Clinical trial NCT06821347: NanO2 in Large VessEL Occlusion Stroke (NOVEL)
Official title: NanO2 in Large VessEL Occlusion Stroke (NOVEL): a Multicentre Single-blind, Randomised, Placebo-controlled Blinded Biomarker End-point Clinical Trial of Perfluorocarbon in Acute Ischaemic Stroke Due to Large Vessel Occlusion
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: PHASE2
Conditions: Stroke Acute
Keywords: acute ischaemic stroke
large vessel occlusion
thrombolysis
Lead sponsor: NHS Greater Glasgow and Clyde
Sponsor class: OTHER
Collaborators: name: University of Glasgow
name: NuvOx LLC
First posted: 2025-02-12
Enrollment: 172
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This is a National Institute for Health Research (NIHR) Efficacy and Mechanism Evaluation (EME) clinical trial aiming to investigate a possible new treatment to limit damage to the brain caused by a stroke. Strokes that are caused by a clot blocking an artery in the brain ('ischaemic' strokes) starve brain tissue of oxygen and nutrients. Over a short period of time without oxygen, this tissue becomes permanently damaged. The trial aims to investigate the effects of a drug that carries extra oxygen, called NanO2, on the amount of brain tissue damage. By carrying extra oxygen to brain tissue NanO2 may allow the tissue to survive for longer. It might be especially useful to prevent further damage happening while treatments to try and open the blocked blood vessel are given. Treatments may include 'clot-busting' drugs, or procedures to physically open a blocked artery. These treatments are very effective, but take time to successfully open the blockage. The study will involve treating people as early as possible after the stroke, and comparing brain scans before and after treatment. Patients diagnosed with a stroke that has occurred within the past 9 hours will be eligible to participate. The study will involve 8-15 hospitals across the UK. Participation in the study will last approximately 90 days. The majority of the study assessments will be during the first 5 days during inpatient hospital stay. There will be a telephone follow-up at 30 days and 90 days post-discharge.


Eligibility criteria: Inclusion Criteria:

1. Male or non-pregnant female aged ≥ 18 years
2. Acute ischemic stroke fulfilling perfusion imaging criteria (ischemic core volume \< 70 mL, mismatch ratio \> 1.8 and mismatch volume \> 15 mL using RAPID or equivalent CE-marked software)
3. Eligible for thrombolysis or thrombectomy
4. Intracranial LVO on CTA (occlusion of the terminal ICA, MCA-M1, ≥1 proximal MCA-M2, or proximal posterior cerebral artery (PCA-P1))
5. ≤ 9 hours after last known well (if waking with symptoms, last known well time is calculated as the mid-point between going to sleep and waking)
6. Pre-stroke functional independence (estimated pre-stroke mRS ≤2)
7. NIHSS score ≥ 6 (or NIHSS ≥ 2 if PCA-P1 occlusion) at randomisation

Exclusion Criteria:

1. History of significantly impaired renal eGFR (\<30ml/min) or hepatic function (transaminases \>3 times upper limit of normal or history of cirrhosis), unstable angina or heart failure (NYHA 3 or 4).
2. Pre-existing lung disease requiring supplemental chronic or intermittent oxygen therapy (NB oxygen therapy given post-stroke is not an exclusion)
3. Previous hypersensitivity reaction to NanO2 excipients and/or compounds similar to NanO2
4. Pregnancy (for women of child-bearing potential a negative pregnancy test will be required prior to randomisation) or breast feeding women.

   Women of child-bearing potential is defined as experienced menarche; AND not undergone successful surgical sterilisation (hysterectomy, bilateral salpingectomy, or bilateral oophorectomy); AND not post-menopausal i.e. amenorrhea for ≥12 consecutive months (without another medical cause)
5. Participation in another CTIMP within preceding 90 days or 5 half-lives of the investigational product, whichever is longer, or previous participation in NOVEL.

Primary outcomes:
measure: Volume of penumbral tissue salvaged based on follow-up imaging (diffusion weighted MRI, or non-contrast CT if MRI cannot be obtained) compared with pre-treatment penumbral tissue volume from CT Perfusion.
timeFrame: Baseline to 24hrs
Secondary outcomes:
measure: National Institutes of Health Stroke Scale (NIHSS) change from baseline to day 5
timeFrame: Baseline to Day 5
measure: NIHSS score change from baseline to 24h
timeFrame: Baseline to 24hrs
measure: 24 hour NIHSS score
timeFrame: Baseline to 24hrs
measure: Proportion achieving substantial early neurological improvement (NIHSS score reduced by ≥8 points or a score equal to 0 or 1) at 24 hours
timeFrame: Baseline to 24hrs
measure: Distribution of modified Rankin Scale (mRS) scores at 30 and 90 days
timeFrame: Baseline to Day 30 and Day 90
measure: Proportion achieving independence (mRS score ≤2) at 90 days
timeFrame: Baseline to Day 90
measure: Proportion achieving excellent neurological outcome (mRS score 0-1) at 90 days
timeFrame: Baseline to Day 90
measure: Health-related Quality of Life using the EQ-5D score at 90 days
timeFrame: Baseline to Day 90
measure: Mortality
timeFrame: Baseline to Day 90
measure: Cumulative incidence of Serious Adverse Events at 24h, day 5 and day 90
timeFrame: Baseline to Day 90
Other outcomes:
Locations:
city: Glasgow
country: United Kingdom
facility: NHS Greater Glasgow and Clyde
Study officials:
References: