Cerebrovascular AccidentPhase 2NCT01808261
Proof of Concept (POC) in Patients With Ischaemic Stroke
A Phase 2 study testing GSK249320 100/mg in people with Cerebrovascular Accident, run by GlaxoSmithKline at 36 sites in 4 countries.
Trial summary
Study MAG104615, a Proof of Concept Study for GSK249320 versus placebo in Stroke Patients. Read more about this study
- Who is it for?
- Ages 18 to 90 years
- Conditions the study is for
- Cerebrovascular Accident
- What is being tested?
- GSK249320 100/mg
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 134 participants
- Where
- 36 sitesin 4 countries
- Study dates
- 18 May 2013to 28 Jul 2014
- Phase
- Phase 2
- 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 90 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Have a confirmed diagnosis of stroke according to the World Health Organization definition which is, 'a rapid onset event of vascular origin reflecting a focal disturbance of cerebral function, excluding isolated impairments of higher function, and persisting longer than 24 hours [World Health Organization, 1989].
- Stroke onset must be within the last 24-72 hours of the first infusion of Investigational Product. Time of stroke onset is defined at the time at which the patient/relative is first aware of the stroke deficit. For patients who awake with deficits, or who are found unconscious, the time of onset is defined as the time at which they were last known to be symptom free.
- Have a stroke that is radiologically confirmed to be ischemic and supratentorial. The diameter of the ischemic lesion is >15mm in any single direction or the volume is >4cc. See the Study Procedures Manual (SPM) for guidance on how to calculate the lesion size.
- Have a total NIHSS score of 3-21.
- Have a lower limb deficit from the incident stroke which is defined as a score of 1-4 on the NIHSS Motor Leg question (question #6).
- Aged 18-90, inclusive.
- Expectation the subject will receive standard physical, occupational and speech rehabilitation therapy as indicated for the post stroke deficits.
- Male subjects and female subjects of non-child-bearing and child-bearing potential are allowed to participate in this study. See Section 11, Appendix 1 for definitions. Females of child-bearing potential must have a negative pregnancy test prior to enrollment and must agree to use one of the contraceptive methods specified in Section 11, Appendix 1.
Who cannot join
- Ability to walk >0.8m/s as measured by the Gait Velocity assessment.
- History of a previous symptomatic stroke within 3 months prior to study entry.
- Presence of significant disability prior to the current stroke. Significant disability is defined as having a pre-stroke Rankin score of >2.
- Subjects who are not alert or are unresponsive as defined by a score of 2 or 3 on the NIHSS Level of Consciousness question (Question 1a).
- Presence of significant aphasia likely to confound or interfere with completion of the study assessments.
- Presence of a significant pre-existing gait deficit prior to study entry that is likely to confound clinical evaluations
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- Presence of pre-existing neurologic or psychiatric disease which is active and not adequately controlled such that it interfered with major activities of daily living immediately prior to the current stroke and is likely to interfere with study participation/visits or confound clinical evaluations.
- The subject poses a significant suicide risk, in the opinion of the investigator.
- Current or chronic history of liver disease, known hepatic or biliary abnormalities (except Gilbert's syndrome or asymptomatic gallstones), or known history of hepatitis B or hepatitis C infection. A positive hepatitis B or hepatitis C result on the GSK labs drawn at baseline/Study Day 1 do not exclude a subject from continuing in the study unless there are associated clinical signs/symptoms of liver disease; however, the subject should be treated as clinically indicated and the GSK Medical Monitor should be contacted for further discussion.
- Presence of either a central or peripheral demyelinating disease, such as multiple sclerosis or IgM monoclonal gammopathy of unknown significance (MGUS).
- Expected death due to the incident stroke, or evidence of a chronic co-morbid condition or unstable acute systemic illness which, in the opinion of the investigator, could shorten the subject's survival such that it would limit his/her ability to complete the study.
- Presence of the following ECG values on baseline ECG: QTc > 500 msec (using either Bazett's formula (QTcB) or Fridericia's formula (QTcF)); or uncorrected QT >600msec (machine or manual over-read). If the ECG indicates a prolonged QTc interval value outside these limits, two further ECGs should be performed during the same sitting and the average QTc value of these triplicate ECGs calculated. If the average value exceeds the stated limits, the subject is not eligible.
- Participation in any investigational rehabilitation paradigm targeting stroke recovery during the duration of this study.
- Have a contraindication to MRI as per local hospital practice/guidelines.
- The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer).
- Prior treatment with GSK249320.
- History of sensitivity to Investigational Product excipients (acetate buffer, polysorbate 80 and sodium chloride) that, in the opinion of the investigator or GSK Medical Monitor, contraindicates the subject's participation.
