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Penumbral Rescue by normobaric O = O administration in patients with ischemic stroke and target mismatch proFile (PROOF): Study protocol of a phase IIb trial
S. Poli, J. Mbroh, JC. Baron, AB. Singhal, D. Strbian, C. Molina, R. Lemmens, G. Turc, R. Mikulik, P. Michel, T. Tatlisumak, HJ. Audebert, M. Dichgans, R. Veltkamp, J. Hüsing, H. Graessner, J. Fiehler, J. Montaner, AK. Adeyemi, K. Althaus, JF....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu protokol klinické studie, časopisecké články
- MeSH
- endovaskulární výkony * metody MeSH
- ischemická cévní mozková příhoda * komplikace diagnóza MeSH
- ischemie mozku * komplikace MeSH
- klinické zkoušky, fáze II jako téma MeSH
- kvalita života MeSH
- kyslík terapeutické užití MeSH
- lidé MeSH
- multicentrické studie jako téma MeSH
- trombektomie metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- protokol klinické studie MeSH
RATIONALE: Oxygen is essential for cellular energy metabolism. Neurons are particularly vulnerable to hypoxia. Increasing oxygen supply shortly after stroke onset could preserve the ischemic penumbra until revascularization occurs. AIMS: PROOF investigates the use of normobaric oxygen (NBO) therapy within 6 h of symptom onset/notice for brain-protective bridging until endovascular revascularization of acute intracranial anterior-circulation occlusion. METHODS AND DESIGN: Randomized (1:1), standard treatment-controlled, open-label, blinded endpoint, multicenter adaptive phase IIb trial. STUDY OUTCOMES: Primary outcome is ischemic core growth (mL) from baseline to 24 h (intention-to-treat analysis). Secondary efficacy outcomes include change in NIHSS from baseline to 24 h, mRS at 90 days, cognitive and emotional function, and quality of life. Safety outcomes include mortality, intracranial hemorrhage, and respiratory failure. Exploratory analyses of imaging and blood biomarkers will be conducted. SAMPLE SIZE: Using an adaptive design with interim analysis at 80 patients per arm, up to 456 participants (228 per arm) would be needed for 80% power (one-sided alpha 0.05) to detect a mean reduction of ischemic core growth by 6.68 mL, assuming 21.4 mL standard deviation. DISCUSSION: By enrolling endovascular thrombectomy candidates in an early time window, the trial replicates insights from preclinical studies in which NBO showed beneficial effects, namely early initiation of near 100% inspired oxygen during short temporary ischemia. Primary outcome assessment at 24 h on follow-up imaging reduces variability due to withdrawal of care and early clinical confounders such as delayed extubation and aspiration pneumonia. TRIAL REGISTRATIONS: ClinicalTrials.gov: NCT03500939; EudraCT: 2017-001355-31.
Center for Rare Diseases Eberhard Karls University Tubingen Germany
Centre Hospital Regional Universitaire de Nancy Nancy France
Coordinating Centre for Clinical Trials University of Heidelberg Heidelberg Germany
Department of Anaesthesia and Critical Care CHU Grenoble Alpes Grenoble France
Department of Anesthesiology and Intensive Care Medicine Eberhard Karls University Tubingen Germany
Department of Brain Sciences Imperial College London London UK
Department of Cardiology Universitatsspital Basel Basel Switzerland
Department of Infectiology Eberhard Karls University Tuebingen Germany
Department of Neurology Alfried Krupp Hospital Essen Germany
Department of Neurology and Stroke Center Hopital fondation Adolphe de Rothschild Paris France
Department of Neurology and Stroke Eberhard Karls University University Hospital Tubingen Germany
Department of Neurology Boston Medical Center Boston MA USA
Department of Neurology Duke University School of Medicine Durham NC USA
Department of Neurology Ghent University Hospital Ghent Belgium
Department of Neurology Heidelberg University Hospital Heidelberg Germany
Department of Neurology Helsinki University Hospital and University of Helsinki Helsinki Finland
Department of Neurology Hopital Sainte Anne Universite de Paris Paris France
Department of Neurology Hospital University de Bellvitge Barcelona Spain
Department of Neurology KSA Kantonsspital Aarau and University of Bern Bern Switzerland
Department of Neurology Ludwig Maximilian University Munich Germany
Department of Neurology Massachusetts General Hospital Harvard Medical School Boston MA USA
Department of Neurology Sahlgrenska University Hospital Gothenburg Sweden
Department of Neurology St John's Hospital Vienna Austria
Department of Neurology University Hospital Essen Essen Germany
Department of Neurology University Hospital Hamburg Eppendorf Hamburg Germany
Department of Neurology University Hospital of Ulm Ulm Germany
Department of Neurology University Hospital Schleswig Holstein Kiel Germany
Department of Neurology University Hospitals Leuven Leuven Belgium
Department of Neurology University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Neurology Vall d'Hebron University Hospital Barcelona Spain
Department of Neuroradiology University Hospital Hamburg Eppendorf Hamburg Germany
Department of Neurosciences Experimental Neurology KU Leuven University of Leuven Leuven Belgium
Department of Radiology Boston Medical Center Boston MA USA
Department of Vascular and Interventional Radiology Ghent University Hospital Ghent Belgium
Duke Clinical Research Institute Durham NC USA
Duke University School of Medicine Durham NC USA
European Clinical Research Infrastructure Network Paris France
German Center for Neurodegenerative Diseases Munich Germany
German Centre for Cardiovascular Research Munich Germany
Hertie Institute for Clinical Brain Research Eberhard Karls University Tubingen Germany
Hospital Clinico Universitario de Valladolid Valladolid Spain
Inserm U1216 Grenoble Institut Neurosciences Université Grenoble Alpes Grenoble France
Institute for Stroke and Dementia Research University Hospital LMU Munich Munich Germany
International Clinical Research Centre St Anne's University Hospital in Brno Brno Czech Republic
Landeskrebsregister Nordrhein Westfalen Bochum Germany
Munich Cluster for Systems Neurology Munich Germany
Neurology CHU Grenoble Alpes Grenoble France
Neuroradiology MRI Department CHU Grenoble Alpes Grenoble France
Neuroradiology University Hospital Hamburg Eppendorf Hamburg Germany
Neurosciences Cliniques Centre Hospitalier Universitaire Vaudois Lausanne Switzerland
Vall d'Hebron Institut de Recerca Neurovascular Research Lab Barcelona Spain
Citace poskytuje Crossref.org
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