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Efficacy and Safety of Actovegin in Post-stroke Cognitive Impairment (PSCI)

A 12-month, International, Parallel Group, Randomised, Multi-centre, Double-blind, Placebo-controlled Trial to Examine the Effect of Actovegin® Treatment Given First Intravenously and Subsequently Orally Over 6 Months, in Subjects With Post-stroke Cognitive Impairment (PSCI).

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01582854
Acronym
ARTEMIDA
Enrollment
503
Registered
2012-04-23
Start date
2012-06-30
Completion date
2014-11-30
Last updated
2016-02-22

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Post-Stroke Cognitive Impairment (PSCI)

Keywords

Post-Stroke Cognitive Impairment (PSCI), Stroke, Actovegin, Cognition disorders

Brief summary

The aim of this trial is to provide evidence that Actovegin has a symptomatic effect in subjects with post stroke cognitive impairment (PSCI) during a six month treatment period compared to subjects administered placebo. Subjects received IV infusions whilst in hospital, and tablets once discharged. Subjects were followed up for a further six months after their treatment had been stopped to explore if the cognitive symptoms of the subjects treated with Actovegin showed sustained improvement. The trial also explored the possible prevention of dementia with Actovegin in patients who had suffered a recent ischaemic stroke, as well as the effect of Actovegin on other stroke outcomes. Safety information on Actovegin was collected.

Detailed description

The drug tested in this study is called actovegin. Actovegin was tested to treat people who have post stroke cognitive impairment. This study looked at the improvement of cognitive symptoms in people who take actovegin compared to placebo. The study enrolled 503 patients. Participants were randomly assigned (by chance, like flipping a coin) to one of the two treatment groups-which remained undisclosed to the patient and study doctor during the study: * Actovegin-2000 mg intravenous solution; 2- 200 mg tablets 3 times a day * Placebo intravenous solution; tablets (dummy inactive) - this is a solution or tablet that looks like the study drug but has no active ingredient All participants received daily intravenous infusions in the hospital (up to a maximum of 20 infusions) followed by 2-200 mg tablets three times a day for the remainder of the 6-month treatment period. This multi-centre trial was conducted in Belarus, Kazakhstan and Russia. The overall time to participate in this study was 12 months. Participants made multiple visits to the clinic plus a final visit after receiving their last dose of study drug for a follow-up assessment.

Interventions

Actovegin solution for infusion and Actovegin tablets

DRUGPlacebo

Actovegin placebo-matching solution for infusion and Actovegin placebo-matching tablets

Sponsors

Takeda
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Main Inclusion Criteria: * Participant has suffered a recent supra-tentorial ischaemic stroke supported by computed tomography (CT) scan or magnetic resonance imaging (MRI) findings (in accordance with local practice). * Participant is male or female, aged 60 years or above. * Participant has a score on the National Institute of Health Stroke Scale (NIHSS) between 3 and 18 (inclusive). * Participant is capable of completing the Montreal Cognitive Assessment (MoCA) and has a score of ≤ 25 points with adjustment for level of education (4-9 school years ≤ 23 points, 10-12 years ≤ 24 points, \>12 years ≤ 25 points). Main

Exclusion criteria

* Participant has a medical history of dementia. * Participant has a known medical history of major depression or psychotic disorder. * Participant is indicated for treatment with thrombolytics or carotid surgery as the current standard of care. Randomisation Criteria: * Inclusion Criteria. * Ability to perform Alzheimer's Disease Assessment Scale + Cognitive Subscale Extended Version (ADAS-cog+). *

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Alzheimer's Disease Assessment Scale + Cognitive Subscale Extended Version (ADAS-cog+) at Month 6Baseline and Month 6The ADAS-cog measures cognitive performance by combining the ratings of 11 items. The cognitive domains mainly addressed by ADAS-cog are: memory (short term), language, ability to orientate (reflects memory), construction/planning of simple designs and performance. The extended version of the ADAS-cog (ADAS-cog+) includes 3 additional items: a 2-number cancellation task to test for attention, a delayed recall task to test for memory consolidation and a maze test for executive performance. Each item is scored and then the item scores are totaled. Total scores range from 0 (best) to 90 (worst). Higher scores indicate greater cognitive impairment. A negative change from Baseline indicates improvement. Analysis of Covariance (ANCOVA) model was used for analyses that included treatment, pooled centre, and their interaction as factors and Baseline ADAS-cog+ score as a covariate.

