INTERACT3 study officially launched

In October 2017, INTERACT3, the third in a series of INTERACT studies, has been launched. This time called the INTEnsive care bundle with blood pressure reduction in Acute Cerebral haemorrhage Trial, it was successfully launched across a network of more than 80 hospitals in China.

The INTERACT trials were designed to establish the effects of early intensive blood pressure (BP) lowering on recovery for patients with acute intracerebral haemorrhage (ICH), the most serious form of acute stroke.  The first, INTERACT1, involved 404 ICH patients recruited from China, Korea and Australia, and showed that early intensive lowering of BP to a target systolic level of <140 mmHg with intravenous agents was feasible, well tolerated, and appeared to reduce growth of the haematoma compared to standard recommended management recommended at the time, to control elevated BP to a more conservative systolic level of <180 mmHg. The second, main study, INTERACT2, involved 2839 participants from 21 countries to show that early intensive BP treatment was safe and improved chances of recovery with better physical function, and resulted in a shift in clinical guidelines recommending better control of BP in ICH.  However, there remains ongoing uncertainty over the benefits of such treatment in patients with large ICH or undergoing surgery, and in the more appropriate implementation of the treatment within routine care. 

INTERACT3 has therefore been initiated as a collaboration between clinical researchers at West China Hospital (WCH), Chengdu and The George Institute (TGI), China, with Professor Chao You, senior neurosurgeon at WCH, and Professor Craig Anderson, Executive Director of TGI China, as the joint principal investigators. INTERACT3 aims to establish the effects of ‘care bundle’ involving the early use of intensive BP lowering, control of glucose and fever, and correction of anticoagulation, as compared to routine care.  The study will use novel stepped wedge cluster clinical trial design to roll-out a quality improvement strategy involving the interventions across hospitals in China and overseas.

“Despite the magnitude of the burden imposed by stroke and the high cost to health services, there are still limited treatment for the condition.  However, active therapy involving rapid control of elevated physiological variables such as BP show considerable promise and can be readily incorporated into clinical practice”, said Professor Anderson, confirming the novelty and significance of the study.  “The study will provide important further evidence based evidence to support guidelines and clinical practice not just in China where the burden of stroke is enormous, but all around the world.”