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Implant for Augmentation of Cerebral Blood Flow Trial, Effectiveness and Safety in a 24 Hour Window (ImpACT-24A) (ImpACT-24A)

25. januar 2019 opdateret af: BrainsGate

A Multicenter, Randomized, Double Blind, Sham Control, Parallel Arm Trial to Assess Effectiveness and Safety of the Ischemic Stroke System ISS, as an Adjunct to Standard of Care in Subjects With Acute Ischemic Stroke

The primary objective of the study is to assess the safety and effectiveness of SPG stimulation with the ISS in patients with an acute ischemic stroke in the anterior circulation initiated within 24 hours from stroke onset.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This study was first registered as NCT00826059 on January 19, 2009 under the name ImpACT-24.

Background:

Recruitment to ImpACT-24 was halted, the protocol was amended and then the study was resumed. Later, it was decided to define the first part (before the halt) as a separate study - ImpACT-24A, and identify the continuation of the study as ImpACT-24B. ImpACT-24B continues to be registered as NCT00826059, and ImpACT-24A is registered in this new record.

Detailed Description:

A multi-center, multinational, randomized, double blind, sham control, adjunctive to Standard of Care, parallel arm study with ongoing DSMB review of accumulated safety data.

Screening:

Treatment should be initiated between 8 and 24 hours from stroke onset. All screened patients will be identified by patient number and will sign the informed consent prior to any study procedure initiation.

Period 1: Day 1-5

Day 1- Eligible subjects will be randomized in a 2:1 (ISS Stimulation: Sham Control) ratio:

Group 1: Implantation and ISS Stimulation during five consecutive days & Standard of Care Group 2: Implantation and Sham Stimulation during five consecutive days & Standard of Care The implantation will be performed by a trained physician. Stimulation/sham stimulation will be delivered Day 2-5 ISS / Sham Stimulation will be repeated during the following four consecutive days by trained personnel within 18-26 hours from preceding stimulation.

Day 5 / Day of Discharge. Following the last ISS /Sham Stimulation, explantation will be performed.

Subjects will continue with Standard of Care as needed and will be released from the hospital upon investigator's judgment.

Period 2: Day of Discharge - 90±7 days During this period both groups (ISS Stimulation and Sham Control) will be treated according to Standard of Care either at the hospital, rehabilitation center or at home.

Scheduled visits will be performed on day 30±7 and day 60 ±7, which will include safety and effectiveness assessments.

Final Visit Day 90±7 days: The final visit will be performed at the study site and will include safety and effectiveness evaluations.

Patients will be contacted by study personnel via telephone on Day 180±7 and on Day 360±7 in order to assess their quality of life status.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

327

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Tennessee
      • Chattanooga, Tennessee, Forenede Stater, 37404
        • Erlanger Stroke Center
  • Spanien
      • Barcelona, Spanien
        • Hospital Vall d'Hebron
      • Girona, Spanien
        • Hospital Universitari de Girona
  • Tyskland
      • Erlangen, Tyskland
        • Erlangen University Clinic
      • Essen, Tyskland
        • Essen University Clinic
      • Heidelberg, Tyskland
        • Heidelberg University Clinic
      • Leipzig, Tyskland
        • Leipzig University Clinic
      • Münster, Tyskland
        • Munster University Clinic

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 85 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  1. Age: ≥ 18 years and ≤ 85 of both genders.
  2. Clinical diagnosis of an acute ischemic stroke in the Carotid, Middle or Anterior Cerebral Artery territories
  3. Baseline NIHSS ≥ 7 and ≤ 18
  4. Ability to initiate treatment within 8- 24 hours from stroke onset.

Exclusion Criteria:

  1. Intracranial hemorrhage or hemorrhagic transformation
  2. Massive stroke
  3. Acute ischemic stroke in the posterior circulation
  4. Minor stroke
  5. Treated with IV-tPA ,IA-tPA or neurothrombectomy devices for the current stroke
  6. Previous stroke in the last 6 months or pre-existing disability
  7. Patients with bleeding propensity or any condition in the oral cavity that prevents implantation
  8. Known cerebral arteriovenous malformation, cerebral aneurysm.
  9. Clinical suspicion of septic embolus.
  10. Uncontrolled hypertension (systolic >185 mmHg and/or diastolic >110 mmHg)
  11. Serious systemic infection.
  12. Women known to be pregnant or having a positive or indeterminate pregnancy test.
  13. Patients with other implanted neural stimulator/ electronic devices (pacemakers).
  14. Life expectancy < 1 year from causes other than stroke.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Firedobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Active Stimulation
Device: The Ischemic Stroke System SPG stimulation and standard of care
Enhed: Active Stimulation
SPG stimulation and standard of care
Sham-komparator: Sham Stimulation
Device: Sham control Sham stimulation and standard of care
Enhed: Sham Stimulation
Sham SPG stimulation and standard of care

