Denne siden ble automatisk oversatt og nøyaktigheten av oversettelsen er ikke garantert. Vennligst referer til engelsk versjon for en kildetekst.

Intravenous Thrombolysis Plus Hypothermia for Acute Treatment of Ischemic Stroke

11. januar 2011 oppdatert av: University of California, San Diego

Phase 1 Study of Intravenous Thrombolysis Plus Hypothermia for Acute Treatment of Ischemic Stroke

The purpose of this trial is to evaluate if it is safe to use tissue plasminogen activator (tPA) within 6 hours of stroke onset when combined with hypothermia.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

A stroke is usually caused by a blockage in one of the arteries that carries blood to the brain. Research has shown that tissue plasminogen activator (tPA)-a naturally occurring protein that opens blocked arteries by dissolving blood clots-activates the body's ability to dissolve recently formed blood clots and reduces or prevents the brain damage caused by a stroke.

The Food and Drug Administration (FDA) has approved the use of tPA for people having a stroke when taken within 3 hours of stroke onset, but not for those who arrive at the hospital more than 3 hours after stroke onset.

Researchers believe that a lower body temperature (hypothermia) may be beneficial while a stroke is happening because hypothermia may prevent further brain injury, or may make the stroke less damaging. In particular, hypothermia may make it possible to use tPA later than 3 hours after a stroke begins. This study will determine if it is safe to use tPA within 6 hours of the start of a stroke when combined with hypothermia.

Patients will receive a standard stroke evaluation, which includes blood tests, a computed tomography (CT) scan, complete physical and neurological examinations, and an electrocardiogram (EKG) to determine eligibility for the study.

Participants will be randomly assigned to a study group based on when their stroke began. Those who arrive at the hospital less than 3 hours from stroke onset will receive tPA alone or tPA with cooling (hypothermia). Those who arrive at the hospital 3 to 6 hours after stroke onset will be assigned to 1 of 4 groups-receiving either tPA alone, tPA with cooling, cooling alone, or standard medical care. Length of participation (including observation after the patient leaves the hospital) is 90 days.

This study is part of the Specialized Program of Translational Research in Acute Stroke (SPOTRIAS), which allows researchers to enhance and initiate translational research that ultimately will benefit stroke patients by treating more patients in less than 2 hours, and finding ways to treat additional patients later.

Studietype

Intervensjonell

Registrering (Forventet)

130

Fase

  • Fase 1

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • California
      • Palo Alto, California, Forente stater, 94304
        • Stanford Medical Center
      • San Diego, California, Forente stater, 92103
        • Scripps Mercy Hospital
      • San Diego, California, Forente stater, 92037
        • University of California San Diego, Thornton Hospital
      • San Diego, California, Forente stater, 92103
        • University of California San Diego, Hillcrest Medical Center
    • Connecticut
      • Hartford, Connecticut, Forente stater, 06102
        • Hartford Hospital
    • Missouri
      • St. Louis, Missouri, Forente stater, 63110
        • Saint Louis University Medical Center
    • Texas
      • Houston, Texas, Forente stater, 77030
        • Herman Memorial Hospital

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 80 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Age 18 to 80
  • All eligibility criteria for t-PA administration for acute ischemic stroke as outlined by the NINDS tPA Guidelines are met with the exception of time from onset
  • Stroke onset within 6 hours prior to planned start of tPA
  • Any subtype of ischemic stroke with NIHSS < 7 at the time hypothermia begins

Exclusion Criteria:

