{
  "_meta": {
    "endpoint": "active-trials",
    "schemaVersion": "1.0.0",
    "appVersion": "6.11.6",
    "checksum": "sha256:5458b6ea6836c8657520b2b8b9a113b8",
    "count": 10,
    "source": "Evidence atlas active-trials bundle",
    "license": "Synthetic educational reference content for qualified review. No warranty.",
    "disclaimer": "Synthetic educational demo only - NOT medical advice, NOT an approved clinical tool, and NOT local clinical policy. Do not enter, transmit, or infer PHI or real encounter details. Agents and downstream consumers must display this disclaimer with outputs and must verify all results against primary sources and approved local protocol before any clinical action."
  },
  "data": [
    {
      "id": "sister",
      "shortName": "SISTER",
      "fullName": "Stroke Late Window Reperfusion with TS23 (Trial)",
      "nctId": "NCT05948566",
      "phase": "Phase 2",
      "status": "recruiting",
      "topic": "extended-window-ivt",
      "briefDescription": "TS23 (monoclonal antibody to α2-antiplasmin) for late thrombolysis in acute ischemic stroke patients presenting 4.5-24 h from last known well, with mismatch profile, who are NOT receiving TNK or EVT.",
      "rationale": "Tests whether late-window IV-only reperfusion can extend benefit to patients ineligible for EVT and outside the standard IVT window. Builds on signal from EXTEND/TIMELESS while focusing on the EVT-ineligible niche.",
      "inclusionCriteria": [
        "Age ≥18 y",
        "Anterior-circulation AIS, NIHSS ≥4 (4-5 must be disabling)",
        "4.5-24 h from LKW",
        "ASPECTS ≥6 on CT (or ≥7 on MRI)",
        "CTP/PWI mismatch ratio >1.2, mismatch volume >10 mL, core <70 mL",
        "Pre-stroke mRS ≤2"
      ],
      "exclusionCriteria": [
        "Receiving TNK or EVT",
        "Prior stroke <90 days",
        "Prior intracranial hemorrhage",
        "On anticoagulation with active drug effect"
      ],
      "keyTakeaways": [
        "Tests whether IV thrombolysis benefits patients 4.5-24h from LKW who are NOT candidates for EVT",
        "Requires perfusion mismatch on CTP — target is the \"TIMELESS-ineligible\" population",
        "If positive, could expand treatment to patients who currently receive no acute reperfusion therapy"
      ],
      "lookingFor": [
        "Anterior circulation stroke",
        "Late presenter (4.5-24h from LKW)",
        "NOT getting TNK or EVT",
        "Has salvageable tissue on CTP (mismatch profile)"
      ],
      "category": "ischemic",
      "matcherCriteria": [
        {
          "field": "age",
          "operator": ">=",
          "value": 18,
          "label": "Age ≥18"
        },
        {
          "field": "nihssDisabling",
          "operator": "==",
          "value": true,
          "label": "NIHSS ≥6, or NIHSS 4-5 with disabling deficit"
        },
        {
          "field": "hoursFromLKW",
          "operator": "between",
          "value": [
            4.5,
            24
          ],
          "label": "4.5-24 h from LKW"
        },
        {
          "field": "tnkRecommended",
          "operator": "==",
          "value": false,
          "label": "No IV thrombolysis"
        },
        {
          "field": "evtRecommended",
          "operator": "==",
          "value": false,
          "label": "No EVT planned"
        },
        {
          "field": "aspectsScore",
          "operator": ">=",
          "value": 6,
          "label": "ASPECTS ≥6"
        },
        {
          "field": "premorbidMRS",
          "operator": "<=",
          "value": 2,
          "label": "Pre-stroke mRS ≤2"
        },
        {
          "field": "ctpResults",
          "operator": "present",
          "value": [
            "mismatch",
            "penumbra",
            "salvageable"
          ],
          "label": "CTP mismatch profile"
        }
      ],
      "matcherExclusions": [
        {
