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Central Retinal Artery OcclusionPhase 3TenCRAOSNCT04526951

TENecteplase in Central Retinal Artery Occlusion Stuy (TenCRAOS)

A Phase 3 study of Central Retinal Artery Occlusion, run by Oslo University Hospital at 18 sites in 6 countries.

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

TENecteplase in Central Retinal Artery Occlusion (TenCRAOS): A Prospective, randomized-controlled, double-dummy, double-blind phase 3 multi-centre trial of TNK 0.25 mg/kg + placebo vs. ASA + placebo (2 arms with 1:1 block randomization). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Central Retinal Artery Occlusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
81 participants
Where
18 sitesin 6 countries
Study dates
30 Oct 2020to 20 Jun 2025
Phase
Phase 3
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Non-arteritic central retinal artery occlusion with ≥ 1.0 logMAR visual acuitiy and symptoms lasting less than 4.5 hours.
  • Ability to administer the Investigator Medicinal Product (IMP) within 4.5 hours of symptom onset.
  • Age ≥18 years.
  • Informed written consent of the patient.
  • A woman of childbearing potential (WOCBP) must confirm that in her opinion, she cannot be pregnant, OR if there is a possibility that she is pregnant, a negative pregnancy test must be confirmed before any IMP is given.

Who cannot join

  • Other active intervention targeting CRAO.
  • Branch retinal artery occlusion, cilioretinal artery supplying the macula, combined arterial-venous occlusion, proliferative diabetic retinopathy, elevated intraocular pressure (> 30 mmHg) or clinical suspicion of ophthalmic artery occlusion occlusion (e.g. choroidal nonperfusion, absence of cherry red spot, no light perception).
  • Systemic diseases; severe general diseases, systemic arterial hypertension (blood pressure >185/110 mmHg), despite medical therapy, or clinical suspicion of acute systemic inflammation.
  • Presence of intracranial haemorrhage on brain MRI/CT.
  • Medical history: heart attack within the last 6 weeks, intracerebral bleeding or neurosurgical operation within the last 4 weeks, therapy with anticoagulation, allergic reaction to contrast agent, hemorrhagic diathesis, aneurysms, inflammatory vascular diseases (eg, giant cell arteritis, granulomatosis with polyangitis), endocarditis, or gastric ulcer.
  • No willingness and ability of the patient to participate in all follow-up examinations.
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  • Pregnancy (if suspicion of pregnancy s-hCG or u-hCG must be negative).
  • Allergy or intolerance to any ingredients of IMP or placebo or gentamicin.
  • Other conditions / circumstances likely to lead to poor treatment adherence (eg, history of poor compliance, alcohol or drug dependency, no fixed abode).
  • Significant bleeding disorder either at present or within the past 6 months.
  • Effective oral anticoagulant treatment, eg, warfarin sodium (INR >1.3).
  • Effective anticoagulant treatment with heparin or low molecular weight heparin the last 48 hours.
  • Any history of central nervous system damage (ie, neoplasm, aneurysm, intracranial or spinal surgery).
  • Known hemorrhagic diathesis.
  • Major surgery, biopsy of a parenchymal organ, or significant trauma within the past 2 months (this includes any trauma associated with acute myocardial infarction).
  • Recent non-compressible vessel puncture within 2 weeks.
  • Recent trauma to the head or cranium.
  • Prolonged cardiopulmonary resuscitation (>2 minutes) within the past 2 weeks.
  • Acute pericarditis and/or subacute bacterial endocarditis.
  • Acute pancreatitis.
  • Severe hepatic dysfunction, including hepatic failure, cirrhosis, portal hypertension (oesophageal varices) and active hepatitis.
  • Active peptic ulceration.
  • Arterial aneurysm and known arterial/venous malformation.
  • Neoplasm with increased bleeding risk.
  • Any known history of hemorrhagic stroke or stroke of unknown origin.
  • Known history of ischemic stroke or transient ischemic attack in the preceding 3 months.
  • Dementia.

Trial locations and contacts

18 sites in 6 countries.

