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Efficacy of SUN N4057 in Subjects With Acute Ischemic Stroke and Measurable Penumbra on Magnetic Resonance Imaging (MRI)

Phase 2
Terminated
Conditions
Stroke
Interventions
Registration Number
NCT00272909
Lead Sponsor
Daiichi Sankyo
Brief Summary

This research study is designed to evaluate the safety, tolerability, and efficacy of SUN N4057 (piclozotan) in subjects with acute ischemic stroke within 9 hours of the onset of symptoms.

Detailed Description

The primary objective of the study is to determine the efficacy of a 72 hour infusion of SUN N4057 (piclozotan) in subjects with clinical findings of an acute ischemic stroke and a magnetic resonance imaging (MRI) demonstrating a measurable penumbra (perfusion-weighted imaging \[PWI\] minus diffusion-weighted imaging \[DWI\] volume). Efficacy will be determined by comparing the proportion of subjects with no growth in stroke lesion volume as assessed by DWI at Screening to stroke lesion volume assessed by FLAIR (fluid-attenuated inversion recovery) on Day 28 in the piclozotan group versus the placebo group.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
43
Inclusion Criteria

General inclusion criteria:

  • Males or females >= 18 and <= 85 years of age at randomization. Female subjects must be either:

    • Surgically sterile;
    • Postmenopausal for at least 1 year; or
    • Non-pregnant, confirmed by a serum pregnancy test, and using a method of birth control that is acceptable to the investigator.
  • Neurological examination demonstrating localizing cortical signs

  • Receipt of study drug less than 6 hours (50% of subjects) or between 6 and 9 hours, inclusive, (50% of subjects) after the onset of symptoms (for un-witnessed stroke, last time seen in normal state or at bedtime for un-witnessed stroke during sleep)

  • Signed informed consent from subject or legally acceptable representative

  • NIHSS score of 6 - 22, inclusive, or at least 2 on the aphasia item of the NIHSS with a location of MRI findings consistent with aphasia

MRI-determined inclusion criteria:

  • Acute ischemic stroke with substantial cortical involvement in the middle cerebral artery (MCA) distribution, as verified by the Screening DWI abnormality and/or Screening PWI abnormality. (Note: white matter involvement, in addition to cortex, is not an exclusion.)
Exclusion Criteria

General exclusion criteria:

  • Two or more of the following:

    • Reduced level of consciousness (score >= 2 on NIHSS Q1a)
    • Forced eye deviation or total gaze paresis (score of 2 on NIHSS Q2)
    • Dense hemiplegia (no movement) of upper and lower extremities (score of 4 on NIHSS Q5 regarding motor arm and a score of 4 on NIHSS Q6 regarding motor leg)
  • Pre-stroke modified Rankin score >= 2 at Screening

  • Rapid neurological improvement from Screening up to the start of drug infusion

  • Persistent systolic blood pressure (SBP) > 220 mmHg and/or diastolic blood pressure (DBP) > 120 mmHg (confirmed by at least three readings taken at least 3 minutes apart) prior to randomization. If subsequent readings are consistently below these levels, either spontaneously or following mild antihypertensive therapy, subject may be enrolled.

MRI-determined exclusion criteria:

  • Intracranial hemorrhage as verified by Screening MRI. (Note: intracranial hemorrhage on pre-screen computerized tomography [CT] scan also excludes subject.)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
2piclozotan high dosepiclozotan IV infusion, high dose, for 72 hours.
1piclozotan low dosepiclozotan IV infusion, low dose, for 72 hours.
3placeboplacebo (normal saline) IV infusion, for 72 hours.
Primary Outcome Measures
NameTimeMethod
Improvement in MRI28 days
Secondary Outcome Measures
NameTimeMethod
The change in stroke lesion volume from Screening to day 2828 days
Clinical outcomes at Days 28 and 90 using the individual clinical scales (Modified Rankin Scale, Barthel Index, and National Institutes of Health Stroke Scale [NIHSS]).Days 28 and 90
To assess the safety and tolerability of SUN N4057 (piclozotan) in subjects with acute stroke.Days 28, 60 and 90

Trial Locations

Locations (47)

