- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05372718
Thrombolysis With Recombinant Non-immunogenic Staphylokinase vs Surgery in Patients With Acute Limb Ischemia FORAT Trial (FORAT)
Multicenter, Open-label, Randomized Clinical Trial of Efficacy and Safety of the Thrombolysis With Recombinant Non-immunogenic Staphylokinase (Fortelyzin®) in Patients With ALI vs Surgery
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Fortelyzin® (the active substance Forteplase) is a recombinant non-immunogenic staphylokinase with high fibrinselective thrombolytic activity. In a multicentre, randomised clinical trial in patients with ST-segment elevation myocardial infarction (FRIDOM), non-immunogenic staphylokinase was administered as a single intravenous bolus of 15 mg in all patients, regardless of bodyweight, and showed similar high reperfusion patency and fewer minor bleeding events compared with tenecteplase, as well as the absence of neutralising IgGs. Results of the multicentre, randomised clinical trial in patients with an acute ischaemic stroke (FRIDA) suggested that the non-immunogenic staphylokinase administrated as a single intravenous bolus of 10 mg in all patients within the 4-5 h after the onset of symptoms is non-inferior to alteplase. Mortality, symptomatic intracranial haemorrhage, and serious adverse events did not differ between treatment groups.
Mortality in the ALI continues to be high. According to the Guidelines on the management of patients with ALI, intravenous systemic thrombolysis is ineffective in patients with this condition. In contrast, catheter-directed thrombolysis based on the principle that activation of fibrin-bound plasminogen to the active enzyme plasmin is the most effective approach of lysing pathologic thrombi in the lower extremities of I-II b degree of ALI (Evidence level I-A).
So the main objective of this study is to evaluate the efficacy and safety of intra-arterial intrathrombus administration of the recombinant non-immunogenic staphylokinase (Fortelyzin®) in patients with ALI vs surgery.
Study Type
Enrollment (Anticipated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Sergey S. Markin, MD, PhD
- Phone Number: +7 (906) 796-89-06
- Email: amsemenof@gmail.com
Study Locations
-
-
-
Moscow, Russian Federation, 115446
- Recruiting
- S.S. Yudin City Clinical Hospital
-
Contact:
- Bogdan B. Orlov, PhD
-
Principal Investigator:
- Bogdan B. Orlov, PhD
-
Moscow, Russian Federation, 123182
- Not yet recruiting
- Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency
-
Contact:
- Troitskiy V. Alexander, MD, PhD
- Phone Number: +7 (495) 395-61-97
- Email: dr.troitskiy@gmail.com
-
Principal Investigator:
- Troitskiy V. Alexander, MD, PhD
-
Rostov-on-Don, Russian Federation, 344022
- Not yet recruiting
- Rostov State Medical University
-
Contact:
- Igor I. Prostov, PhD
- Phone Number: +7 (863) 250-40-75
- Email: igor-prostov@mail.ru
-
Principal Investigator:
- Igor I. Prostov, PhD
-
Tver, Russian Federation, 170036
- Not yet recruiting
- Tver Regional Clinical Hospital
-
Contact:
- Vladimir V. Bobkov, PhD
- Phone Number: +7 4822775454
- Email: vladibo73@gmail.com
-
Principal Investigator:
- Vladimir V. Bobkov, PhD
-
Volgograd, Russian Federation, 400138
- Not yet recruiting
- Volgograd City Clinical Hospital of Emergency #25
-
Contact:
- Eduard A. Ponomarev, MD, PhD
- Phone Number: +7 8442585426
- Email: ponomarev67@mail.ru
-
Principal Investigator:
- Eduard A. Ponomarev, MD, PhD
-
-
Moscow Region
-
Sergiyev Posad, Moscow Region, Russian Federation, 141301
- Recruiting
- Sergiyev Posad Regional Clinical Hospital
-
Contact:
- Anton G. Koledinskyi, MD, PhD
- Phone Number: +7 (49654) 2-22-84
-
Principal Investigator:
- Anton G. Koledinskyi, MD, PhD
-
-
Republic Of Tatarstan
-
Kazan, Republic Of Tatarstan, Russian Federation, 420012
- Recruiting
- Kazan State Medical University
-
Contact:
- Ivan I. Klushkin, MD, PhD
- Phone Number: +7 (843) 223-04-13
- Email: hirurgivan@mail.ru
-
Principal Investigator:
- Ivan I. Klushkin, MD, PhD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Men and women aged 18 and older;
- Diagnosis of I-II b degree of ALI;
Patient consent to use reliable contraceptive methods throughout the study and for 3 weeks after:
- women who have a negative pregnancy test and use the following contraceptives: intrauterine devices, oral contraceptives, contraceptive patch, prolonged injectable contraceptives, double barrier method of contraception. Women who are not fertile can also take part in the study (documented conditions: hysterectomy, tubal ligation, infertility, menopause for more than 1 year);
- men using barrier contraception. The study may also involve men who are not fertile (documented conditions: vasectomy, infertility);
- Availability of signed and dated informed consent of the patient to participate in the study.
