ClinicalTrials.gg
CompletedNCT04088630FITCHUpdated Jan 23, 2025Results posted

Fingolimod as a Treatment of Cerebral Edema After Intracerebral Hemorrhage

An Early Phase 1 interventional study of Fingolimod and Placebo in Intracerebral Hemorrhage, Cerebral Edema and Stroke Hemorrhagic, sponsored by Wake Forest University Health Sciences. Completed at 1 site in United States. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2025-01-23.

Sponsored by Wake Forest University Health Sciences · Early Phase 1, Interventional, and Treatment

Phase
Early Phase 1
Study type
Interventional
Enrollment
28
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

The purpose of this study is to test the safety and effectiveness of a single dose of fingolimod in patients with primary spontaneous intracerebral hemorrhage (ICH).

Read the detailed description

This is a double-blinded, placebo-controlled pilot trial of fingolimod in patients with primary spontaneous intracerebral hemorrhage. Eligible participants will be allocated to study groups using fixed allocation randomization and a computer-based random number-generating allocation. For those patients who meet all inclusion criteria without exclusion criteria subjects will receive oral or nasogastric tube (NGT) or Dobhoff feeding tube administration of fingolimod versus placebo. Participants will be monitored at time of enrollment and days 1, 3 5, 7, and 14 (discharge dependent) by 2 blinded assessors (neuroscience subspecialists) and will receive standard of care for the duration of the study. After discharge from the hospital, participants will enter a follow up phase of 12 months, with clinic visits at 30±14 days, 90±14 days, 180±14 days, and 365±14 days. They will receive a standard of care neuroimaging at these follow up time-points and will be assessed with the pre-selected outcome assessments established by the NINDS Common Data Elements for Stroke.

02

Conditions studied

  • Intracerebral Hemorrhage
  • Cerebral Edema
  • Stroke Hemorrhagic
  • Intracerebral Hemorrhage, Hypertensive
  • Intracerebral Hemorrhage Intraparenchymal

Keywords

  • Fingolimod
  • Neurologic Deficits
  • Brain Injury
  • Stroke
  • Intracerebral hemorrhage
  • Neuroimmunomodulation
03

In context

Cerebral Hemorrhage

457 studies on the registry are indexed under Cerebral Hemorrhage; 172 are open to participants now.

This study's enrollment of 28 is below the median of 100 across 269 interventional studies indexed under Cerebral Hemorrhage.

Browse Cerebral Hemorrhage studies →

Lead sponsor

Wake Forest University Health Sciences is the lead sponsor of 1,351 studies on the registry; 201 are open to participants now.

Of its 332 completed or terminated interventional studies of FDA-regulated products, 251 (76%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Has given written to participate in the study in accordance with required regulations; if a participant is not capable of providing informed consent, written consent must be obtained from the participant's legally authorized representative (LAR). When the LAR is not available for consent, Docusign for econsent may be obtained.

Stated willingness to comply with all study procedures and availability for the duration of the study.

Men and non-pregnant women ages 18-80 years old Has a confirmed diagnosis of spontaneous supratentorial ICH. The presence of cerebellar ICH is exclusionary. Presence of hydrocephalus due to mass effect and cerebral edema is not exclusionary. If the patient has hydrocephalus requiring CSF drainage, an external ventricular drain will be placed as standard of care and will not be exclusionary.

Symptoms less than 24 hours prior to enrollment if all eligibility criteria are met. An unknown time of onset is exclusionary. Use the time the patient was last known to be well for patients that awaken from sleep with symptoms.

Has a GCS score ≥ 5 on presentation. Has a National Institutes of Health Stroke Scale (NIHSS) score ≥ 4 on presentation.

Maintenance of SBP \< 200 mmHg at the time of enrollment and randomization. Historical Modified Rankin Scale score of 0-2.

Exclusion criteria

Exclusion Criteria:

Men or women \< 18 years old Incarcerated patients ICH known as a result of trauma. Primary intraventricular hemorrhage without significant intraparenchymal component.

Ruptured aneurysm, arteriovenous malformation (AVM), vascular anomaly, Moyamoya disease, hemorrhagic conversion of an ischemic infarct, recurrence of recent (\< 1 year) hemorrhage, neoplasms diagnosed with radiographic imaging.

