Clinical trial • Phase III • Neurology

TENECTEPLASE for Acute ischemic stroke

Phase III trial of TENECTEPLASE for Acute ischemic stroke.

Overview

Trial Therapeutic Area
Neurology
Trial Disease
Acute ischemic stroke
Trial Stage
Phase III
Drug Modality
Small molecule|Peptide/protein/enzyme

Key dates

Initial CTIS Submission Date
25-10-2024
First CTIS Authorization Date
23-01-2025

Trial design

Factor Xa inhibitors (current standard of care): RIVAROXABAN (oral; product record shows max total dose 30 mg), APIXABAN (oral; product record shows max total dose 20 mg), EDOXABAN (oral; product record shows max total dose 60 mg).-controlled Phase III trial in Norway, Denmark, Sweden.

Comparator
Factor Xa inhibitors (current standard of care): RIVAROXABAN (oral; product record shows max total dose 30 mg), APIXABAN (oral; product record shows max total dose 20 mg), EDOXABAN (oral; product record shows max total dose 60 mg).
Target Sample Size
500
Trial Duration For Participant
90

Eligibility

Recruits 500 Vulnerable population selected. Subject information and informed consent forms are available for patients, next of kin and legal/professional legal representatives (documents listed: L1_ICF patients; L1_ICF next of kin; L1_ICF_Professional Legal Representative; L1_ICF_legal representative). Consent may be obtained from legal representatives/next of kin where applicable..

Vulnerable Population
Vulnerable population selected. Subject information and informed consent forms are available for patients, next of kin and legal/professional legal representatives (documents listed: L1_ICF patients; L1_ICF next of kin; L1_ICF_Professional Legal Representative; L1_ICF_legal representative). Consent may be obtained from legal representatives/next of kin where applicable.

Inclusion criteria

  • {"criterion_text":"- Participant must be 18 years of age or older.\n- Ingestion of FXa inhibitors within the last 48 hours of symptom onset (or ongoing prescription of FXa inhibitor if unknown)\n- Clinical diagnosis of AIS with disabling neurological deficit\n- Presenting within 4.5 h of symptom onset or after awakening with symptoms of AIS with FLAIR-DWI mismatch on MRI as judged by the (neuro-) radiologist.\n- Informed consent."}

Exclusion criteria

  • {"criterion_text":"- Endovascular treatment eligible patients with isolated large vessel occlusion of the intracranial internal carotid artery (ICA), the M1 segment of the middle cerebral artery (MCA), or both confirmed by CT or MR angiography and expected time from randomization to groin puncture of <30 minutes.\n- Systolic BP >185 mmHg or diastolic BP >110 mmHg despite antihypertensive treatment\n- Known bleeding diathesis; manifest or recent severe bleeding; significant bleeding disorder last 6 months.\n- Arterial puncture at a noncompressible site; biopsy or lumbar puncture <7 days; major surgery, traumatic external heart massage, obstetrical delivery or serious trauma <14 days; history of intracranial haemorrhage; stroke <2 months, CNS neurosurgery <2 months; serious head trauma <2 months; pericarditis; sepsis; bacterial endocarditis; pericarditis; acute pancreatitis; neoplasm with increased bleeding risk; any serious medical illness likely to interact with treatment (i.e. aortic dissection); confounding pre-existent neurological or psychiatric disease.\n- Any condition that, in the opinion of the treating physician, puts a patient at risk if treated with thrombolysis (i.e. signs of cerebral hemorrhage, known cerebral amyloid angiopathy, CT with signs of early ischemia greater than one-third of the middle cerebral artery territory)."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Early neurological improvement, defined as a reduction of ≥8 points on the National Institutes of Health Stroke Scale (NIHSS), or NIHSS of 0-1 at 24 hours ± 12.","definition_or_measurement_approach":"Defined as a reduction of ≥8 points on the National Institutes of Health Stroke Scale (NIHSS), or NIHSS of 0-1 measured at 24 hours ± 12 hours."}

