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Manipulating the Peri-Infarct Area Using Maraviroc to Enhance Motor Skills After Stroke

Not Applicable
Recruiting
Conditions
Ischemic Stroke
Stroke
Stroke Acute
Interventions
Registration Number
NCT07080567
Lead Sponsor
Emmanuel Carrera
Brief Summary

MASTER is a single-center, patient and investigator-blinded, Randomized Controlled Trial (RCT) to compare the efficacy of Maraviroc, a C-C chemokine receptor 5 (CCR5) antagonist, against placebo regarding motor function and motor learning skills in the first 3 months after ischemic stroke.

Detailed Description

Stroke is a common disease and one of the leading causes of death and disability worldwide. Despite advances in acute stroke therapies (intravenous thrombolysis and/or mechanical thrombectomy), deficits remain frequent after stroke. Pharmacological approaches have the benefit of being independent of patient participation, are easily administered, and involve limited medical resources. Unfortunately, the efficacy of several drugs that improve behavioural in preclinical models have yet to be confirmed in humans. Maraviroc, a C-C chemokine receptor 5 (CCR5) antagonist has shown promise in preclinical models, and instead of targeting neurotransmitters, is believed to augment rehabilitation by decreasing infarct size, increasing neuroplasticity, and most importantly, improving behaviour.

The MASTER trial is a single-center, double-blinded, randomized placebo-controlled, phase II clinical trial designed to evaluate the efficacy of Maraviroc (Celsentri) compared to a placebo, in improving outcomes following ischemic stroke in the early stage of recovery. 80 patients will be recruited within 5 days of stroke onset, and will receive either Maraviroc or a placebo drug for 90 days.

Participants will be assessed using a combination of clinical measurements, motor tests, and biometrics throughout the 90 days of intervention, and upon follow-up at 6-months post stroke onset. Several types of brain images will be obtained before and after the intervention period (day 0 and day 90), and participants will also perform a motor learning task before and after the intervention period (day 0 and day 90). Study personnel and participants will be blinded to the treatment, which will be randomly assigned to an intervention group with stratification based on side of the infarct and motor deficit.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Informed consent as documented by signature
  • ≥18 years at time of signing of informed consent
  • Acute ischemic stroke.
  • Stroke onset < 7 days from randomization.
  • Contralateral, unilateral, incomplete upper limb paresis, incl. :
  • FMA-UE < 63/66
  • Residual voluntary finger extension (VFE) of > 10 degrees
Exclusion Criteria
  • Pregnancy/lactation or positive pregnancy test in women of childbearing age
  • Pre-stroke handicap (mRS > 2)
  • Diseases affecting motor function (e.g., Parkinson's Disease, Amyotrophic Lateral Sclerosis (ALS))
  • Participation in another study with investigational medicinal product within 30 days preceding and during the present study
  • Enrolment of the investigator, his/her family members, employees, or other dependent persons
  • Known hypersensitivity to Maraviroc, Mannitol, peanuts, or soy
  • History of significant liver disease, hepatitis, elevated liver function tests (> 1.5 upper limit of normal)
  • History of significant renal disease or End Stage Renal Disease/dialysis, acute renal injury, Creatinine Clearance (CrCl < 30ml/min/1.73m2)
  • Patients with cardiovascular comorbidities and risk for orthostatic hypotension
  • HIV infection
  • Concomitant use of strong CYP3A4 inhibitors or inducers

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
MaravirocMaravirocMaraviroc (Celsentri) 300 mg twice daily
PlaceboMannitolPlacebo (Mannitol) encapsulated
Primary Outcome Measures
NameTimeMethod
Upper Extremity Fugl-Meyer Assessment (FMA-UE) ScoreDay 90

Reliable and validated score of motor function of the upper extremities after stroke. Range: 0-66, higher values indicating better motor function.

Secondary Outcome Measures
NameTimeMethod
Motor Learning ScoreDay 0, 90

A motor sequence learning score assessing the capability of the participant to learn a finger tapping sequence of 6 items.

Number of adverse events (AE) of special interestDay 0-180 (inclusive)

The number of patients experiencing AE of special interest : MACE (Major Adverse Cardiovascular Events) - Acute myocardial infarction ; Acute coronary syndrome ; Stroke ; Heart failure ; All cause death ; Cardiovascular death ; Revascularization AND any liver adverse events AND any infection adverse events. Assesed by: CTCAE v5.0

Number of Serious Adverse Events (SAE)0-180 days (inclusive)

Number of any SAEs occuring during the study follow-up. Assessed by: CTCAE v5.0.

Trial Locations

Locations (1)

Geneva University Hospital

🇨🇭

Geneva, Switzerland

Geneva University Hospital
🇨🇭Geneva, Switzerland
Nicolas Broc, MD
Sub Investigator
Emmanuel Carrera, MD
Principal Investigator
Gabriel Byczynski, PhD
Sub Investigator
Elisabeth Dirren, MD, PhD
Sub Investigator

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