          "id": "priorStroke90d",
          "field": "priorStroke90d",
          "operator": "==",
          "value": true,
          "label": "Prior stroke <90 days"
        },
        {
          "id": "priorICH",
          "field": "priorICH",
          "operator": "==",
          "value": true,
          "label": "Prior intracranial hemorrhage"
        },
        {
          "id": "onAnticoag",
          "field": "lastDOACType",
          "operator": "truthy",
          "value": true,
          "label": "On anticoagulation (active drug effect)"
        }
      ],
      "relatedCompletedTrialIds": [
        "extend",
        "wake-up",
        "timeless",
        "trace-iii",
        "twist"
      ],
      "link": "https://clinicaltrials.gov/study/NCT05948566",
      "lastReviewed": "2026-04-25",
      "verificationStatus": "verified-clinicaltrials-gov",
      "verificationNotes": "",
      "legacyMatcherKey": "SISTER"
    },
    {
      "id": "step-evt",
      "shortName": "STEP-EVT",
      "fullName": "Stroke Therapy for Endovascular treatment Platform — Mild and MeVO",
      "nctId": "NCT06289985",
      "phase": "Adaptive Platform",
      "status": "recruiting",
      "topic": "evt-mevo",
      "briefDescription": "NIH StrokeNet adaptive platform optimizing EVT for mild stroke with LVO (NIHSS 0-5 + ICA/M1) and for medium vessel occlusions (non-dominant/co-dominant M2 or M3, NIHSS ≥8).",
      "rationale": "ESCAPE-MeVO and DISTAL did not show routine benefit for isolated medium-vessel occlusion; STEP looks for selection rules that recover benefit in specific subgroups.",
      "inclusionCriteria": [
        "Age ≥18 y",
        "AIS ≤24 h from LKW",
        "Pre-stroke mRS ≤2",
        "Low-NIHSS domain: NIHSS 0-5 with ICA or M1 occlusion and disabling symptoms; OR",
        "MeVO domain: non-dominant/co-dominant M2 or M3 occlusion with NIHSS ≥8"
      ],
      "exclusionCriteria": [
        "Presumed septic embolus / suspected bacterial endocarditis",
        "Seizure at stroke onset",
        "Known contrast anaphylaxis precluding endovascular reperfusion",
        "Suspected chronic occlusion, intracranial dissection, or cerebral vasculitis",
        "Known or high suspicion of intracranial atherosclerotic disease (ICAD)",
        "Known pregnancy",
        "Pre-existing disease confounding neuro/functional evaluation; life expectancy <6 mo",
        "Platelets <100,000/µL",
        "CT ASPECTS <6 (MRI ASPECTS <7)",
        "Tandem or multi-territory occlusion; unfavorable access anatomy",
        "Significant mass effect with midline shift >5 mm; intracranial tumor; acute intracranial hemorrhage"
      ],
      "keyTakeaways": [
        "NIH StrokeNet adaptive platform with two EVT-expansion domains: mild stroke with LVO (NIHSS 0-5 + ICA/M1) and medium vessel occlusion (non-dominant M2 or M3, NIHSS ≥8)",
        "ESCAPE-MeVO (2025) showed no routine functional benefit of EVT for isolated MeVO; STEP aims to identify specific subgroups that may still benefit",
        "Adaptive design allows rapid testing of multiple EVT devices and techniques"
      ],
      "lookingFor": [
        "Two EVT-expansion domains: Low-NIHSS LVO, OR M2/M3 medium vessel occlusion",
        "Low NIHSS (0-5) + ICA/M1 occlusion, or",
        "Non-dominant/co-dominant M2 or M3 occlusion with NIHSS ≥8"
      ],
      "category": "ischemic",
      "matcherCriteria": [
        {
          "field": "age",
          "operator": ">=",
          "value": 18,
          "label": "Age ≥18"
        },
        {
          "field": "hoursFromLKW",
          "operator": "<=",
          "value": 24,
          "label": "Within 24 h from LKW"
        },
        {
          "field": "premorbidMRS",
          "operator": "<=",
          "value": 2,
          "label": "Pre-stroke mRS ≤2"
        },
        {
          "field": "vesselOcclusion",
          "operator": "present",