Secondary endpoints

  • {"endpoint_text":"- Percentage change in NIHSS from baseline to 24 h ± 12 h.","definition_or_measurement_approach":"Percentage change in NIHSS from baseline to 24 hours ± 12 hours."}
  • {"endpoint_text":"- Percent change in infarct volume at 24 h ± 12 hours.","definition_or_measurement_approach":"Percent change in infarct volume measured by CT/MRI at 24 hours ± 12 hours."}
  • {"endpoint_text":"- Proportion of patients: - obtaining a good functional outcome (mRS 0-2) at day 90 (+/- 2weeks); obtaining an excellent functional outcome (mRS 0-1) at day 90 (+/- 2 weeks); mRS category at day 90 (+/- 2 weeks).","definition_or_measurement_approach":"Functional outcome measured by modified Rankin Scale (mRS) at day 90 (± 2 weeks): proportions achieving mRS 0-2 and mRS 0-1 and distribution of mRS categories."}
  • {"endpoint_text":"- Occurrence of sICH on CT/MRI within 36 hours post IVT causally related to an increase of 4 points or more on the NIHSS.","definition_or_measurement_approach":"Symptomatic intracerebral hemorrhage (sICH) on CT/MRI within 36 hours after IV thrombolysis, defined as radiographic ICH causally related to an increase of ≥4 points on the NIHSS."}
  • {"endpoint_text":"- Any ICH on CT/MR within 36 hours post IVT.","definition_or_measurement_approach":"Any intracerebral hemorrhage detected on CT or MRI within 36 hours after IV thrombolysis."}
  • {"endpoint_text":"- Occurrence of death within 90 days.","definition_or_measurement_approach":"All-cause mortality assessed up to 90 days after treatment."}

Recruitment

Planned Sample Size
500
Recruitment Window Months
97
Consent Approach
Informed consent is required. Subject information and informed consent forms are available for patients and for next of kin/legal representatives (documents listed in the record: L1_ICF patients; L1_ICF next of kin; L1_ICF_Professional Legal Representative; L1_ICF_legal representative). The presence of legal representative/next-of-kin ICFs indicates consent procedures for incapacitated participants via legal representatives; no languages or age-specific assent details are specified in the record.

Geography

Total Number Of Sites
28
Total Number Of Participants
500

Norway

Earliest CTIS Part Ii Submission Date
15-01-2025
Latest Decision Or Authorization Date
10-03-2025
Processing Time Days
54
Number Of Sites
13
Number Of Participants
300

