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Revacept in Symptomatic Carotid Stenosis (RevaceptCS02)

Primary Purpose

Carotid Stenosis, Atherosclerosis, Stroke

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Revacept
Placebo
Sponsored by
AdvanceCor GmbH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carotid Stenosis

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Signed written informed consent
  2. Target population

    • Diagnosis:

      • Extracranial carotid artery stenosis (diagnosed by vascular duplex ultrasound peak flow or angiography)
      • Lesions with ≥ 50 % stenosis according to the European Carotid Surgery Trial (ECST) criteria
      • TIA, amaurosis fugax or stroke within the last 30 days
    • Age and sex: Men and women aged > 18 years Women of childbearing potential (WOCBP) must be using an adequate method of contraception to avoid pregnancy throughout the study and for up to 4 weeks after receiving investigational product in such a manner that the risk of pregnancy is minimised.

Exclusion Criteria:

  1. Sex and reproductive Status:

    • WOCBP who are unwilling or unable to use an acceptable method to avoid pregnancy for up to 4 weeks after receiving investigational product.
    • Women who are pregnant or breastfeeding
    • Women with a positive pregnancy test on enrollment or prior to investigational product administration.
  2. Target disease exceptions

    • NIHSS score > 18
    • Recent intracerebral haemorrhage by X-ray computed tomography (CT) or nuclear magnetic resonance (NMR)
    • Cardiac cause of embolisation (atrial fibrillation or other cardiac source e.g. artificial heart valves)
  3. Medical history and concurrent disease

    • History of hypersensitivity, contraindication or serious adverse reaction to inhibitors of platelet aggregation, hypersensitivity to related drugs (cross-allergy) or to any of the excipients in the study drug
    • History or evidence of thrombocytopenia (<30.000/ul), bleeding diathesis or coagulopathy (pathological international normalised ratio (INR) or activated partial thromboplastin time (aPTT))
    • Thrombolysis within the last 48 hours
    • Relevant haemorrhagic transformation as determined by CT, NMR or anamnesis
    • Oral anticoagulation or dual anti-platelet therapy with aspirin or clopidogrel and other P2Y inhibitors at screening (3 days for dipyridamole extended release; 8 hours for tirofiban/Aggrastat)
    • Sustained hypertension (systolic BP > 179 mmHg or diastolic BP >109 mmHg)
    • History of severe systemic disease such as terminal carcinoma, renal failure (or current creatinine > 200 umol/l), cirrhosis, severe dementia, or psychosis
    • Current severe liver dysfunction (transaminase level greater than 5-fold over upper normal range limit)
    • Active autoimmune disorder such as systemic lupus erythematosus, rheumatoid arthritis, vasculitis or glomerulonephritis
    • Known atrial fibrillation or other clinically significant ECG abnormalities (at present)

Sites / Locations

  • Site 01: Department of Neurology, TU Munich
  • Site 08: Universitätsklinikum Essen, Klinik für Neurologie
  • Site 11: Universitätsklinikum Hamburg Eppendorf
  • Site 07: Medizinische Hochschule Hannover, Klinik für Neurologie
  • Site 12: Universitätsklinikum Leipzig AöR
  • Site 09: Universitätsmedizin Mainz, Klinik und Poliklinik für Neurologie
  • Site 04: Universitätsklinikum Tübingen, Klinik für Allgemeine Neurologie
  • Site 06: Universitätsklinikum Ulm, Abteilung für Neurologie
  • Site 23 - University Hospital Coventry NHS Trust
  • Site 26 - University College London Hospital
  • Site 28 - King's College London Hospital
  • Site 20: St George's NHS Trust

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Active Comparator

Active Comparator

Arm Label

Phosphate buffered saline (PBS), 1% sucrose, 4% mannitol

40 mg Revacept

120 mg Revacept

Arm Description

Placebo control with PBS, 1% sucrose and 4% mannitol

low dose Revacept 40mg in PBS, 1% sucrose, 4% mannitol

high dose revacept 120mg in PBS, 1% sucrose, 4% mannitol

Outcomes

Primary Outcome Measures

New DWI Lesion(s)
The number of new diffusion weighted imaging (DWI) lesion(s) reported. (1 day after intervention compared to baseline).