- Pregnant females as determined by positive urine hCG test prior to enrollment.
- Lactating females.
- Subjects considered unwilling or unable to comply with the procedures and study visit schedule outlined in the protocol.
Trial locations and contacts
36 sites in 4 countries.
36 sites in 4 countries
Germany13 sites
GSK Investigational Site
Bremen, 28177
GSK Investigational Site
Celle, Lower Saxony, 29223
GSK Investigational Site
Erlangen, Bavaria, 91054
GSK Investigational Site
Essen, North Rhine-Westphalia, 45122
GSK Investigational Site
Freiburg im Breisgau, Baden-Wurttemberg, 79106
GSK Investigational Site
Friedrichshafen, Baden-Wurttemberg, 88048
GSK Investigational Site
Hamburg, 22417
GSK Investigational Site
Hamburg, 22763
GSK Investigational Site
Hanover, Lower Saxony, 30625
GSK Investigational Site
Leipzig, Saxony, 04103
GSK Investigational Site
Münster, North Rhine-Westphalia, 48149
GSK Investigational Site
Osnabrück, Lower Saxony, 49076
GSK Investigational Site
Ulm, Baden-Wurttemberg, 89081
United Kingdom11 sites
GSK Investigational Site
Cambridge, CB2 0QQ
GSK Investigational Site
Exeter, EX2 5DW
GSK Investigational Site
Glasgow, G51 4TF
GSK Investigational Site
Harrow, HA1 3UJ
GSK Investigational Site
Liverpool, L7 8XP
GSK Investigational Site
London, SE5 9RS
GSK Investigational Site
London, SW17 0QT
GSK Investigational Site
Newcastle upon Tyne, NE1 4LP
GSK Investigational Site
Romford, RM7 0AG
GSK Investigational Site
Salford, M6 8HD
GSK Investigational Site
Torquay, TQ2 7AA
United States6 sites
GSK Investigational Site
Jacksonville, Florida, 32209
GSK Investigational Site
Lexington, Kentucky, 40536
GSK Investigational Site
Nashville, Tennessee, 37232
GSK Investigational Site
Orange, California, 92868-4280
GSK Investigational Site
Peoria, Illinois, 61637
GSK Investigational Site
Portland, Oregon, 97239
Canada6 sites
GSK Investigational Site
Edmonton, Alberta, T6G 2B7
GSK Investigational Site
Edmonton, Alberta, T6L 5X8
GSK Investigational Site
Greenfield Park, Quebec, J4V 2H1
GSK Investigational Site
London, Ontario, N6A 5A5
GSK Investigational Site
Saint-Jérôme, Quebec, J7Z 5T3
GSK Investigational Site
Toronto, Ontario, M4N 3M5
About this study
Official title: Study MAG104615, a Proof of Concept Study for GSK249320 Versus Placebo in Stroke Patients
Study MAG104615, a Proof of Concept Study for GSK249320 versus placebo in Stroke Patients.
Read the detailed description
Myelin-associated glycoprotein (MAG) is one of the key proteins known to inhibit neuronal regeneration when released from oligodendrocytes in conditions of neuronal injury, such as stroke. GSK249320 is a humanised monoclonal antibody (mAb) that binds with high specificity to MAG and antagonises or neutralises MAG-mediated inhibition and has been shown to improve functional recovery after stroke in pre-clinical models, possibly by promoting neuroregeneration and plasticity. The present study (MAG104615) is designed to establish Proof of Concept (PoC) for GSK249320 in ischemic stroke patients. MAG104615 will be a placebo-controlled, double-blind, multicenter, randomized, repeat dose, Bayesian design study. PoC will be achieved by demonstrating a clinically meaningful improvement in lower limb motor recovery, specifically by evaluating changes in gait velocity from baseline to Day 90/Month 3. Subjects will also be followed out to Day 180/Month 6 to further evaluate longer term motor recovery and safety. Additional secondary efficacy measures of motor recovery will be evaluated to further demonstrate and characterize the extent and duration of overall motor recovery after treatment with GSK249320. Changes in disability and neurological impairment will be characterized after treatment with GSK249320 and explored for how they relate to motor recovery. This PoC study will also further characterize the safety, PK, and immunogenicity of GSK249320 will explore pharmacodynamic (PD) markers, and will explore use of actigraphy to measure motor recovery. Subjects will be stratified by gait velocity at baseline for randomization (1:1 allocation) into one of two treatment groups: 15mg/kg GSK249320, or placebo. Each subject will receive 2 repeat IV doses of GSK249320 or placebo.
