BRAVE-DREAMS (BRAin VEnous DRainage Exploited Against Multiple Sclerosis)

NCT ID: NCT01371760

Last Updated: 2015-12-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

212 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-08-31

Study Completion Date

2015-12-31

Brief Summary

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To assess in a double blinded randomized control trial (RCT) study design safety and effectiveness of balloon angioplasty of the main extracranial and extravertebral veins in multiple sclerosis (MS) associated to chronic cerebrospinal venous insufficiency (CCSVI).

Mean follow-up 1 year. 5-8 Italian centres 360 relapsing remitting (RR) MS patients will be randomized, with expanded disability disease scale (EDSS) ranging 2-5.5, age 18-65.

Detailed Description

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Safety will be assessed by measuring serious and minor adverse effects related to treatment.

Effectiveness will be assessed by measuring 2 primary endpoints:

1. Clinical parameters will be expressed in an integrated functional measure leading to the score, respectively, of improved, stable, worsened. Functional assessment is performed by tools permitting a quantification and will be made by a team of independent assessors. Clinical instrumental evaluation will be performed at baseline, and subsequently on 3 months basis. The outcome parameters leading to the composite functional measure are instrumental parameters, less assessor dependent, singularly validated for measuring the disability in MS. They are the followings: A) Dynamic Balance Assessment: Balance Master Limits of Stability (LOS). In static platform, swinging to reach the set position of center of pressure. B) Walking Function: The subject walks spontaneously for 10 meters with chronometric measure of time counting the number of steps. The test calculates the walk ratio i.e. ratio between length and step frequency. C) Manual dexterity. Box \& Block test, moving wooden cubes. D) Sphincter control: Post-voiding residual by ultrasounds. F) Visual acuity: Low-contrast visual acuity Sloan Letter Chart.
2. Magnetic Resonance Imaging (MRI) outcome measures: T1Gad active lesion.T2 lesion volume MRI evaluation at baseline, 6, 12 months.

Secondary endpoints are: EDSS, chronic fatigue, cognitive function, rate of restenosis, annualized relapse rate.

Conditions

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Multiple Sclerosis Venous Insufficiency

Keywords

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Multiple sclerosis Chronic cerebrospinal venous insufficiency Percutaneous Transluminal Angioplasty (PTA) Internal jugular vein Azygous vein

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Intervention

The patients will undergo PTA of the extracranial cerebral veins

Group Type EXPERIMENTAL

Venous PTA

Intervention Type PROCEDURE

PTA of the internal jugular and/or azygous vein

Controls

The patients will undergo sham procedure

Group Type SHAM_COMPARATOR

Catheter Venography

Intervention Type OTHER

The patients will undergo catheter venography but not PTA

Interventions

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Venous PTA

PTA of the internal jugular and/or azygous vein

Intervention Type PROCEDURE

Catheter Venography

The patients will undergo catheter venography but not PTA

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* patients affected by CCSVI associated with MS
* relapsing-remitting and\\or secondary progressive
* 18-65 years old
* EDSS 2-5
* disease duration \< 10y
* No relapse in the 30 days preceding the procedure
* clinical stability in the last 6 months with disease mod. treatments
* Patients under the best available therapy

Exclusion Criteria

* patients previously treated for CCSVI or inserted in other clinical trials in the last 3 months
* under treatment with natalizumab
* pregnant or refusing to adopt contraception
* presence of significant comorbidities
* alcool-drug abuse
* thrombophilia
* contraindication to MR
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Regione Emilia-Romagna

OTHER

Sponsor Role collaborator

S. Anna Hospital

OTHER

Sponsor Role lead

Responsible Party

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Paolo Zamboni

PI

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Paolo Zamboni, MD

Role: PRINCIPAL_INVESTIGATOR

S. Anna Hospital, University of Ferrara, Ferrara, Italy

Graziella Filippini, MD

Role: STUDY_CHAIR

Istituto Neurologico Besta, Milano, Italy

Locations

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S. Anna Hospital

Ferrara, Fe, Italy

Site Status

S. Anna Hospital, University of Ferrara, Ferrara, Italy

Ferrara, , Italy

Site Status

Countries

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Italy

References

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Zamboni P, Galeotti R, Menegatti E, Malagoni AM, Gianesini S, Bartolomei I, Mascoli F, Salvi F. A prospective open-label study of endovascular treatment of chronic cerebrospinal venous insufficiency. J Vasc Surg. 2009 Dec;50(6):1348-58.e1-3. doi: 10.1016/j.jvs.2009.07.096.

Reference Type RESULT
PMID: 19958985 (View on PubMed)

Zamboni P, Galeotti R, Salvi F, Giaquinta A, Setacci C, Alborino S, Guzzardi G, Sclafani SJ, Maietti E, Veroux P; Brave Dreams Research Group. Effects of Venous Angioplasty on Cerebral Lesions in Multiple Sclerosis: Expanded Analysis of the Brave Dreams Double-Blind, Sham-Controlled Randomized Trial. J Endovasc Ther. 2020 Feb;27(1):1526602819890110. doi: 10.1177/1526602819890110. Epub 2019 Nov 17.

Reference Type DERIVED
PMID: 31735108 (View on PubMed)

Zamboni P, Tesio L, Galimberti S, Massacesi L, Salvi F, D'Alessandro R, Cenni P, Galeotti R, Papini D, D'Amico R, Simi S, Valsecchi MG, Filippini G; Brave Dreams Research Group. Efficacy and Safety of Extracranial Vein Angioplasty in Multiple Sclerosis: A Randomized Clinical Trial. JAMA Neurol. 2018 Jan 1;75(1):35-43. doi: 10.1001/jamaneurol.2017.3825.

Reference Type DERIVED
PMID: 29150995 (View on PubMed)

Zamboni P, Bertolotto A, Boldrini P, Cenni P, D'Alessandro R, D'Amico R, Del Sette M, Galeotti R, Galimberti S, Liberati A, Massacesi L, Papini D, Salvi F, Simi S, Stella A, Tesio L, Valsecchi MG, Filippini G; Chair of the Steering Committee. Efficacy and safety of venous angioplasty of the extracranial veins for multiple sclerosis. Brave dreams study (brain venous drainage exploited against multiple sclerosis): study protocol for a randomized controlled trial. Trials. 2012 Oct 3;13:183. doi: 10.1186/1745-6215-13-183.

Reference Type DERIVED
PMID: 23034121 (View on PubMed)

Related Links

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Other Identifiers

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S. Anna Hospital

Identifier Type: -

Identifier Source: org_study_id