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NCT05065216ClinicalTrials.gov

Treatment of Acute Ischemic Stroke (ReMEDy2 Trial)

Phase 2/3 Adaptive Design, Randomized Double-blind Placebo-controlled Study to Evaluate the Safety and Efficacy of DM199 for the Treatment of Acute Ischemic Stroke (ReMEDy2 Trial)

En recrutementAccepte des participants actuellement, selon la fiche du registre.
Contacter cette étude

En bref

This is a Phase 2/3 study evaluating the safety and efficacy of DM199 (rinvecalinase alfa) in treating participants with moderate stroke severity, who present within 24 hours of Acute Ischemic Stroke (AIS) onset due to small and medium vessel occlusions…

Phase 2 / Phase 3728 participants recherchés86 sites10 pays

Catégories

Enregistré dans 1 registre

Une même étude peut être enregistrée dans plusieurs registres. Nous l'affichons une seule fois et renvoyons vers chaque fiche que nous détenons.

Les informations de l'essai sont affichées telles que publiées par le registre, dans leur langue d'origine.

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How this study is set up

The points below are drawn from the public registry record for this study. Each one cites the field or sentence it came from. A dash (—) means the record does not state something — not that it is missing or wrong. Many well-run studies, especially small ones, leave some of these blank.

  • Present: Registered before enrolment beganFirst posted 2021-10-04; recorded start 2021-11-07
  • Present: Has a defined primary outcomeA primary outcome measure is listed in the record
  • Present: The primary outcome states a time frameThe primary outcome measure records a time frame
  • Present: Participants are randomly assignedAllocation is recorded as randomised
  • Present: Has a comparison groupThe record lists a placebo or comparator arm, or more than one study arm
  • Present: Uses blinding (masking)A masking level is recorded in the record
  • Not stated: An ethics committee is not stated in the registry recordThis registry's ingested record has no ethics-committee field
  • Not stated: Regulatory oversight (such as an IND or IDE) is not stated in the registry recordThis registry's ingested record has no regulatory-authorisation field
  • Not stated: A data monitoring committee is not stated in the registry recordThis registry's ingested record has no data-monitoring-committee fieldA data monitoring committee is not required for many smaller studies, and its absence here is not unusual.
  • Present: No cost to participants is mentioned in the recordChecked the summary, description and eligibility text; no cost-to-participant phrase found
  • Present: Sponsor has 2 other studies in this databaseCounted from the lead sponsor named in the record (DiaMedica Therapeutics Inc)
  • Not stated: No posted results from this sponsor are in this database yetBased on the sponsor’s studies in this database
  • The record lists 3 conditions.
  • Lead sponsor type recorded as: industry.
  • Intervention regulatory context: investigational, within a phased regulatory pathway.

Trial stature

Three independent measures of this study, described from its registry record — not a recommendation about it. A rigorous study by investigators nobody has heard of is better evidence than a weak study led by a famous one. How these are scored.

Methodological rigourDEFINITIVE

A definitive-grade design for a phase 3 study, judged from its ClinicalTrials.gov record.

How this score is built
  • Randomised allocation20/20

    Participants are randomly allocated between arms

  • Blinding13/20

    Double-blind

  • Control arm13/15

    Placebo / sham control arm

  • Primary-outcome specificity10/10

    Named primary outcome with a defined time frame

  • Endpoint type7/10

    Clinical-event endpoint

  • Multi-centre8/8

    Multi-centre: 66 sites

  • Data monitoring committee7/7

    A data monitoring committee is in place

  • Prospective registration5/5

    Registered before the study start date

  • Protocol / SAP posted0/5

    No protocol or SAP posted to the registry

ScaleMEDIUM

A medium-sized study, international in scope: 728 participants (target), run at 86 sites, across 10 countries.

How this score is built
  • Enrolment28/40

    728 participants (target)

  • Site count21/25

    66 sites

  • Country count12/15

    9 countries

  • Planned duration10/10

    Planned over about 62 months

  • Sponsor scale1/10

    DiaMedica Therapeutics Inc has led 3 trials in our corpus

Investigator standingUNKNOWN

We have no verifiable track record for the investigator named on this trial. That is common for early-career investigators and for records held outside ClinicalTrials.gov — it is not a negative signal.

How this score is built
  • Investigator standing0/100

    No investigator recorded in the registry for this trial

These describe the registry record only, and today we hold ClinicalTrials.gov data. Absent fields lower a score, and absence often reflects registration practice rather than study quality. A high-stature trial is not necessarily safer or a better choice for you — enrolling in a large definitive trial can mean a higher chance of receiving placebo, while a small early-phase study may be the only route to a new therapy.

