Clinical-Trial
TREASURE — Allogeneic Stem Cell Therapy for Acute Ischemic Stroke
A multicenter double-blind phase 2/3 RCT in Japan found that allogeneic MultiStem cell therapy within 18–36 hours of acute ischemic stroke was safe but did not improve excellent-outcome rates at 90 days versus placebo, with exploratory subgroup signals in younger patients.
Fibrinogenase for injection in the treatment of acute ischaemic stroke: a randomised clinical trial — the Chinese snake-venom fibrinolytic that beat placebo on mRS at 90 days
In a 235-patient Chinese RCT of fibrinogenase for injection within 72 hours of AIS onset, the ordinal mRS distribution at 90 days favoured fibrinogenase over placebo (OR 2.38, 95% CI 1.49–3.85; p<0.001), with no excess bleeding or mortality.
Minimally Invasive Surgery vs Medical Management Alone for Intracerebral Hemorrhage — The MIND Randomized Clinical Trial
In the MIND trial, minimally invasive surgery with the Artemis device within 72 hours did not significantly reduce 30-day mortality or improve 180-day disability in supratentorial ICH versus medical management alone.
Thrombus Migration After Tenecteplase Versus Alteplase in Acute Large Vessel Occlusion
In a matched multicenter cohort of 746 large-vessel-occlusion patients undergoing bridging therapy, tenecteplase produced nearly twice the thrombus migration of alteplase (19.3% vs 11.3%), concentrated in the first 60 minutes after IVT, and migration independently predicted functional independence.
Deep-Dive: Argatroban in Acute Ischemic Stroke With Early Neurological Deterioration — A 2023 RCT From China
Argatroban + antiplatelet in END (n=601): 90-d mRS 0–3 80.5% vs 73.3% (aRR 1.10, P=0.03); sICH 0.9% vs 0.7% (P=0.78); mRS shift OR 0.71 (P=0.02).
Deep-Dive: Predictors of Hematoma Expansion and Response to Andexanet — ANNEXA-I Secondary Analyses
ANNEXA-I secondary analyses: andexanet benefit amplifies in highest-risk HE quartiles (NNT ~4) without amplifying thrombotic-event risk; authors propose an 11-to-1 rule.
Deep-Dive: Argatroban Plus DAPT in Branch Atherosclerosis Disease — Halves END
Argatroban+DAPT vs DAPT alone in high-risk branch atherosclerosis disease (n=100): END 20.4% vs 47.1% (P=0.006), mRS 0–1 87.8% vs 68.6% (P=0.025), no excess bleeding.
Deep-Dive: JX10 — A Late-Window Anti-Inflammatory Thrombolytic Hits Phase 2a Safety Mark
JX10 phase 2a (n=90) — late-window (5–12h) thrombolytic met its primary safety endpoint (0% sICH vs 2.6% placebo) and showed a day-90 mRS 0–1 signal (40.4% vs 18.4%, P=0.03).
Deep-Dive: ANNEXA-I Biomarker Substudy — Andexanet's Therapeutic Window Is 1 Hour, and It Cuts Both Ways
ANNEXA-I biomarker substudy: 1-hour reduction in anti-FXa (OR 0.69/100 ng/mL) and rise in ETP (OR 0.94/100 nmol/L-min) both predict fewer hematoma expansions; the ETP rise also independently predicts more thrombotic events (OR 1.08).
Deep-Dive: Perforator Territory Infarction Doubles 90-Day Disability Odds After LVO Thrombectomy
Post-hoc analysis of MR CLEAN-MED + MR CLEAN-NO IV: perforator-territory infarcts after LVO thrombectomy (n=397) triple the odds of worse 90-day mRS without affecting 24-h NIHSS.
Deep-Dive: MR CLEAN M2 Registry — Bridging Therapy Edges Out Direct EVT for M2 Occlusions
MR CLEAN Registry M2 analysis (n=539): bridging IV thrombolysis before EVT improves 90-day mRS vs direct EVT (aOR 1.52, P=0.03); sICH and recanalization similar.
OPTIMAS — Early vs. Delayed DOAC After Ischemic Stroke, by AF Subtype and Time of Diagnosis
OPTIMAS subgroup analysis: in 3,619 stroke patients with AF, neither the time of AF diagnosis nor AF subtype modifies the effect of early DOAC initiation versus delayed initiation.
Deep-Dive: ETLAS-2 — Tadalafil for CSVD Fails Feasibility, but the Imaging Signal Hints at a Better Trial
ETLAS-2 phase II: tadalafil 20 mg daily for 3 months in CSVD fails feasibility (compliance 68% vs 94% placebo) with 2-fold more AEs; per-protocol WMH volume trend suggests mechanistic signal at lower doses.
Deep-Dive: ZODIAC — Laying LVO Patients Flat Before Thrombectomy Cuts Pre-Procedure Deterioration 26-Fold
ZODIAC phase III RCT (n=92, stopped early for efficacy): 0° vs 30° head-of-bed positioning before thrombectomy — END HR 34.40 (95% CI 4.65–254.37), P<0.001; exploratory mortality P=0.03.
Deep-Dive: T-FLAVOR — Tenecteplase 0.25 mg/kg vs Low-Dose Alteplase in LVO Stroke
T-FLAVOR Japanese phase 2 (n=218): tenecteplase vs low-dose alteplase for LVO bridging — substantial reperfusion 10.3% vs 3.6% (90% CI 0.89–12.1; 95% CI −0.19% to 13.2%; mRS shift favors TNK numerically).
Deep-Dive: LAMP Post-Hoc — Liraglutide Cuts Recurrent Stroke in Insulin-Resistant Patients
LAMP post-hoc: liraglutide reduced recurrent stroke in insulin-resistant T2D stroke/TIA patients (HOMA-IR ≥ 2.5) but not in those with preserved insulin sensitivity.
Deep-Dive: Home-Based HIIT for Poststroke Fatigue — First RCT, Small N, Real Signal
First RCT of home-based HIIT for poststroke fatigue: 8-week intervention cut S-FAS by 5.35 points and improved VO2peak by 4.48 mL/kg/min in 43 completers.
Deep-Dive: ACTISAVE — Glenzocimab Fails to Beat Placebo on Top of tPA ± EVT
ACTISAVE failed to confirm a beneficial effect of glenzocimab on mRS in patients with acute ischemic stroke treated by thrombolysis ± thrombectomy.