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)

RecruitingTaking participants now, according to the registry record.

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In brief

Phase 2 / Phase 3728 participants sought86 sites10 countries

Registered in 1 registry

ClinicalTrials.govNCT05065216Open this record at ClinicalTrials.govSynced 5 days ago

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Trial information is shown as published by the registry, in its original language.

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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.

These are facts from the public registry record, not a judgement about the study. Discuss any trial with your own doctor before taking part.

What these facts mean, and what to ask · ruleset v1

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.

Summary

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.

Conditions

Acute Stroke
Ischemic Stroke
Stroke

Eligibility

Eligibility
Sex	All
Ages	18 Years – 90 Years
Healthy volunteers	No

Eligibility as written in the registry

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.

Eligibility in plain statements

This record's criteria have not been broken into separate statements yet. The registry text above is complete and is the authoritative version.

Study design

Study design
Study type	Interventional
Phase	Phase 2 / Phase 3
Allocation	Randomised
Intervention model	PARALLEL
Primary purpose	TREATMENT
Masking	DOUBLE (2)
Enrolment	728 participants sought

Sponsor and collaborators

DiaMedica Therapeutics Inc Sponsor

Arms and 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

Other 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.
Drug 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

Outcome measures

Primary outcome
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).
Time frame Day 90
Secondary outcome
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).
Time frame Day 90
Secondary outcome
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).
Time frame Day 90
Secondary outcome
Mortality Rate
Mortality rate as defined by event rate (%) for mortality over 90 days.
Time frame Day 90
Secondary outcome
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.
Time frame Day 90
Secondary outcome
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).
Time frame Day 90
Secondary outcome
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.
Time frame Day 90

Dates

Dates
Start date	November 7, 2021 (actual)
Primary completion	December 1, 2026 (estimated)
Completion	December 1, 2026 (estimated)
First posted	October 4, 2021 (actual)
Last updated	September 14, 2026
Results posted	Not stated in the registry record
Status last verified	September 2026

Actual means the event happened. Estimated means the sponsor expects it. The two mean different things.

Locations

78 sites are recruiting

Belgium

Belgium
Facility	City	State or region	Status
Imeldaziekenhuis (Imelda Hospital)	Bonheiden	Belgium	Recruiting
UZ Gent	Ghent	Belgium	Recruiting
Jessa Ziekenhuis	Hasselt	Belgium	Recruiting
AZ Groeninge	Kortrijk	Belgium	Recruiting
CHC Montléga	Liège		Recruiting
Clinique St Pierre	Ottignies	Belgium	Recruiting

Canada

Canada
Facility	City	State or region	Status
University of Alberta Hospital	Edmonton	Alberta	Recruiting
Hamilton Health Sciences - Hamilton General Hospital	Hamilton	Ontario	Recruiting
Health Sciences North	Hamilton	Ontario	Recruiting
Sunnybrook Research Institute	North York	Ontario	Recruiting
Vancouver General Hospital	Vancouver	British Columbia	Recruiting

France

France
Facility	City	State or region	Status
Hopital Pellegrin CHU Bordeaux	Bordeaux		Recruiting
Aphm Hopital Timone	Marseille		Recruiting
Chru Nancy Hopital Central	Nancy		Recruiting
CHU Pontchaillou /Hopital Sud Service de Neurologie	Rennes	Brittany Region	Recruiting
CHU Strasbourg Hopital de Hautepierre	Strasbourg		Recruiting

Georgia

Georgia
Facility	City	State or region	Status
West Georgia Medical Center LTD	Kutaisi	Georgia	Active, not recruiting
Israel-Georgia Medical Research Clinic-Healthycore LTD	Tbilisi	Georgia	Active, not recruiting
New Hospitals LTD	Tbilisi	Georgia	Active, not recruiting
Pineo Medical Ecosystem LTD	Tbilisi	Georgia	Active, not recruiting
JSC K. Eristavi National Center of Experimental and Clinical Surgery	Tbilisi	Georgia	Active, not recruiting

Hungary

Hungary
Facility	City	State or region	Status
Bajcsy-Zsilinszky Hospital	Budapest	Hungary	Recruiting
North Buda St. John Central Hospital	Budapest		Not yet recruiting
Petz Aladár County Teaching Hospital	Győr	Vasvári Pál U. 2-4	Recruiting
St. Damjan Greek Catholic Hospital	Kisvárda	Hungary	Recruiting
B.-A.-Z. County Central Hospital	Miskolc	Hungary	Recruiting

Poland

Poland
Facility	City	Status
UCM, Katowice	Katowice	Recruiting
University Hospital in Krakow	Krakow	Recruiting
Szpital Czerniakowski Warsaw	Warsaw	Recruiting
Military Institute of Medicine - National Research Institute	Warsaw	Recruiting
4 Wojskowy Szpital Kliniczny z Polikliniką SP ZOZ we Wrocławiu	Wroclaw	Recruiting
University Hospital of Zielona Góra	Zielona Góra	Recruiting

Romania

Romania
Facility	City	State or region	Status
Fundeni Clinical Institute	Bucharest	Bucharest (Sector 2)	Recruiting
Elias Emergency University Hospital	Bucharest	Romania	Recruiting

Spain

Spain
Facility	City	State or region	Status
Instituto de Investigacion Biomedica de A Coruna (INIBIC)	A Coruña	Spain	Recruiting
Hospital Universitario Germans Trias i Pujol	Badalona	Spain	Recruiting
Hospital Universitari Vall d'Hebron-Institut de Recerca	Barcelona	Spain	Recruiting
Hospital Clínico Universitario de Santiago	Santiago de Compostela	Spain	Recruiting

United Kingdom

United Kingdom
Facility	City	State or region	Status
Addenbrooke's Hospital	Cambridge	United Kingdom	Recruiting
Royal Devon and Exeter Hospital	Exeter	Devon	Recruiting
Victoria Hospital- NHS Fife- Scotland- UK	Kirkcaldy		Recruiting
Leeds Teaching Hospitals NHS Trust	Leeds		Not yet recruiting
St George's Hospital	London	United Kingdom	Recruiting
Barts Health NHS Trust The Royal London Hospital	London		Recruiting
Charing Cross Hospital	London		Recruiting
University College of London	London		Recruiting
James Cook University Hospital	Middlesbrough		Not yet recruiting
The Newcastle upon Tyne Hospitals NHS Foundation Trust - Royal Victoria Infirmary (RVI)	Newcastle upon Tyne	England	Recruiting
Nottingham University Hospital	Nottingham		Recruiting
Royal Stoke University Hospital	Stoke-on-Trent	United Kingdom	Recruiting

36 further sites are listed in the registry record.

Study documents

No documents are linked in this registry record.

Changes over time

August 21, 2026
Site added
20 sites added (86 total)
6686

Registry: ClinicalTrials.gov · NCT########

https://xmedica.io/trials/ctgov/NCT05065216

Categories

Registered in 1 registry

Interested in this study?

How this study is set up

Summary

Conditions

Eligibility

Eligibility as written in the registry

Eligibility in plain statements

Study design

Sponsor and collaborators

Arms and interventions

Interventions

Outcome measures

Dates

Locations

Belgium

Canada

France

Georgia

Hungary

Poland

Romania

Spain

United Kingdom

Study documents

Changes over time