Résumé

This is a Phase 2/3 study evaluating the safety and efficacy of DM199 (rinvecalinase alfa) in treating participants with moderate stroke severity, who present within 24 hours of Acute Ischemic Stroke (AIS) onset due to small and medium vessel occlusions. This study focuses on participants with limited treatment options. Participants who have or will receive mechanical thrombectomy (MT) are not eligible for participation. Additionally, participants who have received fibrinolytics are excluded unless they experience a persistent neurological deficit of moderate severity six or more hours after fibrinolytic treatment. Participants considered for this trial should not be denied the use of standard of care (SoC) AIS therapies, such as fibrinolytics or MT, when appropriate. The double-blinded study will be randomized and placebo-controlled at up to approximately 100 sites.

This is a Phase 2/3 Adaptive Design, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Safety and Efficacy of DM199 for the Treatment of Acute Ischemic Stroke (ReMEDy2 Trial). Participants with AIS will be randomized 1:1 to DM199 or placebo. DM199 will be administered as a single intravenous (IV) dose (0.5 μg/kg; not to exceed 50 μg) followed by subcutaneous (SC) doses at 2 hours (+10 hours) of the IV dose completion and then 2 times per week up to Day 21. The duration of each individual's participation in the study will be approximately 90 days from the time of initial treatment to completion of all study activities. A formal interim analysis will be conducted after 200 participants complete their Day 90 assessment in Part A. The purposes of this interim analysis are to assess safety, allow early stopping of the study for futility, or continuing the study with a revised final sample up to a maximum of 728 participants.

