An Open, Study to Assess the Safety of RGTA® (OTR4132) in Patients With Acute Ischemic Stroke (AIS)

Stroke, Acute Clinical Trial

— MATRISS  

Official title:

An Open, Multi-centre Study to Assess the Safety and Tolerability of RGTA® (OTR4132) in Patients With Acute Ischemic Stroke (AIS)

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT04083001
• Other study ID #: 2018-A03117-48
• Status: Active, not recruiting
• Phase: N/A
• Start date: March 3, 2022
• Est. completion date: April 2024

Study information

• Verified date: October 2023
• Source: Organ, Tissue, Regeneration, Repair and Replacement
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

RGTA® (ReGeneraTing Agent) are synthetic polysaccharides mimicking extra-cellular matrix scaffold elements and protective agents called Heparan Sulphates (HSPGs). OTR4132-MD is provided as a sterile injectable medical device. OTR4132-MD is indicated in anterior circulation acute ischemic stroke (AIS) patients re-vascularized (TICI score 2b - 3) by combined thrombolysis and endovascular thrombectomy within 6 hours of symptoms onset.

Description:

The promising results of OTR4132-MD in the treatment of acute ischemic stroke in animal studies and the excellent results of biocompatibility tests reported in the Investigator's Brochure allowed to design a clinical investigation in humans named MATRISS. As this is a First-In-Man (FIM) study assessing OTR4132-MD, it is designed as a single ascending dose (SAD) to evaluate the safety, tolerability of a single intra-arterial injection of OTR4132-MD in AIS patients treated with combined thrombolysis and thrombectomy. The FIM will include up to 18 patients in up to five dose groups. Each group will comprise 3 subjects. This FIM study will also monitor a dose response relationship in humans: lesion volume change throughout the study period. Patients will be given a single intra-arterial injection of OTR4132-MD with a predefined dose of OTR4132. In the first dose group, the OTR4132 dose is 0.20 mg. The results of this study will serve as a groundwork for the design of a pivotal study in the intended patient population.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 16
• Est. completion date: April 2024
• Est. primary completion date: April 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

• Eligible patients for this study will be included if all of the following conditions

are met:

1. Age 18 to 80 years

2. Acute ischemic stroke in anterior circulation territory, identified by magnetic resonance imaging (MRI)

3. Occlusion of anterior circulation i.e. internal carotid artery or proximal middle cerebral artery (MCA) (M1, M1/M2)

4. Volume of the lesion estimated below two third of the MCA territory

5. Intravenous (IV) thrombolysis performed according to European Stroke Organization (ESO) guidelines

6. Intravenous Alteplase (1h infusion) terminated at least 40min before effective thrombectomy; or Intravenous Tenecteplase (bolus) terminated at least 120min before effective thrombectomy

7. Endovascular thrombectomy initiated within 6 hours of stroke onset

8. Angiography after endovascular treatment: TICI grade 2b - 3

9. Baseline NIHSS (National Institute of Health Stroke Score), including hand testing 11 and 25 at screening

10. No significant pre-stroke disability (pre-baseline modified Rankin Score (mRS) 0-1)

11. Able to follow neuro-rehabilitation programme

12. Patient* or legally authorized representative (family member, trusted person or physician) if patient unable to give consent has signed informed consent.

• Patients unable to give consent at baseline will go through a deferred consent procedure to continue the study (Section 12: Subject Information and Informed Consent)

Exclusion Criteria:

• Eligible patients for this study will not be included if any of the following

conditions are present:

1. Previous symptomatic stroke

2. Pre-existing medical, neurological or psychiatric disease that would confound the neurological evaluation

3. Contra-indication to MRI

4. Evidence of intracranial haemorrhage (ICH)

5. At the discretion of the investigator, patients with co-morbidities associated with a life expectancy of less than 3 months or co-morbidities that could influence the study results or would complicate assessment of outcomes (e.g. dementia, psychiatric disease) or would make clinical follow-up difficult

6. History of allergy or anaphylactic reactions to any of the ingredients of OTR4132-MD or heparinoids

7. Severe renal failure with glomerular filtration rate (GFR) < 30 mL/min

8. Severe uncontrolled arterial hypertension e.g. systolic blood pressure > 185 mmHg or diastolic blood pressure > 110 mmHg, or intravenous medication necessary to reduce blood pressure

9. Increased risk of haemorrhage (such as medical history of significant bleeding disorders, major surgery or significant trauma in the past 3 months, any history of central nervous damage or suspected intracranial haemorrhage, symptoms suggestive of subarachnoid haemorrhage, even if the MRI is normal, international normalized ratio (INR)>1.3 or activated partial thromboplastin time (aPTT)>ULN (upper limit of normal)

10. Suspected cerebral vasculitis based on medical history and imaging

11. Occlusions in multiple vascular territories

12. Evidence of intracranial tumour

13. Evidence of any prior intracranial intervention (i.e. neurosurgery, endovascular intervention)

14. Worsening of medical or neurological conditions or per-procedures complications

15. Any other serious, advanced, or terminal illness (investigator judgment)

16. Pregnant or breastfeeding or women without an adequate contraceptive method

17. Current participation in another investigation drug or device study

18. The patient is not a member or beneficiary of a social security scheme

Related Conditions & MeSH terms

• Ischemic Stroke
• Stroke
• Stroke, Acute

Intervention

Device:
• OTR4132MD
According to Regulation (EU) 2017/745(MDR), OTR4132-MD is an implantable medical device, for short term use which is specifically intended for use in direct contact with systemic circulation system. OTR4132-MD is by definition intended to come into contact with the patient when being injected. It is administered through intra-arterial injection, in an one-shot dose and the majority of the product is eliminated within 24 hours.

Locations

Country	Name	City	State
France	CHU Bordeaux Pellegrin	Bordeaux	Nouvelle Aquitaine
France	CHU Grenoble Alpes	Grenoble	Auvergne Rhône Alpes
France	CHU Nancy	Nancy	Grand Est

Sponsors (3)

Lead Sponsor	Collaborator
Organ, Tissue, Regeneration, Repair and Replacement	Euraxi Pharma, European Commission

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Revascularization on 24-hour follow-up imaging	Revascularization on 24-hour follow-up imaging	24 Hours
Primary	Rate of severe adverse events device related and dose limiting	Severe adverse events	7 Days
Secondary	Survival rates	survival rates	24 hours, 7 Days, 30 Days, 90 Days
Secondary	All cause death	All cause death	24 hours, 7 Days, 30 Days, 90 Days
Secondary	Stroke related death	Stroke related death	24 hours, 7 Days, 30 Days, 90 Days
Secondary	Rate of device related adverse events (AEs) and serious adverse events (SAEs)	rate of device related adverse events	24 hours, 7 Days, 30 Days, 90 Days
Secondary	Rate of adverse events (AEs) and serious adverse events (SAEs) procedure related	Rate of AEs and SAEs propcedure related	24 hours, 7 Days, 30 Days, 90 Days
Secondary	Symptomatic intracranial haemorrhage	Intracranial haemorrhage	24 hours, 7 Days, 30 Days, 90 Days
Secondary	Brain oedema on 24-hour follow-up imaging	brain oedema	24 hours
Secondary	New ischaemic lesions	Ischaemic lesions in new territories on 24-hours follow-up imaging	24 hours