NCT06196320

Brief Summary

The trial is a multicentre, prospective, open-label, blinded endpoint (PROBE), phase 3, randomized controlled design. Patients with acute ischemic stroke due to basilar artery occlusion presenting within 24 hours will be randomized 1:1 to intravenous tenecteplase (0.25mg/kg, maximum 25mg) ± thrombectomy or 'best practice'which may be alteplase (0.9mg/kg) within 4.5 hours from stroke onset or standard care (no lysis) ± thrombectomy at treating clinician's discretion.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
452

participants targeted

Target at P50-P75 for phase_3

Timeline
Completed

Started Jan 2024

Geographic Reach
1 country

59 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

December 6, 2023

Completed
1 month until next milestone

First Posted

Study publicly available on registry

January 9, 2024

Completed
15 days until next milestone

Study Start

First participant enrolled

January 24, 2024

Completed
1.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 11, 2025

Completed
11 days until next milestone

Study Completion

Last participant's last visit for all outcomes

September 22, 2025

Completed
Last Updated

November 26, 2025

Status Verified

April 1, 2025

Enrollment Period

1.6 years

First QC Date

December 6, 2023

Last Update Submit

November 21, 2025

Conditions

Keywords

rhTNK-tPArt-PAIschemic strokephase III trialbasilar artery occlusion

Outcome Measures

Primary Outcomes (1)

  • Modified Rankin Scale (mRS) 0-1 or return to baseline mRS

    The proportion of patients with Modified Rankin Scale (mRS) 0-1 (no disability) or return to baseline mRS (if baseline premorbid mRS =2-3) at 3 months. Scores on the modified Rankin scale range from 0 (no neurologic deficit) to 6 (death).

    3 months

Secondary Outcomes (10)

  • Modified Rankin Scale (mRS) 0-2 or return to baseline mRS

    3 months

  • Modified Rankin Scale (mRS) 0-3 or return to baseline mRS

    3 months

  • Ordinal analysis of the Modified Rankin Scale (mRS)

    3 months

  • Early neurological improvement

    72 hours

  • Successful reperfusion

    initial DSA run prior to thrombectomy

  • +5 more secondary outcomes

Study Arms (2)

Tenecteplase

EXPERIMENTAL

Intravenous tenecteplase (0.25mg/kg, maximum 25mg) within 24 hours ± thrombectomy at treating clinician's discretion

Drug: Tenecteplase

Best Practice (which may include intravenous Alteplase)

ACTIVE COMPARATOR

Intravenous alteplase (0.9mg/kg) within 4.5 hours from stroke onset or standard care (no lysis) ± thrombectomy at treating clinician's discretion

Drug: Best Practice (which may include intravenous Alteplase)

Interventions

Intravenous tenecteplase (0.25mg/kg, maximum 25mg, administered as a bolus over 5-10 seconds) within 24 hours ± thrombectomy at treating clinician's discretion

Also known as: rhTNK-tPA, TNK-tPA
Tenecteplase

Intravenous alteplase (0.9mg/kg) within 4.5 hours from stroke onset or standard care (no lysis) ± thrombectomy at treating clinician's discretion

Also known as: rt-PA
Best Practice (which may include intravenous Alteplase)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age ≥18.
  • Patients presenting with posterior circulation ischemic stroke symptoms due to near-complete or complete basilar artery occlusion within 24 hours from symptom onset (or clinical deterioration/coma) or the time the patient was last known to be well.
  • Presence of a basilar artery occlusion, proven by CT Angiography or MR Angiography. Basilar artery occlusion will be defined as 'potentially retrievable' occlusion at the basilar artery. This can be a near or complete occlusion.
  • Premorbid mRS ≤3 (independent function or requiring only minor domestic assistance and able to manage alone for at least 1 week).
  • Local legal requirements for consent have been satisfied.