Secondary

MeasureTime frameDescription
Change From Baseline in Montreal Cognitive Assessment Scale (MoCA) at End of Infusion Period, Months 3, 6 and 12Baseline, End of Infusion and Months 3, 6 and 12The MoCA is a rapid screening test to assess mild cognitive impairment. It assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation. Time to administer the MoCA is approximately 10 minutes. The total possible score is 0 to 30 points; a score of 26 or above is considered normal. A positive change from Baseline (BL) indicates improvement. ANCOVA model was used for analyses that included treatment and pooled centres as factors, plus years of education and baseline MoCA score as covariates.
Percentage of ADAS-cog+ Responders at Time Points 3, 6 and 12 MonthsBaseline and Months 3, 6 and 12Responder was defined as an improvement of 4 or more from baseline on the ADAS-cog+ scale using observed data. The proportion of responders was compared between treatments using a chi-square test.
Percentage of Participants With a Diagnosis of DementiaMonth 6Diagnosis of dementia will be evaluated after 6 and 12 months classified according to International Statistical Classification of Diseases and related Health Problems 10th Revision (ICD-10) \[Classification of Mental and Behavioural Disorders, Diagnostic Criteria for Research\]. The proportion of participants with dementia was compared between treatments using a Fisher's exact test.
Change From Baseline in National Institutes of Health Stroke Scale (NIHSS) at End of Infusion Period, Months 3, 6 and 12Baseline and End of Infusion and Months 3, 6 and 12The NIHSS is a tool to objectively quantify the impairment caused by a stroke. The NIHSS is composed of 11 items, each of which scores a specific ability between a 0 (normal) to 4 (some level of impairment). The individual scores from each item are summed in order to calculate total possible NIHSS score from 0 (best) to 42 (worst). A negative change from Baseline indicates improvement. ANCOVA model was used for analyses that included treatment and pooled centre as factors and Baseline NIHSS score as a covariate.
Change From Baseline in ADAS-cog+ at Month 3 and Month 12Baseline and Months 3 and 12The ADAS-cog measures cognitive performance by combining the ratings of 11 items. The cognitive domains mainly addressed by ADAS-cog are: memory (short term), language, ability to orientate (reflects memory), construction/planning of simple designs and performance. The extended version of the ADAS-cog (ADAS-cog+) includes 3 additional items: a 2-number cancellation task to test for attention, a delayed recall task to test for memory consolidation and a maze test for executive performance. Each item is scored and then the item scores are totaled. Total scores range from 0 (best) to 90 (worst). Higher scores indicate greater cognitive impairment. A negative change from Baseline indicates improvement. ANCOVA model was used for analyses that included treatment, pooled centre, and their interaction as factors and Baseline ADAS-cog+ score as a covariate.
EuroQol EQ-5D (EQ-5D) at Month 6Month 6EQ-5D is a standardized measure of health status consisting of 5 dimensions: mobility, self -care, usual activities, pain/discomfort and anxiety/depression. The participant rates their level of function in each area using a 5 point scale where 1=no problems (best) to 5=extreme problems (worst). The percentage of participants in each category is reported.
EuroQol EQ-5D (EQ-5D) at Month 12Month 12EQ-5D is a standardized measure of health status consisting of 5 dimensions: mobility, self -care, usual activities, pain/discomfort and anxiety/depression. The participant rates their level of function in each area using a 5 point scale where 1=no problems (best) to 5=extreme problems (worst). The percentage of participants in each category is reported.
EuroQol EQ-5D (EQ-5D) General Health at Months 6 and 12Months 6 and 12The EuroQoL included a visual analogue scale where the subject marks how they feel at that moment on a scale from 0 (the worst health that can be imagined) to 100 (the best health that can be imagined).
Beck Depression Inventory, Version II (BDI-II) at Months 3, 6 and 12Months 3, 6 and 12The BDI-II is a 21-question multiple-choice self-report inventory for measuring the severity of depression. is composed of items relating to symptoms of depression such as hopelessness and irritability, cognitions such as guilt or feelings of being punished, as well as physical symptoms such as fatigue, weight loss, and lack of interest in sex. Each answer is scored on a scale 0 (best) to 3 (worst). Total scores range from 0 to 63 with higher scores indicating more severe depression. BDI II scale: * 0-13 minimal depression * 14-19 mild depression * 20-28 moderate depression * 29-63 severe depression
Barthel Index at Months 3 and 6Months 3 and 6The Barthel Index consists of 10 items that measure a person's daily functioning, specifically the activities of daily living and mobility. The items include: feeding, transfers (bed to chair and back), grooming, toilet use, bathing, mobility (walking on level surface), going up and down stairs, dressing, continence of bowels and bladder. Each performance item is rated, with a given number of points assigned to each level or ranking. Individual scores are summed for a total possible scores ranging from 0 (worst) to 100 (best) with higher scores indicating more independent daily living.