Affections

  • Acute Stroke
  • Ischemic Stroke
  • Stroke

Éligibilité

Éligibilité
SexeTous
Âges18 Years90 Years
Volontaires sainsNon

Éligibilité telle qu'elle figure dans le registre

Inclusion Criteria: 1. Participant is between 18 and 90 years of age inclusive. 2. Participant weight is 40 kg to 166 kg inclusive. 3. Participant to be randomized and treatment initiated within 24 hours of last known normal/AIS stroke onset. 4. Participant has NIHSS ≥5 and ≤15 at approximately the time of randomization. This criterion also applies to participants who meet the following conditions: * The participant initially presents with an NIHSS score below 5 but clinically worsens, including cases of progressing stroke / stroke-in-evolution, resulting in a subsequent persistent NIHSS score of ≥5 and ≤15; and * Participant meets all other inclusion and exclusion criteria, including repeat brain imaging to rule out hemorrhagic transformation. 5. Participant had a pre-morbid mRS score of 0 to 1 (mRS score prior to AIS) as stated by participant or participant's representative. 6. If participant has received fibrinolytic treatment for AIS within 4.5 hours of last know normal/AIS stoke onset and at least 6 hours after completing fibrinolytic treatment, and the participant meets all of the following criteria: * Participant's initial NIHSS score prior to fibrinolytics was ≤15; and * At least six hours after fibrinolytics, the participant has NIHSS score of ≥5 and ≤15 with a persistent deficit; and * The participant's NIHSS score showed less than a 4-point improvement, or worsened, after receiving fibrinolytics; and * Participant meets all other inclusion and exclusion criteria including repeat brain imaging to rule out hemorrhagic transformation. 7. Participant and/or legally authorized representative is able to provide informed consent. 8. Participant is willing and able to comply with the study protocol, in the Investigator's judgment. Exclusion Criteria: 1. At screening, or with repeat imaging (see Inclusion 4 and 6), participant has imaging confirmed hemorrhage stroke. 2. Participant has image findings with symptomatic large vessel occlusion at one or more of the following locations: Intracranial carotid I/T/L or M1 segment MCA, vertebral or basilar artery (BA). 3. Participant has large core of established infarction defined as ASPECTS 0-5. 4. Participant has or will receive MT for their current AIS. 5. Participant has suspected or confirmed extracranial arterial dissection. 6. Participant has imaging findings and/or symptoms consistent with a brain stem or cerebellar stroke. Posterior cerebral artery strokes without any associated brain stem or cerebellar involvement are allowable. 7. Participant has any recorded SBP \<100 mmHg or MAP \<65 mmHg; MAP = DBP + \[1/3 (SBP - DBP)\] (measured with noninvasive BP cuff type monitor) after stroke symptom onset and prior to randomization. 8. Participant is currently prescribed angiotensin-converting enzyme inhibitor (ACEi) and is unable or unwilling to convert to another antihypertensive pharmacological treatment through Day 29 ±1 day (8 days after last treatment). 9. Participant is currently prescribed an ACEi, and the last dose of the ACE inhibitor medication is reported to have been taken \< 24 hours before start of IV study drug infusion as stated by participant or participant's representative. 10. Participant has a history of clinically significant allergic reactions such as angioedema or anaphylaxis requiring hospitalization. 11. Participant has a diagnosis or suspected diagnosis of hereditary angioedema (HAE) or is taking or prescribed medications commonly used as prophylaxis/treatment of HAE, such as C1-esterase inhibitors (Cinryze, Berinert, Ruconest, Haegarda), Danazol, kallikrein inhibitors (Ecallantide, Berotralstat, Lanadelumab), Bradykinin B2 Receptor Antagonists (Icatibant), or other medication designed to influence the kallikrein-kinin system. 12. Life expectancy estimated at ≤1 year prior to enrollment. 13. Participant has clinical evidence of an active infection at the time of enrollment requiring parenteral treatment or hospitalization to monitor or manage the infection. NOTE: Treatment of uncomplicated infections with oral antibiotics would not be an exclusion (for example, the treatment of uncomplicated urinary tract infections or sinus infections with oral antibiotics would not be exclusionary). 14. Participant has known alpha 1-antitrypsin deficiency (α1-antitrypsin deficiency). 15. Participant is pregnant or nursing. NOTE: Participants who agree to stop nursing may be considered for inclusion at the discretion of the Investigator. 16. Participants of child-bearing potential must agree to use medically acceptable contraceptive measures to prevent pregnancy. All participants of childbearing potential (defined as sexually mature participants who have had menses within the preceding 24 months and have not undergone permanent sterilization methods such as hysterectomy, bilateral oophorectomy, bilateral salpingectomy, etc.) must have a negative serum pregnancy test performed locally at screening. Participants of childbearing potential must agree not to attempt to become pregnant or undergo in vitro fertilization. If participating in sexual activity that could lead to pregnancy, participants must use 2 reliable methods (1 per partner is acceptable) of contraception simultaneously while receiving protocol-specified medication and during the study follow-up period. Participants participating in sexual activity must agree to use, or for their partner to use highly effective birth control methods (those with a failure rate of less than 1% per year when used consistently and correctly) until they have completed the study (after the Day 90 visit). Such methods include: * Combined (estrogen and progesterone containing) hormonal oral, intravaginal, or transdermal contraception associated with the inhibition of ovulation * Progesterone-only oral, injectable, or implantable hormonal contraception associated with the inhibition of ovulation * Intrauterine device (IUD) * Intrauterine hormone-releasing system (IUS) * Bilateral tubal occlusion * Vasectomized partner * Sexual abstinence Participants who are not of reproductive potential (who have been postmenopausal for more than 24 consecutive months or have undergone hysterectomy, bilateral oophorectomy, bilateral salpingectomy, etc.) are not required to use contraception. Participants are prohibited from sperm donation. NOTE: A negative serum pregnancy test will be documented during screening if a participant is of child-bearing potential. 17. Participant is currently participating in or has participated in a study using an investigational device or drug or received an investigational drug or investigational use of a licensed drug within 30 days prior to screening. 18. Participant does not have sufficient venous access for infusion of study treatment or blood sampling. 19. Participant is unable or unwilling to comply with protocol requirements, including assessments, tests, and follow-up visits. 20. Participant has any other medical condition which in the opinion of the Investigator will make participation medically unsafe or interfere with the study results.

Éligibilité en énoncés simples

Les critères de cette fiche n'ont pas encore été décomposés en énoncés distincts. Le texte du registre ci-dessus est complet et fait foi.

Conception de l'étude

Conception de l'étude
Type d'étudeInterventionnelle
PhasePhase 2 / Phase 3
RépartitionRandomisée
Modèle d'interventionPARALLEL
Objectif principalTREATMENT
InsuDOUBLE (2)
Recrutement728 participants recherchés

Promoteur et collaborateurs

  • DiaMedica Therapeutics Inc Promoteur

Groupes et interventions

  • DM199EXPERIMENTAL

    DM199 administered by a single intravenous (IV) dose followed by subcutaneous (SC) doses at 2 hours (+10 hours) of the IV dose completion and then 2 times per week up to Day 21.

  • Placebo for DM199 Solution for InjectionPLACEBO_COMPARATOR

    Placebo administered by a single intravenous (IV) dose followed by subcutaneous (SC) doses at 2 hours (+10 hours) of the IV dose completion and then 2 times per week up to Day 21.

