Clinical trial • Cardiology|Neurology

TENECTEPLASE for Acute ischemic stroke

Clinical trial of TENECTEPLASE for Acute ischemic stroke.

Overview

Trial Therapeutic Area
Cardiology|Neurology
Trial Disease
Acute ischemic stroke
Drug Modality
Peptide/protein/enzyme

Key dates

Initial CTIS Submission Date
01-10-2025
First CTIS Authorization Date
16-12-2025

Trial design

Randomised, placebo to metalyse® (placebo comparator); metalyse (tenecteplase) 0.25 mg/kg iv (test drug), single intravenous administration (product also available as metalyse 5 000 units (25 mg) powder for solution for injection).-controlled trial in Germany.

Randomised
Yes
Comparator
Placebo to Metalyse® (placebo comparator); Metalyse (tenecteplase) 0.25 mg/kg IV (test drug), single intravenous administration (product also available as Metalyse 5 000 units (25 mg) powder for solution for injection).
Target Sample Size
668
Trial Duration For Participant
90

Eligibility

Recruits 668 Vulnerable population selected. Subject information and informed consent forms include patient forms and separate legal representative forms and subsequent consent forms (documents listed: L1_DE_SISandICF_Patient_de_redacted; L1_DE_SISandICF_Legal Representative_de_redacted; L1_DE_SISandICF_Patient_Subsequent Consent_de_redacted; L1_DE_SISandICF_Legal Representative_Subsequent Consent_de_redacted; L1_DE_SISandICF_Investigator Art 35 CTR_de_redacted). Consent may be obtained from the patient or, if the patient is unable, from a legal representative; subsequent consent procedures and investigator (Art 35 CTR) forms are provided..

Vulnerable Population
Vulnerable population selected. Subject information and informed consent forms include patient forms and separate legal representative forms and subsequent consent forms (documents listed: L1_DE_SISandICF_Patient_de_redacted; L1_DE_SISandICF_Legal Representative_de_redacted; L1_DE_SISandICF_Patient_Subsequent Consent_de_redacted; L1_DE_SISandICF_Legal Representative_Subsequent Consent_de_redacted; L1_DE_SISandICF_Investigator Art 35 CTR_de_redacted). Consent may be obtained from the patient or, if the patient is unable, from a legal representative; subsequent consent procedures and investigator (Art 35 CTR) forms are provided.

Inclusion criteria

  • {"criterion_text":"- Age ≥ 18 years\n- Clinical diagnosis of acute stroke with disabling deficit\n- National Institutes of Health Stroke Scale (NIHSS) score at least 2\n- Recent intake (within 48 hours prior to enrolment) of a direct oral anticoagulant (apixaban, rivaroxaban, edoxaban, or dabigatran)\n- No evidence of any intracranial haemorrhage on cerebral imaging (CT or MRI) performed after stroke onset and no earlier than 60 minutes before enrolment\n- Stroke symptoms not known to have been present for > 6 h\n- For patients not known to have been awake and without acute stroke symptoms within 4.5 hours prior to enrolment, additional imaging criteria must be satisfied: a) If stroke symptoms are known to have been present for > 4.5 h (late time window): core/penumbra mismatch on MR or CT perfusion imaging; b) If stroke symptoms are not known to have been present for > 4.5 h (unknown time window): core/penumbra mismatch on MR or CT perfusion imaging; or DWI/FLAIR mismatch on MR imaging."}

Exclusion criteria

  • {"criterion_text":"- Contraindication to intravenous thrombolysis, except DOAC therapy\n- Reversal or planned reversal of anticoagulation with idarucizumab or andexanet alfa\n- Concomitant therapy with antithrombotic medications, except DOACs\n- Anticipated stenting of cervical or intracranial artery within 12 hours\n- Anticipated coronary angioplasty within 12 hours\n- Any anticipated surgical intervention within 12 hours\n- Significant pre-stroke disability (mRS > 3)"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Functional outcome (modified Rankin Scale, mRS) 90 days after randomisation","definition_or_measurement_approach":"Modified Rankin Scale (mRS) measured 90 days after randomisation to assess functional outcome."}

