Ischemic StrokePhase 3ALIASNCT00235495
Albumin in Acute Ischemic Stroke Trial
A Phase 3 study testing Albumin and Saline in people with Ischemic Stroke, run by University of Miami at 89 sites in 4 countries.
Trial summary
The goal of the trial is to determine whether human albumin, administered within 5 hours of symptom onset, improves the 3-month outcome of subjects with acute ischemic stroke. Read more about this study
- Who is it for?
- Ages 18 to 83 years
- Conditions the study is for
- Ischemic Stroke
- What is being tested?
- Albumin and Saline
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 841 participants
- Where
- 89 sitesin 4 countries
- Study dates
- Jun 2006to Feb 2013
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 83 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Acute ischemic stroke
- NIH stroke scale score > 5
- Age >= 18 and <= 83
- ALB or placebo can be administered within 5 hours of symptom onset
- ALB or placebo can be administered within 60 minutes of Tissue Plasminogen Activator (tPA) administration in the thrombolysis group
- Signed informed consent
Who cannot join
- Episode/exacerbation of congestive heart failure (CHF) from any cause in the last 6 months. An episode of congestive heart failure is any heart failure that required a change in medication, diet or hospitalization.
- Known valvular heart disease with CHF in the last 6 months.
- Severe aortic stenosis or mitral stenosis.
- Cardiac surgery involving thoracotomy (e.g., coronary artery bypass graft (CABG), valve replacement surgery) in the last 6 months.
- Acute myocardial infarction in the last 6 months.
- Signs or symptoms of acute myocardial infarction, including ECG findings, on admission.
Show all 24Show fewer
- Baseline elevated serum troponin level on admission (>0.1 mcg/L)
- Suspicion of aortic dissection on admission.
- Acute arrhythmia (including any tachycardia - or bradycardia) with hemodynamic instability.
- Findings on physical examination of any of the following: (1) jugular venous distention (JVP > 4 cm above the sternal angle); (2) 3rd heart sound; (3) resting tachycardia (heart rate > 100/min) attributable to congestive heart failure; (4) abnormal hepatojugular reflux; (5) lower extremity pitting edema attributable to congestive heart failure; and/or (6) definite chest x-ray evidence of pulmonary edema.
- Current acute or chronic lung disease requiring supplemental chronic or intermittent oxygen therapy.
- Historical Modified Rankin Score (mRS) ≥2. Patients who live in a nursing home or who are not fully independent for activities of daily living immediately prior to the stroke are not eligible for the trial.
- In-patient stroke. I.e., patients with a stroke occurring as a complication of hospitalization for another condition, or as a complication of a procedure.
- Planned acute use of intra-arterial (IA) tPA or acute endovascular intervention (e.g., stenting, angioplasty, thrombus retrieval device use) must conform to the following criteria: (1) begin within 5 hours of symptom onset, and (2) finish within 7 hours of symptom-onset.
- Fever, defined as core body temperature > 37.5° C (99.5°F).
- Serum creatinine > 2.0 mg/dL or 180 µmol/L.
- Profound dehydration.
- Evidence of intracranial hemorrhage (intracerebral hematoma (ICH), subarachnoid hemorrhage (SAH), epidural hemorrhage, acute or chronic subdural hematoma (SDH)) on the baseline CT or MRI scan.
- History of allergy to albumin.
- History of latex rubber allergy.
- Severe chronic anemia with Hgb < 7.5 g/dL
- Pregnancy, breastfeeding or positive pregnancy test. (Women of childbearing age must have a negative pregnancy test prior to ALB administration.)
- Concurrent participation in any other therapeutic clinical trial.
- Evidence of any other major life-threatening or serious medical condition that would prevent completion of 3-month follow-up, impair the assessment of outcome, or in which ALB therapy would be contraindicated or might cause harm to the subject.
Trial locations and contacts
89 sites in 4 countries.
