NIHR Multicentre Stroke Studies



The National Institute for Health Research provides an infrastructure to foster high quality research in the UK. Click the links for Stroke Research and the Clinical Research Network West Midlands for specific detail. Please contact Christine Roffe, the Specialty Lead for Stroke, or Sissi Ispoglou, the deputy lead, for further information. Active studies and stats can be found on the Daily Recruitment Checker. Please find below a list of past and current studies.

Hyperacute Stroke Studies (the first 9 hours)
ASSENT Daiichi STRO-4708, complex ph1-2, <8h, needs CTA
ANNEXA-4 Portola Open study Andexanet Alfa in acute bleeds due to DOACs
ATTEST-2 alteplase vs tenecteplase <4.5h of AIS (K. Muir)
ECASS-4  complex RCT lysis after 4.5 h of  AIS, needs  MRI  (end 08/18)
EuroHyp-1 complex RCT induced hypothermia for acute stroke
ENCHANTED RCT tight vs standard BP control after lysis <4.5h of onset
MEDIS Pulse Therap. STRO4938 complex RCT microspheres (K. Muir)
PASTA RCT paramedic acute stroke treatment assessment (North East only)
Practise complex RCT decisions for late lysis: perfusion imaging or not?
Pfizer STRO complex ICH ph 1b rct ph2 prothombin acivator<2.5h  -03/17
GTN patch vs pacebo for suspected stroke, given in the ambulance
RECAST-2 remote ischemic preconditioning  (Nottingham and Darby only)
SCIL-1 RA  infarct/complex RCT (Manchester only)
SITS Open complex RCT of MT vs standrd care (CI Mc Walter)-30.09.17
Stabilise  complex RCTcomparison of two thrombectomy devices <4.5 h
SmartChip Obs. study <4.5 h (continues in NCL only)
TASTE complex RCT decision making for tenecteplase via perfusion CT
TICH-2 tranexamic acid for intracerebral haemorrhage (-30.09.2017)
TWIST tenecteplase in wake-up stroke (led by Norway)

Acute Stroke/ SAH/ TIA/ dissection Studies
ATTEST-Additional trunk training in early stroke (3-7d) Guy's&St T only)
Gypsie Glycoprotein 6 in stroke (Canmbridge only) till Sept 2017
MISTIE-3 complex surgery for ICH <48 h alteplase into ventricular  drain

POINT Asprin and clopidogrel vs aspirin <12 h of onset (on hold June 2016)
RESTORE Servier STRO-4889 complex RCT GABA antag N7-20 MRI cort. inf.  d3-6  

Studies requiring vascular surgery and/or interventional radiology input
ACST-2 Carotid endarterect or stenting for asympt. carotid artery stenosis
ECST-2 Carotid endarterect or stenting vs BMT in asympt. mild to mod CAS
Pipleline Flex SFX-01 after SAH Single centre Wessex observational SAH

DNA Lacunar-2 observational needs MRI (CI H Markus)
NAVIGATE Rivaroxab vs asp in embol. stroke of undet. source (-20. 9.17)
RESTART REstart or STop Antithrombotics Randomised Trial (2015-)
AFGEN Long term observational AF study (cardiol.) G. Lip (2014-)
XILO-FIST RCT allopurinol vs control <30d  MRI at baseline + 2y (J Dawson)

Rehabilitation and Life after Stroke
Phader STRO 4441 Phagenesis pharyngeal stimulation for dysphagia
PLORAS  Observational study: predicting language recovery after stroke
RESTORE  ph2 RCT GABA rec antagonist S 44819 3-6 days after AIS
ReNeuron observational RN-CS-0002  CI K. Muir

 Upcoming studies [** complex * hyperacute)
**CHARM Medpace complex RCT glyburide MRI AIS< 9h NIHSS>9 (Q3/17)
**005578 Pharm Olam ph2a RCT angiogenesis AIS<72h N8-20 (EOI 02/17)
**PROMISE single centre MT device study (London)
?**CRIT1345 Servier INTREPID fever prev. for stroke and SAH (EOI 03/17)
?**PISCES-3 Stem cell (detail tbc 2017)
?**Japanese Device study (detail tbc 2017)
?**MASTERS-2 Athersys new stem cell study in AIS (expected Q3 2017)
?**Cerebrotech (detail tbc 2017) Ultarsound scanning study in the ambulance
*MAPS-2 RCT metoclop a/o select. oral decontamin. < 9h (CI Roffe Q4/17)
PRECIOUS 2x2x2 RCT metoclop/ceftriax/paracetx4d AIS<12h N>5 (McWalter)
CAARBS Which Rx for BP in AIS/TIA (T.Robinson/Leics/Oxf/Norw only 03/17)
CONVINCE RCT oral colchizine in AIS start Q3/17 (72h-28 d) CI C. Price
Athersys stem cell trial in stroke patients undergoing rehabilitation EOI 2016
LACI-3 2x2 RCT cilostazol and/or ISMO x 1y in MRI defined LACI to prev. stroke  (Q4/17)
SoSTART AF and ICH to anticogulate or not RCT R. AlShahi-Salman
ODEA TIA Reveal implantation for AF detection R. Veltkamp (EOI June 2017)
PROHIBIT ICH adcvanced MRI and tight BP control (D. Werring)
Roche Bamisanil ph 2 RCT 3-4d severe AIS (EOI Jun 2017)
TRIDENT RCT telmis/amlod/indap <6m of ICH CI C. Anderson (EOI 04/17)