You may not qualify if:

  • Intracerebral haemorrhage (ICH) or other diagnosis (e.g. tumour) identified by baseline imaging.
  • Posterior circulation Acute Stroke Prognosis Early CT Score (PC-ASPECTS) \<6 on non-contrast CT (NCCT) or CTA-source images or MRI diffusion weighted imaging (DWI).
  • Significant cerebellar mass effect or acute hydrocephalus.
  • Established frank hypodensity on non-contrast CT indicating subacute infarction.
  • Bilateral extensive brainstem ischemia.
  • Pre-stroke mRS of ≥4 (indicating moderate to severe previous disability).
  • Other standard contraindications to intravenous thrombolysis.
  • Contraindication to imaging with contrast agents.
  • Clinically evident pregnant women.
  • Vessel imaging showing both anterior and posterior circulation large vessel occlusion.
  • Current participation in another research drug treatment protocol.
  • Known terminal illness such that the patients would not be expected to survive a year.
  • Planned withdrawal of care or comfort care measures.
  • Any condition that, in the judgment of the investigator could impose hazards to the patient if study therapy is initiated or affect the participation of the patient in the study.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (59)

Taihe County Traditional Chinese Medicine Hospital

Fuyang, Anhui, China

Location

Lixin County People's Hospital

Haozhou, Anhui, China

Location

Beijing Tian Tan Hospital, Capital Medical University

Beijing, Beijing Municipality, 100070, China

Location

First People's Hospital of Tianshui

Tianshui, Gansu, China

Location

Guangdong Second Provincial General Hospital

Guangzhou, Guangdong, China

Location

Heyuan People's Hospital

Heyuan, Guangdong, China

Location

Huazhou People's Hospital

Huazhou, Guangdong, China

Location

Shaoguan Qujiang District People's Hospital

Shaoguan, Guangdong, China

Location

The Second Affiliated Hospital of Guizhou Medical University

Guiyang, Guizhou, China

Location

The Second People's Hospital of Guiyang

Guiyang, Guizhou, China

Location

Qiandongnanzhou People's Hospital

Qiandongnan, Guizhou, China

Location

Haikou People's Hospital

Haikou, Hainan, China

Location

Affiliated Hospital of Hebei University

Baoding, Hebei, China

Location

Qiu County People's Hospital

Handan, Hebei, China

Location

The Second Hospital of Qinhuangdao

Qinhuangdao, Hebei, China

Location

Tangshan Guye Traditional Chinese Medicine Hospital

Tangshan, Hebei, China

Location

Qinghe County People's Hospital

Xingtai, Hebei, China

Location

The 2nd Affiliated Hospital of Harbin Medical University

Harbin, Heilongjiang, China

Location

The First Affiliated Hospital of Harbin Medical University

Harbin, Heilongjiang, China

Location

Hongxinglong Hospital of Beidahuang Group

Shuangyashan, Heilongjiang, China

Location

Huaxian People's Hospital of Henan

Anyang, Henan, China

Location

Jiaozuo Coal Industry Central Hospital

Jiaozuo, Henan, China

Location

The First People Hospital of Lingbao

Lingbao, Henan, China

Location

Liuyang Jili Hospital

Liuyang, Henan, China

Location

Nanshi Hospital of Nanyang

Nanyang, Henan, China

Location

Nanle County People's Hospital

Puyang, Henan, China

Location

Nanle Zhongxing Hospital

Puyang, Henan, China

Location

Puyang Oilfield General Hospital

Puyang, Henan, China

Location

Guangshan County People's Hospital

Xinyang, Henan, China

Location

Xi County People's Hospital

Xinyang, Henan, China

Location

Taikang Xian People's Hospital

Zhoukou, Henan, China

Location

People's Hospital of Queshan

Zhumadian, Henan, China

Location

Zhumadian Traditional Chinese Medicine Hospital

Zhumadian, Henan, China

