Abstract Number: Esoc2026ot190 Combination Antithrombotic Treatment for Prevention of Recurrent Ischemic Stroke in Intracranial Atherosclerotic Disease. Catis-icas
Year: 2026
Type: conference-abstract
Abstract: Background and aims ICAD is a common cause of stroke with high recurrence risk even with current guidelines recommended treatment. COMPASS trial (N~27,000) that had patients with systemic atherosclerotic disease showed benefit of low-dose rivaroxaban+ASA in preventing recurrent ischemic stroke without increasing ICH. A pilot study (CATIS-ICAD, N=101) with this combination in those with stroke or high risk TIA attributable to ICAD 30-99% showed feasibility, safety and trend towards efficacy for preventing recurrent ischemic and covert stroke without increasing ICH. Methods CATIS-ICAS aims to demonstrate superiority of rivaroxaban 2.5mg BID+ ASA to DAPT for 90days followed by ASA to prevent strokes in those with ischemic stroke secondary to ICAD of 30-99% Results Global, double-blind, randomized, placebo- controlled phase III study with adaptive design. 1172 patients will be randomized to either the experimental arm or the control arm with in 30 days of the event. Patients >40, with ischemic stroke or high risk TIA, attributable to ICAD 30-99% of a major intracranial artery by MRA/CTA/DSA and mRs < 4 will be eligible. Conclusions Primary outcome: All recurrent strokes (ischemic, hemorrhagic and undefined) Secondary safety outcomes: Hemorrhagic stroke, ISTH major hemorrhage, ISTH clinically relevant non-major bleeding Secondary efficacy outcomes: Ischemic or undefined stroke, MACE, disabling or fatal stroke Conflict of interest
Source: European Stroke Journal
Institutions: Population Health Research Institute, McMaster University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,400
OpenAlex ID: W7160455668
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