Countries

Belarus, Kazakhstan, Russia

Participant flow

Recruitment details

Participants took part in the study at 33 investigative sites in Belarus, Kazakhstan and Russia from 28 June 2012 to 26 November 2014.

Pre-assignment details

Participants who had suffered ischaemic stroke were enrolled equally in 1 of 2 treatment groups, actovegin 2000 mg solution (up to 20 infusions) followed by 200 mg tablets 3 times a day or placebo.

Participants by arm

ArmCount
Actovegin
Actovegin 2000 mg solution, intravenous (IV) infusion for up to 20 days followed by 2 actovegin 200 mg, tablets, orally, 3 times a day for up to 6 months.
248
Placebo
Actovegin placebo-matching solution, intravenous (IV) infusion for up to 20 days followed by 2 actovegin placebo-matching, tablets, orally, 3 times a day for up to 6 months.
255
Total503

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event23
Overall StudyCarotid or Neurosurgery01
Overall StudyDeath85
Overall StudyDisallowed Concomitant Medication32
Overall StudyGeneral Anaesthesia01
Overall StudyLost to Follow-up12
Overall StudyOther Miscellaneous Reason10
Overall StudyPhysician Decision01
Overall StudyRecurrent Stroke138
Overall StudyWithdrawal by Participant811

Baseline characteristics

CharacteristicActoveginPlaceboTotal
Age, Continuous70.3 years
STANDARD_DEVIATION 6.65
69.6 years
STANDARD_DEVIATION 7.18
69.9 years
STANDARD_DEVIATION 6.92
Age, Customized
≤ 65 years
78 participants97 participants175 participants
Age, Customized
> 65 years
170 participants158 participants328 participants
Alcohol Consumption
Daily drinker
0 participants1 participants1 participants
Alcohol Consumption
Never drank
117 participants126 participants243 participants
Alcohol Consumption
Occasional drinker
131 participants128 participants259 participants
Diabetes
No
208 participants198 participants406 participants
Diabetes
Yes
40 participants57 participants97 participants
Fertility Status of Female Participants
Post-menopausal
117 participants137 participants254 participants
Fertility Status of Female Participants
Surgically Sterile/Hysterectomized
3 participants5 participants8 participants
Height167.6 cm
STANDARD_DEVIATION 7.47
167.2 cm
STANDARD_DEVIATION 7.89
167.4 cm
STANDARD_DEVIATION 7.68
Ischaemic Heart Disease or Peripheral Artery Disease
No
3 participants2 participants5 participants
Ischaemic Heart Disease or Peripheral Artery Disease
Yes
245 participants253 participants498 participants
Number of Years of Education12.2 years
STANDARD_DEVIATION 3.41
12.3 years
STANDARD_DEVIATION 3.4
12.3 years
STANDARD_DEVIATION 3.4
Previous Ischaemic Stroke
No
208 participants217 participants425 participants
Previous Ischaemic Stroke
Yes
40 participants38 participants78 participants
Race/Ethnicity, Customized
Asian
3 participants3 participants6 participants
Race/Ethnicity, Customized
Black or African American
1 participants1 participants2 participants
Race/Ethnicity, Customized
Other
4 participants3 participants7 participants
Race/Ethnicity, Customized
White
240 participants248 participants488 participants
Region of Enrollment
Belarus
56 participants58 participants114 participants
Region of Enrollment
Kazakhstan
2 participants2 participants4 participants
Region of Enrollment
Russia
190 participants195 participants385 participants
Sex: Female, Male
Female
120 Participants142 Participants262 Participants
Sex: Female, Male
Male
128 Participants113 Participants241 Participants
Smoking Status
Current smoker
53 participants37 participants90 participants
Smoking Status
Ex-smoker
23 participants23 participants46 participants
Smoking Status
Never smoked
172 participants195 participants367 participants
Weight78.3 kg
STANDARD_DEVIATION 13.76
78.0 kg
STANDARD_DEVIATION 13.73
78.1 kg
STANDARD_DEVIATION 13.73

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
31 / 25031 / 253
serious
Total, serious adverse events
22 / 25017 / 253

Outcome results

Primary

Change From Baseline in Alzheimer's Disease Assessment Scale + Cognitive Subscale Extended Version (ADAS-cog+) at Month 6

The ADAS-cog measures cognitive performance by combining the ratings of 11 items. The cognitive domains mainly addressed by ADAS-cog are: memory (short term), language, ability to orientate (reflects memory), construction/planning of simple designs and performance. The extended version of the ADAS-cog (ADAS-cog+) includes 3 additional items: a 2-number cancellation task to test for attention, a delayed recall task to test for memory consolidation and a maze test for executive performance. Each item is scored and then the item scores are totaled. Total scores range from 0 (best) to 90 (worst). Higher scores indicate greater cognitive impairment. A negative change from Baseline indicates improvement. Analysis of Covariance (ANCOVA) model was used for analyses that included treatment, pooled centre, and their interaction as factors and Baseline ADAS-cog+ score as a covariate.