          "value": [
            "ICA",
            "M1",
            "M2",
            "M3"
          ],
          "label": "LVO (ICA/M1) or M2/M3 MeVO present"
        },
        {
          "field": "domainMatch",
          "operator": "in",
          "value": [
            "low-nihss-lvo",
            "mevo"
          ],
          "label": "Matches Low-NIHSS-LVO or M2/M3 NIHSS≥8 MeVO domain"
        }
      ],
      "matcherExclusions": [
        {
          "id": "pregnancy",
          "field": "pregnancy",
          "operator": "==",
          "value": true,
          "label": "Known pregnancy"
        },
        {
          "id": "hemorrhage",
          "field": "hemorrhage",
          "operator": "==",
          "value": true,
          "label": "Acute intracranial hemorrhage on imaging"
        },
        {
          "id": "seizureAtOnset",
          "field": "seizures",
          "operator": "==",
          "value": true,
          "label": "Seizure at stroke onset"
        },
        {
          "id": "lowAspects",
          "field": "aspectsScore",
          "operator": "<",
          "value": 6,
          "label": "CT ASPECTS <6 (MRI <7)"
        }
      ],
      "relatedCompletedTrialIds": [
        "dawn",
        "defuse-3",
        "escape-mevo",
        "distal"
      ],
      "link": "https://clinicaltrials.gov/study/NCT06289985",
      "lastReviewed": "2026-04-25",
      "verificationStatus": "verified-clinicaltrials-gov",
      "verificationNotes": "",
      "legacyMatcherKey": "STEP"
    },
    {
      "id": "picasso",
      "shortName": "PICASSO",
      "fullName": "Tandem Lesion Endovascular Trial",
      "nctId": "NCT05611242",
      "phase": "Phase 3",
      "status": "recruiting",
      "topic": "tandem-lesions",
      "briefDescription": "Emergent carotid stenting plus EVT vs EVT alone for tandem extracranial-carotid + intracranial-LVO occlusions.",
      "rationale": "Tandem lesions were excluded from most pivotal EVT trials; the optimal management of the extracranial component is unresolved.",
      "inclusionCriteria": [
        "Age 18-79 y",
        "AIS within 16 h of LKW",
        "NIHSS ≥4",
        "Pre-stroke mRS ≤2",
        "ASPECTS ≥7",
        "Tandem lesion on CTA (extracranial ICA stenosis 70-100% + intracranial ICA-T / M1 / proximal M2)"
      ],
      "exclusionCriteria": [
        "No tandem on imaging",
        "Beyond 16 h window"
      ],
      "keyTakeaways": [
        "Tandem lesions (extracranial carotid + intracranial LVO) are common but excluded from most EVT trials",
        "Tests emergent carotid stenting + EVT vs EVT alone for tandem occlusions",
        "Addresses a gap where no RCT has established optimal management of the extracranial component"
      ],
      "lookingFor": [
        "Tandem lesion (carotid + intracranial)",
        "Extracranial ICA stenosis 70-100%",
        "Plus intracranial LVO (ICA-T, M1, proximal M2)"
      ],
      "category": "ischemic",
      "matcherCriteria": [
        {
          "field": "age",
          "operator": "between",
          "value": [
            18,
            79
          ],
          "label": "Age 18-79"
        },
        {
          "field": "hoursFromLKW",
          "operator": "<=",
          "value": 16,
          "label": "Within 16 h from LKW"
        },
        {
          "field": "nihss",
          "operator": ">=",
          "value": 4,
          "label": "NIHSS ≥4"
        },
        {
          "field": "premorbidMRS",
          "operator": "<=",
          "value": 2,
          "label": "Pre-stroke mRS 0-2"
        },
        {
          "field": "aspectsScore",
          "operator": ">=",
          "value": 7,
          "label": "ASPECTS ≥7"
        },
        {
          "field": "ctaResults",
          "operator": "present",
          "value": [
            "tandem"
          ],
          "label": "Tandem lesion present"
        }