- Conditions
- Cerebrovascular Accident
- Being tested
- GSK249320 100/mg, Placebo
- Keywords
- Ischemic Stroke
- Medical subject headings
- Stroke, Ischemic Stroke
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
GSK249320 100/mgDrug
Clear to opalescent, colorless to pale yellow or pale brown, and is supplied as a sterile, concentrated solution (1000mg/vial). GSK249320 is for IV use only.
PlaceboDrug
Placebo is a clear, colorless solution (50mM acetate buffer, pH 5.5 containing 0.02% (w/v) polysorbate-80 and made isotonic with 111.2 mM sodium chloride). Placebo is for intravenous (IV) use only.
| Study group | Role | What they receive |
|---|---|---|
| Placebo | Placebo comparator | Placebo is a clear, colorless solution (50mM acetate buffer, pH 5.5 containing 0.02% (w/v) polysorbate-80 and made isotonic with 111.2 mM sodium chloride). Placebo is for intravenous (IV) use only. Receives: Drug: Placebo |
| GSK249320 100/mg | Active comparator | Clear to opalescent, colorless to pale yellow or pale brown, and is supplied as a sterile, concentrated solution (1000mg/vial). GSK249320 is for IV use only. Receives: Drug: GSK249320 100/mg |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean Change From Baseline (BL) to Month 3/ Day 90 in Gait Velocity
Gait is the way or manner in which a person walks. Gait velocity (walking speed) is an objective, quantitative measure of lower extremity motor recovery in individuals who have had a stroke. Participants were asked to walk at their usual pace over a level, indoor 10 meter (m) distance and were allowed to use their normal assistive devices. The time (seconds[s]) taken by the participants to travel the 10 m distance was recorded. Gait velocity (m/s) as assessed by study personnel was derived as: 10 divided by time to walk 10 m. Two trials of gait velocity were conducted at each time point. Change from BL was calculated as the mean Month 3/Day 90 value minus the mean BL value. BL was defined as Day 1. The measure type displayed are posterior means.
Measured: BL (Day 1) and Month 3/Day 90
Secondary outcomes (27)
Mean Change From BL to Month 6/ Day 180 in Gait Velocity
Gait is the way or manner in which a person walks. Gait velocity (walking speed) is an objective, quantitative measure of lower extremity motor recovery in individuals who have had a stroke. Participants were asked to walk at their usual pace over a level, indoor 10 m distance and were allowed to use their normal assistive devices. The time (s) taken by the participants to travel the 10 m distance was recorded. Gait velocity (m/s) as assessed by study personnel was derived as: 10 divided by time to walk 10 m. Two trials of gait velocity were conducted at each time point. Change from BL was calculated as the mean Month 3/Day 90 value minus the mean BL value. BL was defined as Day 1. The measure type displayed are posterior means.
Measured: BL (Day 1) and Month 6/Day 180
Number of Participants With Indicated Transition From One Gait Velocity Category to Another Category at the Indicated Time Points
Participants were categorized at each visit into the following gait velocity categories: 0 m/s, >0 to <0.4 m/s, >=0.4 m/s to 0.8 m/s and >0.8m/s. A distinction was made between participants who are too incapacitated to walk (i.e., gait velocity = 0m/s) and participants for whom the gait velocity assessment was not performed due to another reason (i.e., truly missing data). Participants were asked to walk at their usual or normal pace and using their normal assistive devices. Two trials of gait velocity were conducted at each time point. The number of participants transitioning from one gait velocity category to another category was assessed at each post-Baseline visit and was presented in terms of the following transition categories: worsened, no change, improved 1 level, improved 2 levels and improved 3 levels. By-visit sample sizes vary due to missing data or early termination of the study, missing data was not imputed.
Measured: BL (Day 1), Month 1/Day 30, Month 2/Day 60, Month 3/Day 90 and Month 6/Day 180.
Change From BL in Dexterity as Measured by Box and Blocks Test
Dexterity is ability of person to use hands skillfully in performing a task. Box and Blocks test is an objective, gross manual dexterity test in individuals with upper limb impairments. Participants were asked to move small wooden blocks from one side of a partitioned box to other. The score was determined by number of blocks transferred within a 60 second time period. Both affected and unaffected arms were tested, starting with the unaffected arm. Change from BL was calculated as the individual post- BL value minus BL value. A higher number of displaced blocks indicated a better gross dexterity and a low number of displaced blocks indicated poor gross dexterity. It was analyzed using fixed effects for treatment, visit, treatment by visit interaction, sex, age, Baseline National Institute of Health stroke scale (NIHSS) total score, BL number of blocks transferred by the affected and unaffected arms, country and presence of concomitant medications that potentially impact recovery.
