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Safety of RNS60 in Large Vessel Occlusion Stroke Patients Undergoing Endovascular Thrombectomy (RESCUE)

Primary Purpose

Stroke, Ischemic

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
RNS60
Placebo
Sponsored by
Revalesio Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stroke, Ischemic focused on measuring Endovascular Thrombectomy

Eligibility Criteria

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

Inclusion Criteria:

  1. Acute ischemic stroke (AIS) selected for emergency endovascular treatment.
  2. Age 18 years or older.
  3. Onset (last-known-well) time to randomization time within 24 hours.
  4. Disabling stroke defined as a baseline National Institutes of Health Stroke Score (NIHSS)

    1. NIHSS > 5 for internal carotid artery (ICA) and M1-middle cerebral artery (MCA) occlusion or
    2. NIHSS > 10 for M2-MCA occlusion.
  5. Confirmed symptomatic intracranial occlusion at one or more of the following locations: Intracranial carotid I/T/L, M1 or M2 segment MCA. Tandem extracranial carotid and intracranial occlusions are permitted.
  6. Pre-stroke (24 hours prior to stroke onset) historical modified Rankin Scale (mRS) ≤2. Patient must be living without requiring nursing care.
  7. Qualifying imaging performed less than 2 hours prior to randomization.
  8. Consent process completed as per applicable laws and regulation and the IRB requirements.

Exclusion Criteria:

  1. Evidence of a large core of established infarction defined as ASPECTS 0-4.
  2. Evidence of absence of collateral circulation on qualifying imaging (Collateral score of 0 or 1).
  3. Any evidence of intracranial hemorrhage or mass lesion on the qualifying imaging.
  4. Planned use of an endovascular device not having approval or clearance by the relevant regulatory authority.
  5. Endovascular thrombectomy procedure is completed as defined by the presence of arterial access closure.
  6. Clinical history, past imaging or clinical judgment suggesting that the intracranial occlusion is chronic or there is suspected intracranial dissection such that there is a predicted lack of success with endovascular intervention.
  7. Estimated or known weight > 130 kg (287 lbs).
  8. Known pregnant/lactating female.
  9. Myocardial infarction within 6 months prior to Screening including non-Q wave MI; Diagnosis of CHF with either:

    1. current clinical signs and symptoms of ventricular dysfunction (e.g., edema, shortness of breath),
    2. CHF medication adjustment within the prior 30 days or
    3. ejection fraction (if report available) of 30% or less measured in the 6 months prior to Screening; as either medically documented or reported by patient or another person considered by the Investigator to be reasonably reliable.
  10. Known renal impairment defined as requiring renal replacement therapy (hemo- or peritoneal dialysis).
  11. Inability to have MRI imaging (Non- MR compatible implants or any other foreseeable reason, including claustrophobia)
  12. Severe or fatal comorbid illness that will prevent improvement or follow up.
  13. Inability to complete follow-up treatment to Day 90.
  14. Participation in another clinical trial investigating a drug, medical device, or a medical procedure in the 30 days preceding trial inclusion and throughout the duration of the trial.
  15. Reported known seizure at time of stroke onset.
  16. Ischemic stroke within previous 30 days.
  17. Patients in normal sinus rhythm with a known QTcF > 450 ms at Screening.
  18. Any other symptom that in the investigator's opinion may complicate or preclude the subject from participating in this trial.

Sites / Locations

  • Northwestern University
  • Oregon Health & Science University
  • The Hospital of the University of Pennsylvania
  • Thomas Jefferson University
  • Rhode Island Hospital
  • Chattanooga Center for Neurologic Research
  • Houston Methodist Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

RNS60 0.5 mL/kg/h

RNS60 1 mL/kg/h

Placebo 1 mL/kg/h

Arm Description

RNS60 0.5 mL/kg/h infusion for 48h (up to a maximum of 60 mL/kg) starting within 30 min of randomization (but prior to arterial access closure)

RNS60 1 mL/kg/h infusion for 48h (up to a maximum of 120 mL/kg) starting within 30 min of randomization (but prior to arterial access closure)

