outcomes as measured by the modified Rankin Scale.
Read the detailed description
ASPIRE is a randomized, double-blinded, phase III clinical trial designed to test the efficacy and safety of anticoagulation, compared with aspirin, in patients with a recent ICH and non-valvular AF. Seven hundred patients will be enrolled over 3.5 years and followed for study outcomes for a minimum of 12 months and maximum of 36 months. The primary efficacy outcome is any stroke (hemorrhagic or ischemic) or death from any cause. The secondary efficacy outcome is the change in the modified Rankin Scale score. Recruitment will take place at sites coordinated through the NIH/NINDS StrokeNet.
- Conditions
- Intracerebral Hemorrhage, Atrial Fibrillation
- Medical subject headings
- Cerebral Hemorrhage, Atrial Fibrillation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ApixabanDrug
Also called Eliquis
Apixaban is an oral anticoagulant of the Factor Xa inhibitor class.
AspirinDrug
Aspirin is an oral antiplatelet drug.
| Study group | Role | What they receive |
|---|---|---|
| Apixaban | Active comparator | Apixaban dosing will be 5 mg tablet in morning and 5 mg tablet in evening. A reduced dose of 2.5 mg tablet in morning and 2.5 mg tablet in evening will be used if: (1) ≥2 of the following are present: age ≥80 years, body weight ≤60 kg, or serum creatinine 1.5-2.4 mg/dL, or (2) Patient is taking a strong CYP3A4/pGP inhibitor (e.g., ketoconazole, itraconazole, ritonavir, or clarithromycin). Receives: Drug: Apixaban |
| Aspirin | Placebo comparator | Aspirin dose will be 81 mg tablet once daily. Receives: Drug: Aspirin |
What is being measured
The primary outcome is the main question the study is designed to answer.
Stroke or death
Incidence of stroke of any type (ischemic or hemorrhagic) or death from any cause
Measured: Up to 3 years
Secondary outcomes (1)
Modified Rankin Scale (mRS) score
Measure of neurologic disability (0=no disability to 6=dead)
Measured: Change from baseline to 12 months; change over duration of follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Apr 2019
- Study start28 Jan 2020
- Primary completionApr 2027 (estimated)
- Study completionApr 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Intracerebral HemorrhageStudies of the same condition, open and under way.
- More trials run by Yale UniversityThe sponsor's other registered studies.
- 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
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 700 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Yale University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Kevin N Sheth, MD, Principal investigator, Yale UniversityHooman Kamel, MD, Principal investigator, Weill Medical College of Cornell University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03907046
- Sponsor's protocol ID
- 2000026409
- Other IDs
- 1U01NS106513-01A1
- Acronym
- ASPIRE
- Status last verified
- May 2026
- First submitted
- 4 Apr 2019
- Last updated
- 8 May 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Cochrane A, Chen C, Stephen J, Ronning OM, Anderson CS, Hankey GJ, Al-Shahi Salman R. Antithrombotic treatment after stroke due to intracerebral haemorrhage. Cochrane Database Syst Rev. 2023 Jan 26;1(1):CD012144. doi: 10.1002/14651858.CD012144.pub3.
PubMed 36700520
Study at a glance
From the registry record, last updated by the sponsor on 8 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Anticoagulation in Intracerebral Hemorrhage (ICH) Survivors for Stroke Prevention and Recovery
- ClinicalTrials.gov ID
- NCT03907046
- Acronym / sponsor ID
- ASPIRE / 2000026409
- Conditions
- Intracerebral Hemorrhage, Atrial Fibrillation
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 700 participants (estimated)
- Lead sponsor
- Yale UniversityUniversity, hospital or other
- Collaborators
- National Institute of Neurological Disorders and Stroke (NINDS)
- Study start
- 28 Jan 2020 (actual)
- Primary completion
- Apr 2027 (estimated)
- Study completion
- Apr 2027 (estimated)
- First posted
- 8 Apr 2019 (actual)
- 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.
