A Study in Chinese Patients to Compare How Tenecteplase and Alteplase Given After a Stroke Improve Recovering of Physical Activity

NCT ID: NCT04915729

Last Updated: 2024-12-10

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1489 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-06-22

Study Completion Date

2023-10-08

Brief Summary

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This study is open to Chinese adults who had an ischaemic stroke, which means that blood vessels in the brain are blocked. To resolve blood clots, people in the study get either tenecteplase or alteplase within 4 hours and 30 minutes after stroke. The purpose of this study is to compare how tenecteplase and alteplase improve peoples' recovering of physical activity. Alteplase is standard of care. Tenecteplase is a modified variant of alteplase that is easier to administer and is approved to treat heart attack. This study is to find out whether tenecteplase is as good as alteplase in people with ischaemic stroke.

Participants are equally put into 2 treatment groups by chance. Participants in one group get tenecteplase as a single injection into a vein. Participants in the other group get alteplase as an injection into a vein (10% of the dose) and the remainder as an infusion over 1 hour.

Participants are in the study for about 3 months. They are in the hospital for the first week after treatment. Then they visit the study site 1 and 3 months after treatment. At these visits, peoples' ability to independently carry out daily activities is assessed. Scores for physical activity are compared between both treatment groups. The doctors also regularly check the general health of the participants.

Detailed Description

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Conditions

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Stroke

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Alteplase active control group

Chinese patients with AIS were screened (visit 1) and randomised (visit 2a) when admitted. Patients received a single dose of alteplase, 0.9 mg/kg, 10% via intravenous (iv) bolus and the remaining 90% of the total dose administered as an iv infusion over 1 h no later than 4.5 hours (h) after symptom onset. Visits on Day 1 consisted of two further visits (Visit 2b and Visit 2c) that were performed 1 h and 2 h after the start of the treatment. Visits 3 to 5 for continuous follow-up were performed on day 2, 8 and 30 after the start of the treatment. Treated patient performed a 90-day follow-up visit after the treatment to complete the study.

Group Type ACTIVE_COMPARATOR

alteplase

Intervention Type DRUG

alteplase

Tenecteplase treatment group

Chinese patients with AIS were screened (visit 1) and randomised (visit 2a) when admitted. Patients received a single dose of tenecteplase, 0.25 mg/kg via intravenous (iv) bolus no later than 4.5 hours (h) after symptom onset. Visits on Day 1 consisted of two further visits (Visit 2b and Visit 2c) that were performed 1 h and 2 h after the start of the treatment. Visits 3 to 5 for continuous follow-up were performed on day 2, 8 and 30 after the start of the treatment. Treated patient performed a 90-day follow-up visit after the treatment to complete the study.

Group Type EXPERIMENTAL

tenecteplase

Intervention Type DRUG

tenecteplase

Interventions

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tenecteplase

tenecteplase

Intervention Type DRUG

alteplase

alteplase

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 years old
* Diagnosis of ischaemic stroke with a measurable neurological deficit on National Institutes of Health Stroke Scale (NIHSS) (0\< NIHSS ≤25); if NIHSS \<4, patients have to be with at least a measurable deficit on motor power (upper or lower limbs ≥1)
* Stroke symptoms should have been present for at least 30 minutes (min) without significant improvement prior to randomisation
* Thrombolytic therapy can be initiated within 4.5 Hour(s) (h) of Acute ischaemic stroke (AIS) onset
* Patients with premorbid modified Rankin Scale (mRS) 0 or 1
* Signed and dated written informed consent in accordance with good clinical practice (GCP) and local legislation prior to trial admission

Exclusion Criteria

* Evidence of intracranial haemorrhage on the Computed tomography (CT) scan or symptoms suggestive of subarachnoid haemorrhage, even if the CT scan is normal
* Patients who must or are expected to continue the intake of restricted medications or any drug considered likely to interfere with the safe conduct of the trial
* Acute bleeding diathesis, including but not limited to

* Known genetic predisposition to bleeding or significant bleeding disorder at present or within the past 6 Month(s) (m)
* Administration of heparin within the previous 48 h and activated partial thromboplastin time (aPTT) exceeding the upper limit of normal for laboratory measurement
* Current use of vitamin K based oral anticoagulants (e.g. warfarin) and a prolonged prothrombin time (International normalised Ratio (INR) \> 1.7 or Prothrombin time (PT)\>15 seconds (s)) or current use of novel oral anticoagulants (i.e. dabigitran, rivaroxiban, or apixiban) with prolongation of activated partial thromboplastin time (aPTT) and/or PT above the upper limit of the local laboratory reference range
* Platelet count of below 100,000/mm3 at screening
* Any history of central nervous system damage (i.e. neoplasm, aneurysm, intracranial or spinal surgery)
* Recent traumatic external heart massage, obstetrical delivery, or recent puncture of a non-compressive blood-vessel (e.g. subclavian or jugular vein puncture) , within the past 10 days
* Known history of suspected intracranial haemorrhage or suspected subarachnoid haemorrhage from aneurysm
* Neoplasm with increased haemorrhagic risk
* Documented ulcerative gastrointestinal disease during the last 3 m, oesophageal varices, arterial aneurysm, or arterial/venous malformations
* Any known disorder associated with a significant increased risk of bleeding
* Bacterial endocarditis or pericarditis at screening
* Acute pancreatitis at screening
* Significant trauma or major surgery (according to the investigator's assessment) in the past 3 m
* Imaging demonstrates multi-lobar infarction (hypodensity \>1/3 cerebral hemisphere)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boehringer Ingelheim

