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Xingnaojing for Moderate-to-severe Acute Ischemic Stroke (XMAS)

Phase 4
Conditions
Acute Ischemic Stroke
Interventions
Other: Standard care
Registration Number
NCT02728180
Lead Sponsor
Dongzhimen Hospital, Beijing
Brief Summary

The main purpose of this trial is to determine whether Xingnaojing, intravenously administered within 24 hours of symptom onset, improves the 3-month outcome in participants with acute ischemic stroke.

Detailed Description

Xingnaojing is widely used in China, but there is lack of high-quality evidence of its efficacy for acute ischemic stroke currently. The primary hypothesis of this trial is that Xingnaojing will increase the proportion of people alive and independent at three months. Xingnaojing, combined with guidelines-based standard care, will be compared to standard care alone in patients with acute ischemic stroke within 24 hours of symptom onset. All patients will have a National Institutes of Health Stroke Scale (NIHSS) entry score of 5-20. Patients in each group will be treated according to the guidelines-based standard care, including intravenous thrombolysis if appropriate. The primary outcome will be determined at 3 months.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
720
Inclusion Criteria
  • Acute ischemic stroke within 24 hours of symptom onset.
  • National Institutes of Health Stroke Scale score ≥ 5 and ≤ 20.
  • Age ≥ 35 and ≤ 80 years.
  • Patient or legally authorized representative has signed informed consent.
Exclusion Criteria
  • Planned or already received endovascular treatment.
  • Suspected secondary stroke caused by tumor, brain trauma, or hematologic diseases.
  • Already dependent in activities of daily living before the present acute stroke (defined as modified Rankin Scare score ≥2 ).
  • Other conditions that lead to motor dysfunction (e.g. severe osteoarthrosis, rheumatoid arthritis).
  • Significant renal or hepatic insufficiency (defined as a serum creatinine concentration, alanine aminotransferase, or aspartate aminotransferase value that is twice greater than the upper limit of normal).
  • Life expectancy of 90 days or less due to other life threatening illness (e.g. advanced cancer).
  • Other conditions that render outcomes or follow-up unlikely to be assessed..
  • Known to be pregnant or breastfeeding.
  • Currently receiving an investigational drug.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Xingnaojing and standard careStandard careSubjects will receive intravenously administered Xingnaojing injection, combined with guidelines-based standard care.
Standard care onlyStandard careSubjects will receive guidelines-based standard care only.
Xingnaojing and standard careXingnaojing injectionSubjects will receive intravenously administered Xingnaojing injection, combined with guidelines-based standard care.
Primary Outcome Measures
NameTimeMethod
Proportion of patients independent90 days

Proportion of patients independent is defined as Modified Rankin Scale score of 0, 1, or 2.

Secondary Outcome Measures
NameTimeMethod
Patient reported outcome (PRO) scale of stroke10 days

Patient reported outcome (PRO) scale of stroke at 10 days.

Activities of daily living30 days and 90 days

Activities of daily living measured by Barthel Index score at 30 days and 90 days.

Deaths from any cause10 days, 90 days

Number of deaths from any cause within 10 days and 90 days after symptom onset.

Safety end points - Number of patients with any adverse events, results of electrocardiography, vital signs and laboratory tests (complete blood count, chemistry and urinalysis).10 days

Number of patients with any adverse events, results of electrocardiography, vital signs and laboratory tests (complete blood count, chemistry and urinalysis).

Comparison of the change in the NIHSS scores from baseline to 10 days in the two groups.Baseline and 10 days.

The NIHSS score ranges from 0 (best score) to 42 (worst score).

Early neurologic deterioration (END)Baseline and 48 hours

Early neurologic deterioration is defined as an increase of 3 points or more in the NIHSS score between baseline and 48 hours.

Symptomatic Intracranial Hemorrhage (sICH)10 dyas

Symptomatic Intracranial Hemorrhage (sICH) within 10 days of stroke onset. (Any ICH related to a decline in neurologic status or the development of new neurologic symptoms which in the judgment of the clinical investigator was related to the ICH.)

Cardiovascular events90 days

Number of patients with recurrence of stroke or myocardial infarction.

Trial Locations

Locations (1)

Dongzhimen Hospital

🇨🇳

Beijing, Beijing, China

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