Measured: BL (Day 1), Month 1/Day 30, Month 2/Day 60, Month 3/Day 90 and Month 6/Day 180
Number of Participants Experiencing Falls
The number of participants who experienced at least one fall between BL to Day 90 and BL to Day 180 is summarized.
Measured: BL (Day 1) Day 90 and Day 180
Number of Falls Over Time
The number of participants who experienced 1, 2, 3 or >=4 falls between BL to Day 90 and BL to Day 180 is summarized. By-visit sample sizes vary due to missing data or early termination of the study. The participants who experienced atleast one-fall were reported
Measured: BL (Day 1), Day 90 and Day 180
Number of Participants With Serious Adverse Events (SAEs) and Adverse Events (AEs)
An AE is any untoward medical occurrence in a participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. A SAE is any untoward medical occurrence that, at any dose: results in death, is life-threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, is a congenital anomaly/birth defect or all events of possible drug-induced liver injury with hyperbilirubinaemia. Medical or scientific judgment is exercised in other situations.
Measured: Up to 14 months
Number of Participants With Events Common to Stroke
Events common to stroke were those events that commonly occurred after a stroke and are generally associated with the underlying stroke or the progression of stroke. These included joint or soft tissue pain, bladder incontinence, depression/mood disorder, urinary tract infection, dysphagia, bowel incontinence, dysarthia, confusion, spasticity, limb edema, aspiration pneumonia, hemorrhagic transformation (symptomatic or asymptomatic), pressure ulcers, progression of stroke, malnutrition, deep vein thrombosis, brain herniation, pulmonary embolism, seizures, and falls.
Measured: From Day 1 until early withdrawal, death, Month 6/Day 180
Change From BL in Vital Signs- Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP)
Safety was measured by monitoring vital signs including blood pressure. The BL for DBP and SBP was the value of pre-dose assessment on Day 1. Change from BL was calculated as the individual post-Baseline value minus the BL value. By-visit sample sizes vary due to missing data or early termination of the study.
Measured: BL (Day 1) , Day 6, Day 180 and early withdrawal (EW) visit
Change From BL in Vitals Signs-Heart Rate
Safety was measured by monitoring vital signs including heart rate. The BL for heart rate was the value of pre-dose assessment on Day 1. Change from BL was calculated as the individual post-BL value minus the BL value. By-visit sample sizes vary due to missing data or early termination of the study. BL was defined as Day 1.
Measured: Day 1, Day 6, Day 180 and EW visit
Change From BL in ECG Parameter-Heart Rate
A single 12-lead ECG was obtained at each time point that measured heart rate. BL was the value obtained on Day 1. Change from BL was calculated as the individual post-Baseline value minus the BL value. By-visit sample sizes vary due to missing data or early termination of the study.
Measured: BL (Day 1) Day 6, Day 30 and EW visit
Change From BL in ECG Parameters
A single 12-lead ECG was obtained at each time point and the following ECG intervals were determined: PR, QRS, QT, RR and corrected QT (QTc), QT interval corrected by Bazett's formula (QTcB), QT interval corrected by Fridericia's formula (QTcF). BL for ECG parameters was the value of Day 1. Change from BL was calculated as the individual post-Baseline value minus the BL value. By-visit sample sizes vary due to missing data or early termination of the study.
Measured: BL (Day 1), Day 6, Day 30 and EW visit
Change From BL in Clinical Chemistry- Albumin and Total Protein
ALB and TP were measured at BL, Day 6, Day 30, Day 90 and Day 180. Baseline was the value obtained on Day 1. Change from BL was calculated as the individual post-Baseline value minus the BL value. By-visit sample sizes vary due to missing data or early termination of the study.
Measured: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From BL in Clinical Chemistry-urea/Blood Urea Nitrogen (BUN), Sodium (Na), Potassium (K), Glucose (Gluc), Chloride (Cl), Calcium (Ca)
Ca, Cl, Gluc, K, Na and BUN were measured at BL, Day 6, Day 30, Day 90 and Day 180. BL was the value obtained on Day 1. Change from BL was calculated as the individual post-Baseline value minus the BL value. By-visit sample sizes vary due to missing data or early termination of the study.
Measured: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From BL in Alkaline Phosphatase (ALP), Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST)
ALP, ALT and AST were measured at BL, Day 6, Day 30, Day 90 and Day 180. BL was the value obtained on Day 1. Change from BL was calculated as the individual post-Baseline value minus the BL value. By-visit sample sizes vary due to missing data or early termination of the study.