18 sites in 6 countries

Norway8 sites
  • Haukeland University Hospital

    Bergen

  • Vestre Viken Hospital Trust Drammen

    Drammen

  • Østfold Hospital Trust Kalnes, Dept of Ophthalmology

    Grålum

  • Helse Nord Trøndelag Trust

    Namsos

  • Oslo University Hospital

    Oslo, 0424

  • Telemark Hospital Trust

    Skien

  • Vestfold Hospital Trust

    Tønsberg

  • St Olav University Hospital

    Trondheim

Other trials in Norway

Denmark3 sites
  • Aarhus University Hospital

    Aarhus

  • Bispebjerg University Hospital

    Copenhagen

  • Rigshospitalet University Hospital

    Copenhagen

Other trials in Denmark

Belgium2 sites
  • University Hospital Antwerp

    Antwerp

  • University Hospital Leuven

    Leuven, 3000

Other trials in Belgium

Finland2 sites
  • Helsinki University Hospital

    Helsinki

  • Turku University Hospital

    Turku

Other trials in Finland

Lithuania2 sites
  • Kauno Klinikos Kaunas

    Kaunas

  • Vilnius University Hospital

    Vilnius

Other trials in Lithuania

Sweden1 site
  • Karolinska University Hospital

    Stockholm

Other trials in Sweden

About this study

Official title: TENecteplase in Central Retinal Artery Occlusion Study (TenCRAOS): A Randomized Placebo-controlled Trial of Early Systemic Tenecteplase Treatment in Patients With Central Retinal Artery Occlusion.

TENecteplase in Central Retinal Artery Occlusion (TenCRAOS): A Prospective, randomized-controlled, double-dummy, double-blind phase 3 multi-centre trial of TNK 0.25 mg/kg + placebo vs. ASA + placebo (2 arms with 1:1 block randomization).

A Prospective, randomized-controlled, double-dummy, double-blind phase 3 multi-centre trial of TNK 0.25 mg/kg + placebo vs. ASA + placebo (2 arms with 1:1 block randomization). At all participating centers, ophthalmologists are involved in the diagnosis and visual outcome measurements using a standardized protocol. The patients will be promptly examined by the ophthalmologist. As soon as the CRAO is diagnosed by the ophthalmologist, the patients will be managed in the stroke unit during treatment, monitoring, and medical investigations. After treatment in the stroke unit, the patients will be re-examined by an ophthalmologist and a neurologist as an out-patient at (30 ±5) and 90 (±15) days

Read the detailed description

Central retinal artery occlusion (CRAO) is an ophthalmologic emergency that, without prompt revascularization, bears high risk of permanent blindness. The condition is typically the result of an artery-to-artery embolism from a carotid plaque or cardio embolism. A recent meta-analysis of observational data indicates that prompt revascularization with systemic thrombolysis might improve outcome. A randomized controlled trial of early systemic thrombolysis for CRAO is therefore warranted. The aim of this project is to assess the effect of systemic tissue plasminogen activator tenecteplase versus placebo administered within 4.5 hours of CRAO onset in patients admitted to the participating hospitals in Europe. The main endpoint is the proportion of patients with ≤ 0.7 logMAR visual acuity 30 (±5) days after treatment, representing an improvement in visual acuity of at least 0.3 logMAR, equal to at least 15 letters/three lines on a visual acuity chart. In addition, we will access differences in visual field parameters and patient reported outcome measures between the groups. This study is based on a broad collaboration and interaction between leading ophthalmologists and neurologists in European centres.

Being tested
Intravenous injection of Tenecteplase and one dose of placebo tablet, One tablet of Acetylsalicylic Acid and one dose of IV placebo
Keywords
thrombolysis tenecteplase
Medical subject headings
Retinal Artery Occlusion

What participants receive

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

  • Intravenous injection of Tenecteplase and one dose of placebo tabletDrug

    Also called Metalyse

    Drug: Tenecteplase Tenecteplase administered as an intravenous injection (0.25 mg/kg body weigh; maximum 25 mg)

  • One tablet of Acetylsalicylic Acid and one dose of IV placeboDrug

    Also called Aspirin

    300 mg Acetylsalisylic acid

Study groups in NCT04526951
Study groupRoleWhat they receive
TenecteplaseActive comparatorThe total dose of tenecteplase is 0.25 mg/kg body weight, maximum 25 mg. The total dose will be given as an intravenous bolus
Receives: Drug: Intravenous injection of Tenecteplase and one dose of placebo tablet
acetylsalicylic acidActive comparatorone tablet of aspirin 300 mg Other Name: Aspirin
Receives: Drug: One tablet of Acetylsalicylic Acid and one dose of IV placebo

What is being measured

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

  1. Proportion of patients with ≤ 0.7 logMAR visual acuity in the affected eye at 30 (±5) days after treatment, representing an improvement in visual acuity of at least 0.3 logMAR (intention-to-treat (ITT) analysis).

    logMAR

    Measured: 30 (±5) days

Secondary outcomes (10)
  1. Proportion of patients with ≤ 0.5 logMAR visual acuity in the affected eye at 30 (±5) and 90 (±15) days.

