Treating Insulin Resistance in patient after Stroke for prevention of stroke and myocardial infarction after ischemic stroke and transient ischemic attack

• Conditions: Insulin resistance in patients who have had a stroke or transient ischaemic attack; Therapeutic area: Diseases [C] - Nervous System Diseases [C10]

• Registration Number: EUCTR2008-005546-23-DE
• Lead Sponsor: Yale University School of Medicine

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2009-05-28
• Last Update Posted: 26 August 2013

Recruitment & Eligibility

• Status: Authorised-recruitment may be ongoing or finished
• Sex: All
• Target Recruitment: 3936

Inclusion Criteria

Inclusion Criteria
a. Ages 40 years or greater at the time of randomization.
b. Ischemic stroke or TIA no less than 14 days and no more than 6 months before randomization
c. Documentation of insulin resistance as defined by a value over 3.0 on the Homeostasis Model Assessment of insulin sensitivity (HOMA).
d. Both ability and willingness to provide informed consent.
e. Presence of none of the exclusion criteria.

Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 80
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 80

Exclusion Criteria

Permanent Exclusions
a.Severely disabling stroke as indicated by an inability to participate in scheduled follow-up activities.
b.Persons whose ischemic stroke or TIA was related to structural cardiac lesion, significant head trauma, proximal arterial dissection or medical instrumentation.
c.Diabetes mellitus as defined by recent use of medication for diabetes as an out-patient (*see note below) or two fasting plasma blood sugars > 126 mg/dL.
d.HgbA1c >= 7.0%.
e.Irreversible medical conditions likely to affect short-term survival or ability to participate in the study protocol. These include:
• Cancer or other chronic disease with poor prognosis (predicted survival of less than four years).
• Severe neurologic or psychiatric disease that would complicate the evaluation of study outcomes (e.g., dementia or schizophrenia).
f.History of intolerance to any thiazolidinedione.
g.Pregnancy, desire to become pregnant, or currently breastfeeding.
h.Oral or estrogen patch contraceptive use.
i.Ongoing use of oral corticosteroids.
j.History of heart failure (includes patients with current or previous NYHA class I-4 heart failure).
k.Active liver disease as defined by known liver disease accompanied by cirrhosis, significant cholestasis, portal hypertension, hepatic encephalopathy, hepatic synthetic dysfunction, or expected significant loss of liver function over the course of the study.
l.History of bladder cancer.
m. High risk for bladder cancer (i.e., current investigated macroscopic hematuria, history of cyclophosphamide exposure, or history of irradiation of the pelvic region)
n.Current participation in a conflicting clinical trial. A conflicting clinical trial is defined as a trial with any of following:
•Intervention that is known to affect the incidence of stroke or myocardial infarction.
•Intervention that is an experimental drug.
•Outcome that includes stroke or myocardial infarction.
•Exclusion for participation in another trial.

Temporary Exclusions
Persons with temporary exclusions may be enrolled as soon as the exclusion has resolved.
a.ALT >2.5 times the upper limit of normal.
b.Hemoglobin <8.5 g/dl.
c.Moderate or severe pitting edema of the feet or legs (IRIS grade 3 or 4).
d.Carotid surgery or carotid stenting procedure scheduled (delay randomization until 2 weeks following procedure).

*Patients who have taken a medication to treat diabetes in the prior 3 months as an out-patient will not be eligible for participation. However, a patient who has recently taken a diabetes medication while hospitalized or for a reason other than diabetes (e.g., for impaired glucose tolerance), may be tested for eligibility after at least 7 days off the medication.

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified