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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2500109773 |
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最近更新日期: Date of Last Refreshed on: |
2025-09-24 18:21:19 |
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注册时间: Date of Registration: |
2025-09-24 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
单硝酸异山梨酯联合丁苯酞改善急性缺血性脑小血管病卒中残障的2×2析因随机对照试验 |
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Public title: |
Isosorbide Mononitrate and Butylphthalide to Reduce the Risk of Disability in Patients with Acute Lacunar Stroke: a 2×2 Factorial Randomized Controlled Trial |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
单硝酸异山梨酯联合丁苯酞改善急性缺血性脑小血管病卒中残障的2×2析因随机对照试验 |
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Scientific title: |
Isosorbide Mononitrate and Butylphthalide to Reduce the Risk of Disability in Patients with Acute Lacunar Stroke: a 2×2 Factorial Randomized Controlled Trial |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
高颖 |
研究负责人: |
王伊龙 |
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Applicant: |
Ying Gao |
Study leader: |
Wang Yilong |
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申请注册联系人电话: Applicant telephone: |
+86 10 5997 6165 |
研究负责人电话: Study leader's telephone: |
+86 10 5997 5029 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
tjssgaoying@163.com |
研究负责人电子邮件: Study leader's E-mail: |
yilong528@aliyun.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
北京市丰台区南四环西路119号 |
研究负责人通讯地址: |
北京市丰台区南四环西路119号 |
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Applicant address: |
119 South Fourth Ring Road West, Fengtai District, Beijing |
Study leader's address: |
119 South Fourth Ring Road West, Fengtai District, Beijing |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
首都医科大学附属北京天坛医院 |
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Applicant's institution: |
Beiling Tiantan Hospital, Capital Medical University |
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研究负责人所在单位: |
首都医科大学附属北京天坛医院 |
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Affiliation of the Leader: |
Beijing Tiantan Hospital, Capital Medical University |
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是否获伦理委员会批准: |
是/Yes |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
KY2024-358-02 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
首都医科大学附属北京天坛医院医学伦理委员会 |
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Name of the ethic committee: |
IRB of Beijing Tiantan Hospital, Capital Medical University |
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伦理委员会批准日期: Date of approved by ethic committee: |
2025-09-08 00:00:00 |
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伦理委员会联系人: |
徐灵灵 |
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Contact Name of the ethic committee: |
Lingling Xu |
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伦理委员会联系地址: |
北京市丰台区南四环西路119号 |
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Contact Address of the ethic committee: |
No.119 South Fourth Ring West Road, Fengtai District, Beijing, China |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 10 5997 6269 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
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研究实施负责(组长)单位: |
首都医科大学附属北京天坛医院;深圳市第二人民医院 |
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Primary sponsor: |
Beijing Tiantan Hospital, Capital Medical University; Shenzhen Second People's Hospital |
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研究实施负责(组长)单位地址: |
北京市丰台区南四环西路119号;广东省深圳市福田区笋岗西路3002号 |
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Primary sponsor's address: |
No.119 South Fourth Ring West Road, Fengtai District, Beijing, China; No.3002 Sungang West Road, Futian District, Shenzhen, Guangdong Province, China |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项 |
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Source(s) of funding: |
Noncommunicable Chronic Diseases-National Science and Technology Major Project |
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Target disease: |
Cerebral small vascular disease |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
III期临床试验 | ||||||||||||||||||||||||||||||||||||||||||||
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Study phase: |
3 |
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研究设计: |
随机平行对照 |
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Study design: |