89 sites in 4 countries
United States69 sites
Abington Memorial Hospital
Abington, Pennsylvania, 19001
Grady Memorial Hospital
Atlanta, Georgia, 30303
Emory University Hospital
Atlanta, Georgia, 30322
Seton Medical Center
Austin, Texas, 78701
University of Maryland Medical Center
Baltimore, Maryland, 21201-1595
Upper Chesapeake Medical Center
Bel Air, Maryland, 21014
New York Methodist Hospital
Brooklyn, New York, 11215
Buffalo General Medical Center
Buffalo, New York, 14203
Mercy Hospital of Buffalo
Buffalo, New York, 14220
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, 27599-7025
Christ Hospital
Cincinnati, Ohio, 45219
University of Cincinnati Medical Center
Cincinnati, Ohio, 45219
Good Samaritan Hospital
Cincinnati, Ohio, 45220
Bethesda North Hospital
Cincinnati, Ohio, 45242-4402
MetroHealth Medical Center
Cleveland, Ohio, 44109-1998
Ohio State University Medical Center
Columbus, Ohio, 43210
John Muir Medical Ctr-Concord
Concord, California, 94520
Detroit Receiving Hospital
Detroit, Michigan, 48201
Henry Ford Hospital
Detroit, Michigan, 48202
Sinai-Grace Hospital
Detroit, Michigan, 48235
Duke University Medical Center
Durham, North Carolina, 27710
St. Elizabeth Medical Center South
Edgewood, Kentucky, 41017
Fairview Southdale Hospital
Edina, Minnesota, 55435
Mercy Health Fairfield Hospital
Fairfield, Ohio, 45014
St. Elizabeth Hospital
Florence, Kentucky, 41042
Penn State Hershey Medical Center
Hershey, Pennsylvania, 17033
Baylor College of Medicine
Houston, Texas, 77030
Memorial Hermann Texas Medical Center
Houston, Texas, 77030
University of Florida/Shands
Jacksonville, Florida, 32209
University of Kentucky Hospital
Lexington, Kentucky, 40536
Loyola University Medical Center
Maywood, Illinois, 60153
Jackson Memorial Hospital, University of Miami
Miami, Florida, 33136-1096
Froedtert Memorial Hospital
Milwaukee, Wisconsin, 53226
Winthrop University Hospital
Mineola, New York, 11501
Hennepin County Medical Center
Minneapolis, Minnesota, 55415
University of Minnesota Medical Center Fairview
Minneapolis, Minnesota, 55454
El Camino Hospital
Mountain View, California, 94040-4378
Yale University School of Medicine
New Haven, Connecticut, 06510
Columbia University Medical Center
New York, New York, 10032
Christiana Hospital
Newark, Delaware, 19718
The Villages Research Group
Ocala, Florida, 34474
Neuroscience Research Institute at Florida Hospital Orlando
Orlando, Florida, 32804
University of Pennsylvania Medical Center
Philadelphia, Pennsylvania, 19104
Temple University Hospital
Philadelphia, Pennsylvania, 19130
Hahnemann University Hospital
Philadelphia, Pennsylvania, 19140
Mayo Clinic Hospital
Phoenix, Arizona, 85054
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, 15213
Providence Portland Medical Center
Portland, Oregon, 97213
Providence St. Vincent Medical Center
Portland, Oregon, 97225
OHSU Legacy Emmanuel Hospital
Portland, Oregon, 97227
Oregon Health & Science University
Portland, Oregon, 97239-3098
Wake Med Health and Hospitals
Raleigh, North Carolina, 27610
Virginia Commonwealth University Medical Center
Richmond, Virginia, 23219
William Beaumont Hospital
Royal Oak, Michigan, 48073
HealthEast Care System/St. Joseph's Hospital
Saint Paul, Minnesota, 55102
UCSF Medical Center
San Francisco, California, 94110
UCSF-San Francisco General Hospital
San Francisco, California, 94110
California Pacific Medical Center, Davies Campus
San Francisco, California, 94114
California Pacific Medical Center, Pacific Campus
