search
Back to results

Reduction of SystemiC Inflammation After Ischemic Stroke by Intravenous DNase Administration (ReSCInD) (ReSCInD)

Primary Purpose

Ischemic Stroke, Inflammatory Response

Status
Recruiting
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Dornase Alfa
Isotonic Saline Solution
Sponsored by
Ludwig-Maximilians - University of Munich
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ischemic Stroke

Eligibility Criteria

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

Inclusion Criteria: Patients with suspected acute ischemic stroke with symptom onset (last-seen-well) until Investigational drug application of less than 12 hours. Consent to participate in the study. Age ≥ 18 years. NIHSS ≥10 at admission. Exclusion Criteria: Presence of any of the following conditions: Sinus or cerebral venous thrombosis, intracerebral haemorrhage, subarachnoid haemorrhage on qualified imaging (cCT with CT-A or MRI with MR-A). However, petechial haemorrhagic transformations of the index infarct and cerebral microhaemorrhages may be included. Active malignant tumour disease in the last 6 months. Current known immunosuppression due to immunomodulatory medication with immunosuppressive dose or underlying immunosuppressive disease (e.g. HIV). Acute fulminant infectious disease in the last 7 days (fever > 38.5°C or suspected by the Investigator). Breastfeeding or pregnant woman, women of childbearing age without known use of contraceptives with positive urine or serum beta-human choriogonadotropin test. Ischemic stroke or myocardial infarction in the previous 30 days. Surgery in the previous 30 days, except minor dermatological or gynaecological surgery without anaesthesia and wound healing disorders and patients with thrombectomy. Estimated or known weight > 100 kg. Known allergies or intolerance to dornase alfa (Pulmozyme) or recombinant protein products derived from Chinese hamster ovary cells. Thrombocytopenia, leukocyte count <1500/μl. Known participation in another clinical trial investigating a drug and/or medical product in the last 7 days before study inclusion. Severe renal insufficiency with GFR≤29 ml/min/ 1.73m³ and/or renal insufficiency requiring dialysis.

Sites / Locations

  • Institute for Stroke and Dementia Research, Ludwig Maximilian University Munich, University HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Pulmozyme

Isotonic Saline Solution

Arm Description

Dornase alfa; intravenous administration; 500 µg/kg

NaCl 0,9 %; intravenous administration; 0,5 ml/kg

Outcomes

Primary Outcome Measures

Concentration of interleukin-1 beta in blood of patients with acute ischemic stroke receiving Dornase alfa compared to placebo treatment with Isotonic Saline Solution.
Outcome of reduced systemic immune response measured by interleukin-1 beta concentration [pg/ml] (at 24±6 hours after symptom onset) measured by Enzyme-linked Immunosorbent Assay (ELISA).

Secondary Outcome Measures

cfDNA concentration in blood.
Measurement of cell-free DNA (cfDNA) concentration [ng/ml] in blood at day 1 (24±6 hours after symptom onset) compared to the placebo group with experimental analysis.
DNase 1 activity in blood.
Comparison of DNase 1 activity [µU/ml] in blood of both treatment arms measured by Enzyme-linked Immunosorbent Assay (ELISA).
Concentration of DNase 1 in blood.
Analysis of the DNase 1 concentration [ng/ml] in patient blood treated with Dornase alfa compared to the placebo group by Enzyme-linked Immunosorbent Assay (ELISA).
Analysis of the composition of the leukocyte population in blood.
Analysing the leukocyte population [%] in blood using flow cytometry in both treatment arms.
Interleukin-6 concentration in blood after treatment.
Measurement of the interleukin-6 concentration [pg/ml] in blood samples (at 24±6 hours after symptom onset) measured by Enzyme-linked Immunosorbent Assay (ELISA).
Caspase 1 concentration in blood after treatment.
Analysing the caspase 1 concentration [pg/ml] in blood (at 24±6 hours after symptom onset) measured by Enzyme-linked Immunosorbent Assay (ELISA).
Assessment of patient safety after Dornase alfa treatment.
Safety aspects of intravenous investigational drug administration in acute ischemic stroke patients will be assessed by monitoring all study patients for 30±3 days and analysis of their: routine clinical diagnostics (worsening stroke is defined as a) progression, hemorrhagic transformation of the index stroke documented by radiological imaging; b) life-threatening need for intervention; c) death from the index stroke; and/or d) increasing disability (as measured by an increase of ≥ 4 points from the lowest NIHSS score measured during hospitalization, or a 1-point increase in mRS), laboratory parameters (hemoglobin, platelets, neutrophil granulocytes, leukocytes, CRP, GFR, creatinine, IL-6) and number of adverse events assessed by CTCAE current version.
Comparison of the incidence of infections and antibiotic treatment in both treatment arms.
Comparing the incidence of infections and antibiotic treatment after Dornase alfa and Isotonic Saline Solution treatment over a period of 30±3 days after symptom onset.
Functional neurological outcome scores (National Institute of Health Stroke Scale [NIHSS, 0-42] and Modified Rankin Scale [mRS, 0-6]) at both treatment arms.
Analysing changes of neurological scores (National Institute of Health Stroke Scale [NIHSS, 0-42] and Modified Rankin Scale [mRS, 0-6]) from baseline to last visit 30±3 days after symptom onset.

