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Dose Escalation of Desmoteplase in Acute Ischemic Stroke (DEDAS) (DEDAS)

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ClinicalTrials.gov Identifier: NCT00638248
Recruitment Status : Completed
First Posted : March 19, 2008
Last Update Posted : March 19, 2008
Sponsor:
Information provided by:
PAION Deutschland GmbH

Brief Summary:
The purpose of this study was to explore trends in safety and efficacy, and to find the optimal dose for the subsequent phase III trial. The decision to initiate the phase III trial will depend on both safety (incidence of symptomatic intracranial hemorrhage) and efficacy (reperfusion measured by MRI and correlating with clinical outcome) profiles. The safety (incidence of symptomatic intracranial haemorrhage) and efficacy (reperfusion measured by MRI and correlating with clinical outcome) profiles gained from this study were the basis of planning the phase III.

Condition or disease Intervention/treatment Phase
Stroke Drug: Desmoteplase Drug: Placebo Phase 1 Phase 2

Detailed Description:

Acute stroke is the third leading cause of mortality in developed countries and the major medical cause of disability in adults. The outcome can be improved by early treatment with thrombolysis. Alteplase (r-tPA) is the only approved thrombolytic drug in the indication of acute ischemic stroke. However, the use of alteplase is currently restricted by the need to administer it within 3 hours of symptom onset. As the risk of transforming a cerebral infarct into haemorrhage probably rises as the time elapsed increases, a thrombolytic drug that carries a lower risk of haemorrhage than alteplase may offer a wider time-to-treatment window and improve the safety profile.

Desmoteplase (DSPA) with its high fibrin specificity, lack of neurotoxicity, potential neuroprotective effect, non-activation by ß-amyloid, and long terminal half-life may account for an improved safety and efficacy profile within the first 9 hours after onset of symptoms.


Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 38 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: International, Multicenter, Double-Blind, Placebo-Controlled, Randomized Phase I/II Trial of Desmoteplase in the Indication of Acute Ischemic Stroke
Study Start Date : March 2003
Actual Primary Completion Date : October 2004
Actual Study Completion Date : October 2004

Arm Intervention/treatment
Active Comparator: 1
Desmoteplase 90µg/kg BW
Drug: Desmoteplase
Desmoteplase 90µg/kg BW i.v. bolus
Active Comparator: 2
Desmoteplase 125 µg/kg BW
Drug: Desmoteplase
Desmoteplase 125 µg/kg BW i.v. bolus
Placebo Comparator: 3
Placebo
Drug: Placebo
Placebo i.v. bolus



Primary Outcome Measures :
  1. National Institutes of Health Stroke Scale (NIHSS), Barthel-Index, mRS [ Time Frame: Day 90 ]
  2. Reperfusion after 4-8 h [ Time Frame: 8 h ]
  3. Infarct lesion volume after 30 days [ Time Frame: Day 30 ]
  4. Safety & pharmacokinetic outcomes [ Time Frame: Day 90 ]


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Ages Eligible for Study:   18 Years to 85 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • scoring 4 to 20 on the National Institute of Health Stroke Scale (NIHSS)
  • showing a perfusion-diffusion mismatch on MRI of 20 %
  • enrolment within a 3 h to 9 h time window after symptom onset.
  • 18-85 years of age

Exclusion Criteria:

  • Participation in any interventional trial in the previous 30 days.
  • Women in the childbearing age.
  • Any history of intracranial hemorrhage, subarachnoid hemorrhage, neoplasm, arteriovenous malformation or aneurysm.
  • Conditions that, according to the judgment of the investigator, might impose an additional risk to any individual stroke patient when receiving study medication (this applied to patients on platelet-function inhibitors as well).
  • MRI exclusion criteria: Evidence of ICH, Evidence of SAH, Signs of extensive early infarction on DWI assessed by evidence of involvement of >1/3 of the middle cerebral artery (MCA) territory. No perfusion deficit, Internal carotid artery (ICA) occlusion ipsilateral to stroke lesion without additional ipsilateral MCA, anterior cerebral artery (ACA) or posterior cerebral artery (PCA) occlusion. Any intracranial pathology that would interfere with the MRI assessment of acute ischemic stroke.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00638248


Sponsors and Collaborators
PAION Deutschland GmbH
Investigators
Principal Investigator: Antony J. Furlan, MD Department of Neurology; the Cleveland Clinic Foundation

Additional Information:
Publications of Results:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Karin Wilhelm-Ogunbiyi, MD / Medical Director & Head of Clinical Development, PAION Deutschland GmbH
ClinicalTrials.gov Identifier: NCT00638248     History of Changes
Other Study ID Numbers: PN01-CLD-000002/01
First Posted: March 19, 2008    Key Record Dates
Last Update Posted: March 19, 2008
Last Verified: March 2008

Keywords provided by PAION Deutschland GmbH:
Acute ischemic stroke

Additional relevant MeSH terms:
Stroke
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Vascular Diseases
Cardiovascular Diseases
Salivary plasminogen activator alpha 1, Desmodus rotundus
Fibrinolytic Agents
Fibrin Modulating Agents
Molecular Mechanisms of Pharmacological Action