Interventions

  • Autre Placebo for DM199 Solution for Injection

    Placebo administered by a single intravenous (IV) dose followed by subcutaneous (SC) doses at 2 hours (+10 hours) of the IV dose completion and then 2 times per week up to Day 21.

  • Médicament Recombinant human tissue kallikrein

    DM199 administered by a single intravenous (IV) dose followed by subcutaneous (SC) doses at 2 hours (+10 hours) of the IV dose completion and then 2 times per week up to Day 21

Critères de jugement

  1. Critère de jugement principal

    Stroke Recovery

    Stroke recovery as defined by participants with excellent functional outcomes at Day 90 as assessed via the Modified Rankin Score (mRS \[dichotomized\]), mRS scores of 0 or 1 represent responders, scale range of 0-6. The mRS (Modified Rankin Scale) is a single-item, clinician-reported measure of functional disability in participants with AIS. Scores range in grade from 0 (no symptoms at all) to 6 (participant death).

    Délai Day 90

  2. Critère de jugement secondaire

    Effect on Disability

    Assessment of effect on disability across the full spectrum of AIS by examining the distribution of mRS (shift) scores (scale range = 0 to 6) at Day 90. The mRS (Modified Rankin Scale) is a single-item, clinician-reported measure of functional disability in participants with AIS. Scores range in grade from 0 (no symptoms at all) to 6 (participant death).

    Délai Day 90

  3. Critère de jugement secondaire

    Independent Function

    Proportion of participants achieving independent function (able to look after their own affairs without assistance) with or without minor disability at Day 90 assessed as mRS 0-2 (dichotomized) mRS scores of 0, 1 or 2 represent responders, scale range of 0-6. The mRS (Modified Rankin Scale) is a single-item, clinician-reported measure of functional disability in participants with AIS. Scores range in grade from 0 (no symptoms at all) to 6 (participant death).

    Délai Day 90

  4. Critère de jugement secondaire

    Mortality Rate

    Mortality rate as defined by event rate (%) for mortality over 90 days.

    Délai Day 90

  5. Critère de jugement secondaire

    Neurological Outcome

    Proportion of participants achieving an excellent neurological outcome defined by National Institute of Health Stroke Scale (NIHSS)= 0-1 (dichotomized) (NIHSS scores of 0 or 1, scale range 0 to 42) at Day 90. The National Institute of Health Stroke Scale (NIHSS) is a clinician-reported measure used to rate the severity of strokes, namely disability and recovery after acute stroke. The scale is comprised of 11 items with item scores ranging from 0 to 4. Total scores range from 0 to 42, with higher scores indicating increased severity.

    Délai Day 90

  6. Critère de jugement secondaire

    Functional Independence

    Proportion of participants achieving an excellent functional independence in activities of daily living defined by Barthel Index score (dichotomized) greater than or equal to 5 (scale range 0 to 100) at Day 90. The Barthel Index (BI) is a 10-item scale assessing activities of daily living and functional disability. Each item is scored in increments of 5 points (0, 5, 10, or 15) and the individual items are summed to produce a total score between 0 and 100, with higher scores representing more optimal performance (100 = fully independent) and lower scores representing inferior performance (0 = totally dependent).

    Délai Day 90

  7. Critère de jugement secondaire

    AIS Recurrence

    Recurrent AIS as defined by proportion of participants who experience a recurrent AIS by Day 90 as assessed by a new, persistent neurological deficit attributable to cerebrovascular ischemia. Imaging findings, if available, should support the diagnosis.

    Délai Day 90

Dates

Dates
Date de début7 novembre 2021 (réelle)
Achèvement principal1 décembre 2026 (estimée)
Achèvement1 décembre 2026 (estimée)
Première publication4 octobre 2021 (réelle)
Dernière mise à jour14 septembre 2026
Résultats publiésNon précisé dans la fiche du registre
Statut vérifié pour la dernière foisseptembre 2026

Réelle signifie que l'événement a eu lieu. Estimée signifie que le promoteur s'y attend. Les deux ont un sens différent.