Sites

Site Name
Haraldsplass Diakonale Sykehus AS
Department Name
Department of Medicine
Principal Investigator Name
Paal Naalsud
Principal Investigator Email
paal.naalsund@haraldsplass.no
Contact Person Name
Paal Naalsud
Contact Person Email
paal.naalsund@haraldsplass.no
Site Name
Vestre Viken HF
Department Name
Medical department
Principal Investigator Name
Håkon Ihle-Hansen
Principal Investigator Email
haaihl@vestreviken.no
Contact Person Name
Håkon Ihle-Hansen
Contact Person Email
haaihl@vestreviken.no
Site Name
St. Olavs Hospital HF
Department Name
Department of Stroke
Principal Investigator Name
Fredrik Ildstad
Principal Investigator Email
Fredrik.Ildstad@stolav.no
Contact Person Name
Fredrik Ildstad
Contact Person Email
Fredrik.Ildstad@stolav.no
Site Name
University Hospital of North Norway
Department Name
Department of Neurology
Principal Investigator Name
Agnethe Eltoft
Principal Investigator Email
Agnethe.Eltoft@unn.no
Contact Person Name
Agnethe Eltoft
Contact Person Email
Agnethe.Eltoft@unn.no
Site Name
Haukeland University Hospital
Department Name
Department of Neurology
Principal Investigator Name
Annette Fromm
Principal Investigator Email
annette.fromm@helse-bergen.no
Contact Person Name
Annette Fromm
Contact Person Email
annette.fromm@helse-bergen.no
Site Name
Sykehuset I Vestfold HF
Department Name
Department of Neurology
Principal Investigator Name
Håvard Lisether
Principal Investigator Email
haalis@siv.no
Contact Person Name
Håvard Lisether
Contact Person Email
haalis@siv.no
Site Name
Helse Møre and Romsdal Health Trust
Department Name
Geriatrician/internal medicine
Principal Investigator Name
Yngve Müller Seljeseth
Principal Investigator Email
postmottak@helse-mr.no
Contact Person Name
Yngve Müller Seljeseth
Contact Person Email
postmottak@helse-mr.no
Site Name
Sykehuset Innlandet
Department Name
Neurological department
Principal Investigator Name
Anette Huse Farmen
Principal Investigator Email
Anette.Huuse.Farmen@sykehuset-innlandet.no
Contact Person Name
Anette Huse Farmen
Site Name
Helse Stavanger HF
Department Name
Department of Neurology
Principal Investigator Name
Soffien Ajmi
Principal Investigator Email
soffien.chadli.ajmi@sus.no
Contact Person Name
Soffien Ajmi
Contact Person Email
soffien.chadli.ajmi@sus.no
Site Name
Oslo University Hospital HF
Department Name
Department of Neurology
Principal Investigator Name
Vojtech Novotny
Principal Investigator Email
vojnov@ous-hf.no
Contact Person Name
Vojtech Novotny
Contact Person Email
vojnov@ous-hf.no
Site Name
Drammen Sykehus
Department Name
Department of Neurology
Principal Investigator Name
Kristin Evensen
Principal Investigator Email
SBEVEK@vestreviken.no
Contact Person Name
Kristin Evensen
Contact Person Email
SBEVEK@vestreviken.no
Site Name
Østfold Hospital Trust
Department Name
Department of Neurology
Principal Investigator Name
Barbara Ratajczak-Tretel
Principal Investigator Email
Barbara.Ratajczak@so-hf.no
Contact Person Name
Barbara Ratajczak-Tretel
Contact Person Email
Barbara.Ratajczak@so-hf.no
Site Name
Hospital of Southern Norway, Kristiansand
Department Name
Department of Neurology
Principal Investigator Name
Mary-Helen Soyland
Principal Investigator Email
mary-helen.soyland@sshf.no
Contact Person Name
Mary-Helen Soyland
Contact Person Email
mary-helen.soyland@sshf.no

Denmark

Earliest CTIS Part Ii Submission Date
11-03-2026
Latest Decision Or Authorization Date
18-03-2026
Processing Time Days
7
Number Of Sites
9
Number Of Participants
100

Sites

Site Name
Sygehus Lillebælt, Region Syddanmark
Department Name
Hjerne- og Nervesygdomme
Principal Investigator Name
Henrik Boye Jensen
Principal Investigator Email
Henrik.Boye.Jensen@rsyd.dk
Contact Person Name
Henrik Boye Jensen
Contact Person Email
Henrik.Boye.Jensen@rsyd.dk
Site Name
Rigshospitalet
Department Name
Neurologisk Afdeling
Principal Investigator Name
Thomas Clement Truelsen
Principal Investigator Email
thomas.clement.truelsen@regionh.dk
Contact Person Name
Thomas Clement Truelsen
Site Name
Odense Universitetshospital
Department Name
Neurologisk Afdeling
Principal Investigator Name
Alex Alban Christensen
Principal Investigator Email
Alex.Alban.Christensen@rsyd.dk
Contact Person Name
Alex Alban Christensen
Contact Person Email
Alex.Alban.Christensen@rsyd.dk
Site Name
Aarhus Universitethospital
Department Name
Neurologisk Afdeling
Principal Investigator Name
Rolf Blauenfeldt
Principal Investigator Email
rolfblau@rm.dk
Contact Person Name
Rolf Blauenfeldt
Contact Person Email
rolfblau@rm.dk
Site Name
Sjællands Universitetshospital
Department Name
Neurologisk Afdeling
Principal Investigator Name
Troels Wienecke
Principal Investigator Email
trw@regionsjaelland.dk
Contact Person Name
Troels Wienecke
Contact Person Email
trw@regionsjaelland.dk
Site Name
Bispebjerg Hospital, Region Hovedstaden
Department Name
Neurologisk Afdeling
Principal Investigator Name
Louisa Marguerite Christensen
Principal Investigator Email
louisa.marguerite.christensen@regionh.dk
Contact Person Name
Louisa Marguerite Christensen
Site Name
Regionshospitalet Gødstrup
Department Name
Neurologisk Afdeling
Principal Investigator Name
Anne Brink Behrndtz
Principal Investigator Email
annebrin@rm.dk
Contact Person Name
Anne Brink Behrndtz
Contact Person Email
annebrin@rm.dk
Site Name
Sygehus Sønderjylland, Aabenraa
Department Name
Afdeling for Hjerne- og Nervesygdomme
Principal Investigator Name
Sepehr Mamoei
Principal Investigator Email
Sepehr.Mamoei@rsyd.dk
Contact Person Name
Sepehr Mamoei
Contact Person Email
Sepehr.Mamoei@rsyd.dk
Site Name
Aalborg Universitetshospital
Department Name
Neurologisk Afdeling
Principal Investigator Name
Daniel Harsfort
Principal Investigator Email
d.harsfort@rn.dk
Contact Person Name
Daniel Harsfort
Contact Person Email
d.harsfort@rn.dk

