Study to Assess the Safety and Efficacy of Sovateltide in Patients With Acute Cerebral Ischemic Stroke

NCT05955326 | Recruiting Phase 4

• 1 other identifier: Sovateltide/CT-4.1/2022
• Study Type: interventional
• Target: 160
• Locations: 1 country
• Sites: 6

Brief Summary

This is a prospective, multicenter, randomized, double-blind, parallel, phase IV study designed to evaluate the safety and efficacy of sovateltide (PMZ-1620, IRL-1620) as a potential treatment for cerebral ischemic stroke.

Conditions

Acute Cerebral Ischemia

Keywords

Stroke; Endothelin; Endothelin B Receptors; Ischemia; IRL 1620; Sovateltide; Neural progenitors

Outcome Measures

Primary Outcomes (1)

• The proportion of patients with adverse events (AEs) and serious adverse events (SAEs)

  Any unfavorable sign, symptom, or disease that occurs while using sovateltide will be reported as an adverse event (AE), including the worsening of pre-existing medical conditions. A severe medical occurrence, such as death, life-threatening situations, hospitalization, significant disability, or congenital anomalies will be reported as a serious adverse event (SAE). All AEs will be collected on CRFs from when the patient signs the informed consent form (ICF) until the study exit. Any SAE that is ongoing at the time the patient exits the study must be followed until the event is resolved or there is a satisfactory explanation that meets one of the following outcomes: 1. Resolved (With sequelae or without sequelae). 2. Death and 3. Unknown (Despite adequate follow-up).

  90 days

Secondary Outcomes (11)

• The proportion of cerebral ischemic stroke patients with a change in modified Rankin Scale (mRS) score of ≥2

  90 days

• The proportion of cerebral ischemic stroke patients with a change in National Institute of Health Stroke Scale (NIHSS) score ≥6

  90 days

• The proportion of cerebral ischemic stroke patients with a change in Barthel index (BI) score ≥60

  90 days

• Change in National Institute of Health Stroke Scale (NIHSS) score

  90 days

• Change in modified Rankin Scale (mRS) score

  90 days

Other Outcomes (1)

• Compare baseline Alberta Stroke Program Early CT (ASPECT) Score for stroke severity and identify sites of ischemic lesions

  90 days

Study Arms (2)

Sovateltide (Tyvalzi™) + Standard treatment

EXPERIMENTAL

A total of 80 patients will be enrolled in the experimental arm. Three doses of sovateltide (each dose of 0.3 μg/kg body weight) will be given as an IV bolus in each patient (randomly assigned to this group) over one minute at an interval of 3 ± 1 hours on day 1, day 3, and day 6 (total dose/day: 0.9 μg/kg body weight). All patients will receive standard stroke treatment as provided by the specific hospital setup. Patients will be closely monitored for the qualifying stroke, followed for 3 months, and assessed for safety and efficacy parameters. Efforts will be made to administer the drug at the same time on days 1, 3, and 6.

Drug: Sovateltide

Normal Saline (Dose: Equal volume) + Standard Treatment

PLACEBO COMPARATOR

A total of 80 patients will be enrolled in this arm. Three doses of an equal volume of normal saline will be administered as an IV bolus in each patient (randomly assigned to this group) over one minute at an interval of 3 ± 1 hours on day 1, day 3, and day 6. All patients will receive standard stroke treatment as provided by the specific hospital setup. Patients will be closely monitored for the qualifying stroke, followed for 3 months, and assessed for safety and efficacy parameters. Efforts will be made to administer the drug at the same time on days 1, 3, and 6.

Other: Normal Saline

Interventions

Sovateltide DRUG

Sovateltide (Tyvalzi™) is a highly selective ETB receptor agonist (Ki values are 0.016 and 1900 nM at ETB and ETA receptors, respectively). It is being developed as a first-in-class neuronal progenitor cell therapy for acute cerebral ischemic stroke. Sovateltide has demonstrated a significant neuroprotection following cerebral ischemia in animal models, while in a clinical phase I trial it was found safe and well-tolerated in healthy human volunteers (CTRI/2016/11/007509). A phase II study (NCT04046484) in 40 patients with cerebral ischemic stroke has demonstrated its superior efficacy with a significant improvement compared to the standard of care and widens the critical time window from 4 hours to 24 hours. A phase III study (NCT04047563) has also been recently completed in 158 patients with cerebral ischemic stroke, demonstrating significant improvement compared to the standard of care.

Also known as: IRL-1620, PMZ 1620, Tycamzzi™, Tyvalzi™

Sovateltide (Tyvalzi™) + Standard treatment

Normal Saline OTHER

Three doses of Normal Saline (0.9% NaCl solution) with a volume equal to the volume of sovateltide will be administered as an IV bolus over one minute, at an interval of 3 hours ± 1 hour on day 1. The dose will be repeated on day 3 and day 6 post-randomization. All the patients in the Normal Saline group will continue receiving standard treatment.

