Trial Outcomes & Findings for Evaluating Neuroprotection in Aneurysm Coiling Therapy (NCT NCT00728182)

NCT ID: NCT00728182

Last Updated: 2013-10-17

Results Overview

Volume of new ischemic lesions as defined by FLAIR MRI at 12-95 hours postdose

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

185 participants

Primary outcome timeframe

Enrolment, Days 2-4

Results posted on

2013-10-17

Participant Flow

Between September 16, 2008 and March 30, 2011, subjects were recruited to 10 hospitals in Canada and 3 in the United States.

12 subjects were randomized into study but did not receive drug:5 due to do endovascular aneurysm repair, 3 due to inability to obtain a pre-procedure MRI,2 due to pre-procedure ECG showing a QTc interval \> 450 ms, 1 due to a fatal aneurysm rupture before drug, and 1 due to refusal by anesthesiologist to give drug to a subject with severe COPD.

Participant milestones

Participant milestones
Measure
1 NA-1
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Overall Study
STARTED
92
93
Overall Study
COMPLETED
89
90
Overall Study
NOT COMPLETED
3
3

Reasons for withdrawal

Reasons for withdrawal
Measure
1 NA-1
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Overall Study
Adverse Event
1
0
Overall Study
Lost to Follow-up
2
0
Overall Study
Death
0
2
Overall Study
Protocol Noncompliance
0
1

Baseline Characteristics

Evaluating Neuroprotection in Aneurysm Coiling Therapy

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
1 NA-1
n=92 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=93 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Total
n=185 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
70 Participants
n=5 Participants
78 Participants
n=7 Participants
148 Participants
n=5 Participants
Age, Categorical
>=65 years
22 Participants
n=5 Participants
15 Participants
n=7 Participants
37 Participants
n=5 Participants
Age Continuous
57.72 years
STANDARD_DEVIATION 10.6 • n=5 Participants
56.05 years
STANDARD_DEVIATION 10.3 • n=7 Participants
56.88 years
STANDARD_DEVIATION 10.5 • n=5 Participants
Sex: Female, Male
Female
64 Participants
n=5 Participants
68 Participants
n=7 Participants
132 Participants
n=5 Participants
Sex: Female, Male
Male
28 Participants
n=5 Participants
25 Participants
n=7 Participants
53 Participants
n=5 Participants
Region of Enrollment
United States
12 participants
n=5 Participants
15 participants
n=7 Participants
27 participants
n=5 Participants
Region of Enrollment
Canada
80 participants
n=5 Participants
78 participants
n=7 Participants
158 participants
n=5 Participants

PRIMARY outcome

Timeframe: Enrolment, Days 2-4

Population: All study patients who received study drug and an analyzable MRI at 12-95 hours postdose.

Volume of new ischemic lesions as defined by FLAIR MRI at 12-95 hours postdose

Outcome measures

Outcome measures
Measure
1 NA-1
n=91 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=93 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Volume of New FLAIR Lesions(MRI)
915 mm^3
Standard Deviation 5598
477 mm^3
Standard Deviation 1611

SECONDARY outcome

Timeframe: Enrolment, Day 2-4

Population: All patients who received study drug and an analyzable MRI at 12-95 hours postdose.

Number of new ischemic lesions as defined by DWI MRI at 12-95 hours postdose.

Outcome measures

Outcome measures
Measure
1 NA-1
n=91 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=93 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Number of New DWI Lesions (MRI)
4.1 Lesions
Standard Deviation 6.8
7.3 Lesions
Standard Deviation 12.6

SECONDARY outcome

Timeframe: Enrolment, Days 2-4

Population: All patients who received study drug and an analyzable MRI scan at 12-95 hours postdose.

Number of new ischemic lesions as defined by FLAIR MRI at 12-95 hours postdose.

Outcome measures

Outcome measures
Measure
1 NA-1
n=91 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=93 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Number of New FLAIR Lesions (MRI)
3.0 Lesions
Standard Deviation 4.4
4.8 Lesions
Standard Deviation 7.7

SECONDARY outcome

Timeframe: Enrolment, Days 2-4

Population: All patients who received study drug and an analyzable MRI at 12-95 hours postdose.

Volume of new DWI lesions as defined by MRI at 12-95 hours postdose.

Outcome measures

Outcome measures
Measure
1 NA-1
n=91 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=93 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Volume of New DWI Lesions (MRI)
966 mm^3
Standard Deviation 5266
645 mm^3
Standard Deviation 1382

SECONDARY outcome

Timeframe: Enrolment, Day 30

Population: All patients who received study drug and outcome assessment at Day 30.

The NIHSS is a standardized neurological method to measure disability and recovery after stroke. Scores range from 0 to 42, with higher scores indicating increasing severity. Scores were dichotomized into 0-1 (good outcome) versus 2 or above. The number of participants scoring 0-1 on the NIHSS at Day 30 was compared for both groups.