Time frame: Baseline and Month 6

Population: Intent-to-treat population, all enrolled participants who received at least one dose of study drug, with data available for analysis. Missing individual item scores (where only some item scores missing) imputed with worst possible score and missing total scores (where all item scores missing) imputed by last observation carried forward.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
ActoveginChange From Baseline in Alzheimer's Disease Assessment Scale + Cognitive Subscale Extended Version (ADAS-cog+) at Month 6-6.8 score on a scaleStandard Error 0.58
PlaceboChange From Baseline in Alzheimer's Disease Assessment Scale + Cognitive Subscale Extended Version (ADAS-cog+) at Month 6-4.6 score on a scaleStandard Error 0.58
p-value: 0.00595% CI: [-3.9, -0.7]ANCOVA
Secondary

Barthel Index at Months 3 and 6

The Barthel Index consists of 10 items that measure a person's daily functioning, specifically the activities of daily living and mobility. The items include: feeding, transfers (bed to chair and back), grooming, toilet use, bathing, mobility (walking on level surface), going up and down stairs, dressing, continence of bowels and bladder. Each performance item is rated, with a given number of points assigned to each level or ranking. Individual scores are summed for a total possible scores ranging from 0 (worst) to 100 (best) with higher scores indicating more independent daily living.

Time frame: Months 3 and 6

Population: Participants from the Intent-to-treat population, all enrolled participants who received at least one dose of study drug, with data available for analyses at the given time-point.

ArmMeasureGroupValue (MEDIAN)
ActoveginBarthel Index at Months 3 and 6Month 3 (n=224,235)100.0 score on a scale
ActoveginBarthel Index at Months 3 and 6Month 6 (n=219,228)100.0 score on a scale
PlaceboBarthel Index at Months 3 and 6Month 3 (n=224,235)100.0 score on a scale
PlaceboBarthel Index at Months 3 and 6Month 6 (n=219,228)100.0 score on a scale
Secondary

Beck Depression Inventory, Version II (BDI-II) at Months 3, 6 and 12

The BDI-II is a 21-question multiple-choice self-report inventory for measuring the severity of depression. is composed of items relating to symptoms of depression such as hopelessness and irritability, cognitions such as guilt or feelings of being punished, as well as physical symptoms such as fatigue, weight loss, and lack of interest in sex. Each answer is scored on a scale 0 (best) to 3 (worst). Total scores range from 0 to 63 with higher scores indicating more severe depression. BDI II scale: * 0-13 minimal depression * 14-19 mild depression * 20-28 moderate depression * 29-63 severe depression

Time frame: Months 3, 6 and 12

Population: Participants from the Intent-to-treat population, all enrolled participants who received at least one dose of study drug, with data available for analyses at the given time-point.

ArmMeasureGroupValue (MEAN)Dispersion
ActoveginBeck Depression Inventory, Version II (BDI-II) at Months 3, 6 and 12Month 3 (n=224, 234)12.5 score on a scaleStandard Deviation 11.02
ActoveginBeck Depression Inventory, Version II (BDI-II) at Months 3, 6 and 12Month 6 (n=219, 227)11.3 score on a scaleStandard Deviation 8.88
ActoveginBeck Depression Inventory, Version II (BDI-II) at Months 3, 6 and 12Month 12 (n=212, 220)10.7 score on a scaleStandard Deviation 7.1
PlaceboBeck Depression Inventory, Version II (BDI-II) at Months 3, 6 and 12Month 3 (n=224, 234)11.6 score on a scaleStandard Deviation 8.08
PlaceboBeck Depression Inventory, Version II (BDI-II) at Months 3, 6 and 12Month 6 (n=219, 227)11.5 score on a scaleStandard Deviation 10.58
PlaceboBeck Depression Inventory, Version II (BDI-II) at Months 3, 6 and 12Month 12 (n=212, 220)11.5 score on a scaleStandard Deviation 8.24
Secondary

Change From Baseline in ADAS-cog+ at Month 3 and Month 12

The ADAS-cog measures cognitive performance by combining the ratings of 11 items. The cognitive domains mainly addressed by ADAS-cog are: memory (short term), language, ability to orientate (reflects memory), construction/planning of simple designs and performance. The extended version of the ADAS-cog (ADAS-cog+) includes 3 additional items: a 2-number cancellation task to test for attention, a delayed recall task to test for memory consolidation and a maze test for executive performance. Each item is scored and then the item scores are totaled. Total scores range from 0 (best) to 90 (worst). Higher scores indicate greater cognitive impairment. A negative change from Baseline indicates improvement. ANCOVA model was used for analyses that included treatment, pooled centre, and their interaction as factors and Baseline ADAS-cog+ score as a covariate.