San Francisco, California, 94115
O'Connor Hospital
San Jose, California, 95128
UCLA Medical Center, Santa Monica
Santa Monica, California, 90024
Intercoastal Neurology/Medical Research Center
Sarasota, Florida, 34239
Sacred Heart Medical Center
Springfield, Oregon, 97477
Saint Louis University
St Louis, Missouri, 63110
Stanford University Medical Center
Stanford, California, 94305
Atlantic Neuroscience Institute, Overlook Hospital
Summit, New Jersey, 07902
University of Arizona Medical Center-South Campus
Tucson, Arizona, 85724-5030
University of Arizona Medical Center
Tucson, Arizona, 85724
John Muir Medical Ctr-Walnut Creek
Walnut Creek, California, 94598
Canada13 sites
Foothills Hospital, University of Calgary
Calgary, Alberta, T2N 2T9
University of Alberta
Edmonton, Alberta, T6G 1Z1
Grey Nuns Community Hospital
Edmonton, Alberta, T6L 5X8
Hopital Charles LeMoyne, Centre de Recherche
Greenfield Park, Quebec, J4V 2H1
Queen Elizabeth II Health Science Centre
Halifax, Nova Scotia, B3H-3A7
Royal Island Hospital
Kamloops, British Columbia, V2C 2T1
London Health Sciences Centre-University Hospital
London, Ontario, N6A 5A5
Trillium Health Centre
Mississauga, Ontario, L5B 1B8
The Ottawa Hospital
Ottawa, Ontario, K1Y 4E9
Centre de Sante et de Service Sociaux de Chicoutimi
Saguenay, Quebec, G7H 5H6
Thunder Bay Regional Health Sciences Centre
Thunder Bay, Ontario, P7B 7C7
University of Toronto, St. Michael's Hospital
Toronto, Ontario, M5C 1R6
Vancouver General Hospital
Vancouver, British Columbia, V5Z 1M9
Israel5 sites
Hadassah Medical Organization, Hadassah University Hospital
‘En Kerem, Jerusalem
Soroka Medical Center
Beersheba, 84101
Rambam Health Care Campus
Haifa, 31096
Tel-Aviv Sourasky Medical Center
Tel Aviv, 64239
Chaim Sheba Medical Center at Tel-Hashomer
Tel HaShomer, Ramat Gan, 52621
Finland2 sites
Helsinki University Central Hospital
Helsinki, FI-00290
Tampere University Hospital
Tampere, FI-33521
About this study
Official title: A Phase III Randomized Multicenter Clinical Trial Of High-Dose Human Albumin Therapy For Neuroprotection In Acute Ischemic Stroke
The goal of the trial is to determine whether human albumin, administered within 5 hours of symptom onset, improves the 3-month outcome of subjects with acute ischemic stroke.
Read the detailed description
Human serum albumin, at 2 g/kg, administered over 2 hours by intravenous infusion, will be compared to placebo (isovolumic normal saline) among patients with acute ischemic stroke. All patients will have a baseline stroke severity measured as NIH Stroke scale score > 5. Patients will treated according to the best standard of care including concurrent treatment with intravenous or intra-arterial thrombolysis where appropriate. The primary outcome will be determined at 3 months. The primary hypothesis is that, using the composite outcome of a modified Rankin score 0-1 or NIH stroke scale score 0-1 at 3 months (or both), the proportion of patients with improved outcomes will be greater by 10% or more in the active treatment group. [The current trial is termed "Part 2" and incorporates revisions to the initial protocol that were instituted after the Data Safety Monitoring Board (DSMB) suspended subject recruitment because of a safety concern after 434 subjects had been enrolled. The protocol revisions of Part 2 resulted from the study team's thorough review of the Part-1 safety data and were designed to optimize safety going forward.]
