NCT07476898

Brief Summary

To verify the efficacy and safety of intravenous tenecteplase (TNK) in patients with disabling minor stroke and large vessel occlusion (LVO) within a 4.5-24 hour time window.

Trial Health

63
Monitor

Trial Health Score

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

Enrollment
864

participants targeted

Target at P50-P75 for phase_3 stroke

Timeline
25mo left

Started Mar 2026

Geographic Reach
1 country

30 active sites

Status
not yet recruiting

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

Study Progress12%
Mar 2026Aug 2028

Study Start

First participant enrolled

March 1, 2026

Completed
9 days until next milestone

First Submitted

Initial submission to the registry

March 10, 2026

Completed
7 days until next milestone

First Posted

Study publicly available on registry

March 17, 2026

Completed
2.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 1, 2028

Expected
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

August 1, 2028

Last Updated

March 17, 2026

Status Verified

March 1, 2026

Enrollment Period

2.3 years

First QC Date

March 10, 2026

Last Update Submit

March 12, 2026

Conditions

Keywords

Ischemic Stroke with Large Vessel OcclusionTenecteplasebeyond 4.5 hours

Outcome Measures

Primary Outcomes (1)

  • Proportion of patients with a modified Rankin Scale (mRS) score of 0-1 at 90 days.

    Proportion of patients with a modified Rankin Scale (mRS) score of 0-1 at 90 days.

    3 months after randomization

Secondary Outcomes (7)

  • Proportion of patients with mRS 0-2 at 90 days.

    3 months after randomization

  • Distribution of mRS score at 90 days.

    3 months after randomization

  • Rate of vessel recanalization.

    3 months after randomization

  • Proportion of patients undergoing rescue mechanical thrombectomy.

    cerebral infarction within 24 hours of onset

  • Proportion of patients with NIHSS score 0-1 or an improvement of ≥4 points from baseline at 24 hours, 7 days, or discharge (whichever occurs first).

    24 hours, 7 days, or discharge after randomization

  • +2 more secondary outcomes

Other Outcomes (8)

  • Increase in NIHSS score ≥4 points within 24 hours, excluding intracranial hemorrhage.

    24 hours after randomization

  • Symptomatic intracranial hemorrhage (sICH) at 36 hours (ECASS III definition).

    36 hours after randomization

  • sICH within 90 days (ECASS III definition).

    3 months after randomization

  • +5 more other outcomes

Study Arms (2)

Tenecteplase

EXPERIMENTAL

Tenecteplase (0.25 mg/kg, intravenous bolus, maximum dose 25 mg) + Standard Medical Management

Drug: Tenecteplase (0.25mg/kg)

Standard Medical Management

ACTIVE COMPARATOR

Immediate Standard Medical Management

Drug: Standard Medical Management

Interventions

Tenecteplase (0.25 mg/kg, intravenous bolus, maximum dose 25 mg) + Delayed dual antiplatelet therapy (initiated 24 hours after thrombolysis: Aspirin 100 mg orally once daily + Clopidogrel 75 mg orally once daily, or Aspirin 100 mg + Ticagrelor 90 mg orally twice daily, continued for 21 days)

Tenecteplase

Immediate dual antiplatelet therapy (Aspirin 100 mg orally once daily + Clopidogrel 75 mg orally once daily, or Aspirin 100 mg + Ticagrelor 90 mg orally twice daily, continued for 21 days)

Standard Medical Management

Eligibility Criteria

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

You may qualify if:

  • Male or female subjects (age ≥ 18 years).
  • Diagnosis of acute ischemic stroke, with intracranial hemorrhage ruled out by CT or MRI.
  • Time from stroke onset or last known well to randomization is 4.5 to 24 hours.
  • NIHSS score 2-5 and meeting the definition of disabling deficit: complete hemianopia (NIHSS question 3 score ≥ 2); severe aphasia (NIHSS question 9 score ≥ 2); neglect (NIHSS question 11 score ≥ 1); any persistent limb weakness against gravity (NIHSS question 6 or 7 score ≥ 2); any functional deficit considered potentially disabling by the physician and patient, such as inability to perform basic activities of daily living (bathing, independent walking, toileting, personal hygiene, and eating) or return to work.
  • LVO (internal carotid artery, middle cerebral artery M1/M2 segments) confirmed by CTA or MRA, including tandem lesions.
  • Core infarct volume \< 70 ml, ischemic penumbra volume ≥ 15 ml, and mismatch ratio ≥ 1.8, as shown by CTP or MRI+MRP.
  • Written informed consent.