Time frame: Baseline and Months 3 and 12

Population: Intent-to-treat population, all enrolled participants who received at least one dose of study drug, with data available for analysis. Missing individual item scores (where only some item scores missing) imputed with worst possible score.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
ActoveginChange From Baseline in ADAS-cog+ at Month 3 and Month 12Change from Baseline at Month 3 (n=224, 234)-5.4 score on a scaleStandard Error 0.53
ActoveginChange From Baseline in ADAS-cog+ at Month 3 and Month 12Change from Baseline at Month 12 (n=211, 219)-8.2 score on a scaleStandard Error 0.66
PlaceboChange From Baseline in ADAS-cog+ at Month 3 and Month 12Change from Baseline at Month 3 (n=224, 234)-4.3 score on a scaleStandard Error 0.52
PlaceboChange From Baseline in ADAS-cog+ at Month 3 and Month 12Change from Baseline at Month 12 (n=211, 219)-4.5 score on a scaleStandard Error 0.66
Comparison: Month 3p-value: 0.12295% CI: [-2.6, 0.3]ANCOVA
Comparison: Month 12p-value: <0.00195% CI: [-5.5, -1.9]ANCOVA
Secondary

Change From Baseline in Montreal Cognitive Assessment Scale (MoCA) at End of Infusion Period, Months 3, 6 and 12

The MoCA is a rapid screening test to assess mild cognitive impairment. It assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation. Time to administer the MoCA is approximately 10 minutes. The total possible score is 0 to 30 points; a score of 26 or above is considered normal. A positive change from Baseline (BL) indicates improvement. ANCOVA model was used for analyses that included treatment and pooled centres as factors, plus years of education and baseline MoCA score as covariates.

Time frame: Baseline, End of Infusion and Months 3, 6 and 12

Population: Participants from the Intent-to-treat population, all enrolled participants who received at least one dose of study drug, with data available for analyses at the given time-point.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
ActoveginChange From Baseline in Montreal Cognitive Assessment Scale (MoCA) at End of Infusion Period, Months 3, 6 and 12Change from BL at End of Infusion (n=242, 247)2.1 score on a scaleStandard Error 0.15
ActoveginChange From Baseline in Montreal Cognitive Assessment Scale (MoCA) at End of Infusion Period, Months 3, 6 and 12Change from Baseline at Month 3 (n=224, 234)3.4 score on a scaleStandard Error 0.2
ActoveginChange From Baseline in Montreal Cognitive Assessment Scale (MoCA) at End of Infusion Period, Months 3, 6 and 12Change from Baseline at Month 6 (n=217, 228)3.8 score on a scaleStandard Error 0.21
ActoveginChange From Baseline in Montreal Cognitive Assessment Scale (MoCA) at End of Infusion Period, Months 3, 6 and 12Change from Baseline at Month 12 (n=211, 220)3.9 score on a scaleStandard Error 0.25
PlaceboChange From Baseline in Montreal Cognitive Assessment Scale (MoCA) at End of Infusion Period, Months 3, 6 and 12Change from Baseline at Month 12 (n=211, 220)2.9 score on a scaleStandard Error 0.24
PlaceboChange From Baseline in Montreal Cognitive Assessment Scale (MoCA) at End of Infusion Period, Months 3, 6 and 12Change from BL at End of Infusion (n=242, 247)1.8 score on a scaleStandard Error 0.15
PlaceboChange From Baseline in Montreal Cognitive Assessment Scale (MoCA) at End of Infusion Period, Months 3, 6 and 12Change from Baseline at Month 6 (n=217, 228)3.1 score on a scaleStandard Error 0.21
PlaceboChange From Baseline in Montreal Cognitive Assessment Scale (MoCA) at End of Infusion Period, Months 3, 6 and 12Change from Baseline at Month 3 (n=224, 234)2.7 score on a scaleStandard Error 0.2
Comparison: End of Infusion Periodp-value: 0.11195% CI: [-0.1, 0.7]ANCOVA
Comparison: Month 3p-value: 0.01695% CI: [0.1, 1.2]ANCOVA
Comparison: Month 6p-value: 0.01395% CI: [0.2, 1.3]ANCOVA
Comparison: Month 12p-value: 0.00395% CI: [0.3, 1.7]ANCOVA
Secondary

Change From Baseline in National Institutes of Health Stroke Scale (NIHSS) at End of Infusion Period, Months 3, 6 and 12

The NIHSS is a tool to objectively quantify the impairment caused by a stroke. The NIHSS is composed of 11 items, each of which scores a specific ability between a 0 (normal) to 4 (some level of impairment). The individual scores from each item are summed in order to calculate total possible NIHSS score from 0 (best) to 42 (worst). A negative change from Baseline indicates improvement. ANCOVA model was used for analyses that included treatment and pooled centre as factors and Baseline NIHSS score as a covariate.