Placebo (normal saline) 1 mL/kg/h infusion for 48h (up to a maximum of 120 mL/kg) starting within 30 min of randomization (but prior to arterial access closure)

Outcomes

Primary Outcome Measures

Proportion of subjects with serious adverse events
Mortality: proportion of participants alive

Secondary Outcome Measures

Mean mRS score
mRS = Modified Rankin Scale
Reduction in mortality rate
Lower event rate on the Kaplan Meier survival curve
Mean NIHSS score
NIHSS = National Institutes of Health Stroke Scale
Proportion of participants with a worsening of stroke
Worsening of stroke defined as progression, or hemorrhagic transformation, of the index stroke as documented by medical imaging and that is (a) life-threatening requiring intervention and/or (b) results in increased disability as gauged by a ≥4 point increase from lowest NIHSS during hospitalization and/or (c) results in death
Mean BI
Mean Barthel Index (BI) at Day 90 relative to pre-stroke BI

Full Information

First Posted
December 31, 2020
Last Updated
August 25, 2023
Sponsor
Revalesio Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT04693715
Brief Title
Safety of RNS60 in Large Vessel Occlusion Stroke Patients Undergoing Endovascular Thrombectomy
Acronym
RESCUE
Official Title
RESCUE: A Randomized, Blinded, Placebo-controlled, Parallel Group Design to Determine the Safety of RNS60 in Large Vessel Occlusion Stroke Patients Undergoing Endovascular Thrombectomy
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
July 7, 2021 (Actual)
Primary Completion Date
November 8, 2023 (Anticipated)
Study Completion Date
November 8, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Revalesio Corporation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A Phase II, randomized, blinded, placebo-controlled, parallel group study with patients experiencing a large vessel occlusion acute ischemic stroke who are selected for endovascular revascularization. Participants will be given a 48 h infusion of either 0.5 mL/kg/h RNS60 (up to a maximum of 60 mL/h), 1 mL/kg/h RNS60 (up to a maximum of 120 mL/h), or 1 mL/kg/h (up to a maximum of 120 mL/h) placebo (normal saline) starting within 30 minutes of consent after confirmation of candidacy for endovascular thrombectomy.
Detailed Description
This study is a Phase II, randomized, blinded, placebo-controlled, parallel group design. Participants experiencing a large vessel occlusion acute ischemic stroke who are selected for endovascular revascularization will be given a 48 h infusion of either 0.5 mL/kg/h RNS60 (up to a maximum of 60 mL/h), 1 mL/kg/h RNS60 (up to a maximum of 120 mL/h), or 1 mL/kg/h (up to a maximum of 120 mL/h) placebo (normal saline) starting within 30 minutes of consent after confirmation of candidacy for endovascular thrombectomy and prior to arterial closure. Outcomes of the main trial will be evaluated throughout a 90 day observation period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stroke, Ischemic
Keywords
Endovascular Thrombectomy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
82 (Actual)