Normal Saline (Dose: Equal volume) + Standard Treatment

Eligibility Criteria

• Age: 18 Years - 78 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult males or females aged 18 years through 78 years (have not had their 79th birthday)
• Patient or Legally Acceptable Representative (LAR) willing to give informed consent before study procedure.
• Stroke is ischemic in origin and radiologically confirmed Computed Tomography (CT) scan or diagnostic magnetic resonance imaging (MRI) before enrolment. No hemorrhage as proved by cerebral CT/MRI scan.
• Cerebral ischemic stroke patients presenting within 24 hours after onset of symptoms with mRS score of 3-4 (pre-stroke mRS score of 0 or 1) and NIHSS score \>5 (NIHSS Level of Consciousness (1A) score must be \< 2). This includes cerebral ischemic stroke patients who completely recovered from earlier episodes before having a new or fresh stroke.
• The patient is \<24 hours from the time of stroke onset when the first dose of Sovateltide therapy is administered. Time of onset is when symptoms began; for stroke that occurred during sleep, time of onset is when the patient was last seen or was self-reported to be normal.
• Reasonable expectation of availability to receive the full Sovateltide course of therapy and to be available for subsequent follow-up visits.

You may not qualify if:

• Patients receiving endovascular therapy or is a candidate for any surgical intervention for the treatment of stroke, which may include but not limited to endovascular techniques.
• Patients classified as comatose are defined as a patient who requires repeated stimulation to attend or is obtunded and requires strong or painful stimulation to make movements (NIHSS Level of Consciousness (1A) score ≥ 2).
• Evidence of intracranial hemorrhage (intracerebral hematoma, intraventricular hemorrhage, subarachnoid hemorrhage, epidural hemorrhage, an acute or chronic subdural hematoma on the baseline CT or MRI scan 4. Known pregnancy.
• Confounding pre-existing neurological or psychiatric disease.
• Concurrent participation in any other therapeutic clinical trial.
• Evidence of any other major life-threatening or serious medical condition that would prevent completion of the study protocol, impair the assessment of outcome, or in which Sovateltide therapy would be contraindicated or might cause harm to the patient.

Sponsors & Collaborators

• Pharmazz, Inc.: lead

Study Sites (6)

Guntur Medical College and Government General Hospital

Guntur, Andhra Pradesh, 522001, India

RECRUITING

Lalitha Super Specialities Hospital Pvt. Ltd.

Guntur, Andhra Pradesh, 522001, India

RECRUITING

Radiant Superspeciality Hospital

Amravati, Maharashtra, 444606, India

RECRUITING

Government Medical College and attached Hospitals

Kota, Rajasthan, 324001, India

RECRUITING

KG Hospital and Post Graduate Medical Institute

Coimbatore, Tamil Nadu, 641018, India

RECRUITING

Maharani Laxmibai Medical College

Jhānsi, Uttar Pradesh, 284128, India

RECRUITING

Related Publications (13)

• Gulati A, Hornick MG, Briyal S, Lavhale MS. A novel neuroregenerative approach using ET(B) receptor agonist, IRL-1620, to treat CNS disorders. Physiol Res. 2018 Jun 27;67(Suppl 1):S95-S113. doi: 10.33549/physiolres.933859.

  PMID: 29947531 BACKGROUND

• Leonard MG, Briyal S, Gulati A. Endothelin B receptor agonist, IRL-1620, reduces neurological damage following permanent middle cerebral artery occlusion in rats. Brain Res. 2011 Oct 28;1420:48-58. doi: 10.1016/j.brainres.2011.08.075. Epub 2011 Sep 7.

  PMID: 21959172 BACKGROUND

• Leonard MG, Briyal S, Gulati A. Endothelin B receptor agonist, IRL-1620, provides long-term neuroprotection in cerebral ischemia in rats. Brain Res. 2012 Jun 29;1464:14-23. doi: 10.1016/j.brainres.2012.05.005. Epub 2012 May 9.

  PMID: 22580085 BACKGROUND

• Leonard MG, Gulati A. Endothelin B receptor agonist, IRL-1620, enhances angiogenesis and neurogenesis following cerebral ischemia in rats. Brain Res. 2013 Aug 28;1528:28-41. doi: 10.1016/j.brainres.2013.07.002. Epub 2013 Jul 11.

  PMID: 23850649 BACKGROUND

• Leonard MG, Prazad P, Puppala B, Gulati A. Selective Endothelin-B Receptor Stimulation Increases Vascular Endothelial Growth Factor in the Rat Brain during Postnatal Development. Drug Res (Stuttg). 2015 Nov;65(11):607-13. doi: 10.1055/s-0034-1398688. Epub 2015 Mar 25.