Parallel |
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研究目的: |
本研究旨在评估单硝酸异山梨酯、丁苯酞及其联合使用对改善急性脑小血管病卒中残障的有效性及安全性,为建立安全、有效、可行的急性脑小血管病策略提供科学依据。 |
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Objectives of Study: |
This study aims to evaluate the efficacy and safety of isosorbide mononitrate, butylphthalide, and their combination in reducing disability in patients with acute lacunar stroke, thereby providing evidence for the development of a safe, effective, and feasible therapeutic strategy for acute lacunar stroke. |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1)年龄 ≥ 30岁; 2)发病7天内的腔隙综合征; 3)发病后颅脑 CT/MRI 表现: a.存在与症状时空对应的腔隙性梗死病灶; b.若未见病灶,则症状持续时间需>24小时,且无其他可疑卒中病因(如脑出血、皮层梗死、癫痫发作等); 4)MoCA量表得分符合: a. 若受教育年限为≤6年,则MoCA ≥ 13分; b.若受教育年限为7-12年,则MoCA ≥ 15分; c. 若受教育年限为≥13年,则MoCA ≥ 18分 ; 5)发病前mRS≤1; 6)受试者或其法定代理人能够并愿意签署知情同意书。 |
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Inclusion criteria |
1) Age >= 30 years; 2) Clinical lacunar syndrome within 7 days; 3) Brain CT/MRI after symptom onset: a. a relevant (in time and location) acute lacunar infarct; b. if no relevant lesion, symptom duration >24 hours, with no other suspected stroke etiologies (such as cerebral hemorrhage, cortical infarction, seizures, etc.) 4) MoCA score meeting the following criteria: a. MoCA >= 13 if educated <= 6 years; b. MoCA >= 15 if 7 <= educated <= 12 years; c. MoCA >= 18 if educated >= 13 years; 5) mRS <= 1 prior to this episode; 6) Patient or a legally authorized representative signed informed consent. |
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排除标准: |
1)此次发病为大动脉粥样硬化性、心源性或其他明确少见原因(如夹层、血管炎等)所致的缺血性卒中(根据TOAST分型); 2)既往诊断或高度怀疑遗传性脑小血管病; 3)筛选前3个月内明确颅内出血病史(包括脑实质出血、脑室内出血、蛛网膜下腔出血、硬膜下/外血肿等); 4)既往已知可能导致认知障碍的神经系统退行性疾病或系统性疾病,如阿尔茨海默症、混合性痴呆、帕金森病;系统性自身免疫病、肝性脑病、肾性脑病等; 5)既往确诊的精神性疾病(DSM-5诊断标准); 6)合并其他活动性、重大神经系统疾病(如癫痫反复发作、颅内肿瘤、血管畸形、直径>3mm的未处理动脉瘤等); 7)存在低血压(坐位收缩压 < 100mmHg)、心动过缓(心率每分钟 < 60 次)、病窦综合征或严重的心肺疾病; 8)既往有充血性心力衰竭、急性心肌梗死或其他严重心功能不全者(NYHA评级III级-IV级); 9)存在凝血功能障碍、出血倾向或系统性出血者,包括但不限于:凝血酶原时间 >3×ULN;血小板计数 < 50×109/L;血友病、毛细血管脆弱症、消化道出血、尿路出血、咯血、玻璃体出血等; 10)存在严重的肝功能、肾功能不全(注:严重肝功能不全指ALT或AST > 3倍正常值上限或合并急性肝炎、慢性活动性肝炎、肝硬化等肝脏疾病;严重肾功能不全指eGFR<45ml/min/1.73m2或肌酐清除率 < 40 ml/min或既往已知慢性肾脏病3期及以上); 11)筛选前4周内有明显的头部创伤,或颅内或脊髓内手术,或大外科手术,或严重躯体创伤; 12)筛选前3天内使用过单硝酸异山梨酯及(或)丁苯酞; 13)存在明确单硝酸异山梨酯或丁苯酞使用禁忌症或对药物成分过敏; 14)预计需要长期服用本试验的禁忌合并用药; 15)处于妊娠期,哺乳期以及试验期间计划妊娠的女性; 16)不能耐受MRI或有MRI禁忌; 17)既往已知患有严重的器质性疾病,或预计生存期<12个月; 18)筛选前30天内参加过或者正在参加其他临床研究; 19)经研究者评估不适合参加本试验的其他情况。 |
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Exclusion criteria: |
1) Ischemic stroke of large artery atherosclerosis, cardioembolism, or other etiologies (TOAST classification); 2) Diagnosed or suspected hereditary CSVD; 3) Intracerebral hemorrhage within the past 3 months including parenchymal, intraventricular, subarachnoid hemorrhage, subdural/epidural hematoma; 4)Neurodegenerative diseases or systemic diseases that may lead to cognitive impairment, such as Alzheimer's disease, mixed dementia, Parkinson's disease, systemic autoimmune diseases, hepatic encephalopathy, or uremic encephalopathy; 5)Previously diagnosed psychiatric disorders (DSM-5 criteria); 6)Other active neurological disorders (e.g., recurrent seizures, brain tumors, vascular malformations, untreated aneurysms >3 mm); 7)Hypotension (seated systolic blood pressure <100 mmHg), bradycardia (heart rate <60 bpm), sick sinus syndrome or severe cardiopulmonary disease; 8)History of congestive heart failure, acute myocardial infarction or other severe cardiac dysfunctions (NYHA Class III-IV); 9)Coagulation disorders, bleeding tendency or systemic bleeding, including but not limited to prothrombin time >3×upper limit of normal (ULN), platelet count <50×109/L, hemophilia, capillary fragility, gastrointestinal bleeding, urinary tract bleeding, hemoptysis, or vitreous hemorrhage, etc; 10)Severe hepatic or renal insufficiency (note: severe hepatic insufficiency is defined as ALT or AST > 3×ULN or acute hepatitis, chronic active hepatitis, cirrhosis; severe renal insufficiency is defined as eGFR < 45 ml/min/1.73m2, creatinine clearance < 40 ml/min, or known chronic kidney disease of stage 3 or higher); 11)Head trauma, intracranial or spinal surgery, major surgical procedures or severe trauma within the past 4 weeks; 12)ISMN or NBP use within the past 3 days; 13)Have contraindications to ISMN or NBP, or allergy to their components; 14)Have to use the contraindicated drugs of this trial for a long time; 15)Pregnant, breastfeeding or planning to pregnant during this study; 16)Unable to tolerate MRI or with MRI contraindications; 17)Have severe diseases or expected survival <12 months; 18)Participate in other clinical trials within 30 days before this trial; 19)Unlikely to comply with study procedures and follow-up procedures for whatever reason in the opinion of the research physician. |
