Efficacy and Safety of Mexidol® in Stroke Therapy

NCT ID: NCT06437626

Last Updated: 2025-12-30

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

304 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-11-18

Study Completion Date

2023-08-18

Brief Summary

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The main purpose of the clinical trial is to evaluate the efficacy and safety of Mexidol® in sequential treatment for patients in the acute and early recovery periods of ischemic stroke compared to placebo. The effect of adding Mexidol® to standard therapy on the degree of impairment of vital functions was assessed including the degree of disability (according to the Modified Rankin Scale, mRS), the severity of neurological symptoms (according to the National Institutes of Health Stroke Scale, NIHSS) and the level of mobility of patients (according to the Rivermead Mobility Index).

Detailed Description

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As the main purpose of the clinical study is to evaluate safety and efficacy of a neuroprotector (Mexidol®), it was crucial to develop strict protocol requirements that would help to avoid the challenges of estimation of neuroprotective effect for stroke therapy. The current treatment options for stroke are still limited and do not take into account rehabilitation period and patients' further quality of life.

As per protocol requirements, 313 participants were screened, 304 participants met all comprehensive eligibility criteria, 25 participants dropped out during the clinical trial period. The Modified Rankin Scale (mRS) was selected as the most representative primary outcome measuring tool due to the adequate representation of functional outcome. Additionally, the neuroprotective efficacy of Mexidol® was assessed for its ability to reduce stroke-related neurologic deficit, to improve mobility after stroke and to influence cognitive impairment and mood disorder symptoms.

Conditions

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Ischemic Stroke

Keywords

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Stroke Ischemic Stroke Neuroprotective Agents Antioxidants Stroke Rehabilitation Recovery of Function Brain Ischemia Acute Stroke Acute Cerebrovascular Accident Cerebral Stroke Neuroprotection Mexidol Ethylmethylhydroxypyridine Succinate

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Mexidol®

Participants received Mexidol® IV 500 mg 2 times a day for 10 days, then Mexidol® FORTE 250 orally 250 mg 1 tablet 3 times a day for 60 days

Group Type EXPERIMENTAL

Mexidol (Ethylmethylhydroxypyridine Succinate)

Intervention Type DRUG

50 mg/ml IV solution, 250 mg tablets

Placebo

Participants received Placebo matching Mexidol® IV 500 mg 2 times a day for 10 days, then Mexidol® FORTE 250 orally 250 mg 1 tablet 3 times a day for 60 days

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo IV solution, Placebo tablets

Interventions

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Mexidol (Ethylmethylhydroxypyridine Succinate)

50 mg/ml IV solution, 250 mg tablets

Intervention Type DRUG

Placebo

Placebo IV solution, Placebo tablets

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis of first-ever hemispheric ischemic stroke (codes ICD-10: I63.0 - I63.9) with the time from onset of a stroke \<48 hours.
* CT or MRI evidences of clinical diagnosis and no evidences of hemorrhagic stroke/hemorrhagic transformation of ischemic stroke.
* The written informed consent form (ICF) is signed and personally dated by the participant or by an impartial witness (by a person who is independent of the trial and cannot be unduly influenced by the people involved with the trial and who attends the informed consent process).
* The Modified Rankin Scale (mRS) score ≥3.
* The National Institutes of Health Stroke Scale (NIHSS) score from 9 to 15 points.
* Negative pregnancy test for women of childbearing age.
* Willingness to use reliable methods of contraception, and/or abstinence, for the duration of therapeutic product exposure.
* The ability to understand the purpose of research, risks associated with the research intervention, obligations and consequences of research participation and their right of withdrawing consent any time during the study.

