Field Administration of Stroke Therapy - Magnesium (FAST-MAG) Trial

This study has been completed.
Information provided by (Responsible Party):
Jeffrey L. Saver, University of California, Los Angeles Identifier:
First received: April 23, 2003
Last updated: December 2, 2014
Last verified: December 2014

The goal of this study is to evaluate the effectiveness and safety of field-initiated magnesium sulfate in improving the long-term functional outcome of patients with acute stroke.

Condition Intervention Phase
Cerebrovascular Accident
Drug: Magnesium Sulfate
Drug: Normal Saline
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Field Administration of Stroke Therapy-Magnesium Trial: A Randomized, Double-Blind, Placebo Controlled Trial of Neuroprotective Magnesium Sulfate Therapy for Acute Stroke Initiated Within 2 Hours of Onset by Paramedics in the Field

Resource links provided by NLM:

Further study details as provided by University of California, Los Angeles:

Primary Outcome Measures:
  • The primary endpoint is the modified Rankin Scale global measure of global disability, assessed 90 days after treatment. [ Time Frame: 3 months after stroke onset ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Barthel Index measure of activities of daily living [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  • NIH Stroke Scale measure of neurologic deficit [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  • Stroke Impact Scale measure of stroke-specific quality of life [ Time Frame: 3 months ] [ Designated as safety issue: No ]
  • Mortality [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]
  • Symptomatic hemorrhagic transformation [ Time Frame: 4 days ] [ Designated as safety issue: Yes ]
  • Recurrent ischemic stroke [ Time Frame: 90 days ] [ Designated as safety issue: Yes ]

Enrollment: 1700
Study Start Date: January 2005
Study Completion Date: March 2013
Primary Completion Date: March 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Magnesium Sulfate Drug: Magnesium Sulfate
Paramedics initiate a loading dose of 4 grams magnesium sulfate IV over 15 minutes, followed after hospital arrival by a maintenance infusion of 16 grams magnesium sulfate IV over 24 hours.
Placebo Comparator: Normal saline Drug: Normal Saline
Paramedics initiate a loading dose of placebo normal saline IV over 15 minutes, followed after hospital arrival by a maintenance infusion of placebo normal saline IV over 24 hours.

Detailed Description:

Stroke is the third leading cause of death and the leading cause of adult disability in the United States. Each year, more than 750,000 Americans suffer a symptomatic stroke.

Currently, rt-PA is the only approved treatment for acute ischemic stroke; however, its usefulness is limited because most patients cannot reach medical attention within the necessary 3-hour time window. In addition, rt-PA cannot be given in the field because it is contraindicated for treatment of patients with brain hemorrhage.

The purpose of this multi-center, randomized, double-blind trial is to demonstrate that paramedic initiation of the neuroprotective agent magnesium sulfate in the field is an effective and safe treatment for acute stroke. This study will analyze magnesium sulfate, an experimental therapy for stroke, versus placebo among ambulance-transported patients with acute stroke. This trial will also demonstrate that paramedics can safely, effectively, and rapidly start neuroprotective therapies for stroke.


Ages Eligible for Study:   40 Years to 95 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Suspected stroke identified by the Los Angeles Prehospital Stroke Screen
  • Age 40-95, inclusive
  • Last known well time within 2 hours of treatment initiation
  • Deficit present for >/= 15 minutes

Exclusion Criteria:

  • Coma
  • Rapidly improving neurologic deficit
  • Pre-existing neurologic, psychiatric, or advanced systemic disease that would confound the neurological or functional outcome evaluations
  • SBP < 90 or > 220
  • Known severe renal dysfunction (on dialysis or known chronic creatinine > 3.0)
  • Severe respiratory distress (O2 sat < 90% or respiratory rate < 12 or >/= 24)
  • Known second or third degree heart block with no pacemaker in place
  • Major head trauma in the last 24 hours
  • Recent stroke within prior 30 days
  • Patient unable to give informed consent and no available on scene consent or assent provider
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00059332

United States, California
The Clinical Coordinating Center is: UCLA School of Medicine, 710 Westwood Plaza
Los Angeles, California, United States, 90095
Sponsors and Collaborators
Jeffrey L. Saver
Principal Investigator: Jeffrey Saver, M.D. UCLA School of Medicine, Study Overall Principal Investigator
Principal Investigator: Sidney Starkman, M.D. UCLA Stroke Center, Co-Principal Investigator
Principal Investigator: Marc Eckstein, M.D. Los Angeles City Emergency Medical Service, Co-Principal Investigator
Principal Investigator: Samuel Stratton, MD Los Angeles and Orange County Emergency Medical Services Agencies, Co-Principal Investigator
Principal Investigator: Frank Pratt, MD Los Angeles County Emergency Medical Service, Co-Principal Investigator
  More Information

Additional Information:
No publications provided by University of California, Los Angeles

Additional publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Jeffrey L. Saver, Professor of Neurology, University of California, Los Angeles Identifier: NCT00059332     History of Changes
Other Study ID Numbers: U01NS44364, U01NS044364
Study First Received: April 23, 2003
Last Updated: December 2, 2014
Health Authority: United States: Food and Drug Administration

Keywords provided by University of California, Los Angeles:
brain attack
magnesium sulfate
prehospital care
emergency medical services

Additional relevant MeSH terms:
Cerebral Infarction
Brain Diseases
Brain Infarction
Brain Ischemia
Cardiovascular Diseases
Central Nervous System Diseases
Cerebrovascular Disorders
Nervous System Diseases
Vascular Diseases
Magnesium Sulfate
Anti-Arrhythmia Agents
Calcium Channel Blockers
Cardiovascular Agents
Central Nervous System Agents
Central Nervous System Depressants
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Peripheral Nervous System Agents
Pharmacologic Actions
Physiological Effects of Drugs
Reproductive Control Agents
Sensory System Agents
Therapeutic Uses
Tocolytic Agents processed this record on July 30, 2015