Secondary Outcome Measures

Full Information

First Posted
July 16, 2012
Last Updated
January 27, 2021
Sponsor
AdvanceCor GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT01645306
Brief Title
Revacept in Symptomatic Carotid Stenosis
Acronym
RevaceptCS02
Official Title
Revacept, an Inhibitor of Platelet Adhesion in Symptomatic Carotid Stenosis: A Phase II, Multicentre; Randomised, Dose-finding, Double-blind and Placebo Controlled Superiority Study With Parallel Groups
Study Type
Interventional

2. Study Status

Record Verification Date
January 2021
Overall Recruitment Status
Completed
Study Start Date
March 8, 2013 (Actual)
Primary Completion Date
October 5, 2018 (Actual)
Study Completion Date
September 23, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AdvanceCor GmbH

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Patients suffering from symptomatic carotid artery stenosis, transient ischemic attacks (TIAs), amaurosis fugax or stroke receive either Revacept (single dose) plus antiplatelet monotherapy or monotherapy alone. Patients receive a single dose of trial medication by intravenous infusion for 20 minutes. Patients are followed up one and three days after treatment, at 3 months and by a telephone interview at 12 months.
Detailed Description
Patients had a more than 50% carotid artery stenosis according to ECST and suffered from ischemic stroke, transitory ischemic attack or intermittent blindness (amaurosis fugax) within the last 30 days. All patients were on standard medication with aspirin or clopidogrel and received heparin for thrombosis prophylaxis. Carotid endarterectomy (CEA), carotid stenting (CAS) or best medical therapy for treatment of the carotid stenosis and prevention of secondary thrombo-emboli was performed according to guidelines. Additional treatment with Revacept or placebo was done on top of the standard therapy. Therefore the control group receiving placebo was already on the standard medical therapy for patients with symptomatic carotid stenosis and received also the guideline conform interventions CEA, CAS or best medical therapy. Secondary prophylaxis of thrombo-embolic ischemic events by Revacept should be investigated. Therefore microemboli were detected by transcranial Doppler and ischemic brain lesions were investigated by diffusion weighted imaging magnetic resonance imaging (DWI-MRI) scan as exploratory endpoints. Moreover clinical endpoints such as stroke, TIA, myocardial infarction, coronary intervention and death were investigated at 1 week, 3 months and 12 months follow-up. Safety was closely monitored with emphasis on bleeding complications as bleeding is the most dreaded complication of anti-thrombotic agents especially in patients with cerebral strokes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Carotid Stenosis, Atherosclerosis, Stroke, Transient-ischaemic Attack, TIA, Amaurosis Fugax