Outcome measures

Outcome measures
Measure
1 NA-1
n=92 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=93 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
National Institutes of Health Stroke Scale (NIHSS).
86 No. of participants with NIHSS 0-1
Interval 0.9 to 1.1
83 No. of participants with NIHSS 0-1
Interval 0.9 to 1.1

SECONDARY outcome

Timeframe: Enrolment, Day 30

Population: All patients who received study drug and an outcome assessment at Day 30

The mRS is a measure of global disability that has been widely applied for evaluating recovery from stroke. Scores range from 0 to 6, with higher scores indicating greater disability. A score of 0 indicates no residual symptoms; 1 = no significant disability/able to carry out all usual activities, despite some symptoms; 2 = slight disability; 3 = moderate disability; 4 = moderately severe disability; 5 = severe disability; 6 = death. The number of participants scoring 0-2 on the mRS at Day 30 was compared in both treatment groups.

Outcome measures

Outcome measures
Measure
1 NA-1
n=92 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=93 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Modified Rankin Scale (mRS).
86 No. of participants with mRS 0-2
Interval 0.9 to 1.1
87 No. of participants with mRS 0-2
Interval 0.9 to 1.1

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrolment, Days 2-4

Population: All subjects who entered the study with a ruptured aneurysm, who received study drug and an analyzable MRI at 12-95 hours postdose.

Volume of new ischemic lesions as defined by FLAIR MRI at 12-95 hours postdose (pre-specified subgroup analysis)

Outcome measures

Outcome measures
Measure
1 NA-1
n=18 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=19 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Volume of New FLAIR Lesions (MRI) - Ruptured Aneurysm Subjects
205 mm^3
Standard Deviation 495
1575 mm^3
Standard Deviation 3229

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrolment, Day 2-4

Population: All subjects who entered the study with a ruptured aneurysm, who received study drug and an analyzable MRI at 12-95 hours postdose.

Number of new ischemic lesions as defined by DWI MRI at 12-95 hours postdose(pre-specified subgroup analysis)

Outcome measures

Outcome measures
Measure
1 NA-1
n=18 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=19 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Number of New DWI Lesions (MRI) - Ruptured Aneuryms Subjects
3.4 Lesions
Standard Deviation 5.9
9.47 Lesions
Standard Deviation 11.6

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrolment, Day 2-4

Population: All subjects who entered the study with a ruptured aneurysm, who received study drug and an analyzable MRI at 12-95 hours postdose.

Number of new ischemic lesions as defined by FLAIR MRI at 12-95 hours postdose(pre-specified subgroup analysis)

Outcome measures

Outcome measures
Measure
1 NA-1
n=18 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=19 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Number of New FLAIR Lesions (MRI) - Ruptured Aneurysm Subjects
2.4 Lesions
Standard Deviation 4.7
6.58 Lesions
Standard Deviation 7.5

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrolment, Day 2-4

Population: All subjects who entered the study with a ruptured aneurysm, who received study drug and an analyzable MRI at 12-95 hours postdose.

Volume of new DWI lesions as defined by MRI at 12-95 hours postdose(pre-specified subgroup analysis)

Outcome measures

Outcome measures
Measure
1 NA-1
n=18 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=19 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Volume of New DWI Lesions (MRI) - Ruptured Aneurysm Subjects
277 mm^3
Standard Deviation 528
1373 mm^3
Standard Deviation 2267

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrolment, Day 30

Population: All subjects who entered the study with a ruptured aneurysm, who received study drug and outcome assessment at Day 30.

The NIHSS is a standardized neurological method to measure disability and recovery after stroke. Scores range from 0 to 42, with higher scores indicating increasing severity. Scores were dichotomized into 0-1 (good outcome) versus 2 or above. The number of participants scoring 0-1 on the NIHSS at Day 30 was compared for participants with ruptured aneurysms in both treatment groups(pre-specified subgroup analysis).

Outcome measures

Outcome measures
Measure
1 NA-1
n=18 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=19 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
National Institutes of Health Stroke Scale (NIHSS) - Ruptured Aneurysm Subjects
18 No. of participants with NIHSS 0-1
13 No. of participants with NIHSS 0-1

OTHER_PRE_SPECIFIED outcome

Timeframe: Enrolment, Day 30

The mRS is a measure of global disability that has been widely applied for evaluating recovery from stroke. Scores range from 0 to 6, with higher scores indicating greater disability. A score of 0 indicates no residual symptoms; 1 = no significant disability/able to carry out all usual activities, despite some symptoms; 2 = slight disability; 3 = moderate disability; 4 = moderately severe disability; 5 = severe disability; 6 = death. The number of participants scoring 0-2 on the mRS at Day 30 with ruptured aneurysms was compared in both treatment groups(pre-specified subgroup analysis).