Time frame: Baseline and End of Infusion and Months 3, 6 and 12

Population: Participants from the Intent-to-treat population, all enrolled participants who received at least one dose of study drug, with data available for analyses at the given time-point.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
ActoveginChange From Baseline in National Institutes of Health Stroke Scale (NIHSS) at End of Infusion Period, Months 3, 6 and 12Change from BL at End of Infusion (n=243, 248)-1.8 score on a scaleStandard Error 0.1
ActoveginChange From Baseline in National Institutes of Health Stroke Scale (NIHSS) at End of Infusion Period, Months 3, 6 and 12Change from Baseline at Month 3 (n=224, 235)-2.9 score on a scaleStandard Error 0.1
ActoveginChange From Baseline in National Institutes of Health Stroke Scale (NIHSS) at End of Infusion Period, Months 3, 6 and 12Change from Baseline at Month 6 (n=219, 228)-3.2 score on a scaleStandard Error 0.1
ActoveginChange From Baseline in National Institutes of Health Stroke Scale (NIHSS) at End of Infusion Period, Months 3, 6 and 12Change from Baseline at Month 12 (n=211, 220)-3.5 score on a scaleStandard Error 0.1
PlaceboChange From Baseline in National Institutes of Health Stroke Scale (NIHSS) at End of Infusion Period, Months 3, 6 and 12Change from Baseline at Month 12 (n=211, 220)-3.4 score on a scaleStandard Error 0.1
PlaceboChange From Baseline in National Institutes of Health Stroke Scale (NIHSS) at End of Infusion Period, Months 3, 6 and 12Change from BL at End of Infusion (n=243, 248)-1.7 score on a scaleStandard Error 0.1
PlaceboChange From Baseline in National Institutes of Health Stroke Scale (NIHSS) at End of Infusion Period, Months 3, 6 and 12Change from Baseline at Month 6 (n=219, 228)-3.2 score on a scaleStandard Error 0.1
PlaceboChange From Baseline in National Institutes of Health Stroke Scale (NIHSS) at End of Infusion Period, Months 3, 6 and 12Change from Baseline at Month 3 (n=224, 235)-2.7 score on a scaleStandard Error 0.1
Comparison: End of Infusion Periodp-value: 0.23995% CI: [-0.4, 0.1]ANCOVA
Comparison: Month 3p-value: 0.13695% CI: [-0.5, 0.1]ANCOVA
Comparison: Month 6p-value: 0.8995% CI: [-0.3, 0.2]ANCOVA
Comparison: Month 12p-value: 0.45595% CI: [-0.4, 0.2]ANCOVA
Secondary

EuroQol EQ-5D (EQ-5D) at Month 12

EQ-5D is a standardized measure of health status consisting of 5 dimensions: mobility, self -care, usual activities, pain/discomfort and anxiety/depression. The participant rates their level of function in each area using a 5 point scale where 1=no problems (best) to 5=extreme problems (worst). The percentage of participants in each category is reported.

Time frame: Month 12

Population: Participants from the Intent-to-treat population, all enrolled participants who received at least one dose of study drug, with data available for analyses at the given time-point.