Secondary endpoints

  • {"endpoint_text":"- Efficacy Endpoint: Nondisabled (mRS score ≤ 1) functional outcome after 90 days","definition_or_measurement_approach":"mRS score ≤ 1 at 90 days"}
  • {"endpoint_text":"- Efficacy Endpoint: Independent (mRS score ≤ 2) functional outcome after 90 days","definition_or_measurement_approach":"mRS score ≤ 2 at 90 days"}
  • {"endpoint_text":"- Efficacy Endpoint: Early neurological deficit (National Institutes of Health stroke scale) after 24 hours","definition_or_measurement_approach":"NIHSS score measured at 24 hours"}
  • {"endpoint_text":"- Efficacy Endpoint: Health-related quality of life (PROMIS®-10) after 90 days","definition_or_measurement_approach":"PROMIS-10 instrument measured at 90 days"}
  • {"endpoint_text":"- Efficacy Endpoint: Cognitive impairment (Montreal Cognitive Assessment) after 90 days","definition_or_measurement_approach":"Montreal Cognitive Assessment (MoCA) measured at 90 days"}
  • {"endpoint_text":"- Safety Endpoint: Any intracranial haemorrhage within 36 hours","definition_or_measurement_approach":"Any intracranial haemorrhage occurring within 36 hours"}
  • {"endpoint_text":"- Safety Endpoint: Symptomatic intracranial haemorrhage within 36 hours (mSITS-MOST)","definition_or_measurement_approach":"Symptomatic intracranial haemorrhage within 36 hours defined by mSITS-MOST criteria"}
  • {"endpoint_text":"- Safety Endpoint: Fatal intracranial haemorrhage within 30 days","definition_or_measurement_approach":"Fatal intracranial haemorrhage occurring within 30 days"}
  • {"endpoint_text":"- Safety Endpoint: Major haemorrhage (ISTH) within 72 hours","definition_or_measurement_approach":"Major haemorrhage as per ISTH criteria within 72 hours"}
  • {"endpoint_text":"- Safety Endpoint: Orolingual angioedema within 4 hours","definition_or_measurement_approach":"Occurrence of orolingual angioedema within 4 hours"}
  • {"endpoint_text":"- Safety Endpoint: Death or dependency (mRS score 4–6) after 90 days","definition_or_measurement_approach":"mRS score 4–6 at 90 days"}
  • {"endpoint_text":"- Safety Endpoint: All-cause mortality after 90 days","definition_or_measurement_approach":"All-cause mortality measured at 90 days"}
  • {"endpoint_text":"- Safety Endpoint: Time to death right-censored at 90 days","definition_or_measurement_approach":"Time to death endpoint with right censoring at 90 days"}

Recruitment

Planned Sample Size
668
Recruitment Window Months
49
Consent Approach
Informed consent provided by the participant; if the participant is unable to consent, a legal representative can provide consent. Subsequent consent forms are available (subsequent consent documents listed). Patient-facing and legal representative informed consent forms are provided (documents are in German as indicated by document titles with '_de'). Investigator Art 35 CTR consent documentation is also provided.

Geography

Total Number Of Sites
34
Total Number Of Participants
668

Germany

Earliest CTIS Part Ii Submission Date
25-11-2025
Latest Decision Or Authorization Date
02-03-2026
Processing Time Days
97
Number Of Sites
34
Number Of Participants
668