  PMID: 25806822 BACKGROUND

• Briyal S, Ranjan AK, Hornick MG, Puppala AK, Luu T, Gulati A. Anti-apoptotic activity of ETB receptor agonist, IRL-1620, protects neural cells in rats with cerebral ischemia. Sci Rep. 2019 Jul 18;9(1):10439. doi: 10.1038/s41598-019-46203-x.

  PMID: 31320660 BACKGROUND

• Ranjan AK, Briyal S, Gulati A. Sovateltide (IRL-1620) activates neuronal differentiation and prevents mitochondrial dysfunction in adult mammalian brains following stroke. Sci Rep. 2020 Jul 29;10(1):12737. doi: 10.1038/s41598-020-69673-w.

  PMID: 32728189 BACKGROUND

• Ranjan AK, Briyal S, Khandekar D, Gulati A. Sovateltide (IRL-1620) affects neuronal progenitors and prevents cerebral tissue damage after ischemic stroke. Can J Physiol Pharmacol. 2020 Sep;98(9):659-666. doi: 10.1139/cjpp-2020-0164. Epub 2020 Jun 23.

  PMID: 32574518 BACKGROUND

• Ranjan AK, Gulati A. Sovateltide Mediated Endothelin B Receptors Agonism and Curbing Neurological Disorders. Int J Mol Sci. 2022 Mar 15;23(6):3146. doi: 10.3390/ijms23063146.

  PMID: 35328566 BACKGROUND

• Gulati A. Endothelin Receptors, Mitochondria and Neurogenesis in Cerebral Ischemia. Curr Neuropharmacol. 2016;14(6):619-26. doi: 10.2174/1570159x14666160119094959.

  PMID: 26786146 BACKGROUND

• Kaundal RK, Deshpande TA, Gulati A, Sharma SS. Targeting endothelin receptors for pharmacotherapy of ischemic stroke: current scenario and future perspectives. Drug Discov Today. 2012 Jul;17(13-14):793-804. doi: 10.1016/j.drudis.2012.02.017. Epub 2012 Mar 8.

  PMID: 22406696 BACKGROUND

• Bhalla S, Leonard MG, Briyal S, Gulati A. Distinct Alteration in Brain Endothelin A and B Receptor Characteristics Following Focal Cerebral Ischemia in Rats. Drug Res (Stuttg). 2016 Apr;66(4):189-95. doi: 10.1055/s-0035-1559779. Epub 2015 Sep 23.

  PMID: 26398673 BACKGROUND

• Puppala B, Awan I, Briyal S, Mbachu O, Leonard M, Gulati A. Ontogeny of endothelin receptors in the brain, heart, and kidneys of neonatal rats. Brain Dev. 2015 Feb;37(2):206-15. doi: 10.1016/j.braindev.2014.04.008. Epub 2014 May 10.

  PMID: 24815227 BACKGROUND

MeSH Terms

Conditions

Stroke; Ischemia

Interventions

sovateltide; Saline Solution

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Crystalloid Solutions; Isotonic Solutions; Solutions; Pharmaceutical Preparations

Study Officials

• Manish Lavhale, Ph.D.

  Pharmazz India

  STUDY DIRECTOR

Central Study Contacts

Dharmesh Shah, Dr.

CONTACT

+91(120)256-9779; dharmesh.shah@pharmazz.com

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: In this double-blind study, the patient and all relevant personnel involved with the conduct and interpretation of the study (including the investigator, investigational site personnel, and the sponsor or designee's staff) will remain blinded to the identity of the Investigational Product (IP) assigned and the randomization codes. The final randomization list will be kept strictly confidential, filed securely by the independent biostatistician, and accessible only to authorized persons as per the sponsor's standard operating procedures until the completion of the study.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Model Details: The Investigational product (IP) is Sovateltide. It is a lyophilized product, available as Sovateltide injection containing 30 μg of Sovateltide (IRL-1620) in a 5.0 mL vial. The investigational product will be provided by Pharmazz India Pvt. Ltd. Three doses of Sovateltide (each dose of 0.3 μg/kg body weight) will be administered as an IV bolus over one minute at 3 ± 1 hours interval on day 1. The dose will be repeated on day 3 and day 6 post-randomization. Sovateltide will be administered as an IV bolus dose over one minute within 24 hours of the stroke onset. All the patients in the Sovateltide group will continue receiving standard treatment. The reference product is Normal Saline therapy. Three doses of Normal Saline (Equal volume) will be administered as an IV bolus over one minute, at an interval of 3 hours ± 1 hour on day 1. The dose will be repeated on day 3 and day 6 post-randomization. All the patients in the Normal Saline group will continue receiving standard treatment.

Study Record Dates

• First Submitted: July 5, 2023
• First Posted: July 21, 2023
• Study Start: January 8, 2024
• Primary Completion: February 1, 2026
• Study Completion: March 1, 2026
• Last Updated: December 31, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

IN (6)