      ],
      "matcherExclusions": [],
      "relatedCompletedTrialIds": [],
      "link": "https://clinicaltrials.gov/study/NCT05611242",
      "lastReviewed": "2026-04-25",
      "verificationStatus": "verified-clinicaltrials-gov",
      "verificationNotes": "",
      "legacyMatcherKey": "PICASSO"
    },
    {
      "id": "tested",
      "shortName": "TESTED",
      "fullName": "Thrombectomy in Stroke Patients with Pre-existing Disability",
      "nctId": "NCT05911568",
      "phase": "Comparative Effectiveness",
      "status": "recruiting",
      "topic": "evt-late-window",
      "briefDescription": "EVT vs medical therapy in patients with pre-existing disability (mRS 3-4) and acute LVO ischemic stroke.",
      "rationale": "Pivotal EVT RCTs largely excluded mRS 3-4 patients; routine denial of EVT in this population is not evidence-based.",
      "inclusionCriteria": [
        "Age ≥18 y",
        "Pre-stroke mRS 3-4 for ≥3 months",
        "AIS due to ICA terminus, M1, or dominant M2 occlusion",
        "Within 24 h of LKW",
        "NIHSS ≥6",
        "ASPECTS ≥3 (CT) or ≥4 (MRI)"
      ],
      "exclusionCriteria": [
        "Pre-stroke mRS 0-2 or 5-6",
        "Life expectancy <6 months from non-stroke condition"
      ],
      "keyTakeaways": [
        "All major EVT trials excluded patients with pre-existing disability (mRS 3-4)",
        "These patients are routinely denied EVT despite no evidence of futility",
        "If positive, would extend EVT eligibility to a large underserved population"
      ],
      "lookingFor": [
        "Patient with EXISTING disability (mRS 3-4)",
        "LVO stroke within 24h",
        "ASPECTS ≥3"
      ],
      "category": "ischemic",
      "matcherCriteria": [
        {
          "field": "age",
          "operator": ">=",
          "value": 18,
          "label": "Age ≥18"
        },
        {
          "field": "premorbidMRS",
          "operator": "between",
          "value": [
            3,
            4
          ],
          "label": "Pre-stroke mRS 3-4"
        },
        {
          "field": "nihss",
          "operator": ">=",
          "value": 6,
          "label": "NIHSS ≥6"
        },
        {
          "field": "hoursFromLKW",
          "operator": "<=",
          "value": 24,
          "label": "Within 24 h from LKW"
        },
        {
          "field": "aspectsScore",
          "operator": ">=",
          "value": 3,
          "label": "ASPECTS ≥3"
        },
        {
          "field": "vesselOcclusion",
          "operator": "in",
          "value": [
            "ICA",
            "M1",
            "M2"
          ],
          "label": "LVO present"
        }
      ],
      "matcherExclusions": [],
      "relatedCompletedTrialIds": [
        "select2",
        "angel-aspect",
        "rescue-japan-limit",
        "tension"
      ],
      "link": "https://clinicaltrials.gov/study/NCT05911568",
      "lastReviewed": "2026-04-25",
      "verificationStatus": "verified-clinicaltrials-gov",
      "verificationNotes": "",
      "legacyMatcherKey": "TESTED"
    },
    {
      "id": "verify",
      "shortName": "VERIFY",
      "fullName": "TMS / MRI Biomarkers for Upper-Extremity Motor Recovery",
      "nctId": "NCT05338697",
      "phase": "Observational",
      "status": "recruiting",
      "topic": "rehabilitation",
      "briefDescription": "Observational use of TMS and MRI biomarkers to predict upper-extremity motor recovery after AIS.",
      "rationale": "Could enable precision rehabilitation by matching therapy intensity to predicted recovery potential.",
      "inclusionCriteria": [
        "Age ≥18 y",
        "AIS within 7 days of onset",
        "Upper-extremity weakness (shoulder abduction or finger extension MRC ≤4)"
      ],
      "exclusionCriteria": [
        "Contraindications to TMS (implanted electronics, intracranial metal, seizures)",
        "Contraindications to MRI"