Sites

Site Name
Universitaetsklinikum Duesseldorf AöR
Department Name
Klinik für Neurologie
Contact Person Name
Michael Gliem
Site Name
Klinikum Dortmund gGmbH
Department Name
Neurologische Klinik
Contact Person Name
Gernot Reimann
Contact Person Email
Gernot.Reimann@klinikumdo.de
Site Name
Klinikum Nuernberg
Department Name
Klinik für Neurologie
Contact Person Name
Jan Liman
Site Name
Staedtisches Klinikum Lueneburg gGmbH
Department Name
Klinik für Neurologie und Klinische Neurophysio-logie
Contact Person Name
Waltraud Pfeilschifter
Site Name
Medizinische Hochschule Hannover
Department Name
Klinik für Neurologie mit Klinischer Neurophysiologie
Contact Person Name
Ramona Schuppner
Site Name
Universitaetsklinikum Wuerzburg AöR
Department Name
Neurologische Klinik und Poliklinik
Contact Person Name
Christian Hametner
Contact Person Email
hametner_c@ukw.de
Site Name
Universitaetsklinikum Aachen AöR
Department Name
Klinik für Neurologie
Contact Person Name
Arno Reich
Contact Person Email
areich@ukaachen.de
Site Name
Klinikum der Technischen Universitaet Muenchen (TUM Klinikum)
Department Name
Klinik und Poliklinik für Neurologie
Contact Person Name
Silke Wunderlich
Contact Person Email
Silke.wunderlich@mri.tum.de
Site Name
Klinikum Aschaffenburg-Alzenau gGmbH
Department Name
Neurologische Klinik
Contact Person Name
Oliver Bähr
Site Name
Katholische Hospitalvereinigung Weser-Egge gGmbH
Department Name
Klinik für Neurologie
Contact Person Name
Mark Obermann
Contact Person Email
m.obermann@khwe.de
Site Name
Gesundheit Nord gGmbH Klinikverbund Bremen
Department Name
Neurologische Klinik
Contact Person Name
Andreas Kastrup
Site Name
Klinikum Der Landeshauptstadt Stuttgart gKAöR
Department Name
Neurologische Klinik
Contact Person Name
Marc Wolf
Contact Person Email
ma.wolf@klinikum-stuttgart.de
Site Name
Evangelisches Krankenhaus Mettmann GmbH
Department Name
Akademisches Lehrkrankenhaus der Universität
Contact Person Name
Bert Bosche
Contact Person Email
b.bosche@evk-mettmann.de
Site Name
Universitaetsklinikum Bonn AöR
Department Name
Klinik für Vaskuläre Neurologie
Contact Person Name
Gabor Petzold
Contact Person Email
Gabor.Petzold@ukbonn.de
Site Name
Klinikum Frankfurt Hoechst GmbH
Department Name
Klinik für Neurologie
Contact Person Name
Thorsten Steiner
Contact Person Email
thorsten.steiner@varisano.de
Site Name
Charite Universitaetsmedizin Berlin KöR
Department Name
Klinik für Neurologie mit Experimenteller Neurologie, Centrum für Schlaganfallforschung Berlin
Contact Person Name
Christian Nolte
Contact Person Email
christian.nolte@charite.de
Site Name
University Medical Center Hamburg-Eppendorf
Department Name
Klinik und Poliklinik für Neurologie
Contact Person Name
Eckhard Schlemm
Contact Person Email
e.schlemm@uke.de
Site Name
Klinikum Altenburger Land GmbH
Department Name
Klinik für Neurologie/ Neurologische Intensivmedizin
Contact Person Name
Jörg Berrouschot
Site Name
Universitaet Leipzig
Department Name
Klinik und Poliklinik für Neurologie
Contact Person Name
Dominik Michalski
Site Name
LMU Klinikum Muenchen AöR
Department Name
Institut für Schlaganfall- und Demenzforschung
Contact Person Name
Martin Dichgans
Site Name
Heidelberg University
Department Name
Neurologische Klinik und Poliklinik
Contact Person Name
Carolin Hoyer
Contact Person Email
carolin.hoyer@umm.de
Site Name
HELIOS Dr. Horst Schmidt Kliniken Wiesbaden GmbH
Department Name
Klinik für Neurologie
Contact Person Name
Frank Arne Wollenweber
Site Name
Universitaetsmedizin der Johannes Gutenberg-Universitaet Mainz KöR
Department Name
Klinik und Poliklinik für Neurologie
Contact Person Name
Timo Uphaus
Site Name
Muehlenkreiskliniken AöR
Department Name
Universitätsklinik für Neurologie und Neurogeriatrie
Contact Person Name
Peter Schellinger
Site Name
Universitaet Muenster
Department Name
Klinik für Neurologie
Contact Person Name
Antje Schmidt-Pogoda
Site Name
Otto Von Guericke Universitaet Magdeburg
Department Name
Universitätsklinik für Neurologie
Contact Person Name
Jens Neumann
Contact Person Email
jens.neumann@med.ovgu.de
Site Name
Evangelische Krankenhausstiftung Oldenburg
Department Name
Universitätsklinik für Neurologie
Contact Person Name
Thomas Liman
Contact Person Email
Thomas.Liman@uni-oldenburg.de
Site Name
Universitaetsklinikum Schleswig-Holstein AöR
Department Name
Klinik für Neurologie
Contact Person Name
Milani Deb-Chatterji
Contact Person Email
Milani.Deb-Chatterji@uksh.de
Site Name
Technische Universitaet Dresden
Department Name
Klinik und Poliklinik für Neurologie
Contact Person Name
Timo Siepmann
Contact Person Email
timo.siepmann@ukdd.de
Site Name
Universitaetsklinikum Erlangen AöR
Department Name
Neurologische Klinik
Contact Person Name
Stefan Gerner
Contact Person Email
stefan.gerner@uk-erlangen.de
Site Name
Universitaetsklinikum Schleswig-Holstein AöR
Department Name
Campus Lübeck Klinik für Neurologie
Contact Person Name
Georg Royl
Contact Person Email
Georg.Royl@uksh.de
Site Name
Martha-Maria Krankenhaus Halle-Doelau gGmbH
Department Name
Klinik für Neurologie
Contact Person Name
Frank Hoffmann
Contact Person Email
frank.hoffmann@martha-maria.de
Site Name
Philipps-Universitaet Marburg
Department Name
Klinik und Poliklinik für Neurologie
Contact Person Name
Anja Gerstner
Contact Person Email
gerstner@med.uni-marburg.de
Site Name
Universitaetsklinikum Knappschaftskrankenhaus Bochum GmbH
Department Name
Klinik für Neurologie
Contact Person Name
Ilka Kleffner