Measured: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From BL in Clinical Chemistry- Direct Bilirubin, Total Bilirubin, Creatinine
Direct bilirubin, total bilirubin and creatinine were measured at BL, Day 6, Day 30, Day 90 and Day 180. BL was the value obtained on Day 1. Change from BL was calculated as the individual post-Baseline value minus the BL value. By-visit sample sizes vary due to missing data or early termination of the study.
Measured: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From BL in Eosinophils (EOS), Lymphocytes (LYM), Total Absolute Neutrophil Count (ANC), Platelet (PLT) Count, White Blood Cell (WBC) Count
EOS, LYM, Total ANC, PLT count and WBC count were measured at BL, Day 6, Day 30, Day 90 and Day 180. BL was the value obtained on Day 1. Change from BL was calculated as the individual post-Baseline value minus the BL value.By-visit sample sizes vary due to missing data or early termination of the study.
Measured: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From BL in Hematology- Hemoglobin
Hemoglobin was measured at BL Day 6, Day 30, Day 90 and Day 180. BL was the value obtained on Day 1. Change from BL was calculated as the individual post-Baseline value minus the BL value. . By-visit sample sizes vary due to missing data or early termination of the study.
Measured: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From Baseline in Hematology- Hematocrit
Hematocrit was measured at Baseline, Day 6, Day 30, Day 90 and Day 180. BL was the value obtained on Day 1. Change from BL was calculated as the individual post-Baseline value minus the BL value.By-visit sample sizes vary due to missing data or early termination of the study.
Measured: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From BL in NIHSS Total Score
The NIHSS is a 15 item, standardized, disease-specific, deficit scale which measures neurological impairment (level of consciousness, eye movements, visual fields, facial symmetry, motor strength (arm and leg), coordination, sensation, language (aphasia and dysarthria), and neglect) and is used to quantify participant status by measuring the severity of the stroke as assessed by NIHSS certified study personnel. The total NIHSS score is calculated as the sum of responses to the 15 items. The total NIHSS score ranges from 0-42, with a higher score indicative of a more severe impairment. By-visit sample sizes vary due to missing data or early termination of the study. Change from BL was calculated as the individual post-Baseline value minus the BL value. BL was defined as the value at Day 1.
Measured: BL (Day 1), Day 30, Day 90 and Day 180
Number of Participants With Suicidal Ideation Via Columbia Suicide Severity Rating Scale (CSSRS)
C-SSRS is a clinician-rated scale that evaluates severity and change of suicidality by integrating both suicidality behavior and ideation. For Suicidal Ideation (SI), participants were scored non-suicidal:0, wish to be dead:1, non-specific active suicidal thoughts:2, active suicidal ideation with associated thoughts of methods without intent:3, active suicidal ideation with some intent to act on suicidal thoughts without clear plan:4, active suicidal ideation with plan and intent:5 (most severe). SI intensity total score was the sum of suicidal ideation severity rating scores for frequency, duration, controllability, deterrents, and reasons for ideation. For each item, each participant got an intensity score from 0(none) to 5(worst). Therefore, the suicidal ideation intensity total score range from 0 to 25, with a score of 0 given for no suicidal ideation.
Measured: Da y 1, Da y 6, Day 30, Day 60, Day 90 and Day 180
Maximum Observed Plasma Concentration (Cmax) for GSK249320
Cmax is the maximum observed concentration of GSK249320 obtained at the end of infusion post dose on Day 6. Due to early termination of the study, this data was not collected.
Measured: Pre-dose and post-dose up to Day 180
Time to Reach Maximum Observed Plasma Concentration (Tmax) GSK249320
Tmax is the time of the occurrence of Cmax. The Cmax is defined as the maximum observed concentration of GSK249320 obtained at the end of infusion post dose on day 6. Due to early termination of the study data for Tmax was not collected.
Measured: Pre-dose and post-dose up to Day 180
PK as Measured by Plasma Decay Half-life (t1/2) GSK249320
Blood samples were collected for determination of plasma concentrations of GSK249320. Terminal phase half-life was derived from the plasma concentration-time data. Only participants in the GSK249320 15 mg/kg group were analyzed.
Measured: Up to Day 180
Area Under the Concentration-time Curve From 0 to 5 Days [AUC(0-5d)] and Area Under the Concentration-time Curve From Time Zero (Pre-dose) Extrapolated to Infinite Time [AUC(0-inf)] for GSK249320
Blood samples were collected for determination of plasma concentrations of GSK249320. AUC (0-5d) and AUC (0-inf) were derived from the plasma concentration-time data. AUC(0-5d) is the model predicted AUC over the planned TAU of 5 days. Only participants in the GSK249320 15 mg/kg group were analyzed.