Outcome measures

Outcome measures
Measure
1 NA-1
n=18 Participants
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=19 Participants
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Modified Rankin Scale (mRS)- Ruptured Aneurysm Subjects
17 No. of participants with mRS 0-2
14 No. of participants with mRS 0-2

Adverse Events

1 NA-1

Serious events: 9 serious events
Other events: 83 other events
Deaths: 0 deaths

2 Placebo

Serious events: 14 serious events
Other events: 85 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
1 NA-1
n=92 participants at risk
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=93 participants at risk
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Gastrointestinal disorders
Gastrointestinal
0.00%
0/92
2.2%
2/93 • Number of events 2
Injury, poisoning and procedural complications
Procedural complications
1.1%
1/92 • Number of events 1
2.2%
2/93 • Number of events 2
Nervous system disorders
Nervous system
3.3%
3/92 • Number of events 3
9.7%
9/93 • Number of events 14
Renal and urinary disorders
Genitourinary
1.1%
1/92 • Number of events 1
1.1%
1/93 • Number of events 1
Respiratory, thoracic and mediastinal disorders
Respiratory
1.1%
1/92 • Number of events 2
1.1%
1/93 • Number of events 2
Vascular disorders
Vascular
3.3%
3/92 • Number of events 3
3.2%
3/93 • Number of events 3
General disorders
Administration site
1.1%
1/92 • Number of events 1
0.00%
0/93

Other adverse events

Other adverse events
Measure
1 NA-1
n=92 participants at risk
20 amino acid peptide that consists of a 9 amino acid domain that inhibits PSD-95 and a 11 amino acid domain than enables the peptide to cross the blood-brain barrier. NA-1 : single intravenous dose of 2.6 mg/kg of NA-1 administered as a 10-minute infusion
2 Placebo
n=93 participants at risk
Placebo : single intravenous dose of 2.6 mg/kg of placebo administered as a 10-minute infusion
Nervous system disorders
Headache
45.7%
42/92 • Number of events 47
39.8%
37/93 • Number of events 39
Gastrointestinal disorders
Nausea
35.9%
33/92 • Number of events 33
29.0%
27/93 • Number of events 28
Gastrointestinal disorders
Vomiting
13.0%
12/92 • Number of events 12
8.6%
8/93 • Number of events 8
Vascular disorders
Hypotension
9.8%
9/92 • Number of events 10
6.5%
6/93 • Number of events 6
Injury, poisoning and procedural complications
Procedural pain
2.2%
2/92 • Number of events 2
10.8%
10/93 • Number of events 10
Vascular disorders
Hypertension
4.3%
4/92 • Number of events 4
7.5%
7/93 • Number of events 7
Eye disorders
Eye pain
1.1%
1/92 • Number of events 1
5.4%
5/93 • Number of events 5
Gastrointestinal disorders
Constipation
4.3%
4/92 • Number of events 4
7.5%
7/93 • Number of events 7
General disorders
Fatigue
1.1%
1/92 • Number of events 1
7.5%
7/93 • Number of events 7
General disorders
Puncture site pain
5.4%
5/92 • Number of events 5
5.4%
5/93 • Number of events 5
Infections and infestations
Urinary tract infection
7.6%
7/92 • Number of events 7
3.2%
3/93 • Number of events 3
Metabolism and nutrition disorders
Hypocalcaemia
4.3%
4/92 • Number of events 4
5.4%
5/93 • Number of events 5
Metabolism and nutrition disorders
Hypokalaemia
6.5%
6/92 • Number of events 6
4.3%
4/93 • Number of events 4
Musculoskeletal and connective tissue disorders
Back pain
6.5%
6/92 • Number of events 6
7.5%
7/93 • Number of events 7
Nervous system disorders
Dizziness
6.5%
6/92 • Number of events 6
2.2%
2/93 • Number of events 3
Nervous system disorders
Hypoaesthesia
4.3%
4/92 • Number of events 4
5.4%
5/93 • Number of events 5
Psychiatric disorders
Anxiety
3.3%
3/92 • Number of events 3
7.5%
7/93 • Number of events 8
Renal and urinary disorders
Haematuria
5.4%
5/92 • Number of events 5
4.3%
4/93 • Number of events 4
Skin and subcutaneous tissue disorders
Alopecia
5.4%
5/92 • Number of events 5
2.2%
2/93 • Number of events 2
Vascular disorders
Haematoma
6.5%
6/92 • Number of events 6
7.5%
7/93 • Number of events 7

Additional Information

Roberta Anderson, Vice President of Clinical Development

NoNO Inc.

Phone: 613 833-1020

Results disclosure agreements

  • Principal investigator is a sponsor employee The Investigator shall have the right to publish any information after prior submittal to NoNO, where NoNO can request a hold for up to 60 days, provided that no publication shall disclose Proprietary Information other than Data containing the results of the Study. Investigators may not publish in the first 18 months after the close of the trial except within a publication representing all participating clinical sites.
  • Publication restrictions are in place

Restriction type: OTHER