Sweden

Earliest CTIS Part Ii Submission Date
11-02-2026
Latest Decision Or Authorization Date
02-03-2026
Processing Time Days
19
Number Of Sites
6
Number Of Participants
100

Sites

Site Name
Karolinska University Hospital
Department Name
Neurologi
Principal Investigator Name
Boris Keselmann
Principal Investigator Email
boris.keselman@regionstockholm.se
Contact Person Name
Boris Keselmann
Site Name
Region Skane Skanes Universitetssjukhus (Malmo St. Johns)
Department Name
Neurologi
Principal Investigator Name
Fredrik Buchwald
Principal Investigator Email
fredrik.buchwald@skane.se
Contact Person Name
Fredrik Buchwald
Contact Person Email
fredrik.buchwald@skane.se
Site Name
Norrlands universitetssjukhus
Department Name
Neuro-huvud-halscentrum
Principal Investigator Name
Johan Birnefeld
Principal Investigator Email
johan.birnefeld@umu.se
Contact Person Name
Johan Birnefeld
Contact Person Email
johan.birnefeld@umu.se
Site Name
Uppsala University Hospital
Department Name
Medicinkliniken
Principal Investigator Name
Karl Sjölin
Principal Investigator Email
karl.sjolin@akademiska.se
Contact Person Name
Karl Sjölin
Contact Person Email
karl.sjolin@akademiska.se
Site Name
Danderyds Sjukhus AB
Department Name
Neurologiska
Principal Investigator Name
Sara Jadidi
Principal Investigator Email
sara.jadidi@regionstockholm.se
Contact Person Name
Sara Jadidi
Contact Person Email
sara.jadidi@regionstockholm.se
Site Name
Region Skane Skanes Universitetssjukhus (Lund)
Department Name
Neurologi
Principal Investigator Name
Gunnar Andsberg
Principal Investigator Email
gunnar.andsberg@skane.se
Contact Person Name
Gunnar Andsberg
Contact Person Email
gunnar.andsberg@skane.se

Sponsor

Primary sponsor

Full Name
Oslo University Hospital HF
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Norway

Investigational products

Investigational Product Name
TENECTEPLASE
Active Substance
TENECTEPLASE
Modality
Peptide/protein/enzyme
Routes Of Administration
INTRAVENOUS
Route
Intravenous
Maximum Dose
25 mg
Investigational Product Name
ALTEPLASE
Active Substance
ALTEPLASE
Modality
Peptide/protein/enzyme
Routes Of Administration
INTRAVENOUS
Route
Intravenous
Maximum Dose
90 mg
Investigational Product Name
RIVAROXABAN
Active Substance
RIVAROXABAN
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
Oral
Maximum Dose
30 mg
Investigational Product Name
APIXABAN
Active Substance
APIXABAN
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
Oral
Maximum Dose
20 mg
Investigational Product Name
EDOXABAN
Active Substance
EDOXABAN
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
Oral
Maximum Dose
60 mg

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