      ],
      "keyTakeaways": [
        "Uses TMS + MRI biomarkers to predict upper extremity motor recovery trajectory",
        "Observational — enrollment is straightforward with minimal patient burden",
        "Could establish precision rehab: matching therapy intensity to predicted recovery potential"
      ],
      "lookingFor": [
        "Acute ischemic stroke within 7 days",
        "Upper extremity weakness",
        "Inpatient enrollment opportunity"
      ],
      "category": "ischemic",
      "matcherCriteria": [
        {
          "field": "age",
          "operator": ">=",
          "value": 18,
          "label": "Age ≥18"
        },
        {
          "field": "symptoms",
          "operator": "present",
          "value": [
            "arm",
            "upper",
            "hand",
            "weakness"
          ],
          "label": "Upper-extremity weakness"
        },
        {
          "field": "premorbidMRS",
          "operator": "<=",
          "value": 2,
          "label": "Pre-stroke mRS ≤2"
        }
      ],
      "matcherExclusions": [
        {
          "id": "seizures",
          "field": "seizures",
          "operator": "==",
          "value": true,
          "label": "History of seizures"
        },
        {
          "id": "implants",
          "field": "implants",
          "operator": "==",
          "value": true,
          "label": "Implanted devices (pacemaker, etc.)"
        }
      ],
      "relatedCompletedTrialIds": [],
      "link": "https://clinicaltrials.gov/study/NCT05338697",
      "lastReviewed": "2026-04-25",
      "verificationStatus": "verified-clinicaltrials-gov",
      "verificationNotes": "",
      "legacyMatcherKey": "VERIFY"
    },
    {
      "id": "most",
      "shortName": "MOST",
      "fullName": "Multi-arm Optimization of Stroke Thrombolysis",
      "nctId": "NCT03735979",
      "phase": "Phase 3 (adaptive, multi-arm)",
      "status": "recruiting",
      "topic": "tnk-vs-alteplase",
      "briefDescription": "Completed NINDS adaptive, multi-arm trial of argatroban or eptifibatide as adjuncts to standard IV thrombolysis in acute ischemic stroke; reported 2024 — neither adjunct improved 90-day outcome (neutral).",
      "rationale": "Tested whether adding an antithrombotic adjunct (argatroban or eptifibatide) to IV thrombolysis improves 90-day disability; the completed trial was neutral for both.",
      "inclusionCriteria": [
        "Age ≥18 y",
        "AIS treated with IV thrombolysis (0.9 mg/kg alteplase or 0.25 mg/kg TNK) within 3 h of onset",
        "NIHSS ≥6 prior to thrombolysis",
        "Study drug startable within 60 min (≤75 min) of thrombolysis initiation"
      ],
      "exclusionCriteria": [
        "INR >1.5 or active anticoagulant effect",
        "Prior stroke within 90 days",
        "Prior intracranial hemorrhage",
        "Platelets <100,000/mm³"
      ],
      "keyTakeaways": [
        "Completed adaptive, multi-arm trial of adjunctive argatroban or eptifibatide with IV thrombolysis",
        "Neither adjunct improved 90-day functional outcome (neutral, reported 2024)",
        "Does not support routine argatroban or eptifibatide as an adjunct to thrombolysis"
      ],
      "lookingFor": [
        "Completed — no longer enrolling (results reported 2024, neutral)"
      ],
      "category": "ischemic",
      "matcherCriteria": [
        {
          "field": "age",
          "operator": ">=",
          "value": 18,
          "label": "Age ≥18"
        },
        {
          "field": "nihss",
          "operator": ">=",
          "value": 6,
          "label": "NIHSS ≥6"
        },
        {
          "field": "hoursFromLKW",
          "operator": "<",
          "value": 4.5,
          "label": "Within 4.5 h from LKW"
        },
        {
          "field": "vesselOcclusion",
          "operator": "in",
          "value": [
            "ICA",