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
158 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Phosphate buffered saline (PBS), 1% sucrose, 4% mannitol
Arm Type
Placebo Comparator
Arm Description
Placebo control with PBS, 1% sucrose and 4% mannitol
Arm Title
40 mg Revacept
Arm Type
Active Comparator
Arm Description
low dose Revacept 40mg in PBS, 1% sucrose, 4% mannitol
Arm Title
120 mg Revacept
Arm Type
Active Comparator
Arm Description
high dose revacept 120mg in PBS, 1% sucrose, 4% mannitol
Intervention Type
Drug
Intervention Name(s)
Revacept
Other Intervention Name(s)
40 mg or 120 mg
Intervention Description
single intravenous injection
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Control Group
Intervention Description
single intravenous injection
Primary Outcome Measure Information:
Title
New DWI Lesion(s)
Description
The number of new diffusion weighted imaging (DWI) lesion(s) reported. (1 day after intervention compared to baseline).
Time Frame
1 day post intervention
Other Pre-specified Outcome Measures:
Title
Patients With Any Stroke or Transient Ischemic Attack (TIA)
Description
patients with any stroke or TIA occuring within 90 days after IMP application.
Time Frame
90 days after IMP application
Title
Major Bleedings
Description
patients with major bleedings occuring within 90 days after IMP application
Time Frame
90 days after IMP application
Title
Any Clinical Event
Description
patients with any stroke & TIA, myocardial infarction & percutaneous coronary intervention (PCI), death or bleeding within one year (365 days) after IMP application.
Time Frame
365 days after IMP application
Title
Anti-Drug Antibodies
Description
Anti-drug antibodies were measured at baseline and 3 month after IMP application. Number of patients with positive anti-drug antibodies compared to baseline are counted.
Time Frame
3 month (+/- 1 month) after IMP application
Title
Participants With Adverse Events (AEs)
Description
All adverse events were assessed during complete study period (~ 1 year after IMP application).
Time Frame
~ 365 days after IMP application (whole study period)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed written informed consent Target population Diagnosis: Extracranial carotid artery stenosis (diagnosed by vascular duplex ultrasound peak flow or angiography) Lesions with ≥ 50 % stenosis according to the European Carotid Surgery Trial (ECST) criteria TIA, amaurosis fugax or stroke within the last 30 days Age and sex: Men and women aged > 18 years Women of childbearing potential (WOCBP) must be using an adequate method of contraception to avoid pregnancy throughout the study and for up to 4 weeks after receiving investigational product in such a manner that the risk of pregnancy is minimised. Exclusion Criteria: Sex and reproductive Status: WOCBP who are unwilling or unable to use an acceptable method to avoid pregnancy for up to 4 weeks after receiving investigational product. Women who are pregnant or breastfeeding Women with a positive pregnancy test on enrollment or prior to investigational product administration. Target disease exceptions NIHSS score > 18 Recent intracerebral haemorrhage by X-ray computed tomography (CT) or nuclear magnetic resonance (NMR) Cardiac cause of embolisation (atrial fibrillation or other cardiac source e.g. artificial heart valves) Medical history and concurrent disease History of hypersensitivity, contraindication or serious adverse reaction to inhibitors of platelet aggregation, hypersensitivity to related drugs (cross-allergy) or to any of the excipients in the study drug History or evidence of thrombocytopenia (<30.000/ul), bleeding diathesis or coagulopathy (pathological international normalised ratio (INR) or activated partial thromboplastin time (aPTT)) Thrombolysis within the last 48 hours Relevant haemorrhagic transformation as determined by CT, NMR or anamnesis Oral anticoagulation or dual anti-platelet therapy with aspirin or clopidogrel and other P2Y inhibitors at screening (3 days for dipyridamole extended release; 8 hours for tirofiban/Aggrastat) Sustained hypertension (systolic BP > 179 mmHg or diastolic BP >109 mmHg) History of severe systemic disease such as terminal carcinoma, renal failure (or current creatinine > 200 umol/l), cirrhosis, severe dementia, or psychosis Current severe liver dysfunction (transaminase level greater than 5-fold over upper normal range limit) Active autoimmune disorder such as systemic lupus erythematosus, rheumatoid arthritis, vasculitis or glomerulonephritis Known atrial fibrillation or other clinically significant ECG abnormalities (at present)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Holger Poppert, Prof. Dr.
Organizational Affiliation
Department of Neurology, TU Munich
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Ian M Loftus, MD
Organizational Affiliation
St George's NHS Trust
Official's Role
Principal Investigator
Facility Information:
Facility Name
Site 01: Department of Neurology, TU Munich
City
Munich
State/Province
Bavaria
ZIP/Postal Code
81675
Country
Germany
Facility Name
Site 08: Universitätsklinikum Essen, Klinik für Neurologie
City
Essen
ZIP/Postal Code
45147
Country
Germany
Facility Name
Site 11: Universitätsklinikum Hamburg Eppendorf
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Site 07: Medizinische Hochschule Hannover, Klinik für Neurologie
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
Site 12: Universitätsklinikum Leipzig AöR