Patients with unstable mass or evolving intracranial compartment syndrome. Brainstem hemorrhage or irreversible impaired brain stem function (bilateral fixed, dilated pupils and extensor motor posturing), GCS ≤ 4.

count \< 100,000; > 1.4. Any irreversible coagulopathy or known clotting disorder. Known history of Mobitz Type II second-degree or third-degree atrioventricular (AV) block or sick sinus syndrome.

Admission within the past 6 months for the following: myocardial infarction, unstable angina, stroke, decompensated heart failure requiring hospitalization, or Class III/IV heart failure.

Baseline ≥500 ms. Current treatment with Class Ia or Class III anti-arrhythmic drugs. Implanted cardiac devices that are not compatible with the desired MRI sequences needed for the study (non-contrast T1, T2, SWI/GRE, and FLAIR sequences).

Abnormal liver function or liver failure. Active acute infection that is deemed by the Principal Investigator to be .

Chronic viral or fungal infection. Active use of antineoplastic, , or immunomodulating therapies. Leukopenia with a WBC \< 2.0 x 109/L. Not expected to survive to the 365 day visit due to co-morbidities or is DNR/DNI status prior to randomization.

Active drug or alcohol use or dependence that, in the opinion of the investigator, would interfere with adherence to study requirements.

Concomitant enrollment in another interventional study. Inability or unwillingness of participant or legal guardian/representative to give written .

Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

05

Study design

Phase
Early Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
28 participants (actual)

Study arms

  • Experimental
    Fingolimod

    In addition to Standard of care treatment, those participants randomized to the fingolimod group will receive a single dose of 0.5 mg oral fingolimod within 24 hours of symptom onset.

    Drug: Fingolimod

  • Placebo comparator
    Placebo Control

    In addition to Standard of care treatment, those participants randomized to the control group will receive a single dose placebo pill within 24 hours of symptom onset

    Drug: Placebo

  • Experimental
    Open-label Fingolimod

    In addition to standard of care treatment,10 subjects who are unable to be administered oral medication will be assigned to the open-label group who will receive a single dose of 0.5 mg oral fingolimod within 24 hours of symptom onset to assess feasibility of administration through NGT or Dobhoff tube.

    Drug: Open-label Fingolimod

Interventions

  • A single dose of 0.5 mg oral fingolimod within 24 hours of symptom onset

  • DrugPlacebo

    A single oral placebo pill within 24 hours of symptom onset

  • DrugOpen-label Fingolimod

    A single dose of 0.5 mg fingolimod through an NGT or Dobhoff tube within 24 hours of symptom onset

06

What researchers measure

Primary outcomes

  1. Number of Participants With Clinically Significant Cardiac Events

    Number of participants with clinically significant cardiac events. Clinically significant cardiac events include myocardial infarction, unstable angina, stroke, transient ischemic attack, any heart failure, bradycardia and heart block. Cardiac events were monitored with telemetry up to and after 72 hours while hospitalized. A check in was performed at 30 days with an in-person clinical or hospital visit to ascertain any cardiac events via patient discussion and medical record review.

    Time frame: up to 30 days post-ictus

  2. Rate of Nosocomial Infections (UTI, Sepsis, and Pneumonia)

    Rate of nosocomial infections (UTI, sepsis, and pneumonia) by group

    Time frame: up to 90 days post-ictus

  3. Rate of Neurologic Decline

    considered a change ≥ 4 points of the NIHSS between enrollment and 30 days post-ictus. A higher score indicates higher severity and poorer prognosis. Scale is 0-42.

    Time frame: up to 30 days post-ictus

Secondary outcomes

  1. Rate of Successful Administration of Fingolimod Through an NGT or Dobhoff Tube

    Rate of successful administration of fingolimod through an NGT or Dobhoff tube in Open-label group only

    Time frame: Enrollment

  2. Percent Change in Lymphocyte Subpopulations of CD4+ T Cells

    Percent Change in Lymphocyte Subpopulations of CD4+ T Cells

    Time frame: Enrollment to 30 days

  3. Percent Change in Lymphocyte Subpopulations of CD8+ T Cells

    Percent change in lymphocyte subpopulations of CD8+ T Cells

    Time frame: Enrollment and 30 days

  4. Percent Change in Lymphocyte Subpopulations of CD19+ B Cells

    Percent change in lymphocyte subpopulations of CD19+ B cells

    Time frame: Enrollment and 30 days

  5. Change in Hematoma Volume Obtained by MRI

    Average decrease per day by group in volumetric measurement calculations of hematoma obtained by MRI between enrollment and 365 days. All MRI imaging data obtained on hematoma volume between enrollment and 365 days were used to calculate estimates via a linear mixed effects model controlling for repeated measures within subject.

