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Efficacy and Safety Study of DP-b99 in Treating Acute Ischemic Stroke (MACSI)
This study is not yet open for participant recruitment.
Verified by D-Pharm Ltd., May 2009
First Received: May 4, 2009   Last Updated: May 5, 2009   History of Changes
Sponsored by: D-Pharm Ltd.
Information provided by: D-Pharm Ltd.
ClinicalTrials.gov Identifier: NCT00893867
  Purpose

The purpose of this trial is to determine if intravenous administration of the metal ion trapping agent DP-b99 within 1-9 hours of acute ischemic stroke onset, and then for 3 additional days (4 consecutive days in total) is effective in improving long term outcome. Patients will be followed up for 3 months after the stroke.


Condition Intervention Phase
Acute Ischemic Stroke
Drug: DP-b99
Drug: Placebo
Phase III

U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator), Placebo Control, Parallel Assignment, Safety/Efficacy Study
Official Title: A Double Blind, Randomized, Placebo-Controlled, Parallel Group, Multicenter Phase 3 Pivotal Study to Assess the Safety and Efficacy of 1mg/kg/Day Intravenous DP-b99 Over 4 Consecutive Days Versus Placebo When Initiated Within One to Nine Hours of Acute Ischemic Stroke Onset

Further study details as provided by D-Pharm Ltd.:

Primary Outcome Measures:
  • Modified Rankin Scale (mRS) categorical analysis ("shift") [ Time Frame: 90 days ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Recovery, defined as a score of ≤ 1 on mRS Recovery, defined as a score of ≤ 1 on NIHSS. [ Time Frame: 90 days ] [ Designated as safety issue: No ]
  • Safety and tolerability [ Time Frame: throughout study - baseline until day 90 ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 770
Study Start Date: June 2009
Estimated Study Completion Date: June 2012
Estimated Primary Completion Date: June 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
DP-b99: Experimental Drug: DP-b99
1mg/kg/day over 4 consecutive days given intravenously and initiated within 1-9 hours of acute stroke onset.
Mannitol: Placebo Comparator Drug: Placebo
1mg/kg/day over 4 consecutive days given intravenously and initiated within 1-9 hours of acute stroke onset.

Detailed Description:

This will be a randomized, double-blind, placebo-controlled, multicenter, multi-national, parallel-arm, pivotal study comparing a placebo group to a DP-b99 group treated with intravenous 1.0 mg/kg/d for 4 consecutive days, in patients with an entry National Institutes of Health Stroke Scale (NIHSS) score of 10-16 and a clinical syndrome that includes at least 1 of the following: language dysfunction, visual field defect or neglect (specifically, at least 1 point on NIHSS items 3, 9 or 11). Alternatively, patients without at least 1 point on NIHSS items 3, 9 or 11 may be enrolled if routine diffusion-weighted magnetic resonance imaging (DW MRI) or computed tomography perfusion scan indicates that the acute stroke involves the cerebral cortex, and as long as the overall acute neurological deficit is within the range of 10-16 NIHSS points. Clinical trial material (CTM) will be administered within 1 to 9 hours after the onset of acute ischemic stroke symptoms. Subjects will be randomized at a ratio of 1:1 to receive either DP-b99 or placebo. After the initial hospitalization (which should be at least 4 days) follow up visits will take place on study days 30 and 90.

  Eligibility

Ages Eligible for Study:   18 Years to 85 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Males or females 18 to 85 years of age, inclusive
  2. Have suffered an acute hemispheric ischemic stroke, defined as acute, focal, neurological deficit(s), secondary to a presumed vascular event, which must include both or one of the following:

    • At least one of the following components (as reflected by at least 1 point on any of the corresponding items of the NIHSS: 9, 3 or 11):

      • Language dysfunction (aphasic disorder, excluding dysarthria)
      • Visual field defect (excluding monocular blindness)
      • Extinction and Inattention (formerly Neglect),
    • An indication on routine diffusion-weighted magnetic resonance imaging (DW-MRI) or computed tomography perfusion scan at screening /baseline that the acute stroke involves the cerebral cortex
  3. Have suffered the onset of an acute ischemic stroke that can be evaluated and treatment initiated within 1 to 9 hours after the onset of acute ischemic stroke symptoms (onset is defined as the time that the subject was last seen in a normal state, or bedtime for unwitnessed strokes occurring during sleep)
  4. Have at screening a NIHSS score of 10 to 16, inclusive
  5. Have readily accessible peripheral venous access for clinical trial material (CTM) administration and blood sampling
  6. Have the ability to understand the requirements of the study and be willing to provide written informed consent (IC) (as evidenced by signature on an informed consent document approved by an institutional review board (IRB) or independent ethics committee (IEC), and agree to abide by the study restrictions and return for the required assessments (In the event of incapacitated subjects, informed consent will be sought from a legally acceptable representative or by any other means as approved by the IRB or IEC).
  7. Have provided written authorization for use and disclosure of protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA) in the United States and the Personal Information Protection and Electronic Documents Act (PIPEDA) in Canada

