This is a randomized, multi-center, prospective, double blind study. The primary objective is to assess the efficacy and safety of glyburide (RP-1127) compared to placebo in participants with a severe anterior circulation ischemic stroke who are likely to develop malignant edema.This objective will be addressed by comparing the proportion of glyburide treated particpants and placebo treated participants with a Day 90 modified Rankin Scale (mRS) ≤ 4 without decompressive craniectomy (DC). The secondary objective is to assess the efficacy of RP-1127 compared to placebo in participants with a severe anterior circulation ischemic stroke who were likely to develop malignant edema.
The study population consists of participants with a clinical diagnosis of acute severe anterior circulation ischemic stroke, a baseline diffusion weighted image (DWI) lesion between 82 and 300 cm3, age 18-80 years, and time from symptom onset to start of study infusion of ≤10 hours. The study will enroll both participants that do not receive intravenous (IV) recombinant tissue plasminogen activator (rtPA) and those that receive IV rtPA within 4.5 hours of stroke. Enrollment will be randomized controlling for site, age ≤60 (yes/no), and IV rtPA treatment at baseline (yes/no). Participants will be randomized equally between glyburide and placebo.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
86
Administered as specified in the treatment arm.
Administered as specified in the treatment arm.
University of Arizona Medical Center
Tucson, Arizona, United States
Stanford University Medical Center
Stanford, California, United States
Yale University School of Medicine
New Haven, Connecticut, United States
University of Florida, Jacksonville
Jacksonville, Florida, United States
Northwestern Memorial Hospital
Chicago, Illinois, United States
University of Louisville Hospital
Louisville, Kentucky, United States
Maine Medical Center
Scarborough, Maine, United States
University of Maryland School of Medicine
Baltimore, Maryland, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
UMASS Memorial Medical Center
Worcester, Massachusetts, United States
...and 7 more locations
Percentage of Participants with a Modified Rankin Scale (mRS) score of ≤ 4 Without Decompressive Craniectomy (DC)
The mRS scale runs from 0-6, the scoring is as follows: 0 - No symptoms, 1 - No significant disability, 2 - Slight disability, 3 - Moderate disability, 4 - Moderately severe disability, 5 - Severe disability, 6 - Dead
Time frame: Day 90
Number of Participants with Adverse Events and Serious Adverse Events
An adverse event (AE) is any symptom, sign, illness or experience that develops or worsens in severity during the course of the study. A serious adverse event is any AE that is fatal, life-threatening, requires or prolongs hospital stay, results in persistent or significant disability or incapacity, a congenital anomaly or birth defect, or an important medical event
Time frame: Up to 1 Year
Percentage of Participants Undergoing DC or Dead
Time frame: Baseline and Day 14
Change from Baseline in Ipsilateral Hemispheric Swelling
To be assessed using Magnetic Resonance Imaging (MRI).
Time frame: Baseline up to 72-96 Hours
Change from Baseline in Lesional Swelling
To be assessed using MRI.
Time frame: Baseline up to 72-96 Hours
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