Clinical Trial Results:
Evaluation of the feasibility of modulating and measuring endogenous neurogenesis with erythropoietin (rhEPOα) to expedite recovery after stroke
Summary
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EudraCT number |
2011-000123-33 |
Trial protocol |
GB |
Global end of trial date |
04 Apr 2014
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Results information
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Results version number |
v1(current) |
This version publication date |
26 Oct 2018
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First version publication date |
26 Oct 2018
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Other versions |
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Summary report(s) |
FINAL STUDY REPORT |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
RH EPOA-REHAB
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Additional study identifiers
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ISRCTN number |
ISRCTN50896492 | ||
US NCT number |
- | ||
WHO universal trial number (UTN) |
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Sponsors
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Sponsor organisation name |
King's College Hospital
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Sponsor organisation address |
Denmark Hill, London, United Kingdom, SE5 9RS
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Public contact |
Professor Lalit Kalra, King's College Hospital NHS Foundation Trust, 0044 0203299 1718, lalit.kalra@kcl.ac.uk
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Scientific contact |
Professor Lalit Kalra, King's College Hospital NHS Foundation Trust, 0044 0203299 1718, lalit.kalra@kcl.ac.uk
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Sponsor organisation name |
King's College London
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Sponsor organisation address |
The Strand, London, United Kingdom, WC2R 2LS
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Public contact |
Professor Lalit Kalra, King's College London, 0044 0203299 1718, lalit.kalra@kcl.ac.uk
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Scientific contact |
Professor Lalit Kalra, King's College London, 0044 0203299 1718, lalit.kalra@kcl.ac.uk
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
29 Jul 2014
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
03 Sep 2013
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Global end of trial reached? |
Yes
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Global end of trial date |
04 Apr 2014
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Was the trial ended prematurely? |
Yes
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General information about the trial
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Main objective of the trial |
Does treatment with erythropoetin (EPO) during post acute rehabilitation of non-thrombolysed patients improve functional recovery in stroke patients?
Can multimodal MR imaging be used for in vivo monitoring of brain repair in humans and do MRI parameters correlate with clinical measures of function recovery.
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Protection of trial subjects |
The Data Monitoring Committee will review safety data, incidence of new thrombotic events and any cases where the Hb rises above the normal range. The data will be reviewed afte r10 patients have been recruited into each of the treatment arms, or 6 monthly intervals, whichever is sooner.
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Background therapy |
Not applicable | ||
Evidence for comparator |
Not applicable | ||
Actual start date of recruitment |
13 Nov 2012
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
United Kingdom: 12
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Worldwide total number of subjects |
12
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EEA total number of subjects |
12
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
8
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From 65 to 84 years |
4
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85 years and over |
0
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Recruitment
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Recruitment details |
12 subjects were recruited however only 10 were eligible after baseline and only 3 subjects completed the protocol visits. | ||||||||||||
Pre-assignment
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Screening details |
Baseline Assessment Within 48 Hours of Onset of Stroke The following information will be collected prior to randomisation: - Consent – Medical history, stroke characteristics, vascular risk profile – National Institute of Health Stroke Scale (NIHSS) score – BP, temperature, heart rate – Haemogram, renal and liver function tests – CT findings | ||||||||||||
Period 1
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Period 1 title |
Overall Trial (overall period)
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Is this the baseline period? |
Yes | ||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Not blinded | ||||||||||||
Arms
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Arm title
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Full study | ||||||||||||
Arm description |
The research design was to investigate 3 groups of 30 stroke patients each who were within 48 hours of stroke onset, had not been thrombolysed and had no contraindications to rhEPOα treatment. All groups received the best usual treatment consisting of structured multidisciplinary rehabilitation on a stroke unit. In addition, participants in the second group received rh EPOα alfa (Eprex) 40,000 IU given intravenously at 1, 3 and 5 days and those in the third group will receive rh EPOα 40,000 IU/ given intravenously at 7, 14, 21 days. The differences in recovery between the groups was assessed at 30 and 90 days after randomisation by measuring clinical recovery in function and changes in the brain perfusion and structure using magnetic resonance (MR) imaging. | ||||||||||||
Arm type |
Experimental | ||||||||||||
Investigational medicinal product name |
EPREX 40,000 IU/ml, solution for injection in pre-filled syringe
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
Each patient will receive epoetin alfa (EPREX) 40,000 IU given intravenously over 5-10 minutes at 1, 3 and 5 days or 7, 14 and 21 days post
randomization.
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Baseline characteristics reporting groups
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Reporting group title |
Overall Trial
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Reporting group description |
- | |||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Full study
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Reporting group description |
The research design was to investigate 3 groups of 30 stroke patients each who were within 48 hours of stroke onset, had not been thrombolysed and had no contraindications to rhEPOα treatment. All groups received the best usual treatment consisting of structured multidisciplinary rehabilitation on a stroke unit. In addition, participants in the second group received rh EPOα alfa (Eprex) 40,000 IU given intravenously at 1, 3 and 5 days and those in the third group will receive rh EPOα 40,000 IU/ given intravenously at 7, 14, 21 days. The differences in recovery between the groups was assessed at 30 and 90 days after randomisation by measuring clinical recovery in function and changes in the brain perfusion and structure using magnetic resonance (MR) imaging. |
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End point title |
Clinical Endpoint [1] | ||||||
End point description |
– Fugl-Meyer scale score
– Fugl-Meyer scale score change from baseline
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End point type |
Primary
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End point timeframe |
Clinical outcome measures will be assessed at baseline, 30 ± 5 days and 90 ±10 days after randomisation.
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Notes [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: The findings would not be significant as the number of participants at the close of the study was well below the numbers needed to be statistically significant. Only 3 participants completed the trial. |
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Attachments |
EPO-REHAB tables |
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No statistical analyses for this end point |
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End point title |
Clinical Endpoint | ||||||
End point description |
Secondary clinical outcome measures were the NIHSS score, Functional Independence Measure (FIM), FIM Motor score, Modified Rankin score (MRS) and Mortality
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End point type |
Secondary
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End point timeframe |
Baseline and 30 days post dose.
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No statistical analyses for this end point |
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End point title |
Imaging | ||||||
End point description |
Evaluate whether MRI techniques can be used for in vivo imaging of brain repair in humans and correlate MRI parameters with clinical measures of function recovery
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End point type |
Secondary
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End point timeframe |
90 days post dose
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No statistical analyses for this end point |
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Adverse events information [1]
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Timeframe for reporting adverse events |
Throughout the trial.
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Assessment type |
Systematic | ||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||
Dictionary version |
17.1
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Reporting groups
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Reporting group title |
Whole Trial
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Reporting group description |
- | ||||||||||
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Frequency threshold for reporting non-serious adverse events: 0% | |||||||||||
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Notes [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported. Justification: No adverse events were recorded due to the very small final dataset. |
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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08 Aug 2011 |
Changes to MHRA-approved protocol , including inclusion/exclusion, following REC review |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
The findings would not be significant as the number of participants at the close of the study was well below the numbers needed to be statistically significant. Only 3 participants completed the trial. |