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rhTNK-tPA for Acute Ischemic Stroke Under Simplified Imaging in the Extended Time Window (SIMPLIFIED)

11. juni 2026 oppdatert av: Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

rhTNK-tPA for Acute Ischemic Stroke Under Simplified Imaging in the Extended Time Window: A Multicenter, Prospective, Randomized Controlled, Open-label, Blinded-Endpoint Trial

The PEARL-SIMPLIFIED trial is a multicenter, prospective, randomized controlled, open-label, blinded-endpoint study. It aims to evaluate the efficacy and safety of intravenous tenecteplase (TNK) in patients with acute ischemic stroke (AIS) presenting in the extended 4.5-24 hour window, using a simplified imaging selection strategy based solely on non-contrast CT (NCCT).

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

The PEARL-SIMPLIFIED trial is a multicenter, prospective, randomized controlled, open-label, blinded-endpoint study with a target enrollment of at least 750 patients. The trial focuses on individuals with acute ischemic stroke (AIS) presenting within a 4.5 to 24-hour window who are not planned for endovascular thrombectomy (EVT). Patients meeting simplified imaging criteria based on non-contrast CT (NCCT) are randomized 1:1 to receive a single intravenous bolus of 0.25 mg/kg tenecteplase (TNK) or standard medical treatment. The primary outcome is the 90-day excellent functional outcome, defined as a modified Rankin Scale (mRS) score of 0-1. Safety outcomes include symptomatic intracranial hemorrhage (sICH) and 90-day mortality.

Studietype

Intervensjonell

Registrering (Antatt)

750

Fase

  • Fase 3

Kontakter og plasseringer

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

Studiekontakt

Studer Kontakt Backup

Studiesteder

  • Kina
      • Guangzhou, Kina, 510120
        • Rekruttering
        • Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University
        • Ta kontakt med:
        • Ta kontakt med:
        • Hovedetterforsker:
          • Yamei Tang, MD, PhD

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

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  1. Age 18 years or older.
  2. Presumed acute ischemic stroke of the anterior circulation.
  3. Acute ischemic stroke symptom onset between 4.5 to 24 hours prior to enrollment; including wake-up stroke and unwitnessed stroke, onset time refers to 'last-known well time'.
  4. Baseline National Institutes of Health Stroke Scale (NIHSS) 6-25 (inclusive).
  5. Limited early ischemic changes on non-contrast CT (NCCT).
  6. Written informed consent signed by patients or their legally authorized representatives.

Exclusion Criteria:

  1. Clearly demarcated hypodensity on non-contrast CT related to the current stroke, with limited anticipated clinical benefit as judged by the investigator.
  2. Intracranial or subarachnoid hemorrhage identified on baseline NCCT.
  3. Endovascular thrombectomy (EVT) planned at the time of randomization.
  4. Pre-stroke mRS≥2.
  5. Allergy to the test drug and its ingredients.
  6. Severe head trauma or ischemic stroke in the last 3 months.
  7. Intracranial or intraspinal surgery within 3 months before enrollment.
  8. Intracranial tumor or large-size aneurysm found before enrollment.
  9. Gastrointestinal or urinary system hemorrhage within the past 3 weeks.
  10. Active visceral bleeding.
  11. Aortic arch dissection confirmed by examination or medical history.
  12. Infective endocarditis confirmed by examination or medical history.
  13. Platelet count less than 100 × 109 /L.
  14. Patients received heparin or low-molecular-weighted heparin treatment within 24h before enrollment.
  15. Pregnant or lactating women.
  16. Blood glucose <50 mg/dl (2.78mmol/L) or >400 mg/dl (22.2mmol/L) during screening.
  17. Uncontrolled hypertension with persistent systolic blood pressure >185 mmHg or diastolic blood pressure >110 mmHg, refractory to medical management.
  18. Life expectancy less than 6 months due to malignancy, severe cardiopulmonary disease, or other terminal illness.
  19. Participating in other trials.
  20. Other conditions deemed unsuitable for the study by the investigator, such as inability to comprehend or comply with study procedures or follow-up due to mental illness, cognitive or emotional disorder.

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: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Intervention Arm
Intravenous tenecteplase
Legemiddel: Tenecteplase (rhTNK-tPA) (0.25 mg/kg, to maximum of 25mg)
Patients randomized to the intervention arm will receive tenecteplase via a single intravenous bolus (0.25 mg/kg; maximum dose 25 mg), administered immediately following randomization.
Aktiv komparator: Control Arm
Standard medical treatment
Legemiddel: Standard medical treatment
Patients in the control arm will receive standard medical treatment.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Excellent functional outcome
Tidsramme: at 90 (±14) days
The proportion of mRS score 0-1 at 90 (±14) days.
at 90 (±14) days

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Ordinal distribution of mRS
Tidsramme: at 90 (±14) days
The proportion of mRS distribution at 90 (±14) days
at 90 (±14) days
Favorable functional outcome
Tidsramme: at 90 (±14) days
The proportion of mRS score 0-2 at 90 (±14) days
at 90 (±14) days
Change in NIHSS Score at 24 (±12) hours
Tidsramme: at 24 (±12) hours
NIHSS score change from baseline at 24 (±12) hours
at 24 (±12) hours
Change in NIHSS Score at 7 (±1) days or discharge
Tidsramme: at 7 (±1) days or discharge
NIHSS score change from baseline at 7 (±1) days or discharge
at 7 (±1) days or discharge
Quality of life (EQ-5D-5L)
Tidsramme: at 90 (±14) days
Quality of life measured by EQ-5D-5L at 90 (±14) days
at 90 (±14) days
Symptomatic intracranial hemorrhage
Tidsramme: within 36 hours
Symptomatic intracranial hemorrhage (sICH) within 36 hours from randomization (SITS-MOST criteria)
within 36 hours
Any intracranial hemorrhage
Tidsramme: within 36 hours
Any intracranial hemorrhage within 36 hours
within 36 hours
Major extracranial bleeding
Tidsramme: within 36 hours
Major extracranial bleeding within 36 hours (GUSTO criteria: moderate and severe bleeding)
within 36 hours
Mortality
Tidsramme: within 90 days
All-cause mortality within 90 days
within 90 days

Samarbeidspartnere og etterforskere

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

Sponsor

Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

Etterforskere

  • Hovedetterforsker: Yamei Tang, MD, PhD, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University

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 (Antatt)

1. august 2026

Primær fullføring (Antatt)

1. desember 2028

Studiet fullført (Antatt)

1. desember 2028

Datoer for studieregistrering

Først innsendt

22. april 2026

Først innsendt som oppfylte QC-kriteriene

19. mai 2026

Først lagt ut (Faktiske)

26. mai 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

15. juni 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

11. juni 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • SYSKY-2026-479-02

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

JA

IPD-planbeskrivelse

The IPD will be available from the Principal Investigator upon reasonable request 6 months after the trial completion.

IPD-delingstidsramme

6 months after the trial completion.

Tilgangskriterier for IPD-deling

The IPD will be available from the Principal Investigator upon reasonable request 6 months after the trial completion.

IPD-deling Støtteinformasjonstype

  • STUDY_PROTOCOL
  • SEVJE
  • ICF
  • ANALYTIC_CODE
  • CSR

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

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