Deferoxamine In the Treatment of Aneurysmal Subarachnoid Hemorrhage (DISH)
Aditya S. Pandey, MD
Summary
Aneurysmal subarachnoid hemorrhage (aSAH) has a high incidence of mortality and significant morbidity, with mortality exceeding 30% in the first two days.The initial injury is related to increasing intracranial pressure, cerebral edema, and neuronal injuries associated with the release of iron. Iron has been shown to increase the incidence of cerebral edema, ischemia, and formation of hydrocephalus. Deferoxamine mesylate (DFO), a hydrophilic chelator, creates a stable complex with free iron thus preventing the formation of iron related free radicals. This trial will evaluate the safety and efficacy of clinical deferoxamine for the treatment of aSAH for patients that are admitted to the hospital at the University of Michigan. Eligible participants will be enrolled and randomized to 1 of 2 doses of Deferoxamine or placebo (saline). Information regarding the patients will be collected and followed for up to 6 months post discharge.
Eligibility
- Age range
- 18–80 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Aneurysmal SAH confirmed with vascular imaging * Aneurysm treated with endovascular or microsurgical intervention * Hunt-Hess ≤ 4 * Modified Fisher Grade I-IV * Glasgow Coma Scale (GCS) ≥ 7 following External Ventricular Drain (EVD) placement if indicated * First dose of drug can be administered within 24 hours of symptom onset * Functional independence prior to SAH, Modified Rankin Scale (mRS) ≤ 1 * Informed consent obtained by patient or legal authorized representative (LAR) Exclusion Criteria: * Previous hypersensitivity to or treatment with deferoxamine * Presence…
Interventions
- DrugDeferoxamine
There will be 3 doses given to the patients days 1-3. Dose will be given intravenous with a fixed rate of 7.5 milligram per kilogram per hour (mg/kg/hr). The second dose will be given 24 hours after the first dose, and the third dose will be given 48 hours after the initial dose. Patients will be randomized to 32 mg/kg or 48 mg/kg of Deferoxamine.
- DrugPlacebo
There will be 3 doses given to the patients days 1-3. Dose will be given intravenous with a fixed rate of 7.5 mg/kg/hr. The second dose will be given 24 hours after the first dose, and the third dose will be given 48 hours after the initial dose.
Location
- University of MichiganAnn Arbor, Michigan