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Trial registered on ANZCTR
Registration number
ACTRN12609000983202
Ethics application status
Approved
Date submitted
16/09/2009
Date registered
13/11/2009
Date last updated
13/11/2009
Type of registration
Prospectively registered
Titles & IDs
Public title
Exenatide in acute ischemic stroke - effect on cerebral inflammation and glucose homeostasis
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Scientific title
Exenatide in acute ischemic stroke - effect on cerebral inflammation and glucose homeostasis
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Universal Trial Number (UTN)
U1111-1112-4778
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute ischemic stroke
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Condition category
Condition code
Stroke
240028
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Ischaemic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Role of Exenatide injection in acute ischemic stroke. Exenatide injection will be administered in dose of 5 mcg twice daily subcutaneously to selected acute stroke patients within 12 hours of symptom onset. The drug will administered for the duration of in-hospital admission with a minimum period of 5 days and maximum period of 2 weeks.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
Historical control of stroke patients and normal volunteers will be used for comparison of inflammatory marker levels
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Control group
Historical
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Outcomes
Primary outcome [1]
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Changes in the levels of inflammatory/endothelial cell markes in acute ischemic stroke patients treated with Exenatide. C-Reactive Protein (CRP), Interleukin (IL)-6, IL-10, IL-18, Tumor Necrosis Factor (TMF) alpha, Matrix Metalloproteinase (MMP) 9, Plasminogen Activator Inhibitor (PAI) - 1 and adhesion molecules (ICAM-1, VCAM-1) will be assayed using ELISA technique from plasma.
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Assessment method [1]
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Timepoint [1]
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at baseline and at 1,3,5,7 and 14 days
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Secondary outcome [1]
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Glycemic control in patients with acute ischemic stroke receiving Exenatide. This will be done by measuring blood glucose levels at baseline and twice daily. Blood glucose level will be assessed by finger prick technique using a calibrated glucometer.
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Assessment method [1]
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Timepoint [1]
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Twice every day during hospital admission
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Secondary outcome [2]
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Incidence of side effects, especially hypoglycemia, nause or vomiting. Hypoglycemia will be diagnosed by twice daily blood glucose estimations. Any symptoms which could be potentially related to hypoglycemia will be investigated by immediate blood glucose estimation in addition to the twice daily tests. Nausea and vomiting will be assessed as mild, moderate or severe according to the level of patient distress by clinical judgement.
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Assessment method [2]
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Timepoint [2]
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During hospital admission
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Eligibility
Key inclusion criteria
18 – 85 years
Stroke symptom onset within 12 hours
Measurable neurological deficit (National Institute of Health Stroke Scale [NIHSS] 4-22)
Blood sugar level on admission = 3mmol/L
Pre-morbid Modified Rankin Scale 0-2
Computed Tomography (CT) Scan Brain excluded intracerebral haemorrhage
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Minimum age
18
Years
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Maximum age
85
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Unlikely to survive beyond 14 days
Pregnant (known or suspected) or breast feeding
Previous clinical stroke in the last one month
Concomitant inflammatory disease
Diabetic patients already on Exenatide or combination insulin and oral hypoglycaemic agents
Have a known allergy or hypersensitivity to exenatide.
Past history of pancreatitis or evidence of active pancreatitis.
Patients with other severe gastrointestinal disease like gastroparesis and dumping syndrome
Patients with end stage renal disease (creatinine clearance < 30 ml/mt)
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
The study is a non-randomized initial pilot study of 10 patients with acute ischemic stroke. All patients will receive Exenatide injection. The inflammatory marker levels in these 10 patients will be compared with levels obtained from historical controls.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/12/2009
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
10
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
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3128
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Monash university eastern clinical research unit
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Address [1]
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Level 3, Clive ward building
16 Arnold street, Box Hill
Vic 3128, Australia
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Monash university eastern clinical research unit
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Address
Level 3, Clive ward building
16 Arnold street, Box Hill
Vic 3128, Australia
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Eastern Health Research and Ethics Committee
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Ethics committee address [1]
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5 Arnold Street, Box Hill, Victoria, 3128 Ph: 03-98953259
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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21/09/2009
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Approval date [1]
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06/11/2009
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Ethics approval number [1]
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E28/0910
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Summary
Brief summary
Exenatide which is a drug approved for use in Type 2 Diabetes has been shown in animal experimental models of stroke to have neuroprotective effect. Elevated blood glucose level during stroke has been shown to be a cause of bad outcome and this can be seen even in non-diabetic patients as a stress response to stroke. . Exenatide, when administered to stroke patients may control blood glucose levels effectively and reduce insulin resistance, which may help in reducing cerebral inflammation after stroke. On this background we have designed this initial pilot study of Exenatide use in 10 patients with acute ischemic stroke to see the changes in inflammatory level markers and also to look at the safety and feasibility issues before a larger randomized controlled trial can be conducted.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Christopher Bladin
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Address
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Level 4, Clive ward building
16 Arnold street
Box Hill, Vic, 3128
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Country
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Australia
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Phone
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+61 3 98954974
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Fax
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+61 3 98950304
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Email
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[email protected]
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Contact person for scientific queries
Name
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Christopher Bladin
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Address
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Level 4, Clive ward building
16 Arnold street
Box Hill, Vic, 3128
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Country
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Australia
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Phone
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+61 3 98954974
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Fax
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+61 3 98950304
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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