Bovis Calculus Stativus Treat Acute Cerebral Ischemic Stroke With Impaired Consciousness

Trial statusNot yet recruiting
Trial phasePhase 2, Phase 3
Trial typeInterventional
Biological sexAll
Age18+
SponsorXiang Luo

About this trial

Acute ischemic stroke (AIS) is a severe and life-threatening condition, with 35% of AIS patients experiencing impaired consciousness upon admission within 24 hours of onset. Previous studies indicated that patients with impaired consciousness at the onset of stroke have a higher incidence of stroke-related complications, particularly cerebral edema and pneumonia, as well as higher in-hospital and three-month mortality rates. The etiology of impaired consciousness in AIS is complex: ischemic damage to reticular activating system of the brainstem can directly lead to cell necrosis and result in impaired consciousness. Furthermore, secondary pathological changes following AIS, such as excitatory amino acid toxicity, oxidative stress, free radical production, and cascading inflammatory responses, can indirectly worsen impaired consciousness. Therefore, impaired consciousness at the onset of AIS is the result of cellular damage under multiple pathophysiological mechanisms. Developing neuroprotective drugs with multiple targets is key to effectively improving adverse outcomes related to impaired consciousness in AIS. However, there is currently a lack of treatment specifically aimed at improving impaired consciousness at the onset of AIS.

Cultivated Bovine Bezoar (Bovis Calculus Stativus, BCS) combines the advantages of pharmacological similarity to natural bovine by adding components such as deoxycholic acid, cholic acid, and composite calcium bilirubin to fresh bovine bile. It is rich in various trace elements and amino acids and is a compound medication that can exert neuroprotective effects through multiple pathways and targets. In traditional Chinese medicine, it has long been used to treat various consciousness disorder-related diseases, including stroke. The various components of in vitro cultivated bezoar are also widely used in clinical research for various neurological diseases.The above evidence fully demonstrates that BCS is an optimal treatment for impaired consciousness in stroke.

The goal of this clinical trial is to learn if Bovis Calculus Stativus works to treat acute cerebral ischemic stroke with impaired consciousness. It will also learn about the safety of Bovis Calculus Stativus. The main questions it aims to answer are:

1. Does Bovis Calculus Stativus treat and alleviate consciousness disorders in patients with acute cerebral infarction accompanied by impaired consciousness ? 2. What medical problems do participants have when taking Bovis Calculus Stativus?

Researchers will compare Bovis Calculus Stativus to a placebo (a look-alike substance that contains no drug) to see if Bovis Calculus Stativus works to treat acute cerebral ischemic stroke with impaired consciousness.

Participants will:

1. receive treatment with Bovis Calculus Stativus (or placebo) for 5 days. 2. Take an in-person or telephone follow-up within 90 days after the acute stroke.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age ≥ 18 years;

Clinically diagnosed with ischemic cerebral infarction;

GCS score: 3-12;

Time from symptom onset to randomization ≤ 24 hours, including wake-up stroke or stroke without a witness; the time of symptom onset is defined as the "last known well time";

Disqualifiers

Use of in BCS within 24 hours before treatment;

Known pregnancy or breastfeeding, or positive pregnancy test before randomization;

Allergy to BCS;

Impaired consciousness caused by other diseases, such as metabolic disorders (e.g., ketoacidosis), trauma, infectious diseases (e.g., pneumonia), neoplastic diseases (e.g., glioma), or toxic conditions (e.g., organophosphate poisoning);

Trial design

Design model

Parallel

Treatments tested in this trial

  • Bovis Calculus Stativus (BCS)

    Drug

    Patients with acute ischemic stroke accompanied by impaired consciousness within 72 hours and a Glasgow Coma Scale (GCS) score of 3-12, who are randomized to the experimental group, will be administered 0.6 g of BCS orally or via nasogastric tube immediately in the emergency room. Subsequently, in accordance with guidelines, they will receive standard acute stroke treatment along with 0.6 g of BCS twice daily (bid) orally or via nasogastric tube for 5 consecutive days.

  • Placebo

    Drug

    Patients with acute ischemic stroke accompanied by impaired consciousness within 72 hours and a GCS score of 3-12, who are randomized to the control group, will be administered a placebo following the same regimen in the emergency room. Subsequently, in accordance with guidelines, they will receive standard acute stroke treatment along with the placebo administered orally or via nasogastric tube for 5 consecutive days.

Treatment groups

220 Participants
are divided into 2 treatment groups
Group A: Bovis Calculus Stativus (BCS) groupExperimental treatment 1 intervention
Group B: placebo groupPlacebo comparator 1 intervention

Trial outcomes

Primary outcomes

1

Proportion of patients with GCS improvement ≥2 points

Proportion of patients with a GCS score increase of 2 points or more to assess the improvement rate of impaired consciousness

Time frame
Day 8 after randomization

Secondary outcomes

1

GCS shift analysis

GCS score overall shift assessment of consciousness disturbance overall improvement ratio

Time frame
Day 8 after randomization
2

Proportion of mRS 0-2

Proportion of overall favorable prognosis

Time frame
Day 90 after randomization
3

Proportion of NIHSS score 0-1 or a reduction of ≥4 points from baseline

Proportion of good neurological function recovery

Time frame
Day 8 after randomization
4

EQ-5D-5L index score

The EQ-5D-5L index score is a single summary number that represents a person's overall health state based on the EQ-5D-5L descriptive system. It's a crucial tool for calculating Quality-Adjusted Life Years (QALYs) used in health economics and outcomes research.The five levels are: * Level 1: No problems * Level 2: Slight problems * Level 3: Moderate problems * Level 4: Severe problems * Level 5: Extreme problems / Unable to

Time frame
Day 90 after randomization

Other outcomes

1

The incidence of SAE

The incidence of SAE

Time frame
Day 8 after randomization
2

All-cause mortality

All-cause mortality

Time frame
Day 8 after randomization

Locations

This trial has no locations.

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Xiang Luo

Lead sponsor

Tongji Hospital

Sponsor institution

The Fifth Hospital of Wuhan

Collaborator

Jingzhou Hospital of Traditional Chinese Medicine

Collaborator

Xiangyang Hospital of Traditional Chinese Medicine

Collaborator

Wuhan Hospital of Traditional Chinese Medicine

Collaborator

Hubei Hospital of Traditional Chinese Medicine

Collaborator

Wuhan No.1 Hospital

Collaborator

Wuhan Central Hospital

Collaborator

Xiangyang No.1 People's Hospital

Collaborator

Taihe Hospital affiliated to Hubei University of Medicine

Collaborator

Yichang Hospital of Traditional Chinese Medicine

Collaborator

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