- Conditions
- Ischemic Stroke
- Being tested
- Albumin, Saline
- Keywords
- stroke
- Medical subject headings
- Ischemic Stroke, Stroke
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AlbuminBiological
human albumin, 25%, 2.0g/kg intravenously (or equivalent volume of saline control), infused over 2 h, commencing within 5 hours of stroke onset
SalineDrug
equivalent volume of isotonic saline control
| Study group | Role | What they receive |
|---|---|---|
| Albumin (ALB) | Active comparator | Albumin (human albumin, 25% solution, 2.0 g/kg), infused intravenously over a period of 2 hours Receives: Biological: Albumin |
| Saline | Placebo comparator | Saline (isotonic solution), 8 ml/kg, infused intravenously over a 2-hour period Receives: Drug: Saline |
What is being measured
The primary outcome is the main question the study is designed to answer.
The Number of Participants With Favorable Outcome Defined as National Institute of Health Stroke Scale (NIHSS) Score of 0-1 and/or Modified Rankin Scale (mRS) of 0-1.
The National Institutes of Health Stroke Scale (NIHSS) is a systematic assessment tool that provides a quantitative measure of stroke-related neurologic deficit. The scores range from 0 to 42 with a score of greater than 20 indicating severe neurologic deficit. The mRS ranges from 0-6 representing perfect health without symptoms to death. A score of 0 is no symptoms at all and a score of 1 is no significant disability. Able to carry out all usual duties and activities.
Measured: at 3 months
Secondary outcomes (21)
Number of Participants With a Composite Outcome of mRS 0-1 and/or NIHSS 0-1 and/or Decrease in NIHSS From Baseline by 10 or More Points
Measured: at 3 months
Number of Participants With a NIHSS of 0-1 at 24 Hours
The National Institutes of Health Stroke Scale (NIHSS) is a systematic assessment tool that provides a quantitative measure of stroke-related neurologic deficit. The scores range from 0 to 42 with a score of greater than 20 indicating severe neurologic deficit.
Measured: at 24 hours
Number of Participants With a NIHSS 0-1 at 90 Days.
The National Institutes of Health Stroke Scale (NIHSS) is a systematic assessment tool that provides a quantitative measure of stroke-related neurologic deficit. The scores range from 0 to 42 with a score of greater than 20 indicating severe neurologic deficit.
Measured: at 90 days
The Number of Participants With a Score on the mRS 0-1 at 90 Days.
The mRS ranges from 0-6 representing perfect health without symptoms to death. 0 = No symptoms at all. 1 = No significant disability. Able to carry out all usual duties and activities. 2 = Slight disability. Unable to carry out all previous activities but able to look after own affairs without assistance. 3 = Moderate disability. Requires some help, but able to walk unassisted. 4 = Moderately severe disability. Unable to walk unassisted and unable to attend to own bodily needs without assistance. 5 = Severe disability. Bedridden, incontinent, and requires constant nursing care and attention. 6 = Dead.
Measured: at 90 days
The Number of Participants With a Score on the mRS of 0-2 at 90 Days.
The mRS ranges from 0-6 representing perfect health without symptoms to death. 0 = No symptoms at all. 1 = No significant disability. Able to carry out all usual duties and activities. 2 = Slight disability. Unable to carry out all previous activities but able to look after own affairs without assistance. 3 = Moderate disability. Requires some help, but able to walk unassisted. 4 = Moderately severe disability. Unable to walk unassisted and unable to attend to own bodily needs without assistance. 5 = Severe disability. Bedridden, incontinent, and requires constant nursing care and attention. 6 = Dead.
Measured: at 90 days
Number of Participants With a Favorable Outcome Per Modified Rankin Scare (mRS)
Assessed as the final global disability level on the modified Rankin scale (mRS) at 90 days better than expectation (sliding dichotomy analysis) ) assessed in the intention to treat population.
mRS Scale:
0 - No symptoms.
- - No significant disability. Able to carry out all usual activities, despite some symptoms.
- - Slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities.
- - Moderate disability. Requires some help, but able to walk unassisted.
- - Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted.
- - Severe disability. Requires constant nursing care and attention, bedridden, incontinent.
- - Dead.
