Stroke
Conditions
Keywords
Y-6, stroke
Brief summary
This study aims to evaluate the efficacy of Y-6 sublingual tablets in improving microcirculation dysfunction and reducing thrombo-inflammation in patients who had AIS caused by LVO and will receive EVT. Moreover, we expect to evaluate the safety of using Y-6 sublingual tablet in such study population. This study rationale is based on the following scheme: in patients with acute ischemic stroke caused by LVO, receiving reperfusion therapy may cause futile recanalization and thus lead to microcirculation dysfunction and thrombo-inflammation as consequences. Dexborneol has anti-inflammatory effects and Cilostazol has antiplatelet effects and BBB protection; therefore, the multi-component tablet may exert neuroprotective effects in terms of improving microcirculation dysfunction and reducing thrombo-inflammation in patients with AIS after reperfusion therapy. The primary purpose of this study is to investigate the proportion of modified-Rankin scale (mRS) score recovered to 0\ 1 score at 90 days after randomization. The follow-up duration is 3 months, and the visit schedule is as follows: Subjects enrolled based on randomization procedures will receive visits at screening/baseline period, 1 day, 7 days, 28 days and 90 days after randomization, and in case of any events.
Interventions
each tablet of Y-6 contained 6 mg of dexborneol and 25 mg of cilostazol; Both groups took one tablet q12h for 28 days.
each tablet of Y-6 placebo contained 0.06 mg of dexborneol and 0 mg of cilostazol. Both groups took one tablet q12h for 28 days.
Sponsors
Study design
Eligibility
Inclusion criteria
* 35 years old ≤ Age ≤ 80 years old; * Patients with acute ischemic stroke diagnosed within 24 hours of onset (time from onset to start of endovascular treatment); * Patients with first stroke or mRS score 0-1 prior to this onset ; * Patients with acute intracranial large vessel occlusion (LVO) confirmed by imaging examination, including occlusion of intracranial segments of internal carotid arteries, T-shaped bifurcation, MCA M1 and/or M2 segments and ACA A1 and/or A2 segments; * ASPECTS score ≥ 6 at screening; * 6\<NIHSS score ≤ 25 after this onset; * Patients who had the indications for endovascular treatment and were scheduled for endovascular treatment; * Patients or his/her legal representatives were able to understand and sign the informed consent.
Exclusion criteria
* Patients who are allergic to the active ingredients or excipients of investigational products; * Severe disorder of consciousness at screening: NIHSS 1a consciousness level ≥2 points; * Patients with previously diagnosed intracranial haemorrhage at screening, including parenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, subdural/external hematoma, etc.; * Patients with previously diagnosed intracranial tumor, arteriovenous malformation, or aneurysm at screening; * Patients with previously diagnosed congestive heart failure at screening; * Patients with bilateral LVO at anterior circulation or LVO at posterior circulation or LVO of unknown aetiology at screening; * Patients who have received treatment with warfarin, novel oral anticoagulants, argatroban, snake venom, defibrase, lumbrokinase and batroxobin after onset; * Patients with severe hematologic abnormality or severe hepatic insufficiency or renal insufficiency and received dialysis for various reasons at screening (hematologic abnormality was defined as platelet count \<100×109/L; severe hepatic insufficiency was defined as ALT \> 3 × ULN or AST \>3 × ULN; severe renal insufficiency was defined as serum creatinine \>3.0 mg/dl (265.2 μmol/L) or creatinine clearance \< 30 ml/min); * Patients with previously diagnosed hemorrhagic tendency (including but not limited to): hemorrhagic retinopathy or hereditary hemorrhagic disorders, such as hemophilia, at screening; * Patients with refractory hypertension that is difficult to be controlled by medication (systolic blood pressure \> 180 mmHg or diastolic blood pressure \> 110 mmHg); * Patients with history of major head trauma or stroke within 1 month prior to randomization; * Patients who have received intracranial or spinal surgery within 3 months prior to randomization; * Patients with history of major surgery or serious physical trauma within 1 month prior to randomization; * Male subjects (or their mates) or female subjects who had planned to have a child during the whole study period and within 3 months after the end of the study period or were unwilling to use one or more non-drug contraceptive methods (e.g., complete abstinence, condoms, ligation, etc.) during the study period; * Patients with contraindications to known contrast agents or other contrast agents; * Patients who plan to receive other surgical or intervention therapy within 3 months, which might require discontinuation of the study drugs; * Patients with life expectancy of less than 3 months; * Patients who have received treatment of investigational drugs or devices within previous 3 months; * Other investigator-evaluated conditions which may influence the compliance of patients or where it is not suitable for patients to participate in this trial.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of subjects whose mRS recover to 0-1 at 90 days after randomization. | 90 days | mRS recover to 0-1 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| •mRS at 90 days after randomization | 90 days | mRS (0-6); the scale ranges from 0 to 5, where 0 indicates no symptoms, and 5 signifies severe disability requiring continuous care and assistance. 6, denotes death. |
| • Changes in NIHSS from baseline to 1 day, 7 days and 28 days after randomization; | from baseline to 1 day, 7 days and 28 days | Changes in NIHSS; the total score ranges from 0 to 42, with lower scores indicating better neurological status. |
| • Proportion of patients with early neurological deterioration at 1 day after randomization; | at 1 day | early neurological deterioration |
| • Proportion of subjects with combined vascular events at 90 days after randomization. | 90 days | combined vascular events |
Other
| Measure | Time frame | Description |
|---|---|---|
| • Changes in vital signs after treatment | During the 90 days | • Changes in vital signs after treatment( including blood pressure, pulse, breathing, and other indicators.) |
| • Changes in physical examination findings after treatment | During the 90 days | • Changes in physical examination findings after treatment: Lungs, Gastrointestinal tract, Urinary system, Musculoskeletal system, Skin, Lymph nodes, et |
| • Incidence of platelet count ≤100×10^9/L after treatment | During the 90 days | • Incidence of platelet count ≤100×10\^9/L after treatment |
| • Incidence of any bleeding events after treatment | During the 90 days | • Incidence of any bleeding events after treatment |
| • Incidence of symptomatic intracranial haemorrhage at 28 days after treatment (per Heidelberg heamorrhage classification) | at 28 days | Symptomatic intracranial haemorrhage Heidelberg heamorrhage classification |
| • Incidence of vascular deaths; | During the 90 days | • Incidence of vascular deaths; |
| • Incidence of all-cause deaths after treatment | During the 90 days | • Incidence of all-cause deaths after treatment |
| • Incidence and severity of treatment emergent adverse events (TEAEs) across treatment groups | During the 90 days | TEAEs |
| • Changes in laboratory test results after treatment; | During the 90 days | Changes in laboratory test results (such as the red blood cell count, white blood cell count, platelets, blood biochemical indicators, etc.. ) |