WSC 2025 | Maintaining blood pressure stability in ICH: ATACH-2, INTERACT2, and CLUTCH trials

So I would say that more recently we had another publication. So, you know, for blood pressure treatment studies, you know, blood pressure reduction and achieving a therapeutic goal was therapeutic success. But that doesn’t capture blood pressure fluctuation or blood pressure variation. So we actually analyzed the data for ATACH-2 and actually INTERACT-2 together and defined a new parameter. So we said that blood pressure reduction alone is not a therapeutic success. Blood pressure reduction and maintenance of the blood pressure in a tight window. So we said for that study that you reduce it to a value between 130 and 150 millimeters of mercury. But for the next recording, you maintain it between 130 and 150 millimeters of mercury. And only then we will consider it a therapeutic success. And we took these 4,000 patients and analyzed them. So interestingly, less than 30% of the patients actually achieved that goal. So blood pressure reduction with stability, that is the term we use. They achieved that goal. But if you do actually achieve that goal, you have a much lower chance of death or disability. So actually there is a benefit. So essentially now in the next clinical trial, which is the CLUTCH trial, that is a pragmatic trial that’s happening in the United States, the therapeutic target is defined by blood pressure reduction with stability and not just blood pressure reduction alone. And that actually is a shift from what our blood pressure treatment goals had been in the past and what we anticipate the blood pressure reduction goal will look like in the future. And it incorporates not just blood pressure reduction only, but actually captures the reduction of blood pressure variation or blood pressure fluctuation in the definition of therapeutic success.

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