Efficacy and Safety of QD202 in Participants With Acute Ischemic Stroke Undergoing Thrombolysis Excluding Endovascular Thrombectomy

A Multicentre, Randomized, Double-blinded, Placebo-controlled Phase II Clinical Trial to Evaluate the Safety, Pharmacokinetic Profile, and Efficacy of QD202 Injection in Patients With Acute Ischemic Stroke Undergoing Thrombolysis

This is a randomized, double-blinded, placebo-controlled study investigating the safety and efficacy of QD202 injection in patients with acute ischemic stroke undergoing thrombolysis excluding endovascular thrombectomy. Up to 120 male and female patients with acute ischemic stroke undergoing thrombolysis excluding endovascular thrombectomy will be dosed with QD202 injection or placebo as a 60 minute intravenous infusion after completion of the thrombolysis procedure on Day 1-5 of the study period. Subjects will undergo interim procedures at Day 7 or the day of discharge, Day 30, and end-of-study procedures on Day 90.

Study Overview

Status

Recruiting

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

120

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Guangdong
      • Meizhou, Guangdong, China
        • Recruiting
        • Meizhou People's hospital
        • Contact:
        • Principal Investigator:
          • Tongguo Wei
    • Henan
      • Luoyang, Henan, China
        • Recruiting
        • Luoyang Central Hospital
        • Contact:
        • Principal Investigator:
          • Zhihui Duan
      • Nanyang, Henan, China
        • Recruiting
        • Nanshi Hospital of Nanyang
        • Contact:
        • Principal Investigator:
          • Zhaolong Peng
    • Jilin
      • Changchun, Jilin, China
        • Recruiting
        • Jilin Province People's Hospital
        • Contact:
        • Principal Investigator:
          • Zongshu Li
      • Meihekou, Jilin, China
        • Recruiting
        • Meihe Hospital the First Hospital of Jilin University
        • Principal Investigator:
          • Rui Wang
        • Contact:
    • Liaoning
      • Benxi, Liaoning, China
        • Recruiting
        • Benxi Central Hospital
        • Contact:
        • Principal Investigator:
          • Chengguang Song
      • Fuxin, Liaoning, China
        • Recruiting
        • General Hospital of Fuxin Mining Industry Group of Liaoning Health Industry Group
        • Contact:
        • Principal Investigator:
          • Lianqun Fu
      • Shengyang, Liaoning, China
        • Recruiting
        • Central Hospital Affiliated to Shenyang Medical College
        • Contact:
        • Principal Investigator:
          • Runhui Li
      • Shenyang, Liaoning, China
        • Recruiting
        • General Hospital of Northern Theater Command
        • Contact:
        • Principal Investigator:
          • Huisheng Chen
    • Shandong
      • Linyi, Shandong, China
        • Recruiting
        • Linyi People's Hospital
        • Principal Investigator:
          • Ziran Wang
        • Contact:
      • Weifang, Shandong, China
        • Recruiting
        • Weifang People's Hospital
        • Principal Investigator:
          • Li Zhou
        • Contact:
    • Shanghai Municipality
      • Shanghai, Shanghai Municipality, China
        • Recruiting
        • Shanghai Tenth People's Hospital
        • Contact:
        • Principal Investigator:
          • Jianliang Fu
      • Shanghai, Shanghai Municipality, China
        • Recruiting
        • Huashan Hospital Fudan University
        • Principal Investigator:
          • Liang Chen
        • Principal Investigator:
          • Jing Zhang
        • Contact:
        • Principal Investigator:
          • Xin Cheng
    • Shanxi
      • Linfen, Shanxi, China
        • Recruiting
        • Linfen Central Hospital
        • Principal Investigator:
          • Hongguo Dai
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • 1. Subjects aged 18-85 years (inclusive), regardless of gender;
  • 2. Diagnosed with acute ischemic stroke according to the Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke (2023);
  • 3. Time from stroke onset ≤ 24 hours (Onset time is calculated from the time stroke symptoms appear. If the stroke occurred during sleep or if the time of symptom onset cannot be accurately determined due to aphasia, impaired consciousness, or other reasons, the time the subject was last known to be normal should be used as the onset time);
  • 4. Pre-stroke modified Rankin Scale (mRS) score ≤ 1;
  • 5. After this event and prior to thrombolysis, NIHSS score is between 6 and 20 (inclusive), and the sum of scores on NIHSS Item 5 (motor arm) and Item 6 (motor leg) is ≥ 2;
  • 6. Planned for or have already undergone thrombolytic therapy;
  • 7. Female subjects of childbearing potential must have a negative serum pregnancy test and report no sexual activity within 14 days prior to screening. Subjects of childbearing potential (female or male) must agree to have no plans for pregnancy or sperm donation throughout the study period and are willing to use at least one effective method of contraception;
  • 8. The subject or their legal guardian voluntarily signs the informed consent form (ICF).

