E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Non-cardioembolic ischemic stroke |
Ictus isquémico no cardioembólico |
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E.1.1.1 | Medical condition in easily understood language |
Stroke which occurs when a blood clot has formed somewhere in the human body (but not in the heart) travelled to the brain |
Ictus que ocurre cuando el coágulo de sangre que se ha formado en alguna parte del cuerpo humano (excepto en el corazón), se desplaza al cerebro. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10055221 |
E.1.2 | Term | Ischemic stroke |
E.1.2 | System Organ Class | 100000004852 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10067625 |
E.1.2 | Term | Secondary prevention |
E.1.2 | System Organ Class | 100000004865 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
• To assess the dose response of 3 different doses of BAY 2433334 compared to placebo in reducing the composite of symptomatic ischemic strokes and covert brain infarcts detected by MRI as well as other cerebro- and cardiovascular endpoints in participants with an acute non-cardioembolic ischemic stroke and who are treated with antiplatelet therapy. • To evaluate whether the incidence of bleeding is similar for BAY 2433334 compared to placebo in participants with an acute non-cardioembolic ischemic stroke and who are treated with antiplatelet therapy. |
•Evaluar la respuesta a 3 dosis diferentes de BAY 2433334, en comparación con placebo, para reducir la variable combinada formada por ictus isquémicos sintomáticos e infartos cerebrales silentes detectados por resonancia magnética (RM), así como otras variables cerebrales y cardiovasculares en participantes con ictus isquémico agudo no cardioembólico que son tratados con antiagregante plaquetario. •Evaluar si la incidencia de episodios hemorrágicos con BAY 2433334 es similar, en comparación con placebo, en participantes con un ictus isquémico agudo no cardioembólico que reciben tratamiento antiagregante plaquetario |
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E.2.2 | Secondary objectives of the trial |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Participant must be 45 years of age and older at the time of signing the informed consent 2. Non-cardioembolic ischemic stroke with a. persistent signs and symptoms of stroke lasting for ≥ 24 hours OR b. acute brain infarction documented by computed tomography (CT) or MRI AND c. with the intention to be treated with antiplatelet therapy during the study conduct 3. Imaging of brain (CT or MRI) ruling out hemorrhagic stroke or another pathology that could explain symptoms (e.g. brain tumor, abscess, vascular malformation) 4. Severity of index event nearest the time of randomization: a. Part A: minor stroke (defined as NIHSS ≤ 7) can be enrolled b. Part B: participants with minor or moderate stroke and NIHSS ≤ 15 can be enrolled. Participants undergoing thrombolysis or endovascular therapy (mechanical thrombectomy) can be enrolled but at the earliest 24 hours after the intervention 5. Randomization within 48 hours after the onset of symptoms of the index event (or after patients were last known to be without symptoms in case of wake-up stroke) 6. Ability to conduct an MRI either before randomization or within 72 hours after randomization |
1.Los participantes han de tener (o ser mayores ) de 45 años en el momento de la firma del consentimiento. 2.Ictus isquémico no cardioembólico con: a.signos y síntomas del ictus persistentes durante al menos 24 horas, o más. b. infarto cerebral agudo documentado en un TAC o RM Y c. que esté previsto tratarles con terapia antiplaquetaria durante el curso del ensayo. 3.Dispongan de imagen cerebral (TAC o RM) en la que se descarte ictus hemorrágico o cualquier otra patología que pueda explicar los síntomas (pej. tumor cerebral, abscesos, malformación vascular). 4.Severidad del índice del evento en el momento de la randomización: a. Parte A:se pueden icnluir ictus leves(definidos como NIHSS <=7) b. Parte B: se pueden incluir ictus leves o moderados (definidos como NIHSS <=15)Los pacientes que se hayan sometido a trombólisis o trombectomía mecánica pueden incluirse pero después de 24 horas tras la intervención. 5. Randomización dentro de las 48 horas después de la aparición de síntomas del evento (o después de la última vez que se supo que el paciente estuvo sin síntomas, en el caso de ictus silenciosos) 6. Capacidad de realizar una RM, o antes de la randomización, o dentro de las 72 horas después de la randomización. |
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E.4 | Principal exclusion criteria |
1. Prior ischemic stroke within last 30 days of index event 2. History of atrial fibrillation or suspicion of cardioembolic source of stroke 3. Dysphagia with inability to safely swallow study medication at time of randomization 4. Contraindication to perform brain MRI 5. Part A only: thrombolysis or endovascular therapy (mechanical thrombectomy) performed for index event 7. Active bleeding; known bleeding disorder, history of major bleeding (intracranial, retroperitoneal, intraocular) or clinically significant gastrointestinal bleeding within last 6 months of randomization |