Possible future studies (pre funding EOIs)
**PISTE AI MT for AIS determined by CTA CTP (awaiting funding decision)
**ESCAPE NA1 (Goyal), MT RCT (commercial)TBC
RECAST Intermittent cuff compression of upper limbs <6h (CI T. England)
MAGiC 2x2 RCT mannitol/gliblenclamide <72h AIS NIHSS>15 N.Sprigg Q1/18
RETAKE Return to work (Nottingham)
*DASH Desmopressin for ICH with  Antiplatelet CI N Sprigg EOI Nov 2016
R4VAD Therapy trial J Wardlaw Observational cogn. decline EOI Sept 2016
RAPPSTAR RCT repetetive funct practice in the community H Rodgers EOI 2016
PROPS Comb. fixed dose pill (atorv/asp/ramip) >55yo prim care led
ELAN early vs late anticoag w. DOAC in AIS<48h and AF EOI 01/17 J Dawson
OPTIMAS early vs late anticoag. wDOAC in AIS<4d & AF EOI 2017 D.Werring
TIMING Swedish study of early vs delayed anticoag for AIS and AF
Observational registry of a DOAC (TBC Jan 2017)
Industry Study Rehabilitation device  Mindmaid (TBC Jan 2017)
FISHES D. Day Cambridge iv fluids within 4 h of AIS RfPB Jan 2018

Studies not started /not running in the UK
**STRO-347  ph 1b mRCT <4.5 h if thrombolysis not indicated (Parexel 2014)
**PRISMS Genentech RCT Asp vs alteplase nihss<=5 (CI P Khatri) closed 02/17
**Impact24B  Sphenopalatine gangl. stim. to inc. CBF  8-24 h (not in UK)
Socrates-2 STRO 32062 RCT of ticagrelor&AIS <24h (Not open in UK)
Pharma  SFX01 after SAH  (on hold till Feb 2014)