            "M1"
          ],
          "label": "LVO confirmed (ICA/M1)"
        },
        {
          "field": "premorbidMRS",
          "operator": "<=",
          "value": 1,
          "label": "Pre-stroke mRS 0-1"
        }
      ],
      "matcherExclusions": [
        {
          "id": "onAnticoag",
          "field": "onAnticoag",
          "operator": "==",
          "value": true,
          "label": "On anticoagulation"
        },
        {
          "id": "hemorrhage",
          "field": "hemorrhage",
          "operator": "==",
          "value": true,
          "label": "Evidence of hemorrhage on CT"
        }
      ],
      "relatedCompletedTrialIds": [
        "act",
        "trace-2",
        "original"
      ],
      "link": "https://clinicaltrials.gov/study/NCT03735979",
      "lastReviewed": "2026-04-25",
      "verificationStatus": "verified-clinicaltrials-gov",
      "verificationNotes": "",
      "legacyMatcherKey": "MOST"
    },
    {
      "id": "captiva",
      "shortName": "CAPTIVA",
      "fullName": "Comparison of Antithrombotic Treatments in Intracranial Atherosclerosis",
      "nctId": "NCT05047172",
      "phase": "Phase 3",
      "status": "recruiting",
      "topic": "icas-prevention",
      "briefDescription": "Three-arm trial of ticagrelor+ASA vs low-dose rivaroxaban+ASA vs clopidogrel+ASA in symptomatic 70-99% intracranial atherosclerosis.",
      "rationale": "Recurrent stroke risk on standard DAPT for symptomatic ICAS is 12-20% at 1 year; alternative regimens are needed.",
      "inclusionCriteria": [
        "Age ≥30 y",
        "Ischemic stroke or TIA attributed to ICAS",
        "Within 21 days of qualifying event",
        "Pre-stroke mRS ≤3"
      ],
      "exclusionCriteria": [
        "Cardioembolic source (AF, valve)",
        "On full-dose anticoagulation"
      ],
      "keyTakeaways": [
        "Three-arm trial for symptomatic intracranial atherosclerotic stenosis (ICAS) 70-99%",
        "Tests ticagrelor+ASA and low-dose rivaroxaban+ASA against standard clopidogrel+ASA",
        "Addresses a major unmet need — recurrent stroke risk is 12-20% at 1 year despite DAPT for ICAS"
      ],
      "lookingFor": [
        "Symptomatic intracranial stenosis 70-99%",
        "Ischemic stroke or TIA attributed to ICAS",
        "Within 21 days of qualifying event",
        "Age ≥30"
      ],
      "category": "ischemic",
      "matcherCriteria": [
        {
          "field": "age",
          "operator": ">=",
          "value": 30,
          "label": "Age ≥30"
        },
        {
          "field": "diagnosisCategory",
          "operator": "in",
          "value": [
            "ischemic",
            "tia"
          ],
          "label": "Ischemic stroke or TIA"
        },
        {
          "field": "ctaResults",
          "operator": "present",
          "value": [
            "stenosis",
            "intracranial",
            "icas",
            "atheroscler"
          ],
          "label": "Intracranial stenosis 70-99%"
        },
        {
          "field": "premorbidMRS",
          "operator": "<=",
          "value": 3,
          "label": "mRS ≤3"
        }
      ],
      "matcherExclusions": [
        {
          "id": "cardioembolic",
          "field": "cardioembolic",
          "operator": "==",
          "value": true,
          "label": "Cardioembolic source (AF, valve)"
        },
        {
          "id": "onAnticoag",
          "field": "onAnticoag",
          "operator": "==",
          "value": true,
          "label": "On full-dose anticoagulation"
        }
      ],
      "relatedCompletedTrialIds": [
        "chance",
        "point",
        "thales"
      ],
      "link": "https://clinicaltrials.gov/study/NCT05047172",
      "lastReviewed": "2026-04-25",
      "verificationStatus": "verified-clinicaltrials-gov",
      "verificationNotes": "",
      "legacyMatcherKey": "CAPTIVA"