1. Ictus isquémico , dentro de los 30 días previos al acontecimiento inicial. 2. Historia de fibrilación atrial o sospecha de ictus de etiología cardioembólica. 3. Disfagia con incapacidad de tragar de forma segura la medicación, en el momento de la randomización. 4. Contraindicación para realizar la RM cerebral. 5. Sólo Parte A: trombólisis o terapia endovascular (trombectomía mecánica)realizada para el acontecimiento inicial. 7. Sangrado activo, trastorno de sangrado conocido, historia de sangrado mayor (intracraneal, retroperitoneal, intraocular), o sangrado gastrointestinal clínicamente significante , en los 6 meses previos a la randomización. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Primary Efficacy Endpoint: Number of participants with symptomatic ischemic stroke or covert brain infarcts detected by MRI
Primary Safety Endpoint: Time from randomization to first occurrence of International Society on Thrombosis and Hemostasis (ISTH) major bleeding and clinically relevant non-major (CRNM) bleeding |
Variable principal de eficacia: Número de participantes con ictus isquémico sintomático o infartos cerebrales silentes, detectados por RM. Variable principal de seguridad: Tiempo desde la randomización al primer episodio hemorrágico grave y hemorrágicos no mayores clínicamente relevantes, según la Sociedad Internacional de Trombosis y Hemostasia (Society on Thrombosis and Hemostasis, ISTH). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Primary Efficacy Endpoint: From baseline up to 6 months
Primary Safety Endpoint: From baseline up to 12 months |
Variable principal de eficacia: Desde el inicio hasta los 6 meses. Variable principal de seguridad: Desde el inicio hasta los 12 meses. |
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E.5.2 | Secondary end point(s) |
Secondary Efficacy Endpoints: 1.Number of participants with composite of symptomatic ischemic stroke and covert brain infarcts detected by MRI, CV death, myocardial infarction and systemic embolism 2.Number of participants with covert brain infarcts detected by MRI 3.Time from randomization to first occurrence of symptomatic ischemic stroke 4.Time from randomization to first occurrence of symptomatic ischemic stroke, CV death, myocardial infarction 5.Time from randomization to first occurrence of symptomatic ischemic and hemorrhagic stroke 6.Time from randomization to first occurrence of disabling stroke (mRS≥4) 7.Time from randomization to all-cause mortality
Secondary Safety Endpoints 1. Time from randomization to first occurrence of all bleeding 2. Time from randomization to first occurrence of ISTH major bleeding 3. Time from randomization to first occurrence of ISTH CRNM bleeding 4. Time from randomization to first occurrence of ISTH minor bleeding 5. Time from randomization to first occurrence of Intracerebral hemorrhage (non-traumatic) |
Variables segundarias de eficacia: 1.Número de participantes con combinación de ictus isquémico sintomático e infartos cerebrales silentes detectados por RM, muerte cardiovascular (CV) , infarto de miocardio y embolia sistémica. 2.Número de participantes con infartos cerebrales silentes detectados por RM. 3.Tiempo desde la randomización al primer suceso de ictus isquémico sintomático. 4.Tiempo desde la randomización al primer suceso de ictus isquémico sintomático, muerte CV, infarto de miocardio. 5.Tiempo desde la randomización al primer suceso de ictus isquémico sintomático e ictus hemorrágico. 6.Tiempo desde la randomización al primer suceso de ictus incapacitante (mRS>=4) 7. Tiempo desde la randomización a mortalidad por cualquier causa.
Variables secundarias de seguridad 1. Tiempo desde la randomización hasta el primer suceso hemorrágico. 2.Tiempo desde la randomización hasta el primer suceso de hemorragia mayor según la ISTH. 3.Tiempo desde la randomización hasta el primer suceso de hemorragia NMCR según la ISTH. 4. Tiempo desde la randomización hasta el primer suceso de hemorragia menor según la ISTH 5. Tiempo desde la randomización hasta el primer suceso de hemorragia intracerebral (no traumática). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
From baseline up to 12 months |
Desde el inicio hasta los 12 meses. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 4 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 14 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 166 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Austria |
Belgium |
Bulgaria |
Canada |
China |
Czech Republic |
Denmark |
Finland |
France |
Germany |
Hungary |
Italy |
Japan |
Netherlands |
Poland |
Portugal |
Russian Federation |
Slovakia |
Spain |
Sweden |
Switzerland |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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LPLV |
Última visita del último paciente |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 8 |
E.8.9.1 | In the Member State concerned days | 29 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 8 |
E.8.9.2 | In all countries concerned by the trial days | 29 |