Stroke
Conditions
Keywords
Acute ischemic stroke, Angiography, Desmoteplase, Thrombolytic
Brief summary
The purpose of the study is to determine whether desmoteplase is effective and safe in the treatment of patients with acute ischaemic stroke when given within 3-9 hours from onset of stroke symptoms.
Detailed description
Acute stroke is a major cause of mortality and long-term disability in the developed world. The only currently approved thrombolytic intervention for acute ischemic stroke, which constitutes the majority of strokes, is alteplase (recombinant tissue plasminogen activator; rtPA). The use of alteplase is limited as it is approved for use within 3 hours after symptom onset and by the risk of inducing intracerebral haemorrhage; consequently fewer than 3% of acute stroke subjects are treated. The thrombolytic agent desmoteplase (recombinant Desmodus Salivary Plasminogen Activator alpha-1; rDSPAalpha-1) produced by recombinant biotechnology has its naturally occurring counterpart in the saliva of the vampire bat Desmodus rotundus. Compared to alteplase, desmoteplase has a more favourable profile in terms of high fibrin specificity and non neurotoxicity. The study aims to confirm efficacy and safety of desmoteplase for thrombolytic therapy of patients with acute ischaemic stroke in the extended time window of 3-9 hours after onset of stroke symptoms.
Interventions
DRUGDesmoteplase
90 μg/kg bodyweight, IV, single bolus over 1 - 2 minutes on 1st day
DRUGPlacebo
IV, single bolus over 1 - 2 minutes on 1st day
Sponsors
H. Lundbeck A/S
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosis of acute ischemic stroke * Informed consent * Age between 18 and 85 years * Treatment can be initiated within 3-9 hours after the onset of stroke symptoms * NIHSS Score of 4-24 * Vessel occlusion or high-grade stenosis on MRI or CTA in proximal cerebral arteries
Exclusion criteria
* Pre-stroke mRS \>1 * Previous exposure to desmoteplase * Extensive early infarction on MRI or CT in any affected area * Imaging evidence of ICH or SAH; AV malformation; cerebral aneurysm; or cerebral neoplasm * Internal carotid artery occlusion on the side of the stroke lesion * Treatment with heparin in the past 48 hours and a prolonged partial thromboplastin time * Treatment with oral anticoagulants and a prolonged prothrombin time * Treatment with glycoprotein IIb - IIIa inhibitors within the past 72 hours. Use of single agent oral platelet inhibitors is permitted * Treatment with a thrombolytic agent within the past 72 hours
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Modified Rankin Scale Score | 90 days |
Secondary
| Measure | Time frame |
|---|---|
| National Institutes of Health Stroke Scale (NIHSS) Score | 90 days |
Countries
Australia, Austria, Estonia, France, Germany, Hong Kong, India, Netherlands, Philippines, Poland, Singapore, South Korea, Spain, Switzerland, Taiwan, Thailand, Vietnam
Outcome results
None listed