CAPTIVA is a two-stage Phase III trial randomizing subjects with stroke attributed to 70-99% intracranial atherosclerotic stenosis (sICAS) to: 1) ticagrelor + aspirin 2) low dose rivaroxaban + aspirin 3) clopidogrel + aspirin The primary goal of the trial is to determine if the experimental arm(s) (rivaroxaban or ticagrelor or both) are superior to the clopidogrel arm for lowering the 1-year rate of the primary endpoint (ischemic stroke, intracerebral hemorrhage (ICH), or vascular death). The first stage of the trial is concluded by an interim safety analysis intended to identify an excess of parenchymal intracerebral hemorrhage (ICH) or non-ICH major hemorrhage with ticagrelor + aspirin or low dose rivaroxaban + aspirin that could lead to an early termination of one or both of those arms. The second stage of the trial will determine if the experimental arm(s) (rivaroxaban or ticagrelor or both) that progress to stage 2 are superior to the clopidogrel arm for lowering the 1-year rate of the primary endpoint (ischemic stroke, intracerebral hemorrhage (ICH), or vascular death). An exploratory aim is to estimate the impact of CYP2C19 loss-of-function (LOF) carrier status on any benefit that the ticagrelor or low dose rivaroxaban arms may have in lowering the primary endpoint compared with the clopidogrel arm.

13825CAPTIVA-NCT05047172OpenCAPTIVA is a two-stage Phase III trial randomizing subjects with stroke attributed to 70-99% intracranial atherosclerotic stenosis (sICAS) to: 1) ticagrelor + aspirin 2) low dose rivaroxaban + aspirin 3) clopidogrel + aspirin The primary goal of the trial is to determine if the experimental arm(s) (rivaroxaban or ticagrelor or both) are superior to the clopidogrel arm for lowering the 1-year rate of the primary endpoint (ischemic stroke, intracerebral hemorrhage (ICH), or vascular death). The first stage of the trial is concluded by an interim safety analysis intended to identify an excess of parenchymal intracerebral hemorrhage (ICH) or non-ICH major hemorrhage with ticagrelor + aspirin or low dose rivaroxaban + aspirin that could lead to an early termination of one or both of those arms. The second stage of the trial will determine if the experimental arm(s) (rivaroxaban or ticagrelor or both) that progress to stage 2 are superior to the clopidogrel arm for lowering the 1-year rate of the primary endpoint (ischemic stroke, intracerebral hemorrhage (ICH), or vascular death). An exploratory aim is to estimate the impact of CYP2C19 loss-of-function (LOF) carrier status on any benefit that the ticagrelor or low dose rivaroxaban arms may have in lowering the primary endpoint compared with the clopidogrel arm.The primary goal of the trial is to determine if the experimental arms (rivaroxaban or ticagrelor or both) are superior to the clopidogrel arm for lowering the 1-year rate of ischemic stroke, intracerebral hemorrhage, or vascular death. NCT05047172Externally Peer-Reviewed; NationalAdultTreatmentDrug: Ticagrelor + Aspirin Drug: Rivaroxaban + Aspirin Drug: Clopidogrel + Aspirin Other: Risk Factor ManagementIIINationalDiseases Of The Nervous SystemIntracranial Arteriosclerosis StrokeSomani, SanaMedstar Washington Hospital CenterMedStar Neuroscience & Rehab Research Network16961Meselu AmareMeselu Amaremeselu.b.amare@medstar.net2026.1.0 Build 16 <a href="https://advarra.com" target="_blank">© 2026 Advarra, Inc.</a>