Exclusion Criteria:
- Extensive bleeding at present;
- Intracranial (including subarachnoid) hemorrhage at present;
- Recent gastrointestinal bleeding (within 10 days);
- Major surgery or major trauma within the previous 3 months, recent traumatic brain injury;
- Systolic blood pressure above 180 mm Hg or diastolic blood pressure above 110 mm Hg or the need for intravenous drugs to lower blood pressure to these limits;
- Pregnancy, lactation;
- Known hypersensitivity to Fortelyzin®;
- Platelet count less than 100,000/µL
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Recombinant non-immunogenic staphylokinase
lyophilisate for preparation a solution, 5 mg (745,000 IU) in 20 ml over 1 minute through a perforated multihole catheter intrathrombally. 30 minutes after this injection, infusion of recombinant non-immunogenic staphylokinase will be continued at a dose of 1 mg/hour, maximum 10 mg (50 ml) for 10 hours through a perforated multihole catheter intrathrombally. |
lyophilisate for preparation a solution
Other Names:
|
Experimental: Surgical methods of treatment
endovascular intervention, open surgery and/or bypass surgery in accordance with the current National Guidelines
|
Endovascular intervention, open surgery and/or bypass surgery in accordance with the current National Guidelines
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of patients without amputations
Time Frame: 30 days post randomization
|
Outcome Measure is evaluated in terms of the number of patients without amputations
|
30 days post randomization
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety endpoint - Death from all causes
Time Frame: 30 days post randomization
|
The safety is evaluated in terms of the number of deaths from all causes
|
30 days post randomization
|
Safety endpoint - hemorrhagic stroke
Time Frame: 30 days post randomization
|
The safety is evaluated in terms of the number of hemorrhagic stroke
|
30 days post randomization
|
Safety endpoint - BARC type 3 and 5 bleeding
Time Frame: 30 days post randomization
|
The safety is evaluated in terms of the number of BARC type 3 and 5 bleeding
|
30 days post randomization
|
Safety endpoint - Number and severity of serious adverse events (SAEs) and AEs in organs and systems
Time Frame: 30 days post randomization
|
The safety is evaluated in terms of the number and severity of SAEs and AEs in organs and systems
|
30 days post randomization
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Igor I. Zatevakhin, MD, PhD, N.I. Pirogov Russian Medical University, President of the Russian Society of Surgeons
- Study Director: Sergey S. Markin, MD, PhD, Supergene, LLC
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- FORAT
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Acute Limb Ischemia
-
Assiut UniversityRecruitingAcute Limb IschemiaEgypt
-
Mansoura UniversityCompleted
-
Mast Therapeutics, Inc.Terminated
-
Centre Hospitalier Universitaire de NiceRecruitingAcute Ischemia of Lower LimbFrance
-
Azienda Ospedaliera Universitaria SeneseUnknown
-
Uppsala University HospitalCompletedAcute Ischemia of Lower Limb
-
Penumbra Inc.CompletedLower Extremity Acute Limb Ischemia | LE ALIUnited States, Spain, Germany
-
R3 Vascular Inc.RecruitingCritical Limb Ischemia | Critical Lower Limb Ischemia | Critical Limb-Threatening IschemiaAustralia
-
Medical University InnsbruckCompletedAcute Limb IschemiaCroatia, United Kingdom, Germany, Austria, France, Hungary, Moldova, Republic of, Netherlands, Serbia, Switzerland
-
Center of New Medical TechnologiesNot yet recruiting
Clinical Trials on Recombinant non-immunogenic staphylokinase (Fortelyzin®)
-
Supergene, LLCNot yet recruitingPulmonary EmbolismRussian Federation
-
Supergene, LLCUnknownMyocardial InfarctionRussian Federation
-
Supergene, LLCCompletedMassive Pulmonary EmbolismRussian Federation
-
Supergene, LLCCompletedIschemic StrokeRussian Federation
-
The First Affiliated Hospital of Xiamen UniversityRecruitingRheumatoid ArthritisChina
-
International Vaccine InstituteBill and Melinda Gates Foundation; Thrasher Research Fund; Open PhilanthropyNot yet recruiting
-
Julio RamirezUniversity of LouisvilleTerminatedOsteomyelitisUnited States
-
Celularity IncorporatedActive, not recruitingMetastatic HER2 Positive Gastroesophageal Junction CancerUnited States
-
St. Jude Children's Research HospitalSchering-PloughActive, not recruitingMalignant MelanomaUnited States
-
Washington University School of MedicineNational Cancer Institute (NCI); American Society of Clinical Oncology; ImmunityBio... and other collaboratorsTerminatedLeukemia, Myeloid, AcuteUnited States