  • Etiology other than ischemic stroke
  • Item 1a on NIHSS>1 at the time of enrollment
  • Symptoms resolving or NIHSS < 7 at the time hypothermia begins
  • Contraindications to hypothermia, such as patients with known hematologic dyscrasias which affect thrombosis, (cryoglobulinemia, Sickle cell disease, serum cold agglutinins), or vasospastic disorders such as Raynaud's or thromboangiitis obliterans.
  • Known co-morbid conditions likely to complicate therapy, e.g., end-stage cardiomyopathy, uncompensated arrhythmia, myopathy, liver disease severe enough to elevate bilirubin, history of pelvic or abdominal mass likely to compress inferior vena cava, IVC filters, dementia severe enough to prevent valid consent, end-stage AIDS, known thyroid deficiency, known renal insufficiency likely to impair meperidine (Demerol®) clearance
  • Intracerebral hematoma
  • Any intraventricular hemorrhage
  • SBP > 185 or < 100; DBP > 110 or < 50 mmHg
  • Pregnancy in women of child-bearing potential (must have pregnancy test, urine or blood, prior to therapy).
  • Medical conditions likely to interfere with patient assessment
  • Known allergy to meperidine (Demerol®)
  • Currently taking MAO-I class of medication or used within previous 14 days
  • Life expectancy < 3 months
  • Not likely to be available for long-term follow-up.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Faktoriell oppgave
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: Group 1
Groups 1 and 2: Parallel groups, randomized to hypothermia or no hypothermia. Both groups receive tPA as a part of standard of care.
Legemiddel: tissue plasminogen activator
tPA is a naturally occurring protein that opens blocked arteries by dissolving blood clots
Aktiv komparator: Group 2
Groups 1 and 2: Parallel groups, randomized to hypothermia or no hypothermia. Both groups receive tPA as a part of standard of care.
Legemiddel: tissue plasminogen activator
tPA is a naturally occurring protein that opens blocked arteries by dissolving blood clots
Fremgangsmåte: hypothermia

Hypothermia with or without tPA for stroke. Hypothermia is induced using the Celsius Control™ System.

Subjects are stratified by time to six groups.
Ingen inngripen: Group 3
Groups 3, 4, 5 and 6: Factorial groups, randomized to hypothermia plus tPA, hypothermia alone, tPA alone, or no treatment assignment (standard of care).
Aktiv komparator: Group 4
Groups 3, 4, 5 and 6: Factorial groups, randomized to hypothermia plus tPA, hypothermia alone, tPA alone, or no treatment assignment (standard of care).
Legemiddel: tissue plasminogen activator
tPA is a naturally occurring protein that opens blocked arteries by dissolving blood clots
Aktiv komparator: Group 5
Groups 3, 4, 5 and 6: Factorial groups, randomized to hypothermia plus tPA, hypothermia alone, tPA alone, or no treatment assignment (standard of care).
Fremgangsmåte: hypothermia

Hypothermia with or without tPA for stroke. Hypothermia is induced using the Celsius Control™ System.

Subjects are stratified by time to six groups.
Aktiv komparator: Group 6
Groups 3, 4, 5 and 6: Factorial groups, randomized to hypothermia plus tPA, hypothermia alone, tPA alone, or no treatment assignment (standard of care).
Legemiddel: tissue plasminogen activator
tPA is a naturally occurring protein that opens blocked arteries by dissolving blood clots
Fremgangsmåte: hypothermia

Hypothermia with or without tPA for stroke. Hypothermia is induced using the Celsius Control™ System.

Subjects are stratified by time to six groups.

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Incidence and volume of hemorrhage on CT
Tidsramme: 48 hours post onset
48 hours post onset

Sekundære resultatmål

Resultatmål
Tidsramme
Incidence of AE and SAE
Tidsramme: 90 days post onset
90 days post onset
Mortality in both groups testing whether hypothermia improves mortality after stroke
Tidsramme: 90 Day
90 Day
NIHSS at the end of hypothermia
Tidsramme: Hour 23.5 +/- 30 minutes of hypothermia
Hour 23.5 +/- 30 minutes of hypothermia
Modified Rankin and NIHSS
Tidsramme: 30 and 90days
30 and 90days
CT lesion volume
Tidsramme: 30 days
30 days

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

University of California, San Diego

Samarbeidspartnere

National Institute of Neurological Disorders and Stroke (NINDS)

Etterforskere

  • Hovedetterforsker: Patrick Lyden, MD, University of California San Diego, Stroke Center

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. oktober 2003

Primær fullføring (Faktiske)

1. oktober 2008

Studiet fullført (Faktiske)

1. mai 2009

Datoer for studieregistrering

Først innsendt

26. januar 2006

Først innsendt som oppfylte QC-kriteriene

26. januar 2006

Først lagt ut (Anslag)

27. januar 2006

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

12. januar 2011

Siste oppdatering sendt inn som oppfylte QC-kriteriene

11. januar 2011

Sist bekreftet

1. januar 2009

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • P50NS44148LYDEN

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

Kliniske studier på tissue plasminogen activator

Søk i lignende forsøk

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

CROs by country

CROs in Sweden

Forhold

Sjeldne sykdommer

Legemiddelintervensjoner

Kosttilskudd

Sponsor / samarbeidspartnere

Steder

3
Abonnere