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Trial registered on ANZCTR
Registration number
ACTRN12609000975291
Ethics application status
Approved
Date submitted
3/11/2009
Date registered
11/11/2009
Date last updated
18/01/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomised double blind, placebo-controlled study of Nefiracetam in patients with post- stroke apathy
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Scientific title
In post stroke patients, treatment with nefiracetam decreases the severity of apathy
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Secondary ID [1]
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Nil
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Universal Trial Number (UTN)
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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:
Post stroke apathy
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Condition category
Condition code
Mental Health
252319
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0
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Other mental health disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
450mg Nefiracetam (one capsule orally) twice daily for 12 weeks
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Intervention code [1]
241497
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Treatment: Drugs
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Comparator / control treatment
placebo: one capsule oraly twice daily for 12 weeks. Capsules will be identical in shape size and colour to active medication, only without the active ingredient
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Apathy scale(AS): is a clinician based questionnaire assessed with both the patient and the caregiver together
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Assessment method [1]
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Timepoint [1]
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The AS will be administered at baseline (start of Randomized Control Trial (RCT); then at weeks 4, 8, 12, 24 and 36 weeks post baseline. The baseline assessment will take place no less than 8 weeks post stroke.
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Secondary outcome [1]
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Clinical Global Impression Scale (CGI): clinician based assessment of overall functioning on a continuum from psychological or psychiatric sickness to health. Detects clinical change and placebo-drug differences.
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Assessment method [1]
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Timepoint [1]
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CGI will be administered at baseline (start of RCT) then again at weeks 4, 8, 12, 24 and 36 weeks post baseline.
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Secondary outcome [2]
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Barthel Index (BI): clinician rated assessment of the patient's daily functioning. provides baseline level and monitor improvement in activities of daily living over time
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Assessment method [2]
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Timepoint [2]
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BI will be administered at baseline (start of RCT) and then at weeks 4, 8, 12, 24 and 36 weeks post baseline.
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Secondary outcome [3]
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Functional Impact Measure (FIM): clinician rated assessment of severity of patient disability and functional outcome.
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Assessment method [3]
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Timepoint [3]
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FIM will administered at screening (0-6 months post onset of stroke), baseline (start of RCT); then 4, 8, 12, 24, 36 weeks post baseline.
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Secondary outcome [4]
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Stroke Impact Scale (SIS): a patient self-rated assessment of the impact of stroke on a patient's health and life
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Assessment method [4]
262119
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Timepoint [4]
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SIS will be administered at baseline (start of RCT); then at weeks 4,8,12,24 and 36 weeks post baseline
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Secondary outcome [5]
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Euroquol 5-dimensions (EQ-5): a clinician rated scale to evaluate a patient's health status
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Assessment method [5]
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Timepoint [5]
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EQ-5 will be administered at baseline (start of RCT); then at weeks 4,8,12,24 and 36 weeks post baseline
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Eligibility
Key inclusion criteria
1. Clinical and neurological findings consistent with either hemispheric, brainstem or cerebellar stroke 2. apathy present after stroke 3. able to undergo assessment and take oral medication 4.be cared for by a reliable spouse who can be responsible for administering dose
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Minimum age
40
Years
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Maximum age
90
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1. patients with major depression post stroke 2. stroke resulting from aneurysm, ateriovenous malformation, head injury, intracranial tumour or neoplastic process 3. prestroke dementia 4. severe language comprehension deficits 5. comorbid alcohol or drug abuse 6. severe medical comorbidity 7. current use of neuroleptic or drugs repported to affect apathy 8. apathy resulting from any condition other than stroke 9. Severe renal disease: BUN >=17.85mmol/L; Creatinine >= 176.89 umol/L; proteinuria (dipstick >= +2
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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?
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Intervention assignment
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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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Date of first participant enrolment
Anticipated
1/02/2010
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Actual
27/07/2010
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Date of last participant enrolment
Anticipated
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Actual
22/03/2013
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Date of last data collection
Anticipated
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Actual
31/12/2013
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Sample size
Target
122
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Accrual to date
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Final
13
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Recruitment in Australia
Recruitment state(s)
WA
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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Level 1
16 Marcus Clarke Street
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Fremantle Hospital and Health Service
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Address
Alma St
Fremantle WA 6160
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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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South Metropolitain Area Health Service Human Research Ethics Committee
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Ethics committee address [1]
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Fremantle Hospital and Health Service Alma Street, Fremantle, Western Australia 6160
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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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17/11/2009
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Approval date [1]
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29/01/2010
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Ethics approval number [1]
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09/500
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Summary
Brief summary
The successful psycho-physical rehabilitation of stroke victims remains challenging. Recent advances have resulted in progress in acute treatment of stroke, however post-acute rehabilitation remains basically unchanged. One reason for this is the high frequency of emotional and behavioural disorders post-stroke, such as apathy. Apathy is associated with greater deficits in activities of daily living, more severe cognitive deficits, longer hospital stay, and worse rehabilitation and functional outcomes. There are no known effective pharmacological or psychological treatments for apathy after stroke. We aim to determine if treatment with nefiracetam decreases the severity of post-stroke apathy. We will also test whether nefiracetam results in greater improvement on functional and social impairments, quality of life and cognition as compared to placebo.
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Trial website
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Trial related presentations / publications
A Randomized, Placebo-Controlled, Double-Blind Efficacy Study of Nefiracetam to Treat Poststroke Apathy. Starkstein, S. E. ; Brockman, S. ; Hatch, K. K. ; Bruce, D. G. ; Almeida, O. P. ; Davis, W. A. ; Robinson, R. G. Journal of Stroke and Cerebrovascular Diseases, May 2016, Vol.25(5), pp.1119-1127
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Public notes
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Contacts
Principal investigator
Name
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Prof Sergio Starkstein
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Address
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Level 7, T Block
Fremantle Hospital
PO Box 480
Fremantle WA 6959
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Country
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Australia
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Phone
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+61894312013
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Sergio Starkstein
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Address
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Level 7, T Block
Fremantle Hospital
Fremantle WA 6160
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Country
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Australia
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Phone
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+61 8 9 431 2013
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Fax
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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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Sergio Starkstein
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Address
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Level 7, T Block
Fremantle Hospital
Fremantle WA 6160
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Country
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Australia
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Phone
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+ 61 8 9431 2013
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Fax
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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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