    Time frame: Enrollment and 365 days

  6. Change in Hematoma Volume Obtained by CT

    Average decrease per day by group in volumetric measurement calculations of hematoma obtained by CT between enrollment and 365 days. All CT imaging data obtained on hematoma volume between enrollment and 365 days were used to calculate estimates via a linear mixed effects model controlling for repeated measures within subject.

    Time frame: Enrollment and 365 days

  7. Change in Peri-hematomal Edema Volume Obtained by CT

    Average decrease per day by group in volumetric measurement calculations of peri-hematomal edema volume between enrollment and 365 days. All CT imaging data obtained on peri-hematomal edema volume between enrollment and 365 days were used to calculate estimates via a linear mixed effects model controlling for repeated measures within subject.

    Time frame: Enrollment to 365 days

  8. Change in Peri-hematomal Edema Volume Obtained by MRI

    Average decrease per day by group in volumetric measurement calculations of peri-hematomal edema obtained from radiographic imaging (MRI) between enrollment and 365 days. All MRI imaging data obtained on peri-hematomal edema volume between enrollment and 365 days were used to calculate estimates via a linear mixed effects model controlling for repeated measures within subject.

    Time frame: Enrollment to 365 days

  9. National Institutes of Health Stroke Scale Total Score (NIHSS)

    The scoring range is 0 to 42 points, with higher numbers indicating greater severity. (NIHSS)

    Time frame: 365 days

  10. Interviewer-administered Modified Rankin Scale (mRS)

    The modified Rankin Scale (mRS) will measure functional recovery and ability to perform activities of daily living. The mRS is a 6 point disability scale with scores ranging from 0 (no symptoms) to 5 (severe disability) with 6 indicating death. Lower scores denote better outcome.

    Time frame: 365 days post-ictus

  11. Patient-Reported Outcomes Measurement Information (PROMIS) 10 Questionnaire

    Patient-Reported Outcomes Measurement Information System (PROMIS) 10 questionnaire will measure patient self-reporting of physical and neurobehavioral functions. Mean T-score for general population is 50 with standard deviation of 10. Higher T-scores indicate better physical and mental health. Typically, T-score ranges from 20 to 80.

    Time frame: 365 days

  12. Montreal Cognitive Assessment (MoCA)

    Montreal Cognitive Assessment (MoCA) will measure recovery (neurocognitive). Scores range from 0 to 30 with higher scores denoting better outcomes.

    Time frame: 365 days

  13. Western Aphasia Battery-Revised (WAB-R)

    Western Aphasia Battery-Revised (WAB-R) will measure recovery (neurocognitive and speech). Language and Aphasia subscale scores both range from 0 to 100. Higher scores denote better outcome.

    Time frame: 365 days

  14. Mortality

    Mortality at 30 days

    Time frame: 30 days

  15. Mortality

    Mortality at 90 days

    Time frame: 90 days

  16. All Cause Mortality

    All cause mortality within 365 days

    Time frame: up to 365 days

07

Results

Posted Jan 14, 2025

Participant flow

Adult patients coming the Emergency Department or direct admitted to the Neurosciences Intensive Care Unit at Wake Forest Baptist Hospital between August 2020 and June 2023 with the diagnosis of spontaneous ICH will be identified as potentially eligible participants and screened by interview.

Participant flow — Overall Study
MilestoneFingolimodControlOpen-label Fingolimod
Started9811
24h post-ictus8711
72h post-ictus9710
5-7 days967
10-14 days427
30 days957
90 days958
180 days655
365 days346
Completed343
Not completed648
Withdrew: Lost to follow-up326
Withdrew: Death311
Withdrew: Physician decision011

Outcome measures

PrimaryNumber of Participants With Clinically Significant Cardiac Events

Number of participants with clinically significant cardiac events. Clinically significant cardiac events include myocardial infarction, unstable angina, stroke, transient ischemic attack, any heart failure, bradycardia and heart block. Cardiac events were monitored with telemetry up to and after 72 hours while hospitalized. A check in was performed at 30 days with an in-person clinical or hospital visit to ascertain any cardiac events via patient discussion and medical record review.