Primary Aim: To determine if apixaban is superior to aspirin for prevention of the composite outcome of any stroke (hemorrhagic or ischemic) or death from any cause in patients with recent ICH and atrial fibrillation (AF).
Secondary Aim: To determine if apixaban, compared with aspirin, results in better functional outcomes as measured by the modified Rankin Scale.
Detailed description
ASPIRE is a randomized, double-blinded, phase III clinical trial designed to test the efficacy and safety of anticoagulation, compared with aspirin, in patients with a recent ICH and non-valvular AF. Seven hundred patients will be enrolled over 3.5 years and followed for study outcomes for a minimum of 12 months and maximum of 36 months. The primary efficacy outcome is any stroke (hemorrhagic or ischemic) or death from any cause. The secondary efficacy outcome is the change in the modified Rankin Scale score. Recruitment will take place at sites coordinated through the NIH/NINDS StrokeNet.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Apixaban | Active comparator | Drug: ApixabanApixaban dosing will be 5 mg tablet in morning and 5 mg tablet in evening. A reduced dose of 2.5 mg tablet in morning and 2.5 mg tablet in evening will be used if: (1) ≥2 of the following are present: age ≥80 years, body weight ≤60 kg, or serum creatinine 1.5-2.4 mg/dL, or (2) Patient is taking a strong CYP3A4/pGP inhibitor (e.g., ketoconazole, itraconazole, ritonavir, or clarithromycin). |
| Aspirin | Placebo comparator | Drug: AspirinAspirin dose will be 81 mg tablet once daily. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Age at least 18 years
- Intracerebral hemorrhage (ICH) (including primary intraventricular hemorrhage) confirmed by brain CT or MRI
- Can be randomized within 14-180 days after ICH onset
- Non-valvular AF (defined as atrial fibrillation or atrial flutter), documented by electrocardiography or a physician-confirmed history of prior AF
- Provision of signed and dated informed consent form by patient or legally authorized representative
Key exclusion criteria (15 listed)
- Index event is hemorrhagic transformation of a brain infarction or hemorrhage into a tumor
- History of earlier ICH within 12 months preceding index event
- Active infective endocarditis
- Clear indication for anticoagulant drugs (e.g., requires anticoagulation for deep vein thrombosis or pulmonary embolism) or antiplatelet drugs (e.g., requires aspirin or clopidogrel for recent coronary stent).
- Previous or planned left atrial appendage closure
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 |
|---|---|---|
| ApixabanAlso: EliquisApixaban is an oral anticoagulant of the Factor Xa inhibitor class. | Drug | Apixaban |
| AspirinAspirin is an oral antiplatelet drug. | Drug | Aspirin |
Primary outcome
Stroke or death
Time frame: Up to 3 years
Incidence of stroke of any type (ischemic or hemorrhagic) or death from any cause
1 secondary outcome
Modified Rankin Scale (mRS) score
Time frame: Change from baseline to 12 months; change over duration of follow-up
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 May 2026.
- Derived from this study: PubMed 36700520Cochrane A, Chen C, Stephen J, Ronning OM, Anderson CS, Hankey GJ, Al-Shahi Salman R. Antithrombotic treatment after stroke due to intracerebral haemorrhage. Cochrane Database Syst Rev. 2023 Jan 26;1(1):CD012144. doi: 10.1002/14651858.CD012144.pub3.
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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.
Kevin N Sheth, MD principal investigator
Yale University
Hooman Kamel, MD principal investigator
Weill Medical College of Cornell University
187 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Apixaban and Aspirin in people with Intracerebral Hemorrhage and Atrial Fibrillation, run by Yale University at 187 sites in United States.
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 15 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: looking for participants now, as of the sponsor's last update on 8 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 187 sites in United States. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Kevin N Sheth, MD (443-615-4729, kevin.sheth@yale.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Stroke or death (time frame: Up to 3 years). 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 NCT03907046, which also lists 1 linked publication.
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 8 May 2026.