AzTrials
AzTrials

Ischemic StrokePhase 2SP-8203-2001NCT02787278

Safety and Efficacy of Two Doses of SP-8203 in Patients With Ischemic Stroke Requiring rtPA

A Phase 2 study testing SP-8203 High dose and SP-8203 Low dose in people with Ischemic Stroke, run by Shin Poong Pharmaceutical Co. Ltd. at 8 sites in South Korea.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The current study aims to evaluate the safety of SP-8203, designing in two stages (stage-1, stage-2) to evaluate the safety and efficacy of the combination therapy of SP-8203 and rtPA for the occurrence of cerebral hemorrhage in patients with acute ischemic stroke receiving rtPA standard of care. Read more about this study

Who is it for?
Ages 19 to 80 years
Conditions the study is for
Ischemic Stroke
What is being tested?
SP-8203 High dose and SP-8203 Low dose
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
80 participants
Where
8 sitesSouth Korea
Study dates
5 Jun 2016to 22 Aug 2017
Phase
Phase 2
Are there results?
None posted in the registry

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 19 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Stage 1-specific Criteria Patients with neurologic deficit of ≥4 points and ≤10 points by NIHSS score.
  • Stage 2-specific Criteria Patients with neurologic deficit of ≥4 points by NIHSS score.
  • Common Criteria for Stage 1 and Stage 2
  • Adults aged ≥19 years and ≤80 years.
  • Subjects fulfilling the criteria for rtPA therapy. ① Subjects who can receive rtPA therapy within 4.5 hours after the onset of early symptoms of acute ischemic stroke.
  • ② Subjects requiring rtPA therapy according to the judgment of a neurologist.
  • Subjects available for brain MRI (DWI, GRE/SWI [Susceptibility Weighted Imaging], FLAIR, MRA) scanning
  • Subjects who consent to participate in this trial.

Who cannot join

  • Patients with systemic allergic diseases or hypersensitivity to specific drugs.
  • Patients have condition as follows:
  • <!-- -->
  • Patients who were diagnosed with acute myocardial infarction (AMI) within the last 6 months.
  • Patients who had arrhythmia causing symptoms such as dyspnea or palpitation within the last 6 months.
  • Patients showing the following abnormal ECG findings in stable condition at screening:
Show all 36Show fewer
  • The range of pulse rate - below 60/min or above 120/min
  • 2nd or 3rd degree AV(Atrioventricular) block indicated in ECG
  • Congenital or acquired QT syndrome indicated in ECG
  • ④ Pre-excitation syndrome indicated in ECG
  • 3) Patients with severe heart failure of NYHA(New York Heart Association) Class III or Class IV.
  • NYHA classification of heart failure defined as:
  • Class I: patients with no limitation of activities; they suffer no symptoms from ordinary activities.
  • Class II: patients with slight, mild limitation of activity; they are comfortable with rest or with mild exertion.
  • Class III: patients with marked limitation of activity; they are comfortable only at rest.
  • Class IV: patients who should be at complete rest, confined to bed or chair; any physical activity brings on.
  • 4) Patients with fever (≥ 38℃) or infection signs which require antibiotics at screening 5) Patients with pulmonary diseases (asthma, COPD[Chronic Obstructive Pulmonary Disease ], and active tuberculosis etc.) who have being recently been treated more than 1 month at screening, 6) Patients showing the following hematological findings: Patients with decreased hemoglobin (Hb< 10g/dL), decreased platelet count (PLT< 100,000/mm3) or hematocrit of <25% in complete blood count .
  • 7) Patients who have undergone hemodialysis and/or treatments due to nephropathies, acute or chronic renal failure at screening.
  • 8) Patients with a cancer in following conditions: diagnosed within 6 months before the screening time, or any treatment for cancer within the previous 6 months, or with recurrent/ metastatic cancer 9) Pregnant and breast-feeding women. However, women of childbearing age can participate in the trial only when non-pregnancy is confirmed. Woman of childbearing age is defined as woman who is not definitely menopause and did not receive a surgical contraception 10) Patients who do not consent to use double barrier contraception during the trial period.
  • 11) Patients who have participated in other clinical trials of other drugs within the past 3 months. However, if they participated in observational studies and did not take drugs, they can participate in this trial.
  • 12) Patients who cannot participate in the trial according to the judgment of investigators.
  • 13) Patients with contraindication for the use of rtPA as shown in the below. [Contraindication for the Use of rtPA] A. Patients with hypersensitivity to gentamycin
  • rtPA should not be administered when the risk of bleeding is high as follows:
  • Patients who suffered from significant hemorrhagic diseases within the past 6 months or with known hemorrhagic diathesis.
  • Patients receiving oral anticoagulants such as warfarin sodium (INR>1.3). iii. Patients with apparent hemorrhage or recent serious or risky hemorrhage. iv. Patients with the past history of tumor, aneurysm, or central nervous system damage such as intracranial or intraspinal operation.
  • Patients with hemorrhagic retinopathy, diabetes accompanied with visual disturbance or other ophthalmic hemorrhage.
  • Patients who underwent prolonged or traumatic cardiopulmonary resuscitation (>2 minutes), obstetrical delivery or recently incompressible vascular puncture within the recent 10 days.
  • Patients with uncontrollable severe arterial hypertension. viii. Patients who have underwent major surgery for the recent 3 months or had recently significant trauma including all the trauma cases related with acute myocardial infarction or head trauma.
  • Patients with bacterial endocarditis and pericarditis. x. Patients with acute pancreatitis. xi. Patients confirmed to have records of ulcerative gastrointestinal diseases, esophageal varix, aneurysm or arteriovenous malformation for the recent 3 months.
  • Patients with severe liver diseases including hepatic failure, liver cirrhosis, portal hypertension (esophageal), or active hepatitis.
  • Patients with mild neurologic deficit of <4 points on the NIHSS, or severe condition of >25 points on the NIHSS.
  • Patients with seizure at onset of stroke. E. Patients with clinical presentation which suggests a subarachnoid hemorrhage, even if initial CT scan is normal.
  • Patients who received heparin and have elevated active partial thromboplastin time (aPTT) within 48 hours before the onset of stroke.
  • Patients who has history of stroke or had head injury within the recent 3 months.
  • Patients with systolic blood pressure of >185mmHg or diastolic BP of >110mmHg, or who require aggressive treatment (intravenous administration) to reduce BP to the limits.
  • Patients with blood glucose level of <50mg/dL or >400mg/dL.