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研究实施时间: Study execute time: |
从 From 2024-08-01 00:00:00至 To 2028-07-31 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2025-10-01 00:00:00 至 To 2027-02-28 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
由独立的统计师以分层区组随机的方式用R 软件生成,该统计师不参与研究实施 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
An independent statistician generated a random number sequence using R software in a stratified block random manner. This statistician is not involved in the implementation of the study. |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
公开/Public |
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盲法: |
本研究采用双盲。研究者与受试者均不知道受试者所在的研究分组。研究使用的单硝酸异山梨酯活性药及安慰剂、丁苯酞活性药及安慰剂之间具有相同剂型、形状、颜色、气味、味道。在本研究中,分中心使用的生物学实验没有揭盲的可能。此外,为保证盲法,两组的药物包装、批号均完全相同,包装批号统一标注。每盒药品上将标有唯一的药品ID编号。这一编号将用于指定受试者所接受的治疗,但不会向研究者或受试者提示治疗分配情况。研究实施期间,除了公司的供应链、研究管理部门和受试者安全部门的授权人员之外,各个研究执行小组的成员、研究中心人员以及CRO数据处理人员都不能查看随机化方案。结局的评价亦使用盲法,临床主要有效性终点事件以及严重不良事件提交裁决委员会判读,受试者随机分组对裁决委员会成员设盲。 |
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Blinding: |
This trial is a double-blind study. Both investigators and participants are unaware of the assigned groups. The active and placebo formulations of isosorbide mononitrate and butylphthalide are identical in dosage form, shape, color, odor, and taste. In this study, biological assays can not lead to unblinding. To maintain blinding, the packaging and batch numbers of the study drugs in both groups are completely identical. Each box of medication is labeled with a unique drug ID number, which is used to assign the treatment received by each participant without revealing the treatment allocation. During the study, members of the study execution teams, site investigators, and CRO data handlers are not permitted to access the randomization scheme, except for authorized personnel from the company’s supply chain, study management, and safety departments. Outcome assessments will be also conducted under blinding. Clinical adjudication of primary efficacy outcome events and serious adverse events will be performed by an independent adjudication committee, which remained blinded to participants’ groups. |
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试验完成后的统计结果(上传文件): |
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Calculated Results after
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是否共享原始数据: IPD sharing |
Yes |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
根据科技部国家重大专项管理要求,递交原始数据至指定的数据平台,在专项约定的条件下对专项各承担单位,乃至今后面向所有科技工作者和公众开放共享 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
According to the management requirements of the National Major Projects of the Ministry of Science and Technology, the original data should be submitted to the designated data platform. Under the agreed conditions of the project, the data will be shared among all the project's undertaking units and later made available to all scientific researchers and the public. |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
需在临床试验中的原始记录或者核证副本上记载所有信息,包括临床试验中产生的原始记录、文件和数据,如医院病历、医学图像、实验室记录、备忘录、受试者日记或者评估表、发药记录等。本试验数据录入为直接录入电子数据采集系统(Electronic Data Capture, EDC),研究者或经研究者授权临床研究协调(CRC)根据受试者的原始资料信息通过EDC系统填写受试者信息。记录在eCRF信息应与记录在原始记录中的源数据一致。 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
All information must be recorded in the original records or certified copies during the clinical trial, including original records, documents, and data generated in the trial, such as hospital medical charts, medical images, laboratory records, memoranda, subject diaries or assessment forms, and drug dispensing records. In this study, data entry will be performed directly in the Electronic Data Capture (EDC) system. The investigator, or a clinical research coordinator (CRC) authorized by the investigator, will enter subject information into the EDC system based on the subject’s source documents. The data recorded in the electronic case report form (eCRF) must be consistent with the source data documented in the original records. |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
有/Yes |