Time frame:
up to 30 days post-ictus
Reported as:
Count of participants · Participants
Number of Participants With Clinically Significant Cardiac Events
ParticipantsFingolimodControlOpen-label Fingolimod
Number of Participants With Clinically Significant Cardiac Events300
Statistical analysis
  • Fingolimod vs Control vs Open-label Fingolimod · Fisher Exact · p = 0.0427 (p\<0.05 considered significant. Between group pairwise comparisons performed with Bonferroni correction.)
PrimaryRate of Nosocomial Infections (UTI, Sepsis, and Pneumonia)

Rate of nosocomial infections (UTI, sepsis, and pneumonia) by group

Time frame:
up to 90 days post-ictus
Reported as:
Count of participants · Participants
Rate of Nosocomial Infections (UTI, Sepsis, and Pneumonia)
ParticipantsFingolimodControlOpen-label Fingolimod
Rate of Nosocomial Infections (UTI, Sepsis, and Pneumonia)115
Statistical analysis
  • Fingolimod vs Control vs Open-label Fingolimod · Fisher Exact · p = 0.19
PrimaryRate of Neurologic Decline

considered a change ≥ 4 points of the NIHSS between enrollment and 30 days post-ictus. A higher score indicates higher severity and poorer prognosis. Scale is 0-42.

Time frame:
up to 30 days post-ictus
Reported as:
Count of participants · Participants
Rate of Neurologic Decline
ParticipantsFingolimodControlOpen-label Fingolimod
Rate of Neurologic Decline200
Statistical analysis
  • Fingolimod vs Control vs Open-label Fingolimod · Fisher Exact · p = 0.30
SecondaryRate of Successful Administration of Fingolimod Through an NGT or Dobhoff Tube

Rate of successful administration of fingolimod through an NGT or Dobhoff tube in Open-label group only

Time frame:
Enrollment
Reported as:
Count of participants · Participants
Rate of Successful Administration of Fingolimod Through an NGT or Dobhoff Tube
ParticipantsOpen-label Fingolimod
Rate of Successful Administration of Fingolimod Through an NGT or Dobhoff Tube11
SecondaryPercent Change in Lymphocyte Subpopulations of CD4+ T Cells

Percent Change in Lymphocyte Subpopulations of CD4+ T Cells

Time frame:
Enrollment to 30 days
Reported as:
Median · percent change
Percent Change in Lymphocyte Subpopulations of CD4+ T Cells
percent changeFingolimodControlOpen-label Fingolimod
Percent Change in Lymphocyte Subpopulations of CD4+ T Cells19.6 (-18.8 to 81.9)-2.56 (-10.3 to 3.52)-5.00 (-14.7 to 40.5)
SecondaryPercent Change in Lymphocyte Subpopulations of CD8+ T Cells

Percent change in lymphocyte subpopulations of CD8+ T Cells

Time frame:
Enrollment and 30 days
Reported as:
Median · percent change
Percent Change in Lymphocyte Subpopulations of CD8+ T Cells
percent changeFingolimodControlOpen-label Fingolimod
Percent Change in Lymphocyte Subpopulations of CD8+ T Cells19.3 (-20.4 to 59.0)21.4 (-6.09 to 113)21.6 (-61.5 to 82.9)
SecondaryPercent Change in Lymphocyte Subpopulations of CD19+ B Cells

Percent change in lymphocyte subpopulations of CD19+ B cells

Time frame:
Enrollment and 30 days
Reported as:
Median · percent change
Percent Change in Lymphocyte Subpopulations of CD19+ B Cells
percent changeFingolimodControlOpen-label Fingolimod
Percent Change in Lymphocyte Subpopulations of CD19+ B Cells121 (-39.4 to 186)0.230 (-16.9 to 16.5)9.22 (-84.1 to 43.8)
SecondaryChange in Hematoma Volume Obtained by MRI

Average decrease per day by group in volumetric measurement calculations of hematoma obtained by MRI between enrollment and 365 days. All MRI imaging data obtained on hematoma volume between enrollment and 365 days were used to calculate estimates via a linear mixed effects model controlling for repeated measures within subject.