Trial locations and contacts

8 sites in 1 country.

8 sites in 1 country

South Korea8 sites
  • Pusan National University Hospital

    Busan

  • Kyungpook National University Hospital

    Daegu

  • Myongji Hospital

    Gyeonggi-do

  • Inje University Busan Paik Hospital

    Pusan

  • Asan Medical Center, University of Ulsan

    Seoul

  • Korea University Guro Hospital

    Seoul

  • KyungHee University Medical Center

    Seoul

  • Soonchunhyang University Hospital

    Seoul

Other trials in South Korea

About this study

Official title: A Prospective, Randomized, Double-blinded Phase IIa Clinical Trial to Investigate the Safety and Efficacy of Two Doses of SP-8203 in Patients With Ischemic Stroke Requiring rtPA Standard of Care

The current study aims to evaluate the safety of SP-8203, designing in two stages (stage-1, stage-2) to evaluate the safety and efficacy of the combination therapy of SP-8203 and rtPA for the occurrence of cerebral hemorrhage in patients with acute ischemic stroke receiving rtPA standard of care.

Read the detailed description

As the standard procedure of rtPA therapy, rtPA will be injected intravenously using a device like infusion pump. When reperfusion is not achieved in spite of rtPA therapy, endovascular therapy can be performed according to the judgment of a site investigator.

Stage 1-The trial will be conducted with 11 subjects participating in an open label design manner. Subjects with neurologic deficit of ≥4 point and ≤10 points on NIHSS score will be given SP-8203, 80mg/dose, a total of 6 times at intervals of 12 hours. For the first administration of SP-8203, it should be administered within 30 minutes from the initiation of rtPA administration via a vein route different from one via which rtPA is injected.

Thereafter, the subject will be transferred to MRI scanning room to have brain MRI and MRA performed, and brain CT will be performed to check the occurrence of intracranial hemorrhage at 24 hours after complete administration of the first dose of SP-8203. The subject will be closely monitored by research staff daily from the day of first administration of SP-8203 (Day 0) to Day 5. Brain MRI and MRA will be followed up after the last administration of SP-8203 on Day 5. The subject will make a visit on Day 14 to have his/her neurologic symptoms checked, after which subject's participation in the trial will be completed.

*The DSMB (Date Safety Monitoring Board) meeting will be held, to decide whether to proceed with Stage 2 or not, based on the results of Stage 1.

Stage 2- A total of 69 subjects will be enrolled in double-blind, randomized and parallel design with 23 subjects assigned to low-dose (40mg/dose, 80mg/ day) SP-8203 group, high-dose (80mg/dose, 160mg/day) SP-8203 group or placebo group, respectively.

If a subject, who is able to be enrolled in Stage 2, has neurological deficit of ≥4 point on NIHSS score and give patient's consent to participate in the trial, randomization will be performed and each treatment arm (one of three) will be assigned. The subject will receive the Investigational products a total of 6 times, with 12 hours intervals. Blood sample will be taken after the sixth administration of the Investigational product for pharmacokinetic and pharmacodynamics analysis. For pharmacokinetic analysis , blood sample will be taken at 0, 30, and 120 minutes after the complete sixth administration of the investigational products. For pharmacodynamics analysis, blood sample will be taken at between 24 to 48 hours after the first administration, at 0 minute after the sixth administration and at 4th week visit.

As with Stage 1, the subject will have brain MRI and MRA performed after the administration of investigational product, and brain CT will be performed at 24 hours after completion of the first administration of investigational products.