Full Information

First Posted
April 30, 2023
Last Updated
October 7, 2023
Sponsor
Ludwig-Maximilians - University of Munich
Collaborators
University Hospital Erlangen, University Hospital Regensburg
search

1. Study Identification

Unique Protocol Identification Number
NCT05880524
Brief Title
Reduction of SystemiC Inflammation After Ischemic Stroke by Intravenous DNase Administration (ReSCInD)
Acronym
ReSCInD
Official Title
Reduction of SystemiC Inflammation After Ischemic Stroke by Intravenous DNase Administration (ReSCInD)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 2023 (Anticipated)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
January 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Ludwig-Maximilians - University of Munich
Collaborators
University Hospital Erlangen, University Hospital Regensburg

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The goal of this (monocentric, randomised, placebo-controlled single-blinded; phase 2) clinical trial is to test the hypothesis that DNase 1 administration leads to a reduction in systemic immune response measured in patients after acute ischaemic stroke compared to control treatment. Participants will receive intravenous DNase 1 (500 µg/kg) or placebo (NaCl 0.9%) twice within 24±6 hours after symptom onset (last seen well). Blood samples will be taken at baseline, day 1 and 3. Personal visits will occur on baseline, day 1, 3 and discharge date. A telephone interview will be conducted on day 30±3.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ischemic Stroke, Inflammatory Response

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Monocentric, randomised, placebo-controlled single-blinded, Phase 2 trial
Masking
Participant
Allocation
Randomized
Enrollment
36 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Pulmozyme
Arm Type
Active Comparator
Arm Description
Dornase alfa; intravenous administration; 500 µg/kg
Arm Title
Isotonic Saline Solution
Arm Type
Placebo Comparator
Arm Description
NaCl 0,9 %; intravenous administration; 0,5 ml/kg
Intervention Type
Drug
Intervention Name(s)
Dornase Alfa
Other Intervention Name(s)
Pulmozyme
Intervention Description
Patients will receive an intravenous dose of Dornase alfa twice within within 24±6 hours after symptom onset, administered as a bolus.
Intervention Type
Drug
Intervention Name(s)
Isotonic Saline Solution
Other Intervention Name(s)
NaCl 0,9%
Intervention Description
Patients will receive an intravenous dose of Isotonic saline solution twice within within 24±6 hours after symptom onset, administered as a bolus.
Primary Outcome Measure Information:
Title
Concentration of interleukin-1 beta in blood of patients with acute ischemic stroke receiving Dornase alfa compared to placebo treatment with Isotonic Saline Solution.
Description
Outcome of reduced systemic immune response measured by interleukin-1 beta concentration [pg/ml] (at 24±6 hours after symptom onset) measured by Enzyme-linked Immunosorbent Assay (ELISA).
Time Frame
24±6 hours after symptom onset
Secondary Outcome Measure Information:
Title
cfDNA concentration in blood.
Description
Measurement of cell-free DNA (cfDNA) concentration [ng/ml] in blood at day 1 (24±6 hours after symptom onset) compared to the placebo group with experimental analysis.
Time Frame
24±6 hours after symptom onset
Title
DNase 1 activity in blood.
Description
Comparison of DNase 1 activity [µU/ml] in blood of both treatment arms measured by Enzyme-linked Immunosorbent Assay (ELISA).
Time Frame
24±6h after symptom onset
Title
Concentration of DNase 1 in blood.
Description
Analysis of the DNase 1 concentration [ng/ml] in patient blood treated with Dornase alfa compared to the placebo group by Enzyme-linked Immunosorbent Assay (ELISA).
Time Frame
24±6h after symptom onset
Title
Analysis of the composition of the leukocyte population in blood.
Description
Analysing the leukocyte population [%] in blood using flow cytometry in both treatment arms.
Time Frame
24±6 hours after symptom onset
Title
Interleukin-6 concentration in blood after treatment.
Description
Measurement of the interleukin-6 concentration [pg/ml] in blood samples (at 24±6 hours after symptom onset) measured by Enzyme-linked Immunosorbent Assay (ELISA).
Time Frame
24±6 hours after symptom onset
Title
Caspase 1 concentration in blood after treatment.
Description
Analysing the caspase 1 concentration [pg/ml] in blood (at 24±6 hours after symptom onset) measured by Enzyme-linked Immunosorbent Assay (ELISA).
Time Frame
24±6 hours after symptom onset
Title
Assessment of patient safety after Dornase alfa treatment.
Description
Safety aspects of intravenous investigational drug administration in acute ischemic stroke patients will be assessed by monitoring all study patients for 30±3 days and analysis of their: routine clinical diagnostics (worsening stroke is defined as a) progression, hemorrhagic transformation of the index stroke documented by radiological imaging; b) life-threatening need for intervention; c) death from the index stroke; and/or d) increasing disability (as measured by an increase of ≥ 4 points from the lowest NIHSS score measured during hospitalization, or a 1-point increase in mRS), laboratory parameters (hemoglobin, platelets, neutrophil granulocytes, leukocytes, CRP, GFR, creatinine, IL-6) and number of adverse events assessed by CTCAE current version.
Time Frame
30±3 days after symptom onset
Title
Comparison of the incidence of infections and antibiotic treatment in both treatment arms.
Description
Comparing the incidence of infections and antibiotic treatment after Dornase alfa and Isotonic Saline Solution treatment over a period of 30±3 days after symptom onset.
Time Frame
30±3 days after symptom onset
Title
Functional neurological outcome scores (National Institute of Health Stroke Scale [NIHSS, 0-42] and Modified Rankin Scale [mRS, 0-6]) at both treatment arms.
Description
Analysing changes of neurological scores (National Institute of Health Stroke Scale [NIHSS, 0-42] and Modified Rankin Scale [mRS, 0-6]) from baseline to last visit 30±3 days after symptom onset.
Time Frame
30±3 days after symptom onset