The Stroke Center at Hartford Hospital

🇺🇸

Hartford, Connecticut, United States

Chattanooga Neurology Associates

🇺🇸

Chattanooga, Tennessee, United States

Lakeland Regional Medical Center

🇺🇸

Lakeland, Florida, United States

University of Massachusetts, Memorial Health Center, Department of Neurology

🇺🇸

Worcester, Massachusetts, United States

University of Kentucky, Sanders Brown Center on Aging/Stroke Program

🇺🇸

Lexington, Kentucky, United States

Summa Health System Neurology and Neuroscience Associates

🇺🇸

Akron, Ohio, United States

SUNY at Stony Brook, University Hospital at Stony Brook

🇺🇸

Stony Brook, New York, United States

INOVA Research Center

🇺🇸

Falls Church, Virginia, United States

Charleston Area Medical Center Health Education and Research Institute

🇺🇸

Charleston, West Virginia, United States

Neurologische Klinik, Klinikum Rechts Der Isar Der Tu Munchen

🇩🇪

Munchen, Germany

Sunninghill Hospital Cnr.

🇿🇦

Sunninghill, South Africa

Hospital Universitari Germans Trias i Pujol

🇪🇸

Barcelona, Spain

University Hospital of Girona Dr. Josep Trueta, Neurology Department

🇪🇸

Girona, Spain

Wayne State University

🇺🇸

Detroit, Michigan, United States

Centralny Szpital Kliniczny

🇵🇱

Katowice, Poland

Medical College of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

Collegium Medicum Jegiellonian University

🇵🇱

Krakow, Poland

Chaim Sheba Medical Center

🇮🇱

Tel Hashomer, Israel

Military Institute of Medicine

🇵🇱

Warsaw, Poland

Tel-Aviv Sourasky Medical Center

🇮🇱

Tel-Aviv, Israel

St. Francis Medical Center

🇺🇸

Trenton, New Jersey, United States

Methodist University Hospital

🇺🇸

Memphis, Tennessee, United States

UCLA Stroke Network

🇺🇸

Los Angeles, California, United States

Uz Gasthuisberg, Neurology

🇧🇪

Leuven, Belgium

San Francisco Clinical Research Center

🇺🇸

San Francisco, California, United States

General Hospital Middelheim, Dept. of Neurology

🇧🇪

Antwerp, Belgium

Rambam Medical Center

🇮🇱

Haifa, Israel

Advance Neurology Specialists

🇺🇸

Great Falls, Montana, United States

Via Christi Regional Medical Center

🇺🇸

Wichita, Kansas, United States

OCALA Neurodiagnostic Center

🇺🇸

Ocala, Florida, United States

Clinical Research Center of Winston-Salem

🇺🇸

Winston-Salem, North Carolina, United States

Ruan Neurology Clinic and Clinical Research Center

🇺🇸

Des Moines, Iowa, United States

St. Luke's Hospital

🇺🇸

Kansas City, Missouri, United States

The Methodist Hospital Neurological Institute

🇺🇸

Houston, Texas, United States

Hopital Erasme - Dept. of Neurology, Universite Libre de Bruxelles

🇧🇪

Brussels, Belgium

Universitatsklinikum Essen, Department of Neurology

🇩🇪

Essen, Germany

Neurologische Universitatsklinik und Poliklinik - Neurzentrum

🇩🇪

Freiburg, Germany

Universitatsklinikum Leipzig Aor, Klinik And Poliklinok Fur Neurologie

🇩🇪

Leipzig, Germany

St Augustines Hospital

🇿🇦

Durban, South Africa

Soroka University Medical Center

🇮🇱

Beer-Sheva, Israel

Hadassah University Hospital

🇮🇱

Jerusalem, Israel

Assaf Harofeh Medical Center

🇮🇱

Zrifin, Israel

Vergelegen Medi-Clinic

🇿🇦

Somerset West, South Africa

Hospitales Universitarios Virgen Del Rocio

🇪🇸

Sevilla, Spain

Michigan State University, Sparrow Health System

🇺🇸

East Lansing, Michigan, United States

Moses Cone Hospital

🇺🇸

Greensboro, North Carolina, United States

Southern Illinois University School of Medicine

🇺🇸

Springfield, Illinois, United States

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