Measured: 90 days
Barthel Index (BI) 95-100
The Barthel Index (BI) is an ordinal scale used to measure a subject's performance in activities of daily living (ADL) in ten variables - feeding, transfer (bed to chair), grooming, toilet use, bathing, mobility on a level surface, stair use, dressing, bowels and bladder. It is an assessment of independence in ADL and is scored in increments of 5 points. the highest total score for fully independent subjects equals 100. A higher number is associated with a greater likelihood of being able to live at home with a degree of independence.
Measured: at 90 days
Number of Participants With an EuroQol (EQ-5D) Favorable Score < 0.78
The EQ-5D measures the subject's overall health state in a descriptive system of health-related quality of life (QoL) states consisting of five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) each of which can take one of three responses. The responses record three levels of severity ('no problems', 'some problems', and 'extreme problems) within a particular EQ-5D dimension. The EQ-5D results can be converted to health utility scores.
Measured: at 90 days
Number of Participants With a Stroke Specific Quality of Life Scale (SSQOL) Score of >=3
Stroke, specific, health-related quality of life (SSQoL) is a self-reported survey that includes 12 domains and 49 items which are scored on a 5pt Likert response format with a lower score indicating worse function/lower ability on that item or domain. Domain scores were calculated as an unweighted average of item scores in that domain. Overall Total Score was calculated as an unweighted average of domain scores. Each Domain Score and the Overall Total Score all range from 1-5 with 1 being worst and 5 being the best. We have presented data here for the number of participants that have an unweighted average of domain scores of 3 or greater.
Measured: at 90 days
Trailmaking A
The Trail Making Test is a neuropsychological test of visual attention and task switching that is thought to be sensitive to the presence of cerebral dysfunction. It is a timed test consisting of two parts where the subject is asked to draw a "trail" made by connecting numbers in sequential order (part A) and then in part B the combination of numbers and letters. Scoring is calculated separately for Parts A and B but both scores are provided as the minutes and seconds it takes for the subject to complete ach part. Normally, the entire test (A and B) can be completed in 5-10 minutes.
Measured: at 90 days
Trailmaking B
The Trail Making Test is a neuropsychological test of visual attention and task switching that is thought to be sensitive to the presence of cerebral dysfunction. It is a timed test consisting of two parts where the subject is asked to draw a "trail" made by connecting numbers in sequential order (part A) and then in part B the combination of numbers and letters. Scoring is calculated separately for Parts A and B but both scores are provided as the minutes and seconds it takes for the subject to complete ach part. Normally, the entire test (A and B) can be completed in 5-10 minutes.
Measured: at 90 days
Number of Participants With Neurological Deterioration Within 48 Hours
This is assessed as the number of participants with a neurological adverse event.
Measured: within 48 hours
Neurological Death Within 7 Days
Measured: within 7 days
Recurrent Ischemic Stroke Within 30 Days
Measured: within 30 days
Atrial Fibrillation Within 48 Hours
Measured: within 48 hours
Pulmonary Edema Within 48 Hours
Measured: within 48 hours
Shortness of Breath Within 48 Hours
Measured: within 48 hours
Symptomatic Intracerebral Hemorrhage (ICH) Within 24 Hours
Measured: within 24 hours
Asymptomatic ICH Within 24 Hours
Measured: within 24 hours
Death Within 30 Days
Measured: within 30 days
Death Within 90 Days
Measured: within 90 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Oct 2005 (estimated)
- Study startJun 2006
- Primary completionFeb 2013
- Study completionFeb 2013
Why it stopped: Recruitment halted by DSMB following interim analysis.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Ischemic StrokeStudies of the same condition, open and under way.