Measured: Pre-dose and post-dose up to Day 180
Clearance (CL) for GSK249320
Blood samples were collected for determination of plasma concentrations of GSK249320. CL was derived from the plasma concentration-time data. Analysis was performed for PK Population that comprised of all participants in the Safety Population who had at least one PK sample with a concentration above the non-quantifiable limit. Only participants in the GSK249320 15 mg/kg group were analyzed.
Measured: Up to Day 180
Volume of Distribution (V1 and V2) and Volume at Steady State (Vss) for GSK249320
Blood samples were collected for determination of plasma concentrations of GSK249320. V1, V2 and Vss were derived from the plasma concentration-time data. Analysis was performed for PK Population that comprised of all participants in the Safety Population who had at least one PK sample with a concentration above the non-quantifiable limit. Only participants in the GSK249320 15 mg/kg group were analyzed.
Measured: Up to Day 180
Antibodies Against GSK249320, Assessed Using Electrochemi-luminescent Assay (ECL) Assay
Blood samples were collected and the presence of antibodies against GSK249320 was assessed using ECL assays. Positive result indicated presence of antibodies and negative result indicated absence of antibodies. Confirmed samples with presence of antibodies were further characterized for neutralizing activity as binding antibody (BAb) and neutralising antibody (NAb) by a neutralization assay.By-visit sample sizes vary due to missing data or early termination of the study.
Measured: Day 1, Day 30, Day 180, EW visit and Follow-up visit
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Mar 2013 (estimated)
- Study start18 May 2013
- Primary completion28 Jul 2014
- Study completion28 Jul 2014
Why it stopped: This study was terminated for futility.
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 (1)Papers the sponsor has linked to this study.
- Other trials for Cerebrovascular AccidentStudies of the same condition, open and under way.
- More trials run by GlaxoSmithKlineThe 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 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 134 participants (actual)
Sponsor and investigators
- Lead sponsor
- GlaxoSmithKline
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- GSK Clinical Trials, Study director, GlaxoSmithKline
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01808261
- Sponsor's protocol ID
- 104615
- Status last verified
- Sep 2017
- First submitted
- 14 Feb 2013
- Last updated
- 17 Nov 2017
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- Individual data sharing
- Yes: Patient-level data for this study will be made available through www.clinicalstudydatarequest.com following the timelines and process described on this site.
Publications
Cramer SC, Enney LA, Russell CK, Simeoni M, Thompson TR. Proof-of-Concept Randomized Trial of the Monoclonal Antibody GSK249320 Versus Placebo in Stroke Patients. Stroke. 2017 Mar;48(3):692-698. doi: 10.1161/STROKEAHA.116.014517. Epub 2017 Feb 22.
PubMed 28228578
Study at a glance
From the registry record, last updated by the sponsor on 17 Nov 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Study MAG104615, a Proof of Concept Study for GSK249320 Versus Placebo in Stroke Patients
- ClinicalTrials.gov ID
- NCT01808261
- Acronym / sponsor ID
- 104615
- Conditions
- Cerebrovascular Accident
- Keywords
- Ischemic Stroke
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: This study was terminated for futility.
- Enrolment
- 134 participants (actual)
- Lead sponsor
- GlaxoSmithKlineIndustry (pharma, biotech, devices)
- Study start
- 18 May 2013 (actual)
- Primary completion
- 28 Jul 2014 (actual)
- Study completion
- 28 Jul 2014 (actual)
- First posted
- 11 Mar 2013 (estimated)
- Results
- Posted 3 Oct 2017
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Study MAG104615, a Proof of Concept Study for GSK249320 versus placebo in Stroke Patients.