Sponsor

Primary sponsor

Full Name
University Medical Center Hamburg-Eppendorf
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Germany

Third parties

  • {"country":"Germany","full_name":"University Medical Center Hamburg-Eppendorf","duties_or_roles":"5","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Germany","full_name":"GKM Gesellschaft fuer Therapieforschung mbH","duties_or_roles":"1,12,5,8","organisation_type":"Pharmaceutical company"}
  • {"country":"Germany","full_name":"University Medical Center Hamburg-Eppendorf","duties_or_roles":"14","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Germany","full_name":"University Medical Center Hamburg-Eppendorf","duties_or_roles":"10,6","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Germany","full_name":"University Medical Center Hamburg-Eppendorf","duties_or_roles":"4","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Germany","full_name":"Boehringer Ingelheim Pharma GmbH & Co. KG","duties_or_roles":"14","organisation_type":"Pharmaceutical company"}
  • {"country":"Germany","full_name":"Eppdata GmbH","duties_or_roles":"13","organisation_type":"Pharmaceutical company"}

Co-sponsors

  • GKM Gesellschaft fuer Therapieforschung mbH

Investigational products

Investigational Product Name
Metalyse 5 000 units (25 mg) powder for solution for injection
Active Substance
TENECTEPLASE
Modality
Peptide/protein/enzyme
Routes Of Administration
INTRAVENOUS INJECTION
Route
Intravenous injection
Authorisation Status
Marketing authorisation EU/1/00/169/007 (authorised)
Starting Dose
0.25 mg/kg
Dose Levels
0.25 mg/kg (maximum 25 mg)
Frequency
Single administration
Maximum Dose
25 mg
Investigational Product Name
Placebo to Metalyse®
Modality
Other

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