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TEMPO-‐1 COORDINATING CENTRE Issue1 11101111
New
Issue #2, Halloween
2013
NEWSLETTER TRIALS UPDATE: IN THIS ISSUE
TIER 2 Now Open!
DSMB The Data Safety Monitoring Board (DSMB) recently met on September 30, 2013, to review the first 25 subjects enrolled into Tier 1 (0.1mg/kg dose). The DSMB had no safety concerns; therefore they have agreed that the study continue with enrollment and can proceed to Tier 2 dosing (0.25mg/kg). The DSMB will review the data again after the next 10 subjects have been enrolled to assess safety in Tier 2. A total of 25 subjects will be enrolled into Tier 2.
The first subject was enrolled into Tier 2 at the Calgary site last week. The subject had a Left M1 occlusion; the 4-‐8 hour CTA revealed recanalization of the artery. Subject was discharged home on Day 5 with a NIHSS of 0.
STUDY DRUG Subjects will now be receiving a larger dose of TNK-‐tPA in Tier 2; therefore it is no longer required to use a separate 3 cc syringe to draw up a small, exact amount of TNK-‐tPA. You can now use the 10cc syringe provided in the TNK-‐tPA kit to: 1) inject the sterile water into the TNK-‐tPA, 2) draw up and 3) administer the drug all with the same syringe.
AMENDMENT #2 We have revised the TEMPO-‐1 protocol for clarity. There are no major changes in patient enrollment process or study design. Health Canada has approved Amendment #2, Protocol Version 2.2, dated Aug 28, 2013.
We have clarified that:
a) INR ≤ 1.4 is eligible; INR > 1.4 is excluded.
b) Clinical eligibility does not mandate a current measurable deficit. NIHSS = 0 is not an exclusion.
c) Exclusion #12: Stroke Thrombolysis Guidelines: Enrolment in TEMPO-‐1 and treatment with TNK-‐tPA may still be considered if there is reasonable clinical justification. We have clarified that these are relative guidelines and that if treatment is still considered safe, despite a relative contraindication, it must be justified clinically.
REB approval must be obtained prior to enroling under Amendment #2. No changes are required to the Informed Consent form.
The University of Calgary is the official sponsor for the TEMPO-‐1 trial.
We would like to thank Dr. Jennifer Mandzia for her contributions this past year working on the TEMPO-‐1 trial as a stroke fellow. We wish Jen best wishes practicing in London, Ontario.
We welcome Dr. Veronique Dubuc, from Montreal, Quebec, as our current TEMPO-‐1 fellow.
TEMPO-1 Update:
TEMPO-‐1 COORDINATING CENTRE | Issue 1 2
TEMPO-1 Coordinating
Centre
Rm C1241B-‐1403 29th Street NW
Calgary, AB, T2N 2T9
FAST FACTS TEMPO TIER 1 RESULTS:
21.7% of patients in Tier 1 had complete recanalization. (0.1mg/kg dose)
26.1% of patients had partial recanalization in Tier 1. (0.1mg/kg dose)
NIHSS = 3 median baseline score in Tier 1
TEMPO-‐1 MEDICAL MONITOR HOTLINE
Please note to contact the On Call Medical Monitor for any enrolment questions or Hemorrhagic SAE’s. Call 1-‐855-‐4TEMPO1 (1-‐855-‐483-‐6761).
Current Participating Sites:
Vancouver, B.C.:
PI: Dr. Negar Asdaghi
Coordinators: Erin Tang, Karina Villaluna
Ottawa, Ontario:
PI: Dr. Nikolai Steffenhagen
Coordinator: Sohail Roberts
Charles Les Moyne, Greenfield Park ,Quebec
PI: Dr. Jean Martin Boulanger
Coordinators: Martine Mainville, Lise Blais, Johanne Pontbriand
Pending Participating Sites:
Victoria, B.C:
PI: Dr. Andrew Penn
Coordinator: Leslie Atkins
Montreal, Quebec, CHUM
PI: Dr. Alex Poppe
Coordinator: Marlene Lapierre
Quebec City, Quebec:
PI: Dr. Marie-‐Christine Camden
Coordinators: Claudette Lessard, Annette Hache, Franse Lebel
Sherbrooke, Quebec:
PI: Dr. Francois Moreau
Coordinator: Mario Houde
The TEMPO-1 Executive Committee, July 2013, our last meeting with Jen.
Frequently Asked Questions:
Is it a Protocol Deviation if the ECG is performed after the tNK has been administered?
No, you have 6 hours from subject enrolment to have an ECG performed. Please have the treating Investigator review it, sign and date it promptly.
Can you repeat the baseline CTA if the 90 minute window has expired to restart the clock?
Yes, if the subject’s Creatinine level is normal and an occlusion is seen on the first CTA. The second CTA time will be used for patient enrolment. It may be suggested that a MRA be performed at the 4-‐8 hour follow-‐up to reduce renal contrast overload.
What hemorrhage rate is being quoted in Tier 2 when enroling a subject and obtaining informed consent?
1-‐2%.