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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT06352632




Registration number
NCT06352632
Ethics application status
Date submitted
1/04/2024
Date registered
2/04/2024
Date last updated
19/04/2024

Titles & IDs
Public title
A Multi-faCtorial, mulTi-arm, Multi-staGe, Randomised, gLOBal Adaptive pLatform Trial for Stroke
Scientific title
A Multi-faCtorial, mulTi-arm, Multi-staGe, Randomised, gLOBal Adaptive pLatform Trial for Stroke (ACT-GLOBAL)
Secondary ID [1] 0 0
ACT-GLOBAL_Master
Universal Trial Number (UTN)
Trial acronym
ACT-GLOBAL
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Stroke 0 0
Condition category
Condition code
Stroke 0 0 0 0
Haemorrhagic
Stroke 0 0 0 0
Ischaemic

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Standard-dose intravenous tenecteplase
Treatment: Drugs - Low-dose intravenous tenecteplase
Other interventions - No intravenous tenecteplase
Other interventions - Conservative Blood Pressure Control
Other interventions - Moderate Blood Pressure Control
Other interventions - Intensive Blood Pressure Control
Other interventions - Placebo
Treatment: Drugs - NoNO-42

Experimental: IV thrombolysis domain - This domain has a prospective, randomized, controlled, open-label, parallel group with blinded endpoint assessment (PROBE) design to optimize the use of intravenous Tenecteplase in participants with Acute Ischemic Stroke.

Experimental: Blood Pressure domain - Third Enhanced Control of Hypertension and Thrombectomy Stroke Study (ENCHANTED3/MT) as a domain of ACT-GLOBAL to compare three BP lowering management strategies, that of conservative, moderate and intensive BP lowering in patients with Acute Ischaemic Stroke admitted to participating hospitals who has an elevated SBP after reperfusion therapy via Endovascular Thrombectomy, and reliably determine, which approach leads to improved functional outcome.
Locally available and approved i.v. BP lowering agents can be used in this domain.

Experimental: ACT-42 domain - This domain has a Phase 2b, multicenter, prospective, randomized, open label, blinded-endpoint (PROBE) controlled single-dose adaptive design and aim to determine the efficacy and safety of NoNO-42 in participants with Acute Ischaemic Stroke selected for thrombolysis with or without Endovascular Thrombectomy.


Treatment: Drugs: Standard-dose intravenous tenecteplase
Standard-dose intravenous tenecteplase (0.25 mg/kg body weight); one-time IV bolus injection soon after randomisation

Treatment: Drugs: Low-dose intravenous tenecteplase
Low-dose intravenous tenecteplase (0.18 mg/kg body weight); one-time IV bolus injection soon after randomisation

Other interventions: No intravenous tenecteplase
No intravenous tenecteplase only in subjects on direct oral anticoagulant (DOACs) or those planned for emergency endovascular thrombectomy (EVT)

Other interventions: Conservative Blood Pressure Control
No or minimal Systolic Blood Pressure (SBP) control; SBP reduction by 5-10mmHg or a target of 175-180mmHg if very-high baseline SBP (≥180mmHg); the timing of administration of interventions is specified to be immediately after randomisation; the intervention target is to be achieved ideally at 1 hour after randomisation and maintained for 24 hours (or until hospital discharge or death if this should occur earlier)

Other interventions: Moderate Blood Pressure Control
SBP reduction by 10-20mmHg or a target of 160 ± 5, whichever is higher; no control if low-high baseline SBP (150-160mmHg); the timing of administration of interventions is specified to be immediately after randomisation; the intervention target is to be achieved ideally at 1 hour after randomisation and maintained for 24 hours (or until hospital discharge or death if this should occur earlier)

Other interventions: Intensive Blood Pressure Control
SBP reduction by 30-50mmHg or a target of 140±5 mmHg, whichever is higher after endovascular thrombectomy (EVT); the timing of administration of interventions is specified to be immediately after randomisation; the intervention target is to be achieved ideally at 1 hour after randomisation and maintained for 24 hours (or until hospital discharge or death if this should occur earlier)

Other interventions: Placebo
100 mL of 0.9% normal saline, administered as a single IV infusion with a 20-minute dosing duration.

Treatment: Drugs: NoNO-42
NoNO-42 at weight-based dosing - 2.6 mg/Kg, administered as a single IV infusion with a 20-minute dosing duration
Intervention code [1] 0 0
Treatment: Drugs
Intervention code [2] 0 0
Other interventions
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
modified Rankin scale (mRS) scores
Timepoint [1] 0 0
Platform level time frame: 90 days in Ischaemic Stroke State; Domain specific time frame may differ (details will be included in domain-specific registration)
Secondary outcome [1] 0 0
Excellent functional neurological outcome
Timepoint [1] 0 0
Platform level time frame: 90 days in Ischaemic Stroke State; Domain specific time frame may differ (details will be included in domain-specific registration)
Secondary outcome [2] 0 0
Independent functional neurological outcome
Timepoint [2] 0 0
Platform level time frame: 90 days in Ischaemic Stroke State; Domain specific time frame may differ (details will be included in domain-specific registration)
Secondary outcome [3] 0 0
Health Related Quality of Life
Timepoint [3] 0 0
Platform level time frame: 90 days in Ischaemic Stroke State; Domain specific time frame may differ (details will be included in domain-specific registration)

Eligibility
Key inclusion criteria
Platform

1. Age ≥18 years

2. Clinical diagnosis of stroke

Platform
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
There are no platform level exclusion criteria

Each state and domain will specify additional inclusion and exclusion criteria in the
respective Domain-Specific Registration. Patients who fulfill the overall platform criteria
will be assessed for enrollment into each active domain.

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?


The people assessing the outcomes
Intervention assignment
Factorial
Other design features
Phase
Phase 3
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Not yet recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
1/04/2024
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
1/04/2034
Actual
Sample size
Target
20000
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)

Funding & Sponsors
Primary sponsor type
Other
Name
The George Institute
Address
Country
Other collaborator category [1] 0 0
Other
Name [1] 0 0
University of Calgary
Address [1] 0 0
Country [1] 0 0
Other collaborator category [2] 0 0
Other
Name [2] 0 0
Berry Consultants
Address [2] 0 0
Country [2] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
Stroke is causing 6.6 million deaths and is a major cause of disability worldwide in 2019.
There remains an urgent need for interventions that improve outcomes which can be implemented
with wide applicability for stroke. ACT-GLOBAL is a multi-factorial, multi-arm, multi-stage,
randomised, global adaptive platform trial for stroke, aiming to identify the treatment/s
associated with the highest chance of improving outcome in stroke patients. In ACT-GLOBAL
multiple questions will be evaluated simultaneously and sequentially as data accrues and can
evaluate interactions between different treatment options.
Trial website
https://clinicaltrials.gov/ct2/show/NCT06352632
Trial related presentations / publications
Public notes
This record is viewable in the ANZCTR as it had previously listed Australia and/or New Zealand as a recruitment site, however these sites have since been removed

Contacts
Principal investigator
Name 0 0
Craig Anderson, MD, PhD
Address 0 0
The George Institute
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Xiaoying Chen, PhD
Address 0 0
Country 0 0
Phone 0 0
+61280524549
Fax 0 0
Email 0 0
xchen@georgeinstitute.org.au
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT06352632