Exclusion Criteria

* BMI (Body Mass Index) \> 35.
* Recurrent or hemorrhagic stroke confirmed by CT/MRI.
* Hemorrhagic transformation of ischemic stroke.
* Parkinson's disease/parkinsonism.
* Progressive Multiple Sclerosis.
* Intractable Epilepsy.
* Demyelinating diseases of central nervous system.
* Hereditary and degenerative diseases of the central nervous system.
* Infectious diseases of central nervous system in medical history.
* Traumatic brain injury with severe neurocognitive impairment in medical history.
* Congenital malformations of the nervous system or any neurological disorders that can affect participant's capability (including cognitive and motor skills) to follow protocol procedures.
* Thrombolysis or thrombectomy treatment prior the enrollment.
* Medical history of severe allergies.
* Evidence of hypersensitivity reactions or intolerance associated with ethylmethylhydroxypyridine.
* Evidence of lactose intolerance, galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption.
* Acute surgical pathology.
* Evidence of clinically significant first identified disorder or disease that can affect participant's ability to participate in the clinical trial.
* Evidence of clinically significant severe disease/condition that can affect participant's ability to participate in the clinical trial: respiratory diseases, cardiovascular diseases (CVDs) including SAP ≥ 200 mm Hg and DAP ≥ 100 mm Hg, liver disease with elevation of ALT/AST \> 2 × ULN, kidney disease (еGFR\<30ml/min/1.73 m2), endocrine disorders and diseases, gastrointestinal diseases, pulmonary embolism (PE), deep vein thrombosis (DVT), floating thrombus, convulsive syndrome, uncontrolled hyperthermia, uncontrolled hyperglycemia.
* Medical history of severe mental disorder.
* Dementia of the Alzheimer type (DAT).
* Medical history of cancers within 5 years prior to enrollment.
* Medical history of alcohol/drug addiction.
* Pregnancy or breastfeeding.
* Prescription or use of prohibited medications within 2 weeks prior to enrollment.
* Positive HIV, syphilis, hepatitis B and C test.
* Positive COVID-19 test.
* Participation in another trial within 3 months prior to enrollment.
Minimum Eligible Age

40 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pharmasoft

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Almaty City Hospital № 7

Almaty, , Kazakhstan

Site Status

Kazan City Hospital № 7

Kazan', , Russia

Site Status

Kemerovo City Clinical Hospital № 11

Kemerovo, , Russia

Site Status

Research Institute - Regional Clinical Hospital № 1

Krasnodar, , Russia

Site Status

Federal Center for Brain and Neurotechnology

Moscow, , Russia

Site Status

Russian National Research Medical University n.a. N. I. Pirogov

Moscow, , Russia

Site Status

Rostov State Medical University

Rostov-on-Don, , Russia

Site Status

Alexandrovskaya Hospital

Saint Petersburg, , Russia

Site Status

St. Petersburg Clinical Hospital № 26

Saint Petersburg, , Russia

Site Status

City Hospital № 40 of Kurortny District

Saint Petersburg, , Russia

Site Status

Samara Regional Clinical Hospital n.a. V. D. Seredavin

Samara, , Russia

Site Status

Central Clinical Medical and Sanitary Unit n.a. V. A. Egorov

Ulyanovsk, , Russia

Site Status

Voronezh Regional Clinical Hospital № 1

Voronezh, , Russia

Site Status

Vsevolozhsk Clinical Interdistrict Hospital

Vsevolozhsk, , Russia

Site Status

Yaroslavl Clinical Hospital № 2 (ICU)

Yaroslavl, , Russia

Site Status

Yaroslavl Clinical Hospital № 2

Yaroslavl, , Russia

Site Status

The first clinic of the Tashkent Medical Academy

Tashkent, , Uzbekistan

Site Status

Countries

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Kazakhstan Russia Uzbekistan

References

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Shamalov NA, Fedin AI, Rakhimbaeva GS, Nurguzhaev ES, Khasanova DR, Solovyova EY, Melnikova EV, Yanishevsky SN, Mashin VV, Pizova NV, Poverennova IE, Chuprina SE, Agafina AS, Roshkovskaya LV. [Results of the international multicenter randomized, double-blind, placebo-controlled clinical trial for the evaluation of the efficacy and safety of the sequential therapy with ethylmethylhydroxypyridine succinate in patients in the acute and early recovery periods of ischemic stroke (MIR)]. Zh Nevrol Psikhiatr Im S S Korsakova. 2025;125(8. Vyp. 2):40-53. doi: 10.17116/jnevro202512508240. Russian.

Reference Type BACKGROUND
PMID: 40898634 (View on PubMed)

Koltsov IA, Shchukin IA, Fidler MS, Glukhareva AP, Chubykin VI. [Multimodal antioxidant therapy in ischemic stroke: from MIR trial to bedside]. Zh Nevrol Psikhiatr Im S S Korsakova. 2025;125(12. Vyp. 2):64-71. doi: 10.17116/jnevro202512512264. Russian.

Reference Type DERIVED
PMID: 41456191 (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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PHS-APIS-004-MEX-SOL-TAB

Identifier Type: OTHER

Identifier Source: secondary_id

MexidolMIR2023

Identifier Type: -

Identifier Source: org_study_id