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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT05959759
Other study ID # BTHDMF
Secondary ID
Status Not yet recruiting
Phase Phase 4
First received
Last updated
Start date July 31, 2023
Est. completion date June 1, 2024

Study information

Verified date July 2023
Source Beijing Tiantan Hospital
Contact Yisen Zhang, MD
Phone +86-15001232615
Email zhang-yisen@163.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study was designed to identify whether there is a measurable reduction in inflammation in walls of intracranial aneurysms with oral dimethyl fumarate.


Description:

Intracranial aneurysm (IA) is a common cerebrovascular disease and the main cause of nontraumatic subarachnoid hemorrhage. Once ruptured, it will cause a high mortality rate, and nearly half of the survivors will also have disabilities. After comparing surgical risk and rupture risk, a significant proportion of patients with intracranial aneurysms choose conservative observation. Previous studies suggest that inflammation of aneurysmal wall is a high-risk factor of rupture. Dimethyl fumarate (DMF) acts as an anti-inflammatory agent by activating nuclear factor erythroid 2-related factor 2(Nrf2) and other pathways. Animal experiments found dimethyl fumarate reduces the formation and rupture of intracranial aneurysms. MRI High-resolution vessel wall imaging (HR-VWI) has become a valuable method to assess the Wall of unruptured intracranial aneurysms. Using HR-VWI, it may be possible to detect smaller or more subtle areas of signal enhancement and change, which may give a more precise understanding of the pathology. In this study, DMF was evaluated for its ability to reduce inflammation of the aneurysm wall measured with High-resolution Vessel Wall Imaging (HR-VWI).


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 60
Est. completion date June 1, 2024
Est. primary completion date December 31, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: 1. Male or female aged =18 years. 2. Unruptured IA of =3mm identified on imaging (CT, MRI or digital subtraction angiography). 3. Aneurysm wall enhancement identified by HR-VWI before treatment. 4. Ability to understand the objective of the trial with provision of written informed consent. Exclusion Criteria: 1. MRI contraindications (metallic implant, contrast allergy, claustrophobia, etc). 2. Planned treatment of the aneurysm within 12 months. 3. Current treatment with drugs that might have an anti-inflammatory effect (aspirin, statins, immunosuppressive drugs, etc.). 4. Severely impaired liver or renal function. 5. Retreatment of recurrent aneurysm. 6. Pregnant or lactating women. 7. Malignant diseases (liver disease, kidney disease, congestive heart failure, malignant tumours, etc.). 8. Poor compliance.

Study Design


Intervention

Drug:
Dimethyl fumarate
dimethyl fumarate enteric capsule (the initial dose is 120 mg twice a day, and after 7 days, the dose will be increased to the maintenance dose of 240 mg twice a day, for 6 months), 30 patients for this arm.
Placebo
placebo with the same appearance (color, taste, size, shape), 30 patients for this arm.

Locations

Country Name City State
China Beijing Neurosurgical Institute & Beijing Tiantan Hospital Beijing Beijing

Sponsors (4)

Lead Sponsor Collaborator
Beijing Tiantan Hospital Beijing Chao Yang Hospital, Beijing Neurosurgical Institute, Henan Provincial People's Hospital

Country where clinical trial is conducted

China, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change of aneurysm wall inflammation as measured by HR-VW-MRI. Change of aneurysm wall enhancement index of at least 20% on HR-VM-MRI at the end of 6 months of dimethyl fumarate treatment, compared to no treatment. 6 months
Secondary Change of aneurysmal morphology parameter The proportion of morphological growth of aneurysms from before treatment to the 6 months follow-up. An increase = 1mm in any diameter or the appearance of a daughter sac will be defined as growth in aneurysmal morphology. 6 months
Secondary Change of inflammatory markers in patients Changes in CRP, TNF-a, IL-1ß and IL-6 in patients with unruptured IAs from before treatment to the 6 months follow-up. The CRP, TNF-a, IL-1ß and IL-6 levels will be measured at before treatment and at 6 months follow-up. 6 months
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