Desmoteplase in Acute Ischemic Stroke (DIAS)

Paion

Status and phase: Completed; Phase 2

Conditions: Stroke

Treatments: Drug: Placebo; Drug: Desmoteplase

Study type: Interventional

Funder types: Industry

Identifiers

NCT00638781

PN01-CLD-000001/01

Details and patient eligibility

About

The DIAS study (Part 2) was performed to support the dose finding of desmoteplase treatment in subjects with acute ischemic stroke selected by perfusion/diffusion mismatch on MRI within a time window of 3 to 9 h after stroke-symptom onset. In addition, it assessed safety and tolerability of 3 doses of desmoteplase compared with placebo with special consideration of intracranial hemorrhage and major systemic bleedings.

Full description

Acute stroke is the third leading cause of mortality in developed countries and the major medical cause of disability. The outcome can be improved by early treatment with thrombolysis. Alteplase (r-tPA) is the only approved thrombolytic drug in the indication of acute ischemic stroke. However, the use of alteplase is currently restricted by the need to administer it within 3 hours of symptom onset. As the risk of transforming a cerebral infarct into haemorrhage probably rises as the time elapsed increases, a thrombolytic drug that carries a lower risk of haemorrhage than alteplase may offer a wider time-to-treatment window and improve the safety profile.Desmoteplase (DSPA) with its high fibrin specificity, lack of neurotoxicity, potential neuroprotective effect, non-activation by ß-amyloid, and long terminal half-life may account for an improved safety and efficacy profile within the first 9 hours after onset of symptoms.

Enrollment: 104 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• scoring 4 to 20 on the National Institute of Health Stroke Scale (NIHSS)
• showing a perfusion-diffusion mismatch on MRI of 20 %
• enrolment within a 3 h to 9 h time window after symptom onset.
• 18-85 years of age

Exclusion criteria

• Participation in any interventional trial in the previous 30 days.
• Women in the childbearing age.
• Any history of intracranial hemorrhage, subarachnoid hemorrhage, neoplasm, arteriovenous malformation or aneurysm.
• Conditions that, according to the judgment of the investigator, might impose an additional risk to any individual stroke patient when receiving study medication (this applied to patients on platelet-function inhibitors as well).
• MRI exclusion criteria: Evidence of ICH, Evidence of SAH, Signs of extensive early infarction on DWI assessed by evidence of involvement of >1/3 of the middle cerebral artery (MCA) territory. No perfusion deficit, Internal carotid artery (ICA) occlusion ipsilateral to stroke lesion without additional ipsilateral MCA, anterior cerebral artery (ACA) or posterior cerebral artery (PCA) occlusion. Any intracranial pathology that would interfere with the MRI assessment of acute ischemic stroke.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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104 participants in 4 patient groups, including a placebo group

1

Active Comparator group

Description:

Desmoteplase 62.5 µg/kg BW i.v. bolus

Treatment:

Drug: Desmoteplase

Drug: Desmoteplase

Drug: Desmoteplase

2

Active Comparator group

Description:

Desmoteplase 90 µg/kg BW i.v. bolus

Treatment:

Drug: Desmoteplase

Drug: Desmoteplase

Drug: Desmoteplase

3

Active Comparator group

Description:

Desmoteplase 125 µg/kg BW i.v. bolus

Treatment:

Drug: Desmoteplase

Drug: Desmoteplase

Drug: Desmoteplase

4

Placebo Comparator group

Description:

Placebo i.v. bolus

Treatment:

Drug: Placebo