Time frame:
Enrollment and 365 days
Reported as:
Mean · mm^3 per day
Change in Hematoma Volume Obtained by MRI
mm^3 per dayFingolimodControlOpen-label Fingolimod
Change in Hematoma Volume Obtained by MRI-247.19 ± 75.68-86.29 ± 17.74-210.03 ± 23.81
SecondaryChange in Hematoma Volume Obtained by CT

Average decrease per day by group in volumetric measurement calculations of hematoma obtained by CT between enrollment and 365 days. All CT imaging data obtained on hematoma volume between enrollment and 365 days were used to calculate estimates via a linear mixed effects model controlling for repeated measures within subject.

Time frame:
Enrollment and 365 days
Reported as:
Mean · mm^3 per day
Change in Hematoma Volume Obtained by CT
mm^3 per dayFingolimodControlOpen-label Fingolimod
Change in Hematoma Volume Obtained by CT-156.84 ± 46.35-90.56 ± 54.89-86.73 ± 15.95
SecondaryChange in Peri-hematomal Edema Volume Obtained by CT

Average decrease per day by group in volumetric measurement calculations of peri-hematomal edema volume between enrollment and 365 days. All CT imaging data obtained on peri-hematomal edema volume between enrollment and 365 days were used to calculate estimates via a linear mixed effects model controlling for repeated measures within subject.

Time frame:
Enrollment to 365 days
Reported as:
Mean · mm^3
Change in Peri-hematomal Edema Volume Obtained by CT
mm^3FingolimodControlOpen-label Fingolimod
Change in Peri-hematomal Edema Volume Obtained by CT-65.85 ± 47.50-62.21 ± 64.76-64.93 ± 16.33
SecondaryChange in Peri-hematomal Edema Volume Obtained by MRI

Average decrease per day by group in volumetric measurement calculations of peri-hematomal edema obtained from radiographic imaging (MRI) between enrollment and 365 days. All MRI imaging data obtained on peri-hematomal edema volume between enrollment and 365 days were used to calculate estimates via a linear mixed effects model controlling for repeated measures within subject.

Time frame:
Enrollment to 365 days
Reported as:
Mean · mm^3
Change in Peri-hematomal Edema Volume Obtained by MRI
mm^3FingolimodControlOpen-label Fingolimod
Change in Peri-hematomal Edema Volume Obtained by MRI-327.12 ± 89.61-118.36 ± 31.75-74.96 ± 55.84
SecondaryNational Institutes of Health Stroke Scale Total Score (NIHSS)

The scoring range is 0 to 42 points, with higher numbers indicating greater severity. (NIHSS)

Time frame:
365 days
Reported as:
Median · score on a scale
National Institutes of Health Stroke Scale Total Score (NIHSS)
score on a scaleFingolimodControlOpen-label Fingolimod
National Institutes of Health Stroke Scale Total Score (NIHSS)0 (0 to 0)1 (1 to 2)5 (0 to 8)
SecondaryInterviewer-administered Modified Rankin Scale (mRS)

The modified Rankin Scale (mRS) will measure functional recovery and ability to perform activities of daily living. The mRS is a 6 point disability scale with scores ranging from 0 (no symptoms) to 5 (severe disability) with 6 indicating death. Lower scores denote better outcome.

Time frame:
365 days post-ictus
Reported as:
Median · score on a scale
Interviewer-administered Modified Rankin Scale (mRS)
score on a scaleFingolimodControlOpen-label Fingolimod
Interviewer-administered Modified Rankin Scale (mRS)1.5 (1 to 2)1.5 (1 to 2)2.5 (1 to 3)
SecondaryPatient-Reported Outcomes Measurement Information (PROMIS) 10 Questionnaire

Patient-Reported Outcomes Measurement Information System (PROMIS) 10 questionnaire will measure patient self-reporting of physical and neurobehavioral functions. Mean T-score for general population is 50 with standard deviation of 10. Higher T-scores indicate better physical and mental health. Typically, T-score ranges from 20 to 80.

Time frame:
365 days
Reported as:
Median · score on a scale
Patient-Reported Outcomes Measurement Information (PROMIS) 10 Questionnaire
score on a scaleFingolimodControlOpen-label Fingolimod
Physical T Score48.2 (42.3 to 54.1)55.9 (44.9 to 61.9)47.7 (39.8 to 50.8)
Mental T Score53.4 (47.7 to 59.0)47.7 (33.8 to 62.5)41.1 (41.1 to 50.8)
SecondaryMontreal Cognitive Assessment (MoCA)

Montreal Cognitive Assessment (MoCA) will measure recovery (neurocognitive). Scores range from 0 to 30 with higher scores denoting better outcomes.