Exclusion Criteria:

  • 1. Allergy to any component of QD202 or the placebo.
  • 2. Intracranial hemorrhage detected on cranial computed tomography (CT), including hemorrhagic stroke (e.g., epidural hematoma, intracranial hematoma, intraventricular hemorrhage, subarachnoid hemorrhage) or hemorrhagic transformation of the current cerebral infarction. Subjects with mere microbleeds may be considered for inclusion at the investigator's discretion. Hemorrhage occurring after thrombolytic therapy, as a complication of the treatment and not classified as hemorrhagic stroke, may also be considered for inclusion at the investigator's discretion.
  • 3. Transient ischemic attack (TIA).
  • 4. Poorly controlled blood pressure despite active treatment (hypertension: systolic blood pressure ≥220 mmHg and/or diastolic blood pressure ≥120 mmHg; hypotension: systolic blood pressure ≤90 mmHg and/or diastolic blood pressure ≤40 mmHg).
  • 5. Severe hyperglycemia/hypoglycemia: blood glucose ≥400 mg/dL (22.2 mmol/L) or ≤50 mg/dL (2.8 mmol/L).
  • 6. Heart rate <50 beats per minute and/or >120 beats per minute; second- or third-degree atrioventricular block, sinoatrial block, or sinus arrest; history within 6 months prior to screening of heart failure (NYHA Class III or IV), unstable angina, acute myocardial infarction, or severe arrhythmia (including but not limited to rapid atrial fibrillation, atrial flutter, frequent premature beats, supraventricular or ventricular tachycardia).
  • 7. Severe impairment of consciousness after the current event and prior to thrombolysis: NIHSS level of consciousness (item 1a) score ≥2.
  • 8. History of severe psychiatric disorder or severe dementia.
  • 9. History of depression or anxiety, if the investigator deems participation in this clinical trial inappropriate.
  • 10. Subjects unsuitable for thrombolytic therapy, or those who have undergone or are planned to undergo endovascular interventional therapy.
  • 11. Use of therapeutic neuroprotective agents after stroke onset, including commercially available edaravone, edaravone dexborneol injection concentrate and sublingual tablets, ginkgolides, ginkgo diterpene lactone meglumine, nimodipine, gangliosides, citicoline, piracetam, oxiracetam, butylphthalide, cinepazide maleate injection, mouse nerve growth factor, potential neuroprotective Cerebrolysin (cerebroprotein hydrolysate), deproteinized calf blood extractives injection, ulinastatin, etc. (except mannitol used to reduce intracranial pressure).
  • 12. Concurrent malignancy diagnosed previously and currently undergoing anti-tumor therapy.
  • 13. History of severe systemic disease with an estimated life expectancy of <90 days.
  • 14. Diagnosed with severe active liver disease (e.g., acute hepatitis, chronic active hepatitis, cirrhosis) or alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >2.0 times the upper limit of normal (ULN).
  • 15. Diagnosed with severe active kidney disease, renal insufficiency, or estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m².
  • 16. Bleeding tendency, including platelet count (PLT) <75.0×10⁹/L, or history of major bleeding within 3 months prior to the current event.
  • 17. Major surgery within 4 weeks prior to screening, if the investigator assesses it may affect neurological function scores or 90-day survival.
  • 18. Alcohol dependence, drug abuse, substance addiction, or propensity for addiction.
  • 19. Participation in another clinical trial involving investigational drugs, vaccines, or medical devices within 3 months prior to screening.
  • 20. Any contraindication (e.g., cardiac pacemaker or other metal implants, claustrophobia) preventing or hindering CT or MRI examinations.
  • 21. Allergy to contrast agents.
  • 22. Chronic moderate to severe respiratory disease.
  • 23. Pregnant or breastfeeding women.
  • 24. Any other condition deemed by the investigator to make the subject unsuitable for participation in this clinical trial.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: QD202, 5 milligram (mg)
Participants will receive 100 mg of QD202 on Day 1 and 5 mg of QD202 daily from Day 2 to Day 5.