Exclusion Criteria:

  1. Have an intracerebral or subarachnoid hemorrhage per screening/baseline computerized tomography (CT) scan or susceptibility-weighted magnetic resonance imaging (MRI)
  2. Be a candidate for thrombolytic therapy or have been treated with thrombolytic therapy for the current stroke
  3. Be delirious, comatose or stuporous (a score of ≥2 on item 1.a of the NIHSS) or demented, or having a mental impairment that in the investigator's opinion renders the subject incapable to participate in the study
  4. Have neurological or non-neurological comorbidities that in the investigator's opinion may lead, independent of the current stroke, to further deterioration in the subject's neurological status during the trial period, or may render the study's neurological assessments inconclusive for the purpose of evaluating solely the stroke's effects (e.g., metabolic encephalopathies, hemiplegic migraine, multiple sclerosis, central nervous system tumor, convulsive disorder, monocular blindness)
  5. Have rapid spontaneous improvement of neurological signs during screening/baseline assessments
  6. Have premorbid neurological deficits and functional limitations assessed by a retrospective (pre-current stroke) Modified Rankin Scale score of >1
  7. Have suffered a stroke within 90 days of the screening/baseline assessments that is either diagnostically confirmed or assumed to be in the same cerebral territory as is the current acute stroke
  8. Be a female of childbearing potential (less than 2 years' postmenopausal or not surgically sterilized) who is not willing to use adequate and effective birth control measures for the duration of the trial. Effective birth control measures include hormonal contraception, a barrier method such as a diaphragm, intrauterine device (IUD) and/or condom with spermicide (IUD, diaphragm, condoms alone or the rhythm method are not considered reliable methods)
  9. Have a positive urine pregnancy test at screening/baseline or be a lactating female
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00893867

Contacts
Contact: Gilad Rosenberg, MD, MSc 011 9728 9385100 ext 273 grosenberg@dpharm.com
Contact: Linda S Marshall, MD 011 9728 9385100 ext 206 lmarshall@dpharm.com

Locations
Germany
Universitätsklinik Freiburg, Klinik für Neurologie
Freiburg, Germany, 79106
Israel
Neurological Dept. Edith Wolfson Medical Center
Holon, Israel, 58100
Sponsors and Collaborators
D-Pharm Ltd.
  More Information

Publications:
Responsible Party: D-Pharm, Ltd. ( Dr. Gilad Rosenberg, Vice President Clinical Development )
Study ID Numbers: Ptcl-01373
Study First Received: May 4, 2009
Last Updated: May 5, 2009
ClinicalTrials.gov Identifier: NCT00893867     History of Changes
Health Authority: United States: Food and Drug Administration;   Israel: Ethics Commission;   Israel: Israeli Health Ministry Pharmaceutical Administration;   Israel: Ministry of Health;   Israel: The Israel National Institute for Health Policy Research and Health Services Research;   South Africa: Department of Health;   South Africa: Human Research Ethics Committee;   South Africa: Medicines Control Council;   South Africa: National Health Research Ethics Council

Keywords provided by D-Pharm Ltd.:
acute ischemic stroke
neuroprotective agent

Study placed in the following topic categories:
Cerebral Infarction
Stroke
Vascular Diseases
Brain Ischemia
Central Nervous System Diseases
Brain Infarction
Ischemia
Brain Diseases
Infarction
Neuroprotective Agents
Cerebrovascular Disorders

Additional relevant MeSH terms:
Pathologic Processes
Cerebral Infarction
Nervous System Diseases
Stroke
Vascular Diseases
Brain Ischemia
Central Nervous System Diseases
Cardiovascular Diseases
Brain Infarction
Ischemia
Brain Diseases
Cerebrovascular Disorders

ClinicalTrials.gov processed this record on May 07, 2009