You may not qualify if:

  • Significant pre-stroke neurological deficit (pre-stroke mRS ≥ 2).
  • History of stroke within the last 3 months.
  • History of intracranial hemorrhage.
  • Suspected subarachnoid hemorrhage.
  • Intracranial tumor, vascular malformation, or aneurysm.
  • Major surgery within the last 1 month.
  • Systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 110 mmHg.
  • Platelet count \< 10⁵/mm³.
  • Heparin or oral anticoagulant therapy within 48 hours.
  • Abnormal APTT.
  • Thrombin or factor Xa inhibitors.
  • Severe illness with life expectancy \< 3 months.
  • Blood glucose \< 50 mg/dL (2.7 mmol/L).
  • Participation in any other investigational drug or device study within the last 3 months.
  • Pregnancy.
  • +1 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (30)

Fujian Medical University Union Hospital

Fuzhou, Fujian, 350001, China

Location

Anshan Central Hospital

Anshan, Liaoning, 114001, China

Location

Anshan Changda Hospital

Anshan, Liaoning, 114005, China

Location

Benxi Central Hospital

Benxi, Liaoning, 117000, China

Location

Chaoyang Central Hospital

Chaoyang, Liaoning, 122000, China

Location

Dalian Municipal Central Hospital Affiliated of Dalian University of Technology

Dalian, Liaoning, 116033, China

Location

Dandong Central Hospital

Dandong, Liaoning, 118000, China

Location

Dandong First Hospital

Dandong, Liaoning, 118000, China

Location

Fushun Central Hospital

Fushun, Liaoning, 113006, China

Location

Liaojian Group Fukuang General Hospital

Fushun, Liaoning, 113008, China

Location

Fuxin People's Hospital

Fuxin, Liaoning, 123000, China

Location

Huludao Central Hospital

Huludao, Liaoning, 125000, China

Location

The First Affiliated Hospital of Jinzhou Medical University

Jinzhou, Liaoning, 121001, China

Location

Liaoyang Central Hospital

Liaoyang, Liaoning, 111000, China

Location

Panjin Central Hospital

Panjin, Liaoning, 124010, China

Location

The Second Affiliated Hospital of Shenyang Medical College

Shenyang, Liaoning, 110002, China

Location

Liaoning Provincial People's Hospital

Shenyang, Liaoning, 110016, China

Location

Shenyang Fifth People's Hospital

Shenyang, Liaoning, 110023, China

Location

Central Hospital Affiliated to Shenyang Medical College

Shenyang, Liaoning, 110024, China

Location

Shenyang Fourth People's Hospital

Shenyang, Liaoning, 110031, China

Location

The Fourth Affiliated Hospital of China Medical University

Shenyang, Liaoning, 110032, China

Location

Shenyang First People's Hospital

Shenyang, Liaoning, 110041, China

Location

Shenyang Tenth People's Hospital

Shenyang, Liaoning, 110044, China

Location

Sujiatun District Central Hospital

Shenyang, Liaoning, 110101, China

Location

Tieling Central Hospital

Tieling, Liaoning, 112000, China

Location

Tieling County Central Hospital

Tieling, Liaoning, 112600, China

Location

Liaojian Group Tieling Coal General Hospital

Tieling, Liaoning, 112700, China

Location

Wafangdian Central Hospital

Wafangdian, Liaoning, 116300, China

Location

Wafangdian Third People's Hospital

Wafangdian, Liaoning, 116300, China

Location

Yingkou Central Hospital

Yingkou, Liaoning, 115000, China

Location

MeSH Terms

Conditions

Stroke

Interventions

Tenecteplase

Condition Hierarchy (Ancestors)

Cerebrovascular 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 Proteins

Central Study Contacts

Chuansheng Zhao, M.D

CONTACT

Jinwei Li, M.D

CONTACT

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Masking Details
Multicenter, randomized, open-label, blinded-endpoint (PROBE design), 1:1 allocation, 90-day follow-up.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Multicenter, randomized, open-label, blinded-endpoint (PROBE design), 1:1 allocation, 90-day follow-up.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

March 10, 2026

First Posted

March 17, 2026

Study Start

March 1, 2026

Primary Completion (Estimated)

July 1, 2028

Study Completion (Estimated)

August 1, 2028

Last Updated

March 17, 2026

Record last verified: 2026-03

Data Sharing

IPD Sharing
Will share

Locations