Lieux

78 sites sont en recrutement

Belgium

Belgium
ÉtablissementVilleÉtat ou régionStatut
Imeldaziekenhuis (Imelda Hospital)BonheidenBelgiumEn recrutement
UZ GentGhentBelgiumEn recrutement
Jessa ZiekenhuisHasseltBelgiumEn recrutement
AZ GroeningeKortrijkBelgiumEn recrutement
CHC MontlégaLiègeEn recrutement
Clinique St PierreOttigniesBelgiumEn recrutement

Canada

Canada
ÉtablissementVilleÉtat ou régionStatut
University of Alberta HospitalEdmontonAlbertaEn recrutement
Hamilton Health Sciences - Hamilton General HospitalHamiltonOntarioEn recrutement
Health Sciences NorthHamiltonOntarioEn recrutement
Sunnybrook Research InstituteNorth YorkOntarioEn recrutement
Vancouver General HospitalVancouverBritish ColumbiaEn recrutement

France

France
ÉtablissementVilleÉtat ou régionStatut
Hopital Pellegrin CHU BordeauxBordeauxEn recrutement
Aphm Hopital TimoneMarseilleEn recrutement
Chru Nancy Hopital CentralNancyEn recrutement
CHU Pontchaillou /Hopital Sud Service de NeurologieRennesBrittany RegionEn recrutement
CHU Strasbourg Hopital de HautepierreStrasbourgEn recrutement

Georgia

Georgia
ÉtablissementVilleÉtat ou régionStatut
West Georgia Medical Center LTDKutaisiGeorgiaActif, sans recrutement
Israel-Georgia Medical Research Clinic-Healthycore LTDTbilisiGeorgiaActif, sans recrutement
New Hospitals LTDTbilisiGeorgiaActif, sans recrutement
Pineo Medical Ecosystem LTDTbilisiGeorgiaActif, sans recrutement
JSC K. Eristavi National Center of Experimental and Clinical SurgeryTbilisiGeorgiaActif, sans recrutement

Hungary

Hungary
ÉtablissementVilleÉtat ou régionStatut
Bajcsy-Zsilinszky HospitalBudapestHungaryEn recrutement
North Buda St. John Central HospitalBudapestPas encore en recrutement
Petz Aladár County Teaching HospitalGyőrVasvári Pál U. 2-4En recrutement
St. Damjan Greek Catholic HospitalKisvárdaHungaryEn recrutement
B.-A.-Z. County Central HospitalMiskolcHungaryEn recrutement

Poland

Poland
ÉtablissementVilleÉtat ou régionStatut
UCM, KatowiceKatowiceEn recrutement
University Hospital in KrakowKrakowEn recrutement
Szpital Czerniakowski WarsawWarsawEn recrutement
Military Institute of Medicine - National Research InstituteWarsawEn recrutement
4 Wojskowy Szpital Kliniczny z Polikliniką SP ZOZ we WrocławiuWroclawEn recrutement
University Hospital of Zielona GóraZielona GóraEn recrutement

Romania

Romania
ÉtablissementVilleÉtat ou régionStatut
Fundeni Clinical InstituteBucharestBucharest (Sector 2)En recrutement
Elias Emergency University HospitalBucharestRomaniaEn recrutement

Spain

Spain
ÉtablissementVilleÉtat ou régionStatut
Instituto de Investigacion Biomedica de A Coruna (INIBIC)A CoruñaSpainEn recrutement
Hospital Universitario Germans Trias i PujolBadalonaSpainEn recrutement
Hospital Universitari Vall d'Hebron-Institut de RecercaBarcelonaSpainEn recrutement
Hospital Clínico Universitario de SantiagoSantiago de CompostelaSpainEn recrutement

United Kingdom

United Kingdom
ÉtablissementVilleÉtat ou régionStatut
Addenbrooke's HospitalCambridgeUnited KingdomEn recrutement
Royal Devon and Exeter HospitalExeterDevonEn recrutement
Victoria Hospital- NHS Fife- Scotland- UKKirkcaldyEn recrutement
Leeds Teaching Hospitals NHS TrustLeedsPas encore en recrutement
St George's HospitalLondonUnited KingdomEn recrutement
Barts Health NHS Trust The Royal London HospitalLondonEn recrutement
Charing Cross HospitalLondonEn recrutement
University College of LondonLondonEn recrutement
James Cook University HospitalMiddlesbroughPas encore en recrutement
The Newcastle upon Tyne Hospitals NHS Foundation Trust - Royal Victoria Infirmary (RVI)Newcastle upon TyneEnglandEn recrutement
Nottingham University HospitalNottinghamEn recrutement
Royal Stoke University HospitalStoke-on-TrentUnited KingdomEn recrutement

36 sites supplémentaires sont indiqués dans la fiche du registre.

Documents de l'étude

Aucun document n'est lié dans cette fiche du registre.

Évolution au fil du temps

  1. 21 août 2026

    Site ajouté

    20 sites added (86 total)

    6686