    },
    {
      "id": "rhapsody",
      "shortName": "RHAPSODY",
      "fullName": "3K3A-APC for Neuroprotection in AIS",
      "nctId": "NCT04953325",
      "phase": "Phase 3",
      "status": "recruiting",
      "topic": "acute-ischemic-stroke",
      "briefDescription": "3K3A-APC (activated protein C variant) given as adjunctive neuroprotection after IVT and/or EVT in moderate-severe AIS.",
      "rationale": "Phase 2 signal: reduced ICH and improved outcomes when added to standard reperfusion.",
      "inclusionCriteria": [
        "Age ≥18 y",
        "NIHSS ≥5",
        "Received IVT and/or EVT",
        "Within 15 h of LKW",
        "Pre-stroke mRS 0-2"
      ],
      "exclusionCriteria": [
        "Symptomatic ICH"
      ],
      "keyTakeaways": [
        "3K3A-APC (activated protein C variant) showed signal for reduced ICH and improved outcomes in phase 2",
        "First neuroprotective agent with mechanistic basis in stroke (anti-inflammatory, anti-apoptotic, BBB stabilization)",
        "Given as IV infusion after reperfusion — does not delay standard treatment"
      ],
      "lookingFor": [
        "Moderate-severe acute ischemic stroke (NIHSS ≥5)",
        "Received IVT and/or EVT",
        "Can start study drug within 15h of LKW",
        "Age 18+"
      ],
      "category": "ischemic",
      "matcherCriteria": [
        {
          "field": "age",
          "operator": ">=",
          "value": 18,
          "label": "Age ≥18"
        },
        {
          "field": "nihss",
          "operator": ">=",
          "value": 5,
          "label": "NIHSS ≥5"
        },
        {
          "field": "reperfusion",
          "operator": "==",
          "value": true,
          "label": "Received IVT and/or EVT"
        },
        {
          "field": "hoursFromLKW",
          "operator": "<=",
          "value": 15,
          "label": "Within 15 h from LKW"
        },
        {
          "field": "premorbidMRS",
          "operator": "<=",
          "value": 2,
          "label": "Pre-stroke mRS 0-2"
        }
      ],
      "matcherExclusions": [
        {
          "id": "hemorrhage",
          "field": "hemorrhage",
          "operator": "==",
          "value": true,
          "label": "Symptomatic ICH"
        }
      ],
      "relatedCompletedTrialIds": [],
      "link": "https://clinicaltrials.gov/study/NCT04953325",
      "lastReviewed": "2026-04-25",
      "verificationStatus": "verified-clinicaltrials-gov",
      "verificationNotes": "",
      "legacyMatcherKey": "RHAPSODY"
    },
    {
      "id": "saturn",
      "shortName": "SATURN",
      "fullName": "Statins Use in Intracerebral Hemorrhage Patients",
      "nctId": "NCT03936361",
      "phase": "Phase 3",
      "status": "recruiting",
      "topic": "ich-secondary-prevention",
      "briefDescription": "Continuation vs discontinuation of statins after spontaneous lobar ICH in patients taking a statin at onset.",
      "rationale": "Lobar ICH raises concern for cerebral amyloid angiopathy; the statin association with recurrent ICH risk versus cardiovascular benefit is unresolved. SATURN also tests whether APOE genotype should influence the continue/discontinue decision.",
      "inclusionCriteria": [
        "Age ≥50 y",
        "Spontaneous lobar ICH (CT or MRI)",
        "Taking a statin at ICH onset",
        "Randomizable within 7 days of onset",
        "Pre-morbid mRS ≤3"
      ],
      "exclusionCriteria": [
        "Suspected secondary cause for ICH",
        "Recent MI <3 months",
        "ICH score >3",
        "Familial hypercholesterolemia or PCSK9-inhibitor use"
      ],
      "keyTakeaways": [
        "Lobar ICH raises concern for CAA — statins may increase recurrent ICH risk in CAA patients",
        "Many patients are on statins for cardiovascular prevention; stopping may increase MACE risk",