8. Arms, Groups, and Interventions

Arm Title
RNS60 0.5 mL/kg/h
Arm Type
Experimental
Arm Description
RNS60 0.5 mL/kg/h infusion for 48h (up to a maximum of 60 mL/kg) starting within 30 min of randomization (but prior to arterial access closure)
Arm Title
RNS60 1 mL/kg/h
Arm Type
Experimental
Arm Description
RNS60 1 mL/kg/h infusion for 48h (up to a maximum of 120 mL/kg) starting within 30 min of randomization (but prior to arterial access closure)
Arm Title
Placebo 1 mL/kg/h
Arm Type
Placebo Comparator
Arm Description
Placebo (normal saline) 1 mL/kg/h infusion for 48h (up to a maximum of 120 mL/kg) starting within 30 min of randomization (but prior to arterial access closure)
Intervention Type
Drug
Intervention Name(s)
RNS60
Intervention Description
RNS60 injection solution
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo injection solution
Primary Outcome Measure Information:
Title
Proportion of subjects with serious adverse events
Time Frame
90 days
Title
Mortality: proportion of participants alive
Time Frame
90 days
Secondary Outcome Measure Information:
Title
Mean mRS score
Description
mRS = Modified Rankin Scale
Time Frame
90 days
Title
Reduction in mortality rate
Description
Lower event rate on the Kaplan Meier survival curve
Time Frame
90 days
Title
Mean NIHSS score
Description
NIHSS = National Institutes of Health Stroke Scale
Time Frame
90 days
Title
Proportion of participants with a worsening of stroke
Description
Worsening of stroke defined as progression, or hemorrhagic transformation, of the index stroke as documented by medical imaging and that is (a) life-threatening requiring intervention and/or (b) results in increased disability as gauged by a ≥4 point increase from lowest NIHSS during hospitalization and/or (c) results in death
Time Frame
90 days
Title
Mean BI
Description
Mean Barthel Index (BI) at Day 90 relative to pre-stroke BI
Time Frame
90 days
Other Pre-specified Outcome Measures:
Title
Infarct progression/regression
Description
Infarct size measured by MRI brain imaging
Time Frame
90 days
Title
Quality of life score
Description
Health-related quality of life as measured by the 5-level EuroQoL 5D index (EQ-5D-5L)
Time Frame
90 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Acute ischemic stroke (AIS) selected for emergency endovascular treatment. Age 18 years or older. Onset (last-known-well) time to randomization time within 24 hours. Disabling stroke defined as a baseline National Institutes of Health Stroke Score (NIHSS) NIHSS > 5 for internal carotid artery (ICA) and M1-middle cerebral artery (MCA) occlusion or NIHSS > 10 for M2-MCA occlusion. Confirmed symptomatic intracranial occlusion at one or more of the following locations: Intracranial carotid I/T/L, M1 or M2 segment MCA. Tandem extracranial carotid and intracranial occlusions are permitted. Pre-stroke (24 hours prior to stroke onset) historical modified Rankin Scale (mRS) ≤2. Patient must be living without requiring nursing care. Qualifying imaging performed less than 2 hours prior to randomization. Consent process completed as per applicable laws and regulation and the IRB requirements. Exclusion Criteria: Evidence of a large core of established infarction defined as ASPECTS 0-4. Evidence of absence of collateral circulation on qualifying imaging (Collateral score of 0 or 1). Any evidence of intracranial hemorrhage or mass lesion on the qualifying imaging. Planned use of an endovascular device not having approval or clearance by the relevant regulatory authority. Endovascular thrombectomy procedure is completed as defined by the presence of arterial access closure. Clinical history, past imaging or clinical judgment suggesting that the intracranial occlusion is chronic or there is suspected intracranial dissection such that there is a predicted lack of success with endovascular intervention. Estimated or known weight > 130 kg (287 lbs). Known pregnant/lactating female. Myocardial infarction within 6 months prior to Screening including non-Q wave MI; Diagnosis of CHF with either: current clinical signs and symptoms of ventricular dysfunction (e.g., edema, shortness of breath), CHF medication adjustment within the prior 30 days or ejection fraction (if report available) of 30% or less measured in the 6 months prior to Screening; as either medically documented or reported by patient or another person considered by the Investigator to be reasonably reliable. Known renal impairment defined as requiring renal replacement therapy (hemo- or peritoneal dialysis). Inability to have MRI imaging (Non- MR compatible implants or any other foreseeable reason, including claustrophobia) Severe or fatal comorbid illness that will prevent improvement or follow up. Inability to complete follow-up treatment to Day 90. Participation in another clinical trial investigating a drug, medical device, or a medical procedure in the 30 days preceding trial inclusion and throughout the duration of the trial. Reported known seizure at time of stroke onset. Ischemic stroke within previous 30 days. Patients in normal sinus rhythm with a known QTcF > 450 ms at Screening. Any other symptom that in the investigator's opinion may complicate or preclude the subject from participating in this trial.
Facility Information:
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
The Hospital of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Thomas Jefferson University
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
Rhode Island Hospital
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02903
Country
United States
Facility Name
Chattanooga Center for Neurologic Research
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37404
Country
United States
Facility Name
Houston Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety of RNS60 in Large Vessel Occlusion Stroke Patients Undergoing Endovascular Thrombectomy

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