ArmMeasureGroupValue (NUMBER)
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Mobility_Moderate problem12.5 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Usual activities_Severe problem2.8 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Self-care_Moderate problem6.0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Usual activities_Unable1.2 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Mobility_Unable0.8 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Pain or discomfort_No pain46.8 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Self-care_Severe problem1.6 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Pain or discomfort_Slight pain28.6 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Mobility_Slight problem31.0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Pain or discomfort_Moderate pain8.5 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Self-care_Unable0.4 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Pain or discomfort_Severe pain1.6 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Self-care_No problem55.2 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Pain or discomfort_Extreme pain0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Usual activities_No problem32.7 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Anxiety or depression_Not anxious48.4 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Mobility_Severe problem3.2 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Anxiety or depression_Slightly anxious31.5 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Usual activities_Slight problem39.1 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Anxiety or depression_Moderately anxious4.8 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Self-care_Slight problem22.2 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Anxiety or depression_Severely anxious0.8 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Usual activities_Moderate problem9.7 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Anxiety or depression_Extremely anxious0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 12Mobility_No problem37.9 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Anxiety or depression_Extremely anxious0.4 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Mobility_No problem36.5 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Mobility_Slight problem29.4 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Mobility_Moderate problem11.8 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Mobility_Severe problem7.5 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Mobility_Unable0.8 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Self-care_No problem48.2 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Self-care_Slight problem23.5 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Self-care_Moderate problem9.4 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Self-care_Severe problem3.9 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Self-care_Unable0.8 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Usual activities_No problem31.0 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Usual activities_Slight problem33.7 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Usual activities_Moderate problem15.7 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Usual activities_Severe problem4.3 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Usual activities_Unable1.2 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Pain or discomfort_No pain46.7 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Pain or discomfort_Slight pain26.3 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Pain or discomfort_Moderate pain11.4 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Pain or discomfort_Severe pain1.2 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Pain or discomfort_Extreme pain0.4 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Anxiety or depression_Not anxious47.1 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Anxiety or depression_Slightly anxious27.1 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Anxiety or depression_Moderately anxious10.6 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 12Anxiety or depression_Severely anxious0.8 percentage of participants
Secondary

EuroQol EQ-5D (EQ-5D) at Month 6

EQ-5D is a standardized measure of health status consisting of 5 dimensions: mobility, self -care, usual activities, pain/discomfort and anxiety/depression. The participant rates their level of function in each area using a 5 point scale where 1=no problems (best) to 5=extreme problems (worst). The percentage of participants in each category is reported.

Time frame: Month 6

Population: Participants from the Intent-to-treat population, all enrolled participants who received at least one dose of study drug, with data available for analyses at the given time-point.

ArmMeasureGroupValue (NUMBER)
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Self-care_Slight problem19.8 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Usual activities_Severe problem4.0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Mobility_Severe problem4.0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Usual activities_Unable2.0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Self-care_Moderate problem7.7 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Pain or discomfort_No pain50.0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Mobility_No problem41.5 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Pain or discomfort_Slight pain30.6 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Self-care_Severe problem2.0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Pain or discomfort_Moderate pain6.0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Mobility_Unable0.4 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Pain or discomfort_Severe pain0.8 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Mobility_Moderate problem12.5 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Pain or discomfort_Extreme pain0.4 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Usual activities_No problem32.7 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Anxiety or depression_Not anxious50.0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Self-care_No problem58.5 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Anxiety or depression_Slightly anxious31.0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Usual activities_Slight problem40.7 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Anxiety or depression_Moderately anxious6.0 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Mobility_Slight problem29.8 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Anxiety or depression_Severely anxious0.8 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Usual activities_Moderate problem8.9 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Anxiety or depression_Extremely anxious0.4 percentage of participants
ActoveginEuroQol EQ-5D (EQ-5D) at Month 6Self-care_Unable0.4 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Anxiety or depression_Extremely anxious0 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Mobility_No problem32.2 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Mobility_Slight problem31.8 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Mobility_Moderate problem16.5 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Mobility_Severe problem7.1 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Mobility_Unable0.4 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Self-care_No problem48.6 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Self-care_Slight problem25.5 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Self-care_Moderate problem9.8 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Self-care_Severe problem3.5 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Self-care_Unable0.4 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Usual activities_No problem32.9 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Usual activities_Slight problem34.5 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Usual activities_Moderate problem17.3 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Usual activities_Severe problem2.5 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Usual activities_Unable0.8 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Pain or discomfort_No pain46.3 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Pain or discomfort_Slight pain25.5 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Pain or discomfort_Moderate pain15.3 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Pain or discomfort_Severe pain0.8 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Pain or discomfort_Extreme pain0 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Anxiety or depression_Not anxious48.2 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Anxiety or depression_Slightly anxious29.4 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Anxiety or depression_Moderately anxious9.4 percentage of participants
PlaceboEuroQol EQ-5D (EQ-5D) at Month 6Anxiety or depression_Severely anxious0.8 percentage of participants
Secondary

EuroQol EQ-5D (EQ-5D) General Health at Months 6 and 12

The EuroQoL included a visual analogue scale where the subject marks how they feel at that moment on a scale from 0 (the worst health that can be imagined) to 100 (the best health that can be imagined).

Time frame: Months 6 and 12

Population: Participants from the Intent-to-treat population, all enrolled participants who received at least one dose of study drug, with data available for analyses at the given time-point.

