Status:

COMPLETED

Evaluating Neuroprotection in Aneurysm Coiling Therapy

Lead Sponsor:

NoNO Inc.

Collaborating Sponsors:

Arbor Vita Corporation

Conditions:

Stroke

Eligibility:

All Genders

18+ years

Phase:

PHASE2

Brief Summary

This is a randomized, double-blind, placebo-controlled, single-dose, design investigating the safety, tolerability and efficacy of NA-1, a peptide designed to reduce ischemic brain damage. Up to 200 m...

Eligibility Criteria

Inclusion

  • Inclusion Criteria
  • A diagnosis of a ruptured or unruptured brain aneurysm deemed suitable for repair by neuroendovascular techniques involving intraluminal occlusion by detachable platinum coils, stent-assisted coiling, pipeline stent, balloon-assisted coiling, covered stent only, neck-bridge device, re-coiling, or re-treatment of a previously coiled/treated aneurysm. There are no restrictions on adjunctive devices. For patients with a ruptured aneurysm, endovascular repair must take place within 72 hours of the ictal haemorrhage.
  • If the aneurysm has ruptured, patient should be Grade I-III on the World Federation of Neurological Surgeons (WFNS) grading scale for subarachnoid hemorrhage. If the patient is intubated but alert and able to follow commands (at least a 2-step command), and is not kept intubated for neurological status (i.e., WFNS Grade IV or V), the patient is considered WFNS Grade III and is eligible for the trial.
  • Absence of ongoing ischemic symptoms such as transient ischemic attacks, minor strokes, stroke-in-evolution, or clinical evidence of cerebral vasospasm within 2 weeks prior to randomization. (If a CT scan, cerebral angiogram, or other imaging performed during the 2 weeks prior to randomization shows radiological vasospasm deemed by the treating physician to be potentially clinically significant, the subject is excluded.)
  • Brain MRI imaging (DWI and FLAIR sequences) within 2 weeks prior to the endovascular aneurysm repair procedure as detailed in Section 8.2. Imaging must not demonstrate any focal ischemic stroke defined as a new region of restricted diffusion and/or a focal area of reduced perfusion on a relative mean transit time (rMTT) or relative time to peak (rTTP) map
  • Male or female with a minimum age of 18 years on the day of enrolment.
  • Female subjects of childbearing potential: Negative pregnancy test. After enrolment, blood will be drawn from women of childbearing potential for a confirmatory test of pregnancy as evaluated by a serum B-hCG test. The definition of non-childbearing potential includes the following:
  • Surgically sterile (e.g., hysterectomy with or without oophorectomy; fallopian tube ligation; endometrial ablation), at least 30 days prior to signature of the Informed Consent form
  • At least 5 years post-menopause (i.e., 6 years post last menstrual period), or menopause confirmed by follicle-stimulating hormone (FSH) testing. Non-surgically sterile females or females with undocumented post-menopausal status must be willing to use a medically approved method of birth control for 3 months after completion of dosing.
  • Non-surgically sterile males or males with partners of childbearing potential must be willing to use condoms with spermicide for 3 months after completion of dosing.
  • Body weight less than or equal to 180 kg.
  • Normal or abnormal but not clinically significant findings in the
  • non-neurological physical examination
  • 12-lead ECG
  • PQ or PR interval less than or equal to 210 msec;
  • In unruptured aneurysm cases, QTc interval less than 450 msec for males or 470 msec for females. For ruptured aneurysm cases, QTc interval is not restricted.
  • vital signs
  • blood pressure between 80-180/50-100 mm Hg,
  • body temperature less than or equal to 38.5oC
  • Informed consent and availability of the subject for the entire study period and willingness of the subject to adhere to protocol requirements, as evidenced by a signed Informed Consent Form.
  • Exclusion Criteria
  • Dissecting or mycotic brain aneurysm. Fusiform or atherosclerotic intracerebral aneurysms may be eligible for the trial if endovascular treatment is planned with a goal of exclusion of the aneurysm from the circulation.
  • Planned endovascular vessel sacrifice as the primary modality for aneurysm treatment.
  • Known history of life-threatening allergic reaction to any medication.
  • Chronic renal disease defined as a baseline serum creatinine \> 150 umol/L.
  • Women who are pregnant, or have a positive urine or blood (β-hCG) pregnancy test.
  • Women who are breastfeeding.
  • Any clinically significant psychiatric or psychological disease, which would preclude the patient from completing the protocol.
  • Pre-morbid (estimated) modified Rankin scale score of greater than 2.
  • Previous serious traumatic brain injury that would preclude the patient from completing the protocol or preclude MRI analysis of small strokes.
  • Patients with known HIV infection.
  • Patients who are unable to have an MRI scan for any reason.
  • Participation in a clinical trial with an investigational drug within 30 days preceding this study. Previous participation in the ENACT trial (e.g,, to treat a prior aneurysm), participation in another trial involving NA-1 or prior receipt of NA-1.
  • Any other medical condition that the site investigator deems would put the patient at excessive risk of participation in the study or an expected life expectancy less than 1 year or that would result in inability to collect clinical outcomes at 30 days.

Exclusion

    Key Trial Info

    Start Date :

    August 1 2008

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    May 1 2011

    Estimated Enrollment :

    185 Patients enrolled

    Trial Details

    Trial ID

    NCT00728182

    Start Date

    August 1 2008

    End Date

    May 1 2011

    Last Update

    October 17 2013

    Active Locations (14)

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    Page 1 of 4 (14 locations)

    1

    Barrow Neurological Institute

    Phoenix, Arizona, United States, 85013

    2

    Stanford University Medical Center

    Stanford, California, United States, 94305

    3

    Oregon Health and Science University

    Portland, Oregon, United States, 97239

    4

    Foothills Medical Centre

    Calgary, Alberta, Canada, T2N 2T9