Brain MRI and MRA will be followed-up on Day 5, similarly to Stage 1. However, in Stage 2, the subject will make a visit for close monitoring for patient's neurological condition at 4th week and 12th week. Thereafter, all the procedures of the clinical trial will be completed.

Conditions
Ischemic Stroke
Being tested
SP-8203 High dose, SP-8203 Low dose, Placebo
Keywords
rtPA, Intracranial hemorrhage
Medical subject headings
Ischemic Stroke, Intracranial Hemorrhages

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SP-8203 High doseDrug

    Also called SP-8203 is produced by Shin Poong Pharmaceutical company

    High-dose group: 160mg will be intravenously administered as 80mg/dose twice daily (intervals of 12 hours).

  • SP-8203 Low doseDrug

    Also called SP-8203 is produced by Shin Poong Pharmaceutical company

    Low dose group: 80mg will be intravenously administered as 40mg/dose twice daily (intervals of 12 hours).

  • PlaceboDrug

    Same dosage of SP8203. Placebo will be intravenously administered twice daily (intervals of 12 hours)

Study groups in NCT02787278
Study groupRoleWhat they receive
SP-8203 High dose groupExperimentalSP-8203 160mg (80mg/dose twice a day for three days)
Receives: Drug: SP-8203 High dose
SP-8203 Low dose groupExperimentalSP-8203 80mg (40mg/dose twice a day for three days)
Receives: Drug: SP-8203 Low dose
Placebo groupPlacebo comparatorPlacebo group: twice a day for three days
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The ratio of the incidence of parenchymal hematoma observed on brain CT

    Incidence of parenchymal hematoma observed on brain CT performed at 24 hours in accordance with European Cooperative Acute Stroke Study (ECASS) I and II criteria

    Measured: Brain CT should be performed at 24 ± 3 hours after the complete administration of the first dose of IP. (Screening, Baseline ,Day 0, Day 1)

Secondary outcomes (8)
  1. Incidence rate of serious adverse events

    Incidence rate of serious adverse events

    Measured: Follow up period is 30 days after the last visit.

  2. Neurologic outcomes evaluated by modified Rankin Scale (mRS)

    Neurologic outcomes evaluated by modified Rankin Scale (mRS)

    Measured: Screening, Baseline, Day 0, Day 5, Week 12, Early Termination

  3. Incidence rate symptomatic intracranial hemorrhage (sICH) occuring within 5 days

    Incidence rate symptomatic intracranial hemorrhage (sICH) occuring within 5 days

    Measured: Day 1 Brain CT, Day 5 Brain MRI

  4. Neurologic outcomes evaluated by NIHSS

    Neurologic outcomes evaluated by NIHSS

    Measured: NIHSS should be scored every visit

  5. Neurologic outcomes evaluated by Barthel Index

    Neurologic outcomes evaluated by Barthel Index

    Measured: Day 0, Day 5, Week 12, Early Termination

  6. The rate of death due to any cause

    The rate of death due to any cause

    Measured: it is expected that a follow-up for up to 30 days after the last visit.

  7. Incidence rate of adverse events and adverse drug reactions

    Incidence rate of adverse events and adverse drug reactions

    Measured: it is expected that a follow-up for up to 30 days after the last visit.

  8. Incidence rate of major systemic bleeding according to the International Society on Thrombosis and Hemostasis (ISTH

    Incidence rate of major systemic bleeding according to the International Society on Thrombosis and Hemostasis (ISTH

    Measured: Laboratory tests (hematological test, clinical chemistry test, urinalysis etc.)- Day 1, Day 3, Day-5, Week 4, Week 12

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Jun 2016 (estimated)
  2. Study start5 Jun 2016
  3. Primary completion30 May 2017
  4. Study completion22 Aug 2017

Resources

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
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
80 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02787278
Sponsor's protocol ID
SP-8203-2001
Acronym
SP-8203-2001
Status last verified
Jul 2020
First submitted
18 May 2016
Last updated
21 Jul 2020
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Kim JS, Lee KB, Park JH, Sung SM, Oh K, Kim EG, Chang DI, Hwang YH, Lee EJ, Kim WK, Ju C, Kim BS, Ryu JM; SAFE-TPA Investigators. Safety and Efficacy of Otaplimastat in Patients with Acute Ischemic Stroke Requiring tPA (SAFE-TPA): A Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase 2 Study. Ann Neurol. 2020 Feb;87(2):233-245. doi: 10.1002/ana.25644. Epub 2019 Nov 29.

    PubMed 31721277

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing SP-8203 High dose and SP-8203 Low dose in people with Ischemic Stroke, run by Shin Poong Pharmaceutical Co. Ltd. at 8 sites in South Korea.

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 36 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: finished, as of the sponsor's last update on 21 Jul 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in South Korea. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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 ratio of the incidence of parenchymal hematoma observed on brain CT (time frame: Brain CT should be performed at 24 ± 3 hours after the complete administration of the first dose of IP. (Screening, Baseline ,Day 0, Day 1)). 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 NCT02787278, 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 21 Jul 2020.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in