- More trials run by University of MiamiThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 841 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Miami
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute of Neurological Disorders and Stroke (NINDS), University of Calgary, Medical University of South Carolina, Neurological Emergencies Treatment Trials Network (NETT)
- Responsible party
- Principal investigator, Myron Ginsberg, University of Miami
- Investigators
- Myron D. Ginsberg, MD, Study chair, University of MiamiMichael D. Hill, MD MSc, Principal investigator, University of CalgaryYuko Y Palesch, PhD, Principal investigator, Medical University of South Carolina
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00235495
- Sponsor's protocol ID
- 20060083
- Other IDs
- U01NS054630, NIH NINDS 5U01 NS040406-08, 20060233
- Acronym
- ALIAS
- Status last verified
- Dec 2019
- First submitted
- 14 Sep 2005
- Last updated
- 17 Dec 2019
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Martin RH, Yeatts SD, Hill MD, Moy CS, Ginsberg MD, Palesch YY; ALIAS Parts 1 and 2 and NETT Investigators. ALIAS (Albumin in Acute Ischemic Stroke) Trials: Analysis of the Combined Data From Parts 1 and 2. Stroke. 2016 Sep;47(9):2355-9. doi: 10.1161/STROKEAHA.116.012825. Epub 2016 Jul 26.
PubMed 27462118Hill MD, Martin RH, Palesch YY, Moy CS, Tamariz D, Ryckborst KJ, Jones EB, Weisman D, Pettigrew C, Ginsberg MD. Albumin Administration in Acute Ischemic Stroke: Safety Analysis of the ALIAS Part 2 Multicenter Trial. PLoS One. 2015 Sep 1;10(9):e0131390. doi: 10.1371/journal.pone.0131390. eCollection 2015.
PubMed 26325387Ginsberg MD, Palesch YY, Hill MD, Martin RH, Moy CS, Barsan WG, Waldman BD, Tamariz D, Ryckborst KJ; ALIAS and Neurological Emergencies Treatment Trials (NETT) Investigators. High-dose albumin treatment for acute ischaemic stroke (ALIAS) Part 2: a randomised, double-blind, phase 3, placebo-controlled trial. Lancet Neurol. 2013 Nov;12(11):1049-58. doi: 10.1016/S1474-4422(13)70223-0. Epub 2013 Sep 27.
PubMed 24076337Hill MD, Martin RH, Palesch YY, Tamariz D, Waldman BD, Ryckborst KJ, Moy CS, Barsan WG, Ginsberg MD; ALIAS Investigators; Neurological Emergencies Treatment Trials Network. The Albumin in Acute Stroke Part 1 Trial: an exploratory efficacy analysis. Stroke. 2011 Jun;42(6):1621-5. doi: 10.1161/STROKEAHA.110.610980. Epub 2011 May 5.
PubMed 21546491
Study at a glance
From the registry record, last updated by the sponsor on 17 Dec 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase III Randomized Multicenter Clinical Trial Of High-Dose Human Albumin Therapy For Neuroprotection In Acute Ischemic Stroke
- ClinicalTrials.gov ID
- NCT00235495
- Acronym / sponsor ID
- ALIAS / 20060083
- Conditions
- Ischemic Stroke
- Keywords
- stroke
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Recruitment halted by DSMB following interim analysis.
- Enrolment
- 841 participants (actual)
- Lead sponsor
- University of MiamiUniversity, hospital or other
- Collaborators
- National Institute of Neurological Disorders and Stroke (NINDS), University of Calgary, Medical University of South Carolina, Neurological Emergencies Treatment Trials Network (NETT)
- Study start
- Jun 2006
- Primary completion
- Feb 2013 (actual)
- Study completion
- Feb 2013 (actual)
- First posted
- 10 Oct 2005 (estimated)
- Results
- Posted 11 Sep 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of the trial is to determine whether human albumin, administered within 5 hours of symptom onset, improves the 3-month outcome of subjects with acute ischemic stroke.
