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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04071613
Registration number
NCT04071613
Ethics application status
Date submitted
25/08/2019
Date registered
28/08/2019
Titles & IDs
Public title
Tenecteplase Versus Alteplase for Stroke Thrombolysis Evaluation Trial in the Ambulance
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Scientific title
Tenecteplase Versus Alteplase for Stroke Thrombolysis Evaluation Trial in the Ambulance
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Secondary ID [1]
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2018.043
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Universal Trial Number (UTN)
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Trial acronym
TASTEa
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Stroke, Acute, Stroke Ischemic
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Condition category
Condition code
Stroke
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Haemorrhagic
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Stroke
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Ischaemic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Tenecteplase
Treatment: Drugs - Intravenous tissue plasminogen activator (tPA)
Active comparator: Intravenous tenecteplase (TNK) - Patients will receive intravenous tenecteplase (0.25mg/kg, maximum 25mg, administered as a bolus over \~10 seconds).
Active comparator: Intravenous tissue plasminogen activator (tPA) - Patients will receive intravenous t-PA at the standard licensed dose of 0.9 mg/kg up to a maximum of 90mg, 10% as bolus and the remainder over 1 hour.
Treatment: Drugs: Tenecteplase
Route: IV bolus injection Frequency: once only, within 4.5 hours of stroke onset
Treatment: Drugs: Intravenous tissue plasminogen activator (tPA)
Route: Intravenous (IV) infusion (10% as bolus and the remainder over 60 minutes) Frequency: once only, within 4.5 hours of stroke onset
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Perfusion lesion on CTP
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Assessment method [1]
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The volume of the perfusion lesion on CTP performed on arrival at the receiving hospital, adjusted for pre-treatment NIHSS and time from initiation of treatment to CTP.
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Timepoint [1]
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Within 2hrs of treatment
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Secondary outcome [1]
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Infarct core growth between baseline CTP and 24 hour MRI.
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Assessment method [1]
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Timepoint [1]
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24 hrs
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Secondary outcome [2]
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Percent reperfusion between baseline CTP and 24 hour perfusion imaging (MRI)
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Assessment method [2]
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Timepoint [2]
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24 hrs
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Secondary outcome [3]
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Reduction in NIHSS between pre-treatment score and score on ED arrival, adjusted for pre-treatment NIHSS and time from initiation of treatment to ED NIHSS score
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Assessment method [3]
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Timepoint [3]
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2 hrs
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Secondary outcome [4]
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Reduction in NIHSS between pre-treatment score and score at 24 hours post treatment, adjusted for pre-treatment NIHSS
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Assessment method [4]
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Timepoint [4]
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24 hrs
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Secondary outcome [5]
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Modified Rankin Scale (mRS) at 3 months - ordinal analysis adjusted for baseline NIHSS and age
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Assessment method [5]
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Timepoint [5]
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3 months
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Secondary outcome [6]
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mRS 0-2 or no change from baseline at 3 months adjusted for baseline NIHSS and age
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Assessment method [6]
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Timepoint [6]
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3 months
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Secondary outcome [7]
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Proportion of patients where thrombolytic medication is initiated within 5 minutes of completion of CT on the MSU.
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Assessment method [7]
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Timepoint [7]
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24 hrs
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Secondary outcome [8]
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Time from completion of CT on the MSU to initiation of thrombolysis (CT to needle time)
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Assessment method [8]
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Timepoint [8]
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2 hrs
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Secondary outcome [9]
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mRS 5-6 at 3 months adjusted for baseline NIHSS and age
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Assessment method [9]
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Timepoint [9]
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3 months
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Secondary outcome [10]
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Death due to any cause adjusted for baseline NIHSS and age
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Assessment method [10]
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Timepoint [10]
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During time on study up to 3 months
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Secondary outcome [11]
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Any parenchymal haematoma
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Assessment method [11]
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Timepoint [11]
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During time on study up to 3 months
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Secondary outcome [12]
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ymptomatic intracranial hemorrhage (sICH)
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Assessment method [12]
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Timepoint [12]
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During time on study up to 3 months
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Eligibility
Key inclusion criteria
1. Patients being attended by the mobile stroke unit with an acute ischemic stroke eligible for thrombolysis using standard clinical and CT criteria.