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with suspected acute ischemic stroke with symptom onset (last-seen-well) until Investigational drug application of less than 12 hours. Consent to participate in the study. Age ≥ 18 years. NIHSS ≥10 at admission. Exclusion Criteria: Presence of any of the following conditions: Sinus or cerebral venous thrombosis, intracerebral haemorrhage, subarachnoid haemorrhage on qualified imaging (cCT with CT-A or MRI with MR-A). However, petechial haemorrhagic transformations of the index infarct and cerebral microhaemorrhages may be included. Active malignant tumour disease in the last 6 months. Current known immunosuppression due to immunomodulatory medication with immunosuppressive dose or underlying immunosuppressive disease (e.g. HIV). Acute fulminant infectious disease in the last 7 days (fever > 38.5°C or suspected by the Investigator). Breastfeeding or pregnant woman, women of childbearing age without known use of contraceptives with positive urine or serum beta-human choriogonadotropin test. Ischemic stroke or myocardial infarction in the previous 30 days. Surgery in the previous 30 days, except minor dermatological or gynaecological surgery without anaesthesia and wound healing disorders and patients with thrombectomy. Estimated or known weight > 100 kg. Known allergies or intolerance to dornase alfa (Pulmozyme) or recombinant protein products derived from Chinese hamster ovary cells. Thrombocytopenia, leukocyte count <1500/μl. Known participation in another clinical trial investigating a drug and/or medical product in the last 7 days before study inclusion. Severe renal insufficiency with GFR≤29 ml/min/ 1.73m³ and/or renal insufficiency requiring dialysis.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Arthur Liesz, Prof. Dr.
Phone
+49 89 4400 46242
Email
arthur.liesz@med.uni-muenchen.de
First Name & Middle Initial & Last Name or Official Title & Degree
Saskia Wernsdorf
Phone
+49 89 4400 46119
Email
saskia.wernsdorf@med.uni-muenchen.de
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Martin Dichgans, Prof. Dr.
Organizational Affiliation
Institute for Stroke and Dementia Research, LMU Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Institute for Stroke and Dementia Research, Ludwig Maximilian University Munich, University Hospital
City
Munich
State/Province
Bavaria
ZIP/Postal Code
81377
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Arthur Liesz, Prof. Dr.
Phone
+49 89 4400 46242
Email
arthur.liesz@med.uni-muenchen.de
First Name & Middle Initial & Last Name & Degree
Saskia Wernsdorf
Phone
+49 89 4400 46119
Email
saskia.wernsdorf@med.uni-muenchen.de
First Name & Middle Initial & Last Name & Degree
Martin Dichgans, Prof. Dr.
First Name & Middle Initial & Last Name & Degree
Arthur Liesz, Prof. Dr.

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Reduction of SystemiC Inflammation After Ischemic Stroke by Intravenous DNase Administration (ReSCInD)

We'll reach out to this number within 24 hrs