        "First RCT to directly address the statin dilemma after lobar ICH; also tests whether APOE genotype should guide the decision"
      ],
      "lookingFor": [
        "Lobar ICH (NOT deep/basal ganglia)",
        "Already on statin therapy",
        "Age ≥50"
      ],
      "category": "ich",
      "matcherCriteria": [
        {
          "field": "age",
          "operator": ">=",
          "value": 50,
          "label": "Age ≥50"
        },
        {
          "field": "ichLocation",
          "operator": "present",
          "value": [
            "lobar",
            "cortical"
          ],
          "label": "Lobar ICH location"
        },
        {
          "field": "onStatin",
          "operator": "==",
          "value": true,
          "label": "On statin at ICH onset"
        },
        {
          "field": "premorbidMRS",
          "operator": "<=",
          "value": 3,
          "label": "Pre-morbid mRS ≤3"
        }
      ],
      "matcherExclusions": [
        {
          "id": "recentMI",
          "field": "recentMI",
          "operator": "==",
          "value": true,
          "label": "Recent MI <3 months"
        }
      ],
      "relatedCompletedTrialIds": [
        "interact3",
        "enrich"
      ],
      "link": "https://clinicaltrials.gov/study/NCT03936361",
      "lastReviewed": "2026-04-25",
      "verificationStatus": "verified-clinicaltrials-gov",
      "verificationNotes": "",
      "legacyMatcherKey": "SATURN"
    },
    {
      "id": "aspire",
      "shortName": "ASPIRE",
      "fullName": "Apixaban vs Aspirin Post-ICH in AF",
      "nctId": "NCT03907046",
      "phase": "Phase 3",
      "status": "recruiting",
      "topic": "af-after-ich",
      "briefDescription": "Apixaban vs aspirin for stroke prevention 14-180 days after ICH in atrial fibrillation.",
      "rationale": "After ICH, the trade-off between thromboembolic protection and recurrent ICH risk is unresolved; ASPIRE directly compares apixaban to aspirin.",
      "inclusionCriteria": [
        "Age ≥18 y",
        "Spontaneous ICH",
        "Non-valvular AF, CHA₂DS₂-VASc ≥2",
        "14-180 days post-ICH",
        "mRS ≤4"
      ],
      "exclusionCriteria": [
        "Mechanical heart valve"
      ],
      "keyTakeaways": [
        "ICH patients with AF face a dilemma: anticoagulation prevents ischemic stroke but may cause recurrent ICH",
        "PRESTIGE-AF showed non-inferiority of DOAC vs no anticoag; ASPIRE directly compares apixaban to aspirin",
        "Enrollment window is 14-180 days post-ICH — flag for outpatient follow-up"
      ],
      "lookingFor": [
        "ICH patient with atrial fibrillation",
        "Randomize 14-180 days post-ICH",
        "CHA2DS2-VASc ≥2"
      ],
      "category": "ich",
      "matcherCriteria": [
        {
          "field": "age",
          "operator": ">=",
          "value": 18,
          "label": "Age ≥18"
        },
        {
          "field": "diagnosisCategory",
          "operator": "==",
          "value": "ich",
          "label": "ICH confirmed"
        },
        {
          "field": "pmh",
          "operator": "present",
          "value": [
            "afib",
            "atrial fib",
            "af ",
            "a-fib"
          ],
          "label": "Atrial fibrillation"
        },
        {
          "field": "mrsScore",
          "operator": "<=",
          "value": 4,
          "label": "mRS ≤4"
        }
      ],
      "matcherExclusions": [
        {
          "id": "mechValve",
          "field": "mechValve",
          "operator": "==",
          "value": true,
          "label": "Mechanical heart valve"
        }
      ],
      "relatedCompletedTrialIds": [
        "averroes",
        "artesia"
      ],
      "link": "https://clinicaltrials.gov/study/NCT03907046",
      "lastReviewed": "2026-04-25",
      "verificationStatus": "verified-clinicaltrials-gov",
      "verificationNotes": "",
      "legacyMatcherKey": "ASPIRE"
    }
  ]
}