ArmMeasureGroupValue (MEAN)Dispersion
ActoveginEuroQol EQ-5D (EQ-5D) General Health at Months 6 and 12Month 6 (n=219, 224)67.3 score on a scaleStandard Deviation 16.04
ActoveginEuroQol EQ-5D (EQ-5D) General Health at Months 6 and 12Month 12 (n=212, 220)67.8 score on a scaleStandard Deviation 15.87
PlaceboEuroQol EQ-5D (EQ-5D) General Health at Months 6 and 12Month 6 (n=219, 224)65.0 score on a scaleStandard Deviation 16.82
PlaceboEuroQol EQ-5D (EQ-5D) General Health at Months 6 and 12Month 12 (n=212, 220)65.6 score on a scaleStandard Deviation 17.51
Secondary

Percentage of ADAS-cog+ Responders at Time Points 3, 6 and 12 Months

Responder was defined as an improvement of 4 or more from baseline on the ADAS-cog+ scale using observed data. The proportion of responders was compared between treatments using a chi-square test.

Time frame: Baseline and Months 3, 6 and 12

Population: Participants from the Intent-to-treat population, all enrolled participants who received at least one dose of study drug, with data available for analyses at the given time-point.

ArmMeasureGroupValue (NUMBER)
ActoveginPercentage of ADAS-cog+ Responders at Time Points 3, 6 and 12 MonthsMonth 3 (n=215, 223)59.1 percentage of responders
ActoveginPercentage of ADAS-cog+ Responders at Time Points 3, 6 and 12 MonthsMonth 6 (n=208, 216)62.5 percentage of responders
ActoveginPercentage of ADAS-cog+ Responders at Time Points 3, 6 and 12 MonthsMonth 12 (n=200, 207)69.0 percentage of responders
PlaceboPercentage of ADAS-cog+ Responders at Time Points 3, 6 and 12 MonthsMonth 3 (n=215, 223)48.9 percentage of responders
PlaceboPercentage of ADAS-cog+ Responders at Time Points 3, 6 and 12 MonthsMonth 6 (n=208, 216)52.3 percentage of responders
PlaceboPercentage of ADAS-cog+ Responders at Time Points 3, 6 and 12 MonthsMonth 12 (n=200, 207)58.9 percentage of responders
Comparison: Month 3p-value: 0.03295% CI: [0.9, 19.5]Chi-squared
Comparison: Month 6p-value: 0.03495% CI: [0.8, 19.5]Chi-squared
Comparison: Month 12p-value: 0.03595% CI: [0.8, 19.3]Chi-squared
Secondary

Percentage of Participants With a Diagnosis of Dementia

Diagnosis of dementia will be evaluated after 6 and 12 months classified according to International Statistical Classification of Diseases and related Health Problems 10th Revision (ICD-10) \[Classification of Mental and Behavioural Disorders, Diagnostic Criteria for Research\]. The proportion of participants with dementia was compared between treatments using a Fisher's exact test.

Time frame: Month 6

Population: Participants from the Intent-to-treat population, all enrolled participants who received at least one dose of study drug, with data available for analyses at the given time-point.

ArmMeasureGroupValue (NUMBER)
ActoveginPercentage of Participants With a Diagnosis of DementiaMonth 67.3 percentage of participants
ActoveginPercentage of Participants With a Diagnosis of DementiaMonth 128.7 percentage of participants
PlaceboPercentage of Participants With a Diagnosis of DementiaMonth 610.5 percentage of participants
PlaceboPercentage of Participants With a Diagnosis of DementiaMonth 1212.7 percentage of participants
Comparison: Month 12p-value: 0.22195% CI: [-9.7, 1.7]Fisher Exact
Comparison: Month 6p-value: 0.25195% CI: [-8.5, 2.1]Fisher Exact
Secondary

Percentage of Participants With a Diagnosis of Dementia

Diagnosis of dementia will be evaluated after 6 and 12 months classified according to International Statistical Classification of Diseases and related Health Problems 10th Revision (ICD-10) \[Classification of Mental and Behavioural Disorders, Diagnostic Criteria for Research\].

Time frame: Month 6 and 12

Population: Participants from the Intent-to-treat population, all enrolled participants who received at least one dose of study drug, with data available for analyses at the given time-point.

ArmMeasureGroupValue (NUMBER)
ActoveginPercentage of Participants With a Diagnosis of DementiaMonth 67.3 percentage of participants
ActoveginPercentage of Participants With a Diagnosis of DementiaMonth 128.7 percentage of participants
PlaceboPercentage of Participants With a Diagnosis of DementiaMonth 610.5 percentage of participants
PlaceboPercentage of Participants With a Diagnosis of DementiaMonth 1212.7 percentage of participants

Source: ClinicalTrials.gov · Data processed: Feb 27, 2026