Studies closed to recruitment
Biogen Action-2 STRO-30468 complex RCT ph2 Nataluzimab in AIS <24h
Wake-Up stroke complex RCT of lysis in WUS, decision via MRI (closed 06/17)
LOTS-2 Care Evaluation of a service giving longer-term support (>6 m)
LA-SER PGRX commercial observ. study stroke of undet. origin (close Jan 17)
FOCUS Fluoxetine within 5-15 d of stoke onset (investigator portal)
COGWATCH Rehabilitation for stroke patients who have cognitive difficulties
VWF-ADAMTS 13 Observational, Van Willebrand factror (UCL only)
FAST INDICATE Functional Strength Training to reduce arm weakness
EXTRAS RCT of an extended supported discharge service for stroke patients
RAPID TIA (Rapid Primary Care Initiation of Drug treatment for TIA pilot RCT)HEADPost cluster RCT of head position after stroke
GLORIA AF Obs. study of patients newly anticoagulated for AF Boehringer
PRESERVE BP control in patients with SVD, needs MRI at baseline
GORE REDUCE closure vs antiplatelets alone for PFO (UHB only in WMIDS)
PISCES-2 RENEURON 002: RCT of stem cell treatment for stroke recovery
OCScare/BCoS Care Observational study of cognitive outcome after stroke
TARDIS P-Selectin sub-Study EOI June 2015 (TARDIS Centres only)
TARDIS triple antiplatelets <72 h from onset of stroke or TIA
CROMIS 2 obs. study of microbleeds in anticoagulated patients, requires MR
SMARTcap observational study of a blood test for the diagnosis of stroke
PISTE thrombectomy in patients with MCA /carotid T occlusion
OSIS RENEURON RN-CS-0001: observational study of stroke outcome
CLOTBUST Ultrasond enhanced thrombolysis within 4.h of stroke onset. 
ARTSS 2b Direct thrombin inhibtor (agatroban) x 48h& tpa vs tpa within 4.5h
MULTISTEM Athersys Phase-II RCT adult human stem cells iv <36 h of onset
Dias-4 thrombolysis <9 hrs form onset (looking for new centres)
SOS Penumbra observational <9 h NIHSS>9, large artery occlusion on CTA 
VIST stenting for symptomatic (< 6 mo) atheroslerotic vertebral artery stenosis
VCT-returns (Visual Cue training for walking and turning pilot RCT)
SO2S oxygen supplementation <24 hrs form onset
BMS phase 4 apixaban with and without extra support  RCT 
REFLEX Botox treatment in stroke rehabilitation (commercial)
PODCAST Prevention Of Decline in Cognition: BP control in primary care
DARS Dopamine Augmented Rehabilitation in Stroke. <14 d of stroke onset.
ATRAS study Assistive Technologies in Upper Limb Rehabilitation
TBS effect of repetitive Transcranial magnetic stimulation on arm function >1y
EUBOSS (Early Use of Botulinum Toxin in post Stroke Spasticity)
BCoSlite (Improving diagnosis and treatment of cognitive problems
GOSH Case-control study of genetic polymorphisms in aneurysmal SAH
FACE TIA Cognitive problems after TIA (obs. study)  (slides)
DNA Lacunar Lacunar infarct on MRI and clinically and <70
BUCS observational study, Birmingham University Cognitive Screen
LoTS CARE patient and carer-centred system for longer-term care result
LUNS observational study of Longer-term Unmet Needs after Stroke
OTCH OT in care homes
Modified Rankin Scale < 48 h observational study of pre-stroke Rankin
Clear 2 thrombolysis for intraventricular haemorrhage <24 h from onset
TALECRIS Intra-thrombus plasmin in MCA stroke <8.5h Open, dose escalation.
MASH-2 (<4 days) Magnesium infusion in subarachnoid haemorrhage
STASH  (<4 days) Simvastatin after acute SAH
SRN024 - (Mitsubishi) a phase IIa study of MCI186 in subjects < 72 h of onset
SRN018 (ARC 1779) ARCHEMIX ARC1779 Cerebral Microembolism in CEA
PRET pts w at least one aneurysm prone to recurrence amenable to coiling
PAST-BP  trial of different BP targets for people with a history of stroke or TIA
LILACS small vessel disease <85 (n=40)

Published Results of Studies the WMIDS Stroke LRN has contributed to
PISTE thrombectomy in patients with MCA/carotid-T occlusion -study RESULT
STEPS pharyngeal stimulation  in the tx of dysphagia <6 wks  RESULT
STROKE-INF prophylactic antibiotics for dysphagic stroke(<48 h) RESULTS
CADISS (<7 days of symptom onset) antiplatelet agents or warfarin for extracranial carotid or vertebral artery dissection
ENOS GTN patch and starting/stopping existing antihypertensives <48 h form onset
INTERACT 2  intensive blood pressure lowering after ICH. Strong trend for better outcome with tight blood pressure control. NEJM paper
CLOTS-3 mechanical compression for DVT prevention < 72 h of stroke Results May 2013. Intermittent pneumatic compression stockings save lives after stroke!
STICH-II (<48 h) of Lobar Intracerebral Haemorrhage Results ESC 2013. Strong trend towards better outcome with early surgery. 
ARUBA unruptured brain arteriovenous malformations randomized to active intervention to eliminate the AVM (including surgery, catheter embolization or radiation therapy) or no intervention, stopped 15.04.2013 because of significantly higher mortality in the intervention group. Presented at ESC London, May 2013, publication awaited.
IST-3 thrombolysis <6 h form onset (results) June 2012. Thrombolysis is effective in over 80s and in big strokes. Time is brain treatment most effective within 3 h of onset.
ROCKET comparing an new anticoagulant (rivaroxaban) with warfarin pre-publication press release by Bayer, The Heart Org summary of AHA presentation of Rocket results Dec 2010
ACT NOW: enhanced speech and language therapy (HTA report  results )
VITATOPS: Results as reported at the European Stroke Conference 2010, abstract
CLOTS-trial 1: TED stockings versus no stockings abstract free full text
CLOTS-trial 2: long stockings versus short stockings abstract medscape review
COSSACS: continue or stop blood pressure tablets during the first 2 weeks after stroke abstract
PERFORM: aspirin versus new antiplatelet (terutroban) agent for stroke prevention slide abstract
PROFESS: aspirin and dipyridamole vs clopidogrel abstract and link to free manuscript
PROFESS: telmisartan vs placebo abstract and link to free manuscript