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Inner Mongolia Baogang Hospital

Baotou, , China

Site Status

Beijing Chao-Yang Hospital

Beijing, , China

Site Status

Beijing Tsinghua Changgung Hospital

Beijing, , China

Site Status

Beijing Tiantan Hospital affiliated to Cap Med University

Beijing, , China

Site Status

Beijing Tongren Hospital

Beijing, , China

Site Status

The First Hospital of Jilin University

Changchun, , China

Site Status

The third xiangya hospital of Central South University

Changsha, , China

Site Status

Hexigten Banner Mongolian Traditional Chinese medicine hospital

Chifeng, , China

Site Status

Second Affiliated Hospital Chongqing Medical University

Chongqing, , China

Site Status

Center Hospital of Dalian

Dalian, , China

Site Status

Daqing People's Hospital

Daqing, , China

Site Status

Shengli Oilfield central hospital

Dongying, , China

Site Status

Third Affiliated Hospital of Guangzhou Medical University

Guangzhou, , China

Site Status

The Affiliated Hospital of Guizhou Medical University

Guiyang, , China

Site Status

The Second Affiliated Hospital Zhejiang University School of Medicine

Hangzhou, , China

Site Status

Zhejiang Province People's Hospital

Hangzhou, , China

Site Status

The Affiliated Hospital of Hangzhou Normal University

Hangzhou, , China

Site Status

Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine

Hangzhou, , China

Site Status

Huai'an Second People's Hospital

Huai'an, , China

Site Status

The First Affiliated Hospital of Baotou Medical College

Inner Mongolia, , China

Site Status

The second Hospital of Jiaxing

Jiaxing, , China

Site Status

Center Hospital of Jinan

Jinan, , China

Site Status

Jinhua Municipal Central Hospital

Jinhua, , China

Site Status

The first People's Hospital of Lianyungang

Lianyungang, , China

Site Status

Linfen Central Hospital

Linfen, , China

Site Status

Linyi People's Hospital

Linyi, , China

Site Status

The First People's Hospital of Tancheng County

Linyi, , China

Site Status

The First Affiliated Hospital of Nanchang University

Nanchang, , China

Site Status

Zhongda Hospital Southeast University

Nanjing, , China

Site Status

The Second Affiliated Hospital of Nanjing Medical University

Nanjing, , China

Site Status

The First People's Hospital of Nanning

Nanning, , China

Site Status

The First People's Hospital of Nantong

Nantong, , China

Site Status

Ruian People's Hospital

Ruian, , China

Site Status

Tongren hospital, Shanghai Jiaotong University School of Medicine

Shanghai, , China

Site Status

Tongji Hospital, Tongji University

Shanghai, , China

Site Status

Shanghai East Hospital

Shanghai, , China

Site Status

Shanghai Seventh People's Hospital

Shanghai, , China

Site Status

Affiliated Central Hospital of Shenyang Medical College

Shenyang, , China

Site Status

The First People's Hospital of Shenyang

Shenyang, , China

Site Status

Peking University Shenzhen Hospital

Shenzhen, , China

Site Status

The Second Hospital of Hebei Medical University

Shijiazhuang, , China

Site Status

The Second Affiliated Hospital of Soochow University

Suzhou, , China

Site Status

Taizhou Hospital of Zhejiang Province

Taizhou, , China

Site Status

The 2nd Hospital of Tianjin Medical University

Tianjin, , China

Site Status

The First Center Hospital of Tianjin

Tianjin, , China

Site Status

Tianjin Medical University General Hospital

Tianjin, , China

Site Status

Wuhan Union Hospital

Wuhan, , China

Site Status

Wuxi People's Hospital

Wuxi, , China

Site Status

Xianyang Hospital of Yan'an University

Xianyang, , China

Site Status

Xinxiang Central Hospital

Xinxiang, , China

Site Status

The People's Hospital Of Xuancheng City

Xuancheng, , China

Site Status

Affiliated Hospital, Xuzhou Medical college

Xuzhou, , China

Site Status

Affiliated Hospital of Yangzhou University

Yangzhou, , China

Site Status

Yantai Yuhuangding Hospital

Yantai, , China

Site Status

Yiyang Central Hospital

Yiyang, , China

Site Status

Countries

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China

References

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Meng X, Li S, Dai H, Lu G, Wang W, Che F, Geng Y, Sun M, Li X, Li H, Wang Y. Tenecteplase vs Alteplase for Patients With Acute Ischemic Stroke: The ORIGINAL Randomized Clinical Trial. JAMA. 2024 Nov 5;332(17):1437-1445. doi: 10.1001/jama.2024.14721.

Reference Type DERIVED
PMID: 39264623 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

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Other Identifiers

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1123-0040

Identifier Type: -

Identifier Source: org_study_id