2. Patient's age is =18 years
3. Premorbid mRS <4
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Minimum age
18
Years
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Maximum age
No limit
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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
1. Intracranial hemorrhage (ICH) or other diagnosis (e.g. tumor) identified by CT on the MSU
2. Hypodensity in >1/3 MCA territory or equivalent proportion of ACA or PCA territory on non-contrast CT on MSU
3. Pre-stroke mRS score of > 3 (indicating significant previous disability)
4. Any terminal illness such that patient would not be expected to survive more than 1 year
5. Any condition that, in the judgment of the investigator could impose hazards to the patient if study therapy is initiated or affect the participation of the patient in the study.
6. Pregnant women.
7. Rapidly improving symptoms.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
20/06/2019
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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
16/11/2021
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Sample size
Target
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Accrual to date
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Final
104
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Royal Melbourne Hospital - Melbourne
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Recruitment hospital [2]
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Eastern Health - Melbourne
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Recruitment hospital [3]
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Western Hospital - Melbourne
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Recruitment hospital [4]
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Alfred Hopsital - Melbourne
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Recruitment hospital [5]
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Monash Health - Melbourne
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Recruitment postcode(s) [1]
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3050 - Melbourne
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Recruitment postcode(s) [2]
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- Melbourne
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Funding & Sponsors
Primary sponsor type
Other
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Name
Melbourne Health
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
Ischemic stroke is a major health burden globally and in Australia. Treatment for ischemic stroke is time critical and is significantly more effective if administered within the first 90 minutes of symptom onset. This clinical trial will identify if early administration of oral thrombolytic agent, tenecteplase prior to hospital can improve outcomes from stroke, and reduce costs compared to standard care of IV alteplase in hospital
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Trial website
https://clinicaltrials.gov/study/NCT04071613
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Trial related presentations / publications
Bivard A, Zhao H, Churilov L, Campbell BCV, Coote S, Yassi N, Yan B, Valente M, Sharobeam A, Balabanski AH, Dos Santos A, Ng JL, Yogendrakumar V, Ng F, Langenberg F, Easton D, Warwick A, Mackey E, MacDonald A, Sharma G, Stephenson M, Smith K, Anderson D, Choi P, Thijs V, Ma H, Cloud GC, Wijeratne T, Olenko L, Italiano D, Davis SM, Donnan GA, Parsons MW; TASTE-A collaborators. Comparison of tenecteplase with alteplase for the early treatment of ischaemic stroke in the Melbourne Mobile Stroke Unit (TASTE-A): a phase 2, randomised, open-label trial. Lancet Neurol. 2022 Jun;21(6):520-527. doi: 10.1016/S1474-4422(22)00171-5. Epub 2022 May 4. Bivard A, Zhao H, Coote S, Campbell B, Churilov L, Yassi N, Yan B, Valente M, Sharobeam A, Balabanski A, Dos Santos A, Ng F, Langenberg F, Stephenson M, Smith K, Bernard S, Thijs V, Cloud G, Choi P, Ma H, Wijeratne T, Chen C, Olenko L, Davis SM, Donnan GA, Parsons M. Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation Trial in the Ambulance (Mobile Stroke Unit-TASTE-A): protocol for a prospective randomised, open-label, blinded endpoint, phase II superiority trial of tenecteplase versus alteplase for ischaemic stroke patients presenting within 4.5 hours of symptom onset to the mobile stroke unit. BMJ Open. 2022 Apr 29;12(4):e056573. doi: 10.1136/bmjopen-2021-056573.
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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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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 scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04071613