QD202 is a 19 amino acid peptide that consists of a 8 amino acid active domain and an 11 amino acid domain that enables the peptide to cross the blood-brain barrier.
Experimental: QD202, 10 milligram (mg)
Participants will receive 100 mg of QD202 on Day 1 and 10 mg of QD202 daily from Day 2 to Day 5.
QD202 is a 19 amino acid peptide that consists of a 8 amino acid active domain and an 11 amino acid domain that enables the peptide to cross the blood-brain barrier.
Placebo Comparator: Placebo Comparator
Participants will receive matching placebo daily from Day 1 to Day 5.
The placebo matches the investigational drug in appearance.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Safety and Tolerance
Time Frame: Through study completion, an average of 90 days
To evaluate the safety and tolerability of intravenous infusion of QD202 in patients with acute ischemic stroke undergoing thrombolysis. Incidence of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs); clinically significant changes from baseline in laboratory tests, 12-lead electrocardiograms, vital signs, etc.
Through study completion, an average of 90 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Modified Rankin Scale (mRS)
Time Frame: Day 30 and 90
Proportion of subjects achieving independent functioning as defined as a score of 0-1 or 0-2 on the mRS at Day 30 and Day 90.
Day 30 and 90
National Institutes of Health Stroke Scale (NIHSS)
Time Frame: Day 7 or day of discharge
Proportion of subjects achieving a good outcome as defined as a score of 0-1 on the NIHSS at Day 7 or day of discharge.
Day 7 or day of discharge
National Institutes of Health Stroke Scale (NIHSS)
Time Frame: Baseline up to Day 7 or day of discharge
Proportion of subjects achieving a good outcome as defined as a decrease of 4 or more points from baseline on the NIHSS at Day 7 or day of discharge.
Baseline up to Day 7 or day of discharge
National Institutes of Health Stroke Scale (NIHSS)
Time Frame: Baseline up to Day 90
Change in NIHSS score from baseline to Day 7 or day of discharge, Day 30, and Day 90.
Baseline up to Day 90
Barthel Index (BI)
Time Frame: Day 30 and 90
Proportion of subjects with a Barthel Index (BI) score ≥ 95 at Day 30 and Day 90 of treatment.
Day 30 and 90
The maximum plasma concentration (C[max])
Time Frame: Baseline up to Day 5
The C[max] is the maximum observed plasma concentration and will be determined for QD202.
Baseline up to Day 5
Time to reach the maximum plasma concentration (T[max])
Time Frame: Baseline up to Day 5
Time to reach maximum observed plasma concentration (T[max]) of QD202.
Baseline up to Day 5
Area under the plasma concentration-time curve from time zero to last time of quantifiable concentration (AUC[0-t])
Time Frame: Baseline up to Day 5
Area under the concentration-time curve from time zero to last time of quantifiable concentration of QD202.
Baseline up to Day 5
Terminal elimination half-life (t1/2)
Time Frame: Baseline up to Day 5
Apparent terminal elimination half-life of QD202.
Baseline up to Day 5
Drug Clearance (CL)
Time Frame: Baseline up to Day 5
The efficiency of irreversible elimination of QD202 from the body, typically measured in volume per time.
Baseline up to Day 5

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cerebral Infarct Volume
Time Frame: Baseline up to Day 7 or day of discharge
To measure the change in cerebral infarct volume from baseline in patients with acute ischemic stroke following intravenous infusion of QD202, as assessed by brain imaging.
Baseline up to Day 7 or day of discharge

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 14, 2025

Primary Completion (Estimated)

August 1, 2026

Study Completion (Estimated)

December 1, 2026

Study Registration Dates

First Submitted

April 30, 2026

First Submitted That Met QC Criteria

May 6, 2026

First Posted (Actual)

May 12, 2026

Study Record Updates

Last Update Posted (Actual)

May 12, 2026

Last Update Submitted That Met QC Criteria

May 6, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • IST-003-202508
  • CTR20253923 (Registry Identifier: Center for Drug Evaluation, NMPA)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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 Ischemic Stroke

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