    logMAR

    Measured: 30 (±5) and 90 (±15) days

  2. Mean improvement in logMAR visual acuity in the affected eye from baseline to 30 (±5) and 90 (±15) days.

    logMAR

    Measured: 30 (±5) and 90 (±15) days

  3. Proportion of patients with visual recovery (logMAR ≤ 0.7) and (logMAR ≤ 0.5) in the affected eye 30 (±5) and 90 (±15) days in patients who were treated with tenecteplase within 3 hours of onset

    logMAR

    Measured: 30 (±5) and 90 (±15) days

  4. Number of test points seen (of 100) on monocular Esterman perimetry at 30 (±5) and 90 (±15) days

    Number of test points

    Measured: 30 (±5) and 90 (±15) days

  5. Acute ischemic lesions on follow-up on diffusion-weighted (DWI) MRI or on brain CT at baseline and 24hrs.

    DWI lesions

    Measured: 24 hours

  6. National Institutes of Health Stroke Scale score (NIHSS) at 24hrs and discharge.

    NIHSS score

    Measured: 24 hours

  7. Modified Rankin Scale score (mRS) at discharge, 30 (±5) and 90 days (±15) days.

    mRS score

    Measured: Discharge, 30 (±5) and 90 days (±15) days.

  8. Mean score on National Eye Institute Visual Function Questionnaire (NEI-VFQ 25) at 30 (±5) and 90 (±15) days

    Visual function related quality of life at 30 and 90 days. Measures the dimensions of self-reported vision-targeted health status that are most important for persons who have chronic eye diseases. 100 = best possible, 0 = worst possible

    Measured: 30 (±5) and 90 (±15) days

  9. Mean score on EQ-5D at 30 (±5) and 90 (±15) days

    Quality of life reported at 30 and 90 days. Health status is measured in terms of five dimensions (5D); mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.

    Measured: 30 (±5) and 90 (±15) days

  10. Presence of ocular neovascularisation at 30 (±5) and 90 (±15) days

    presence

    Measured: 30 (±5) and 90 (±15) days

Timeline

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

  1. First posted26 Aug 2020
  2. Study start30 Oct 2020
  3. Primary completion20 Jun 2025
  4. Study completion20 Jun 2025

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
A prospective, randomized-controlled, double-dummy, double-blind phase 3 multi-centre trial of TNK 0.25 mg/kg + placebo vs. ASA + placebo (2 arms with 1:1 block randomisation). At all participating centers, ophthalmologists are involved in the diagnosis and visual outcome measurements using a standardized protocol. The patients will be promptly examined by the ophthalmologist. As soon as the CRAO is diagnosed by the ophthalmologist, the patients will be managed in the stroke unit during treatment, monitoring, and medical investigations. After treatment in the stroke unit, the patients will be re-examined by an ophthalmologist and a neurologist as an out-patient at (30 ±5) and 90 (±15) days.
Masking
Single blind
Who is masked
Participant
Enrolment
81 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04526951
Sponsor's protocol ID
Oslo UH
Other IDs
2018-002546-36, 2019/327, 2024-517606-29-00, 2018
Acronym
TenCRAOS
Status last verified
Jun 2025
First submitted
20 Aug 2020
Last updated
29 Sep 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: There is a plan to share data with the THEIA trial and REVISION trial for IPD meta analysis

Publications

  • Ryan SJ, Jorstad OK, Skjelland M, Pesonen M, Simonsen CZ, Bek T, Blauenfeldt RA, Ijas P, Laitinen A, Khanevski A, Krohn J, Rodahl E, Lemmens R, Demeestere J, Cassiman C, Nakstad I, Evensen K, Sandell T, Hamann S, Truelsen TC, Christensen LM, Rosenbaum S, Matijosaitis V, Zemaitiene R, Ellekjaer H, Almaas E, Austeng D, Mazya MV, Traisk F, Ylikotila P, Salmi U, Jenssen KN, Lisether H, Breivik C, Devik K, Honningsvag LE, Valaikiene J, Cimbalas A, Malmberg VN, Anderson E, Roy A, Skattor TH, Kraglund KL, Kefaloykos C, Olsen IC, Vanacker P, Strbian D, Moe MC, Aamodt AH; TenCRAOS Investigators. A Randomized Trial of Tenecteplase in Acute Central Retinal Artery Occlusion. N Engl J Med. 2026 Jan 29;394(5):442-450. doi: 10.1056/NEJMoa2508515.

    PubMed 41604638

Questions about this trial

What is this clinical trial studying?

A Phase 3 study of Central Retinal Artery Occlusion, run by Oslo University Hospital at 18 sites in 6 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 5 inclusion and 27 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 29 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 18 sites in Norway, Denmark, Belgium, Finland, Lithuania and 1 more country. 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. 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?

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?

Proportion of patients with ≤ 0.7 logMAR visual acuity in the affected eye at 30 (±5) days after treatment, representing an improvement in visual acuity of at least 0.3 logMAR (intention-to-treat (ITT) analysis). (time frame: 30 (±5) days). 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 NCT04526951, 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 29 Sep 2025.

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