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Sliding Dichotomy modified Rankin Scale (mRS) at 3 months
Tidsramme: 90 ±7 days

Final global disability level on the modified Rankin scale (mRS) at 3 months better than expectation (sliding dichotomy analysis) ) assessed in the modified intention to treat (mITT) population defined as all randomized subjects receiving at least the minimal exposure of 1 treatment (ISS Stimulation or Sham Control) session out of the 5 planned sessions.

mRS Scale:

  • 0 - No symptoms.
  • 1 - No significant disability. Able to carry out all usual activities, despite some symptoms.
  • 2 - Slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities.
  • 3 - Moderate disability. Requires some help, but able to walk unassisted.
  • 4 - Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted.
  • 5 - Severe disability. Requires constant nursing care and attention, bedridden, incontinent.
  • 6 - Dead.
90 ±7 days
Number of participants with Serious Adverse Events
Tidsramme: 90 ±7 days
Comparison between the active and sham stimulation groups of all serious adverse events (SAEs)
90 ±7 days
Number of participants with neurological deterioration
Tidsramme: 10 days
Comparison between the active and sham stimulation groups of the rate of neurological deterioration, defined as an increase of 4 or more points on the NIHSS related to any neurological event within the first 10 days after stroke onset
10 days
Number of participants with implantation complications
Tidsramme: 90 ±7 days
The rate of implantation complications as classified by the investigator
90 ±7 days
Number of participants with stimulation-related adverse events
Tidsramme: 90 ±7 days
Comparison between the active and sham stimulation groups of stimulation-related adverse events as classified by the investigator
90 ±7 days
Mortality rate
Tidsramme: 90 ±7 days
Comparison of mortality rates between the active and sham stimulation groups
90 ±7 days

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Sliding Dichotomous 90-day mRS for patients with Aphasia at baseline
Tidsramme: 90 ±7 days

Sliding Dichotomous 90-day mRS for patients with Aphasia at baseline

mRS Scale:

  • 0 - No symptoms.
  • 1 - No significant disability. Able to carry out all usual activities, despite some symptoms.
  • 2 - Slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities.
  • 3 - Moderate disability. Requires some help, but able to walk unassisted.
  • 4 - Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted.
  • 5 - Severe disability. Requires constant nursing care and attention, bedridden, incontinent.
  • 6 - Dead.
90 ±7 days
Binary NIHSS at Day 90
Tidsramme: 90 ±7 days

Binary NIHSS (success for score ≤1 or for ≥ 9-point improvement versus baseline)

The NIHSS (National Institute of Health Stroke Score) is a 42-point scale that quantifies neurological deficits in 11 categories. Ratings for each item are scored with 3 to 5 grades, with 0 as normal.
90 ±7 days
Stroke-related quality of life at 3 months: Stroke Impact Scale-16
Tidsramme: 90 ±7 days

Stroke-related quality of life at 3 months according to the Stroke Impact Scale-16 (SIS-16)

The scale is based on a questionnaire with 16 items. Each answer ranges from 1 (poor) to 5 (good). A final single-item Recovery domain assesses the individual's perception of his/her recovery from stroke, where:

0 = no recovery 100 = full recovery.

Domain scores range from 0-100 and are calculated using the following equation:

Domain score = [(Mean item score - 1) / (5-1) ] x 100
90 ±7 days

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

BrainsGate

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. januar 2009

Primær færdiggørelse (Faktiske)

1. januar 2011

Studieafslutning (Faktiske)

1. marts 2012

Datoer for studieregistrering

Først indsendt

5. december 2018

Først indsendt, der opfyldte QC-kriterier

5. december 2018

Først opslået (Faktiske)

6. december 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

28. januar 2019

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. januar 2019

Sidst verificeret

1. december 2018

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • CLP1000500-24A

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ja

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Kliniske forsøg med Active Stimulation

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Betingelser

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Sponsor / samarbejdspartnere

Placeringer

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