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This study was terminated after completing the first dose level of Sanbenxin 37.5 mg due to the decision made by the sponsor that a new clinical development program for the new form of sublingual tablets would replace the existing plan.
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The SIM0355-201 trial is a multicenter, randomized, double-blind, placebo-controlled exploratory clinical trial with the main study objective of evaluating the safety and tolerability of different doses of Edaravone Dexborneol concentrate injection (Sanbexin IV) combined with conventional medical therapy in patients with intracerebral hemorrhage (ICH). The subject had a clinical diagnosis of ICH, within 6-24 hours from stroke onset to start of study treatment, with the bleeding site in basal ganglia and a hematoma volume ≤ 30 ml at the bleeding site. The trial was divided into two periods (Period A and Period B), with Period A being a dose escalation period divided into two dose levels: the first dose level group (Dose 1 group: Sanbexin IV 37.5 mg; placebo group) and the second dose level group (Dose 2 group: Sanbexin IV 62.5 mg; placebo group). Period B is the expansion phase, where the sample size is increased based on the optimal dose selected in Phase A to observe efficacy and safety.
The SIM0355-201 trial is a multicenter, randomized, double-blind, placebo-controlled exploratory clinical trial with the main study objective of evaluating the safety and tolerability of different doses of Edaravone Dexborneol concentrate injection (Sanbexin IV) combined with conventional medical therapy in patients with intracerebral hemorrhage (ICH). The subject had a clinical diagnosis of ICH, within 6-24 hours from stroke onset to start of study treatment, with the bleeding site in basal ganglia and a hematoma volume ≤ 30 ml at the bleeding site. The trial was divided into two periods (Period A and Period B), with Period A being a dose escalation period divided into two dose levels: the first dose level group (Dose 1 group: Sanbexin IV 37.5 mg; placebo group) and the second dose level group (Dose 2 group: Sanbexin IV 62.5 mg; placebo group). Safety was assessed unblinding after the end of study treatment for all subjects in the first dose level group and escalated to the second dose level if the "safe dose" criterion was met, otherwise the trial was terminated; safety was assessed unblinding after the end of study treatment for all subjects in the second dose level group and the 62.5 mg dose level was selected to enter Stage B if the "safe dose" criterion was met, otherwise the 37.5 mg dose level was selected to enter Stage B. Period B is the expansion phase, where the sample size is increased based on the optimal dose selected in Phase A to observe efficacy and safety.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sanbexin IV | Experimental | Sanbexin IV 37.5 mg (edaravone 30 mg + dexborneol 7.5 mg), intravenous, twice daily, for 14 consecutive days |
|
| Placebo | Placebo Comparator | Sanbexin mimetic agent, intravenous, twice daily, for 14 consecutive days |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sanbexin IV/Placebo | Drug | Sanbexin/Placebo |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of serious adverse events (SAEs) up to 90 days after the first dose of treatment | up to 90 days after the first dose of treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of deaths up to 90 days after the first dose of treatment | up to 90 days after the first dose of treatment | |
| Proportion of subjects with AEs, AEs leading to dose interruption or discontinuation, AEs related to study drug, AEs of special interest (AESls), and with abnormal vital signs, abnormal physical examination findings and abnormal laboratory tests results |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Xiaonan Yao | Simcere Pharmaceutical Co., Ltd | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Affiliated Hospital, Sun Yat-sen University | Guangzhou | Guangdong | 510080 | China |
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Initially, 40 participants were enrolled with a 3:1 randomization ratio (30 to the Sanbexin IV group; 10 to the Placebo group). However, the sponsor considered that the placebo group size was insufficient for accurate safety assessment of the investigational drug. Consequently, 20 additional participants were added, revising the randomization ratio to 1:1. Ultimately, the study included 50 participants in the Sanbexin IV group and 30 in the Placebo group
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| up to 90 days after the first dose of treatment |
| Proportion of subjects with modified Rankin Score (mRS) 0-2, which assesses the degree of disability or dependence in daily activities, with scores ranging from 0 (no symptoms) to 6 (death), at 90 days after the first dose of treatment | at 90 days after the first dose of treatment |
| Proportion of subjects with modified Rankin Score (mRS) 0-1, which assesses the degree of disability or dependence in daily activities, with scores ranging from 0 (no symptoms) to 6 (death), at 90 days after the first dose of treatment | at 90 days after the first dose of treatment |
| Distribution of subjects with modified Rankin Score (mRS), which assesses the degree of disability or dependence in daily activities, with scores ranging from 0 (no symptoms) to 6 (death), at 14, 30, 90 days after the first dose of treatment | at 14, 30, 90 days after the first dose of treatment |
| Distribution of subjects with Glasgow Outcome Score (GOS), which measures functional outcome, with scores ranging from I (Dead) to V (Good Recovery), at 14, 30, 90 days after the first dose of treatment | at 14, 30, 90 days after the first dose of treatment |
| Change from baseline in National Institutes of Health Stroke Scale (NIHSS), which quantifies the impairment caused by a stroke, with scores ranging from 0 (no stroke symptoms) to 42 (the most severe stroke) | at 14, 30, 90 days after the first dose of treatment |
| Proportion of subjects with National Institutes of Health Stroke Scale (NIHSS) 0-2, which quantifies the impairment caused by a stroke, with scores ranging from 0 (no stroke symptoms) to 42 (the most severe stroke) | at 14, 30, 90 days after the first dose of treatment |
| Proportion of subjects with Barthel index (BI), which measures a person's ability to complete activities of daily, with scores ranging from 0 (fully dependent) to 20 (fully independent), at 90 days after the first dose of treatment | at 90 days after the first dose of treatment |
| Imaging endpoints:Change from baseline in perihematomal edema volume (PHEv) and hematoma volume (HV) in milliliters | at 3, 7, 14 days after the first dose of treatment |
| Imaging endpoints:Change from baseline in edema extension distance (EED) in millimetres c) Change from baseline in relative perihematomal edema (PHEv/Hv) in odds ratio | at 3, 7, 14 days after the first dose of treatment |
| Imaging endpoints: Change from baseline in relative perihematomal edema (PHEv/Hv) in odds ratio | at 3, 7, 14 days after the first dose of treatment |
| Plasma pharmacokinetic endpoints: Cmax: maximum observed plasma concentration for edaravone and dexborneol | 1 hour pre-dose and 1, 2 hour post-dose at 3, 14 days after the first dose of treatment |
| Plasma pharmacokinetic endpoints: Tmax: time to reach the maximum plasma concentration (Cmax) for edaravone and dexborneol | 1 hour pre-dose and 1, 2 hour post-dose at 3, 14 days after the first dose of treatment |
| Plasma pharmacokinetic endpoints: AUC(0-inf): area under the plasma concentration-time curve from time 0 to infinity for edaravone and dexborneol | 1 hour pre-dose and 1, 2 hour post-dose at 3, 14 days after the first dose of treatment |
| Plasma biomarker endpoints: a) Change from baseline in white blood cell count (WBC) in 109/L; b) Change from baseline in C-reactive protein (CRP), Thioredoxin (TRX) and matrix metalloproteinases (MMP) in mg/L | at 3, 7, 14 days after the first dose of treatment |