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临床试验/2023-507388-21-00
2023-507388-21-00招募中3 期

Early Reperfusion Therapy with Intravenous Thrombolysis for Recovery of VISION in Acute Central Retinal Artery Occlusion (REVISION) - A double-blind randomized placebo-controlled phase III trial

Universitaetsklinikum Tuebingen AöR25 个研究点 分布在 1 个国家目标入组 1,422 人开始时间: 2023年10月18日最近更新:

试验速览

阶段
3 期
状态
招募中
发起方
入组人数
1,422
试验地点
25
主要终点
Primary efficacy endpoint of the interventional study: Functional recovery to best corrected visual acuity (BCVA) of Logarithm of the Minimum Angle of Resolution (LogMAR) ≤ 0.5 (normal to mild vision impairment according to WHO ICD-11) in the affected eye at Visit (V) 3 (30 ± 5 days), intention-to-treat (ITT) analysis

研究概览

简要总结

Functional recovery to best corrected visual acuity (BCVA) of Logarithm of the Minimum Angle of Resolution (LogMAR) ≤ 0.5 (normal to mild vision impairment according to WHO ICD-11 (WHO, 2019)) in the affected eye at Visit (V) 3 (30 ± 5 days), dichotomized ITT analysis (functional recovery to LogMAR ≤ 0.5 vs. no functional recovery, i.e., LogMAR > 0.5)

入排标准

年龄范围
18 years 至 65+ years(65+ Years, 18-64 Years)
接受健康志愿者

入选标准

  • Age ≥ 18 years
  • Acute non-arteritic CRAO (i.e. sudden, painless monocular vision loss) ≤ 12 hours after symptom onset confirmed by an experienced ophthalmologist through assessment of: BCVA, intraocular pressure, swinging flash light test (relative afferent pupil defect), slit-lamp biomicroscopy, fundoscopy, and OCT of the macula of both eyes* (*within the 4.5-hour time window: to be skipped if not feasible ≤ 10 minutes; beyond the 4.5-hour time window: mandatory)
  • BCVA of LogMAR ≥ 1.3 in the affected eye (functional blindness according to WHO ICD-11)
  • Reading must have been possible with the affected eye before CRAO (LogMAR ≤ 0.5)
  • Neurological examination performed by an experienced stroke neurologist
  • Brain imaging as per local standard for acute retinal ischemia/stroke assessment, either cranial computed tomography (CT) or cranial magnetic resonance imaging (MRI)

排除标准

  • Suspected giant cell arteritis
  • Other-than-CRAO cause of acute visual loss (e.g., retinal detachment, vitreous hemorrhage, acute glaucoma, acute optic neuritis)
  • rapidly improving vision in the affected eye
  • Acute ischemic stroke with indication for on-label intravenous thrombolysis (IVT)
  • Any co-existing or terminal disease with anticipated life expectancy of < 3 months
  • Prior participation in the REVISION trial

结局指标

主要结局

Primary efficacy endpoint of the interventional study: Functional recovery to best corrected visual acuity (BCVA) of Logarithm of the Minimum Angle of Resolution (LogMAR) ≤ 0.5 (normal to mild vision impairment according to WHO ICD-11) in the affected eye at Visit (V) 3 (30 ± 5 days), intention-to-treat (ITT) analysis

Primary efficacy endpoint of the interventional study: Functional recovery to best corrected visual acuity (BCVA) of Logarithm of the Minimum Angle of Resolution (LogMAR) ≤ 0.5 (normal to mild vision impairment according to WHO ICD-11) in the affected eye at Visit (V) 3 (30 ± 5 days), intention-to-treat (ITT) analysis

次要结局

  • NIHSS at V2 (continuous)
  • NEI-VFQ-25 at V3 and V4 (continuous)
  • mRS at V3, and V4 (dichotomized into categories 0 – 1 (excellent outcome) vs. 2 – 6, 0 – 2 (functional independence) vs. 3 – 6, and shift analysis)
  • Functional recovery to LogMAR ≤ 0.5 at V3 (30 ± 5 days) (dichotomized) in the per protocol population
  • Functional recovery to LogMAR ≤ 0.5 at V2 (18 – 72 hours), and V4 (90 ± 10 days) (dichotomized)
  • Shift in visual outcome categories (according to WHO ICD-11 (WHO, 2019): normal vision (LogMAR ≤ 0), mild visual impairment (LogMAR > 0 and ≤ 0.5), moderate visual impairment (LogMAR > 0.5 and ≤ 1.0), severe visual impairment (LogMAR > 1.0 and ≤ 1.3), counting fingers (LogMAR > 1.3 and ≤ counting fingers), hand motion or light perception, and no light perception) at V2, V3, and V4
  • Dichotomized analysis of visual outcome: ‘normal vision to moderate visual impairment’ vs. ‘severe visual impairment or functional blindness’ and ‘normal vision to severe visual impairment’ vs. ‘functional blindness’ at V2, V3, and V4
  • Kinetic visual field using III4e mark at V3 and V4 (as a continuous variable)
  • Central retinal artery recanalization assessed using OCTA of the optic nerve head and the macula at V2, V3, and V4 (continuous)
  • Retinal arterial perfusion assessed using fluorescein angiography at V3 and V4 (continuous)
  • Fraction of patients with, number, and volume of acute ischemic lesions on follow-up diffusionweighted (DWI) cranial magnetic resonance imaging (MRI) at V2 (dichotomous and continuous, respectively)
  • Any bleeding until V2 by Common Terminology Criteria for Adverse Events (CTCAE) v5.0 classification of adverse events (AE), i.e., mild, moderate, severe, life-threatening, leading to death.

研究者

发起方
Universitaetsklinikum Tuebingen AöR
申办方类型
Hospital/Clinic/Other health care facility
责任方
Principal Investigator
主要研究者

Dept. of Neurology and Stroke

Scientific

Universitaetsklinikum Tuebingen AöR

研究点 (25)

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