Location

Chenzhou First People's Hospital

Chenzhou, Hunan, China

Location

The Fourth People's Hospital of Chenzhou

Chenzhou, Hunan, China

Location

Hengyang Central Hospital

Hengyang, Hunan, China

Location

Keshketeng Banner Chinese-Mongolian Hospital

Keshketeng Banner, Inner Mongolia, China

Location

Tongliao People's Hospital

Tongliao, Inner Mongolia, China

Location

Jiujiang First People's Hospital

Jiujiang, Jiangxi, China

Location

Jilin Electric Power Hospital

Changchun, Jilin, China

Location

Siping City Central People's Hospital

Siping, Jilin, China

Location

Liuhe County People's Hospital

Tonghua, Jilin, China

Location

The First Affiliated Hospital of Jinzhou Medical University

Jinzhou, Liaoning, China

Location

The People's Hospital of Liaoning Province

Shenyang, Liaoning, China

Location

The Second People's Hospital of Dongying

Dongying, Shandong, China

Location

Gaomi People's Hospital

Gaomi, Shandong, China

Location

Laizhou City People's Hospital

Laizhou, Shandong, China

Location

Linyi People's Hospital

Linyi, Shandong, China

Location

Qingdao Municipal Hospital

Qingdao, Shandong, China

Location

The Second Affiliated Hospital of Shandong First Medical University

Taian, Shandong, China

Location

The Affiliated Hospital of Shandong Second Medical University

Weifang, Shandong, China

Location

Weifang People's Hospital

Weifang, Shandong, China

Location

Weihai Central Hospital

Weihai, Shandong, China

Location

Yantai Taochun Central Hospital

Yantai, Shandong, China

Location

Zaozhuang Municipal Hospital

Zaozhuang, Shandong, China

Location

Linfen Central Hospital

Linfen, Shanxi, China

Location

The First Affiliated Hospital, Zhejiang University School of Medicine

Hangzhou, Zhejiang, China

Location

Ningbo Beilun District People's Hospital

Ningbo, Zhejiang, China

Location

Beijing Daxing District People's Hospital

Beijing, China

Location

Related Publications (1)

  • Xiong Y, Alemseged F, Cao Z, Schwamm LH, Parsons M, Fisher M, Wu S, Campbell BCV, Wang Y. Tenecteplase versus standard care in patients with acute basilar artery occlusion: a multi-centre, prospective, randomised, open-label, blinded endpoint, phase 3, controlled trial. Stroke Vasc Neurol. 2025 Oct 28:svn-2025-004432. doi: 10.1136/svn-2025-004432. Online ahead of print.

MeSH Terms

Conditions

Ischemic Stroke

Interventions

TenecteplaseTNK-tissue plasminogen activatorPractice Guidelines as Topic

Condition Hierarchy (Ancestors)

StrokeCerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular Diseases

Intervention Hierarchy (Ancestors)

Tissue Plasminogen ActivatorSerine EndopeptidasesEndopeptidasesPeptide HydrolasesHydrolasesEnzymesEnzymes and CoenzymesSerine ProteasesPlasminogen ActivatorsBlood Coagulation FactorsBlood ProteinsProteinsAmino Acids, Peptides, and ProteinsGuidelines as TopicQuality Assurance, Health CareQuality of Health CareHealth Services AdministrationHealth Care Quality, Access, and Evaluation

Study Officials

  • Yongjun Wang, MD

    Beijing Tiantan Hospital

    PRINCIPAL INVESTIGATOR
  • Bruce Campbell, MD, PhD

    University of Melbourne

    PRINCIPAL INVESTIGATOR
  • Fana Alemseged, MD, PhD

    University of Melbourne

    STUDY DIRECTOR
  • Yunyun Xiong, MD, PhD

    Beijing Tiantan Hospital

    STUDY DIRECTOR

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
professor

Study Record Dates

First Submitted

December 6, 2023

First Posted

January 9, 2024

Study Start

January 24, 2024

Primary Completion

September 11, 2025

Study Completion

September 22, 2025

Last Updated

November 26, 2025

Record last verified: 2025-04

Data Sharing

IPD Sharing
Will not share

Locations