Detailed description
Myelin-associated glycoprotein (MAG) is one of the key proteins known to inhibit neuronal regeneration when released from oligodendrocytes in conditions of neuronal injury, such as stroke. GSK249320 is a humanised monoclonal antibody (mAb) that binds with high specificity to MAG and antagonises or neutralises MAG-mediated inhibition and has been shown to improve functional recovery after stroke in pre-clinical models, possibly by promoting neuroregeneration and plasticity. The present study (MAG104615) is designed to establish Proof of Concept (PoC) for GSK249320 in ischemic stroke patients. MAG104615 will be a placebo-controlled, double-blind, multicenter, randomized, repeat dose, Bayesian design study. PoC will be achieved by demonstrating a clinically meaningful improvement in lower limb motor recovery, specifically by evaluating changes in gait velocity from baseline to Day 90/Month 3. Subjects will also be followed out to Day 180/Month 6 to further evaluate longer term motor recovery and safety. Additional secondary efficacy measures of motor recovery will be evaluated to further demonstrate and characterize the extent and duration of overall motor recovery after treatment with GSK249320. Changes in disability and neurological impairment will be characterized after treatment with GSK249320 and explored for how they relate to motor recovery. This PoC study will also further characterize the safety, PK, and immunogenicity of GSK249320 will explore pharmacodynamic (PD) markers, and will explore use of actigraphy to measure motor recovery. Subjects will be stratified by gait velocity at baseline for randomization (1:1 allocation) into one of two treatment groups: 15mg/kg GSK249320, or placebo. Each subject will receive 2 repeat IV doses of GSK249320 or placebo.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Placebo | Placebo comparator | Drug: PlaceboPlacebo is a clear, colorless solution (50mM acetate buffer, pH 5.5 containing 0.02% (w/v) polysorbate-80 and made isotonic with 111.2 mM sodium chloride). Placebo is for intravenous (IV) use only. |
| GSK249320 100/mg | Active comparator | Drug: GSK249320 100/mgClear to opalescent, colorless to pale yellow or pale brown, and is supplied as a sterile, concentrated solution (1000mg/vial). GSK249320 is for IV use only. |
Who may qualify
- Ages
- 18 to 90 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Have a confirmed diagnosis of stroke according to the World Health Organization definition which is, 'a rapid onset event of vascular origin reflecting a focal disturbance of cerebral function, excluding isolated impairments of higher function, and persisting longer than 24 hours [World Health Organization, 1989].
- Stroke onset must be within the last 24-72 hours of the first infusion of Investigational Product. Time of stroke onset is defined at the time at which the patient/relative is first aware of the stroke deficit. For patients who awake with deficits, or who are found unconscious, the time of onset is defined as the time at which they were last known to be symptom free.
- Have a stroke that is radiologically confirmed to be ischemic and supratentorial. The diameter of the ischemic lesion is >15mm in any single direction or the volume is >4cc. See the Study Procedures Manual (SPM) for guidance on how to calculate the lesion size.
- Have a total NIHSS score of 3-21.
- Have a lower limb deficit from the incident stroke which is defined as a score of 1-4 on the NIHSS Motor Leg question (question #6).
Key exclusion criteria (20 listed)
- Ability to walk >0.8m/s as measured by the Gait Velocity assessment.
- History of a previous symptomatic stroke within 3 months prior to study entry.
- Presence of significant disability prior to the current stroke. Significant disability is defined as having a pre-stroke Rankin score of >2.
- Subjects who are not alert or are unresponsive as defined by a score of 2 or 3 on the NIHSS Level of Consciousness question (Question 1a).
- Presence of significant aphasia likely to confound or interfere with completion of the study assessments.
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 |
|---|---|---|
| GSK249320 100/mgClear to opalescent, colorless to pale yellow or pale brown, and is supplied as a sterile, concentrated solution (1000mg/vial). GSK249320 is for IV use only. | Drug | GSK249320 100/mg |
| PlaceboPlacebo is a clear, colorless solution (50mM acetate buffer, pH 5.5 containing 0.02% (w/v) polysorbate-80 and made isotonic with 111.2 mM sodium chloride). Placebo is for intravenous (IV) use only. | Drug | Placebo |
Primary outcome
Mean Change From Baseline (BL) to Month 3/ Day 90 in Gait Velocity
Time frame: BL (Day 1) and Month 3/Day 90
Gait is the way or manner in which a person walks. Gait velocity (walking speed) is an objective, quantitative measure of lower extremity motor recovery in individuals who have had a stroke. Participants were asked to walk at their usual pace over a level, indoor 10 meter (m) distance and were allowed to use their normal assistive devices. The time (seconds[s]) taken by the participants to travel the 10 m distance was recorded. Gait velocity (m/s) as assessed by study personnel was derived as: 10 divided by time to walk 10 m. Two trials of gait velocity were conducted at each time point. Change from BL was calculated as the mean Month 3/Day 90 value minus the mean BL value. BL was defined as Day 1. The measure type displayed are posterior means.
27 secondary outcomes
Mean Change From BL to Month 6/ Day 180 in Gait Velocity
Time frame: BL (Day 1) and Month 6/Day 180
Number of Participants With Indicated Transition From One Gait Velocity Category to Another Category at the Indicated Time Points
Time frame: BL (Day 1), Month 1/Day 30, Month 2/Day 60, Month 3/Day 90 and Month 6/Day 180.
