RecruitingPhase 4NCT06010628

Tenecteplase for Acute Ischemic Stroke Within 4.5 to 6 Hours of Onset (EXIT-BT2)

Intravenous Tenecteplase for Acute Ischemic Stroke Within 4.5 to 6 Hours of Onset (EXIT-BT2): a Prospective, Randomized, Open Label, Blinded Endpoint, and Multi-center Study


Sponsor

General Hospital of Shenyang Military Region

Enrollment

1,440 participants

Start Date

Feb 1, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

To date, the benefit of intravenous thrombolysis is confined within 4.5 hours of onset for acute ischemic stroke (AIS) patients without advanced neuroimaging selection. Unpublished pilot EXIT-BT (EXtending the tIme window of Thrombolysis by ButylphThalide up to 6 Hours after onset) suggest the safety, feasibility and potential benefit of intravenous tenecteplase (TNK) in AIS within 4.5 to 6 hours of onset. The current study aims to investigate the efficacy and safety of TNK for AIS within 4.5 to 6 hours of onset.


Eligibility

Min Age: 18 Years

Inclusion Criteria7

  • Age ≥ 18 year
  • Acute ischemic stroke confirmed by non-contrast computed tomography and use of CTA for assessment of LVO as determined by local investigators;
  • The time from last known well to treatment: 4.5 - 6 hours;
  • NIHSS ≥ 4 at randomization;
  • First stroke onset or past stroke without obvious neurological deficit (mRS≤1);
  • Uncertainty over the benefits and risks of thrombolysis by researcher;
  • Signed informed consent.

Exclusion Criteria8

  • Pre-stroke disability (mRS≥2);
  • Planned intravenous thrombolysis based on WAKE-UP or EXTEND study criterion;
  • Any contraindication to intravenous thrombolysis: Obvious head injury or stroke within 3 months; Subarachnoid or intracranial hemorrhage; History of intracranial hemorrhage; Intracranial tumor, arteriovenous malformation or aneurysm; Intracranial or spinal cord surgery within 3 months; Myocardial infarction within 3 months; Major surgery within 1 month; Gastrointestinal or urinary tract hemorrhage within the previous 30 days; Arterial puncture at a noncompressible site within the previous seven days; Active internal hemorrhage; Coagulation abnormalities: platelet count of <100000/mm3; Aortic arch dissection; Heparin therapy within 24 hours; Infective endocarditis; Oral warfarin is being taken and INR>1.6 or APTT abnormal; Systolic pressure ≥185 mmHg or diastolic pressure ≥110 mmHg; Blood glucose < 50 mg/dl (2.7mmol/L); Neurological deficit after epileptic seizures;
  • Pregnancy;
  • Allergy to test drugs;
  • Comorbidity with other serious diseases;
  • Participating in other clinical trials within 3 months;
  • Patients not suitable for the study considered by researcher.

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Interventions

DRUGTenecteplase

intravenous tenecteplase (0.25 mg/kg, a single bolus over 5 to 10 seconds, a maximum of 25 mg).


Locations(2)

Hui-Sheng Chen

Shenyang, None Selected, China

Department of Neurology, General Hospital of Northern Theater Command

Shenyang, China

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NCT06010628


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