Detailed description
Human serum albumin, at 2 g/kg, administered over 2 hours by intravenous infusion, will be compared to placebo (isovolumic normal saline) among patients with acute ischemic stroke. All patients will have a baseline stroke severity measured as NIH Stroke scale score > 5. Patients will treated according to the best standard of care including concurrent treatment with intravenous or intra-arterial thrombolysis where appropriate. The primary outcome will be determined at 3 months. The primary hypothesis is that, using the composite outcome of a modified Rankin score 0-1 or NIH stroke scale score 0-1 at 3 months (or both), the proportion of patients with improved outcomes will be greater by 10% or more in the active treatment group. [The current trial is termed "Part 2" and incorporates revisions to the initial protocol that were instituted after the Data Safety Monitoring Board (DSMB) suspended subject recruitment because of a safety concern after 434 subjects had been enrolled. The protocol revisions of Part 2 resulted from the study team's thorough review of the Part-1 safety data and were designed to optimize safety going forward.]
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Albumin (ALB) | Active comparator | Biological: AlbuminAlbumin (human albumin, 25% solution, 2.0 g/kg), infused intravenously over a period of 2 hours |
| Saline | Placebo comparator | Drug: SalineSaline (isotonic solution), 8 ml/kg, infused intravenously over a 2-hour period |
Who may qualify
- Ages
- 18 to 83 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Acute ischemic stroke
- NIH stroke scale score > 5
- Age >= 18 and <= 83
- ALB or placebo can be administered within 5 hours of symptom onset
- ALB or placebo can be administered within 60 minutes of Tissue Plasminogen Activator (tPA) administration in the thrombolysis group
Key exclusion criteria (24 listed)
- Episode/exacerbation of congestive heart failure (CHF) from any cause in the last 6 months. An episode of congestive heart failure is any heart failure that required a change in medication, diet or hospitalization.
- Known valvular heart disease with CHF in the last 6 months.
- Severe aortic stenosis or mitral stenosis.
- Cardiac surgery involving thoracotomy (e.g., coronary artery bypass graft (CABG), valve replacement surgery) in the last 6 months.
- Acute myocardial infarction in the last 6 months.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Albuminhuman albumin, 25%, 2.0g/kg intravenously (or equivalent volume of saline control), infused over 2 h, commencing within 5 hours of stroke onset | Biological | Albumin (ALB) |
| Salineequivalent volume of isotonic saline control | Drug | Saline |
Primary outcome
The Number of Participants With Favorable Outcome Defined as National Institute of Health Stroke Scale (NIHSS) Score of 0-1 and/or Modified Rankin Scale (mRS) of 0-1.
Time frame: at 3 months
The National Institutes of Health Stroke Scale (NIHSS) is a systematic assessment tool that provides a quantitative measure of stroke-related neurologic deficit. The scores range from 0 to 42 with a score of greater than 20 indicating severe neurologic deficit. The mRS ranges from 0-6 representing perfect health without symptoms to death. A score of 0 is no symptoms at all and a score of 1 is no significant disability. Able to carry out all usual duties and activities.
21 secondary outcomes
Number of Participants With a Composite Outcome of mRS 0-1 and/or NIHSS 0-1 and/or Decrease in NIHSS From Baseline by 10 or More Points
Time frame: at 3 months
Number of Participants With a NIHSS of 0-1 at 24 Hours
Time frame: at 24 hours
Number of Participants With a NIHSS 0-1 at 90 Days.
Time frame: at 90 days
The Number of Participants With a Score on the mRS 0-1 at 90 Days.
Time frame: at 90 days
The Number of Participants With a Score on the mRS of 0-2 at 90 Days.