Change From BL in Dexterity as Measured by Box and Blocks Test
Time frame: BL (Day 1), Month 1/Day 30, Month 2/Day 60, Month 3/Day 90 and Month 6/Day 180
Number of Participants Experiencing Falls
Time frame: BL (Day 1) Day 90 and Day 180
Number of Falls Over Time
Time frame: BL (Day 1), Day 90 and Day 180
Number of Participants With Serious Adverse Events (SAEs) and Adverse Events (AEs)
Time frame: Up to 14 months
Number of Participants With Events Common to Stroke
Time frame: From Day 1 until early withdrawal, death, Month 6/Day 180
Change From BL in Vital Signs- Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP)
Time frame: BL (Day 1) , Day 6, Day 180 and early withdrawal (EW) visit
Change From BL in Vitals Signs-Heart Rate
Time frame: Day 1, Day 6, Day 180 and EW visit
Change From BL in ECG Parameter-Heart Rate
Time frame: BL (Day 1) Day 6, Day 30 and EW visit
Change From BL in ECG Parameters
Time frame: BL (Day 1), Day 6, Day 30 and EW visit
Change From BL in Clinical Chemistry- Albumin and Total Protein
Time frame: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From BL in Clinical Chemistry-urea/Blood Urea Nitrogen (BUN), Sodium (Na), Potassium (K), Glucose (Gluc), Chloride (Cl), Calcium (Ca)
Time frame: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From BL in Alkaline Phosphatase (ALP), Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST)
Time frame: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From BL in Clinical Chemistry- Direct Bilirubin, Total Bilirubin, Creatinine
Time frame: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From BL in Eosinophils (EOS), Lymphocytes (LYM), Total Absolute Neutrophil Count (ANC), Platelet (PLT) Count, White Blood Cell (WBC) Count
Time frame: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From BL in Hematology- Hemoglobin
Time frame: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From Baseline in Hematology- Hematocrit
Time frame: BL (Day 1), Day 6, Day 30, Day 90 and Day 180
Change From BL in NIHSS Total Score
Time frame: BL (Day 1), Day 30, Day 90 and Day 180
Number of Participants With Suicidal Ideation Via Columbia Suicide Severity Rating Scale (CSSRS)
Time frame: Da y 1, Da y 6, Day 30, Day 60, Day 90 and Day 180
Maximum Observed Plasma Concentration (Cmax) for GSK249320
Time frame: Pre-dose and post-dose up to Day 180
Time to Reach Maximum Observed Plasma Concentration (Tmax) GSK249320
Time frame: Pre-dose and post-dose up to Day 180
PK as Measured by Plasma Decay Half-life (t1/2) GSK249320
Time frame: Up to Day 180
Area Under the Concentration-time Curve From 0 to 5 Days [AUC(0-5d)] and Area Under the Concentration-time Curve From Time Zero (Pre-dose) Extrapolated to Infinite Time [AUC(0-inf)] for GSK249320
Time frame: Pre-dose and post-dose up to Day 180
Clearance (CL) for GSK249320
Time frame: Up to Day 180
Volume of Distribution (V1 and V2) and Volume at Steady State (Vss) for GSK249320
Time frame: Up to Day 180
Antibodies Against GSK249320, Assessed Using Electrochemi-luminescent Assay (ECL) Assay
Time frame: Day 1, Day 30, Day 180, EW visit and Follow-up visit
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Nov 2017.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 28228578Cramer SC, Enney LA, Russell CK, Simeoni M, Thompson TR. Proof-of-Concept Randomized Trial of the Monoclonal Antibody GSK249320 Versus Placebo in Stroke Patients. Stroke. 2017 Mar;48(3):692-698. doi: 10.1161/STROKEAHA.116.014517. Epub 2017 Feb 22.
- Researchers can use this site to request access to anonymised patient level data and/or supporting documents from clinical studies to conduct further research.Link provided by the sponsor.
- Individual participant dataSharing planned: Yes. Patient-level data for this study will be made available through www.clinicalstudydatarequest.com following the timelines and process described on this site.
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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.
GSK Clinical Trials study director
GlaxoSmithKline
36 sites in 4 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing GSK249320 100/mg in people with Cerebrovascular Accident, run by GlaxoSmithKline at 36 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 8 inclusion and 20 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 Nov 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 36 sites in Germany, United Kingdom, United States, Canada. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
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 3 Oct 2017). 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?
Mean Change From Baseline (BL) to Month 3/ Day 90 in Gait Velocity (time frame: BL (Day 1) and Month 3/Day 90). 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 NCT01808261, which also lists 1 linked publication.
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 Nov 2017.