City
Leipzig
ZIP/Postal Code
04103
Country
Germany
Facility Name
Site 09: Universitätsmedizin Mainz, Klinik und Poliklinik für Neurologie
City
Mainz
ZIP/Postal Code
55131
Country
Germany
Facility Name
Site 04: Universitätsklinikum Tübingen, Klinik für Allgemeine Neurologie
City
Tübingen
ZIP/Postal Code
72076
Country
Germany
Facility Name
Site 06: Universitätsklinikum Ulm, Abteilung für Neurologie
City
Ulm
ZIP/Postal Code
89081
Country
Germany
Facility Name
Site 23 - University Hospital Coventry NHS Trust
City
Coventry
ZIP/Postal Code
CV2 2DX
Country
United Kingdom
Facility Name
Site 26 - University College London Hospital
City
London
ZIP/Postal Code
NW1 2BU
Country
United Kingdom
Facility Name
Site 28 - King's College London Hospital
City
London
ZIP/Postal Code
SE5 8AF
Country
United Kingdom
Facility Name
Site 20: St George's NHS Trust
City
London
ZIP/Postal Code
SW17 0QT
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
20430036
Citation
Bultmann A, Li Z, Wagner S, Peluso M, Schonberger T, Weis C, Konrad I, Stellos K, Massberg S, Nieswandt B, Gawaz M, Ungerer M, Munch G. Impact of glycoprotein VI and platelet adhesion on atherosclerosis--a possible role of fibronectin. J Mol Cell Cardiol. 2010 Sep;49(3):532-42. doi: 10.1016/j.yjmcc.2010.04.009. Epub 2010 Apr 27.
Results Reference
background
PubMed Identifier
9880390
Citation
Goertler M, Baeumer M, Kross R, Blaser T, Lutze G, Jost S, Wallesch CW. Rapid decline of cerebral microemboli of arterial origin after intravenous acetylsalicylic acid. Stroke. 1999 Jan;30(1):66-9. doi: 10.1161/01.str.30.1.66.
Results Reference
background
PubMed Identifier
15851601
Citation
Markus HS, Droste DW, Kaps M, Larrue V, Lees KR, Siebler M, Ringelstein EB. Dual antiplatelet therapy with clopidogrel and aspirin in symptomatic carotid stenosis evaluated using doppler embolic signal detection: the Clopidogrel and Aspirin for Reduction of Emboli in Symptomatic Carotid Stenosis (CARESS) trial. Circulation. 2005 May 3;111(17):2233-40. doi: 10.1161/01.CIR.0000163561.90680.1C. Epub 2005 Apr 25.
Results Reference
background
PubMed Identifier
14656994
Citation
Massberg S, Konrad I, Bultmann A, Schulz C, Munch G, Peluso M, Lorenz M, Schneider S, Besta F, Muller I, Hu B, Langer H, Kremmer E, Rudelius M, Heinzmann U, Ungerer M, Gawaz M. Soluble glycoprotein VI dimer inhibits platelet adhesion and aggregation to the injured vessel wall in vivo. FASEB J. 2004 Feb;18(2):397-9. doi: 10.1096/fj.03-0464fje. Epub 2003 Dec 4.
Results Reference
background
PubMed Identifier
10390320
Citation
Molloy J, Markus HS. Asymptomatic embolization predicts stroke and TIA risk in patients with carotid artery stenosis. Stroke. 1999 Jul;30(7):1440-3. doi: 10.1161/01.str.30.7.1440.
Results Reference
background
PubMed Identifier
12649139
Citation
Nieswandt B, Watson SP. Platelet-collagen interaction: is GPVI the central receptor? Blood. 2003 Jul 15;102(2):449-61. doi: 10.1182/blood-2002-12-3882. Epub 2003 Mar 20.
Results Reference
background
PubMed Identifier
9506619
Citation
Ringelstein EB, Droste DW, Babikian VL, Evans DH, Grosset DG, Kaps M, Markus HS, Russell D, Siebler M. Consensus on microembolus detection by TCD. International Consensus Group on Microembolus Detection. Stroke. 1998 Mar;29(3):725-9. doi: 10.1161/01.str.29.3.725.
Results Reference
background
PubMed Identifier
18566102
Citation
Schonberger T, Siegel-Axel D, Bussl R, Richter S, Judenhofer MS, Haubner R, Reischl G, Klingel K, Munch G, Seizer P, Pichler BJ, Gawaz M. The immunoadhesin glycoprotein VI-Fc regulates arterial remodelling after mechanical injury in ApoE-/- mice. Cardiovasc Res. 2008 Oct 1;80(1):131-7. doi: 10.1093/cvr/cvn169. Epub 2008 Jun 19.
Results Reference
background
PubMed Identifier
21502572
Citation
Ungerer M, Rosport K, Bultmann A, Piechatzek R, Uhland K, Schlieper P, Gawaz M, Munch G. Novel antiplatelet drug revacept (Dimeric Glycoprotein VI-Fc) specifically and efficiently inhibited collagen-induced platelet aggregation without affecting general hemostasis in humans. Circulation. 2011 May 3;123(17):1891-9. doi: 10.1161/CIRCULATIONAHA.110.980623. Epub 2011 Apr 18.
Results Reference
background
PubMed Identifier
26046734
Citation
Jamasbi J, Megens RT, Bianchini M, Munch G, Ungerer M, Faussner A, Sherman S, Walker A, Goyal P, Jung S, Brandl R, Weber C, Lorenz R, Farndale R, Elia N, Siess W. Differential Inhibition of Human Atherosclerotic Plaque-Induced Platelet Activation by Dimeric GPVI-Fc and Anti-GPVI Antibodies: Functional and Imaging Studies. J Am Coll Cardiol. 2015 Jun 9;65(22):2404-15. doi: 10.1016/j.jacc.2015.03.573.
Results Reference
background
PubMed Identifier
26046735
Citation
Kleiman NS, Kolandaivelu K. Expanding the Roster: Developing New Inhibitors of Intravascular Thrombosis. J Am Coll Cardiol. 2015 Jun 9;65(22):2416-9. doi: 10.1016/j.jacc.2015.03.576. No abstract available.
Results Reference
background
PubMed Identifier
35695006
Citation
Uphaus T, Richards T, Weimar C, Neugebauer H, Poli S, Weissenborn K, Imray C, Michalski D, Rashid H, Loftus I, Rummey C, Ritter M, Hauser TK, Munch G, Groschel K, Poppert H. Revacept, an Inhibitor of Platelet Adhesion in Symptomatic Carotid Stenosis: A Multicenter Randomized Phase II Trial. Stroke. 2022 Sep;53(9):2718-2729. doi: 10.1161/STROKEAHA.121.037006. Epub 2022 Jun 13.
Results Reference
derived

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Revacept in Symptomatic Carotid Stenosis

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