Time frame: at 90 days
Number of Participants With a Favorable Outcome Per Modified Rankin Scare (mRS)
Time frame: 90 days
Barthel Index (BI) 95-100
Time frame: at 90 days
Number of Participants With an EuroQol (EQ-5D) Favorable Score < 0.78
Time frame: at 90 days
Number of Participants With a Stroke Specific Quality of Life Scale (SSQOL) Score of >=3
Time frame: at 90 days
Trailmaking A
Time frame: at 90 days
Trailmaking B
Time frame: at 90 days
Number of Participants With Neurological Deterioration Within 48 Hours
Time frame: within 48 hours
Neurological Death Within 7 Days
Time frame: within 7 days
Recurrent Ischemic Stroke Within 30 Days
Time frame: within 30 days
Atrial Fibrillation Within 48 Hours
Time frame: within 48 hours
Pulmonary Edema Within 48 Hours
Time frame: within 48 hours
Shortness of Breath Within 48 Hours
Time frame: within 48 hours
Symptomatic Intracerebral Hemorrhage (ICH) Within 24 Hours
Time frame: within 24 hours
Asymptomatic ICH Within 24 Hours
Time frame: within 24 hours
Death Within 30 Days
Time frame: within 30 days
Death Within 90 Days
Time frame: within 90 days
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Dec 2019.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 27462118Martin RH, Yeatts SD, Hill MD, Moy CS, Ginsberg MD, Palesch YY; ALIAS Parts 1 and 2 and NETT Investigators. ALIAS (Albumin in Acute Ischemic Stroke) Trials: Analysis of the Combined Data From Parts 1 and 2. Stroke. 2016 Sep;47(9):2355-9. doi: 10.1161/STROKEAHA.116.012825. Epub 2016 Jul 26.
- Derived from this study: PubMed 26325387Hill MD, Martin RH, Palesch YY, Moy CS, Tamariz D, Ryckborst KJ, Jones EB, Weisman D, Pettigrew C, Ginsberg MD. Albumin Administration in Acute Ischemic Stroke: Safety Analysis of the ALIAS Part 2 Multicenter Trial. PLoS One. 2015 Sep 1;10(9):e0131390. doi: 10.1371/journal.pone.0131390. eCollection 2015.
- Derived from this study: PubMed 24076337Ginsberg MD, Palesch YY, Hill MD, Martin RH, Moy CS, Barsan WG, Waldman BD, Tamariz D, Ryckborst KJ; ALIAS and Neurological Emergencies Treatment Trials (NETT) Investigators. High-dose albumin treatment for acute ischaemic stroke (ALIAS) Part 2: a randomised, double-blind, phase 3, placebo-controlled trial. Lancet Neurol. 2013 Nov;12(11):1049-58. doi: 10.1016/S1474-4422(13)70223-0. Epub 2013 Sep 27.
- Derived from this study: PubMed 21546491Hill MD, Martin RH, Palesch YY, Tamariz D, Waldman BD, Ryckborst KJ, Moy CS, Barsan WG, Ginsberg MD; ALIAS Investigators; Neurological Emergencies Treatment Trials Network. The Albumin in Acute Stroke Part 1 Trial: an exploratory efficacy analysis. Stroke. 2011 Jun;42(6):1621-5. doi: 10.1161/STROKEAHA.110.610980. Epub 2011 May 5.
Related trials for Ischemic Stroke
Not yet recruiting
Temporal Interference Stimulation for Upper-Limb Motor Recovery in Early Subacute Stroke
Acute Ischemic Stroke
RecruitingObservational study
ELATE Study: Evaluating Large-vessel Acute Thrombectomy in Extended Time Window
Acute Ichemic Stroke
Not yet recruiting
Selective Intra-Arterial Hypothermia After Endovascular Treatment for Acute Basilar Artery Occlusion
Acute Ischemic Stroke, Basilar Artery Occlusion
Active, not recruiting
Improving Visual Field Deficits With Noninvasive Brain Stimulation
Visual Field Defect, Peripheral, Stroke
Recruiting
Biomarkers of Paired VNS
Stroke, Ischemic
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Myron D. Ginsberg, MD study chair
University of Miami
Michael D. Hill, MD MSc principal investigator
University of Calgary
Yuko Y Palesch, PhD principal investigator
Medical University of South Carolina
89 sites in 4 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Albumin and Saline in people with Ischemic Stroke, run by University of Miami at 89 sites in 4 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 24 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 17 Dec 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 89 sites in United States, Canada, Israel, Finland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 11 Sep 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The Number of Participants With Favorable Outcome Defined as National Institute of Health Stroke Scale (NIHSS) Score of 0-1 and/or Modified Rankin Scale (mRS) of 0-1. (time frame: at 3 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00235495, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Dec 2019.