Butyphthalide in Combination With Recombinant Tissue Plasminogen Activator for Acute Ischemic Stroke

NCT03394950 | Completed Phase 4

• 1 other identifier: k201731
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

Acute ischemic stroke (AIS) is the most common type of stroke, which has high rate of morbidity, mortality and disability. A large number of studies have confirmed that the thrombolytic therapy can effectively open blood vessels and improve the functional prognosis of acute ischemic stroke. Therefore, all guidelines recommend giving thrombolysis treatment to acute ischemic stroke patients within 4.5 hours of onset. However, about 1/3 patients receiving thrombolysis will have good prognosis, while a large number of patients will still be disabled and even dead. How to improve the neurofunctional prognosis of thrombolytic patients has been a hot topic in the world. Butyl phthalide is type I chemical drugs. Some multicenter randomized, double-blind, placebo-controlled clinical trials have showed that acute ischemic stroke patients taking butyl phthalide has better lateral branch circulation and living ability score than patients taking placebo. Besides, butyl phthalide treatment is safe. The animal experiment indicated that buphthalein could significantly improve secondary side branch circulation, recover the microarterial diameter of the soft meninges in the ischemic region and increase the blood flow rate. Based on the discussion, we assume that: giving butyl phthalide to patients with acute ischemic stroke in advance, might promote and improve the formation of collateral circulation to freeze ischemia penumbra. Based on this hypothesis, we would like to explore the efficacy and safety of butyl phthalide combined with rtPA thrombolysis in the treatment of acute ischemic stroke.

Conditions

Stroke, Ischemic

Keywords

thrombolysis; Butyphthalide

Outcome Measures

Primary Outcomes (1)

• Percentage of mRS score (0-2) (90 days)

  Percentage of mRS score (0-2) at 90 days

  90 days

Study Arms (2)

rtPA combined with Butyphthalide

EXPERIMENTAL

Intravenous treatment with 25mg butyphthalide, followed by intravenous throbolysis with 0.9mg/kg rtPA. Next day, intravenous treatment with 25mg butyphthalide 2 times/day for 14 days, followed by oral butyphthalide capsule (0.2g 3 times/day) to 90 days after thrombolysis. Other treatments were done according to guidelines.

Drug: Butyphthalide combined with rtPA

rtPA compared with placebo

ACTIVE COMPARATOR

Intravenous treatment with placebo injection, followed by intravenous throbolysis with 0.9mg/kg rtPA. Next day, intravenous treatment with placebo injection 2 times/day for 14 days, followed by oral placebo capsule (3 times/day) to 90 days after thrombolysis. Other treatments were done according to guidelines.

Drug: rtPA

Interventions

Butyphthalide combined with rtPA DRUG

Intravenous treatment with 25mg butyphthalide, followed by intravenous throbolysis with 0.9mg/kg rtPA. Next day, intravenous treatment with 25mg butyphthalide 2 times/day for 14 days, followed by oral butyphthalide capsule (0.2g 3 times/day) to 90 days after thrombolysis. Other treatments were done according to guidelines.

rtPA combined with Butyphthalide

rtPA DRUG

Intravenous thrombolysi with 0.9mg/kg rtPA, followed by other treatments according to guidelines

rtPA compared with placebo

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age \>18 years;
• Diagnosis of anterior circulation infarct;
• First stroke onset or past stroke without obvious neurological deficit (mRS≤1);
• Time from onset to treatment ≤4.5 hours;
• SBP/DBP ≤ 180/110mmHg;
• No hemorrhagic imaging changes showed in CT;
• Signed informed consent by patient self or legally authorized representatives.

You may not qualify if:

• History of stroke within 3 months;
• History of intracranial hemorrhage;
• Suspected subarachnoid hemorrhage;
• Intracranial tumour, vascular malformation or arterial aneurysm;
• Major surgery within 1 month;
• Systolic pressure ≥180 mmHg or diastolic pressure ≥110 mmHg;
• Platelet count \< 100×109／L;
• Heparin therapy or oral anticoagulation therapy within 48 hours;
• Severe disease with a life expectancy of less than 3 months;
• Blood glucose \< 50 mg/dL (2.7mmol/L);
• Patients who have received any other investigational drug or device within 3 months;
• Researchers consider patients inappropriate to participate in the registry. -

Sponsors & Collaborators

• Hui-Sheng Chen: lead

Study Sites (1)

General Hospital of ShenYang Military Region

Shenyang, China

Location

MeSH Terms

Conditions

Ischemic Stroke

Condition Hierarchy (Ancestors)

Stroke; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Officials

• chen huisheng, doctor

  General Hospital of Shenyang Military Region

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: January 3, 2018
• First Posted: January 9, 2018
• Study Start: May 25, 2018
• Primary Completion: May 29, 2021
• Study Completion: May 29, 2021
• Last Updated: June 2, 2021

Record last verified: 2021-06

Locations

CN (1)