Time frame:
365 days
Reported as:
Median · score on a scale
Montreal Cognitive Assessment (MoCA)
score on a scaleFingolimodControlOpen-label Fingolimod
Montreal Cognitive Assessment (MoCA)25 (24 to 26)24 (21 to 25)20 (17 to 25)
SecondaryWestern Aphasia Battery-Revised (WAB-R)

Western Aphasia Battery-Revised (WAB-R) will measure recovery (neurocognitive and speech). Language and Aphasia subscale scores both range from 0 to 100. Higher scores denote better outcome.

Time frame:
365 days
Reported as:
Median · score on a scale
Western Aphasia Battery-Revised (WAB-R)
score on a scaleFingolimodControlOpen-label Fingolimod
Language score98.8 (97.5 to 100)96.9 (86.9 to 98.8)90.0 (70.6 to 93.1)
Aphasia score100 (100 to 100)98.3 (94.2 to 100)95.0 (73.3 to 95.8)
SecondaryMortality

Mortality at 30 days

Time frame:
30 days
Reported as:
Count of participants · Participants
Mortality
ParticipantsFingolimodControlOpen-label Fingolimod
Mortality010
SecondaryMortality

Mortality at 90 days

Time frame:
90 days
Reported as:
Count of participants · Participants
Mortality
ParticipantsFingolimodControlOpen-label Fingolimod
Mortality110
SecondaryAll Cause Mortality

All cause mortality within 365 days

Time frame:
up to 365 days
Reported as:
Count of participants · Participants
All Cause Mortality
ParticipantsFingolimodControlOpen-label Fingolimod
All Cause Mortality311

Adverse events

Collected over Enrollment to 365 days. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Fingolimod3/9 (33.3%)3/9 (33.3%)0/9 (0%)
Control1/8 (12.5%)1/8 (12.5%)0/8 (0%)
Open-label Fingolimod1/11 (9.1%)5/11 (45.5%)0/11 (0%)
Most frequent serious events
Most frequent serious events
EventFingolimodControlOpen-label Fingolimod
InfectionInfections and infestations1/91/85/11
Cardiac eventCardiac disorders3/90/80/11

Baseline characteristics

Age, Continuous
Age, Continuous(years)FingolimodControlOpen-label FingolimodTotal
Median71.0 (67.0 to 77.0)67.0 (64.8 to 69.0)59.0 (48.5 to 67.5)66.0 (54.8 to 74.3)
Sex: Female, Male
Sex: Female, Male(Participants)FingolimodControlOpen-label FingolimodTotal
Female22610
Male76518
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)FingolimodControlOpen-label FingolimodTotal
Hispanic or Latino1247
Not Hispanic or Latino86721
Unknown or Not Reported0000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)FingolimodControlOpen-label FingolimodTotal
American Indian or Alaska Native0000
Asian0000
Native Hawaiian or Other Pacific Islander0000
Black or African American2226
White76922
More than one race0000
Unknown or Not Reported0000
Prior stroke
Prior stroke(Participants)FingolimodControlOpen-label FingolimodTotal
Count of participants0213
Hypertension
Hypertension(Participants)FingolimodControlOpen-label FingolimodTotal
Count of participants58821
Diabetes
Diabetes(Participants)FingolimodControlOpen-label FingolimodTotal
Count of participants2046
Coronary Artery Disease
Coronary Artery Disease(Participants)FingolimodControlOpen-label FingolimodTotal
Count of participants1225

6 further baseline measures are reported on the registry.

08

Study locations

1 site
  • Wake Forest University Health Sciences
    Winston-Salem, North Carolina 27157, United States
09

References and documents

Publications

  • Qureshi AI, Mendelow AD, Hanley DF. Intracerebral haemorrhage. Lancet. 2009 May 9;373(9675):1632-44. doi: 10.1016/S0140-6736(09)60371-8. PubMed 19427958 ↗
  • van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol. 2010 Feb;9(2):167-76. doi: 10.1016/S1474-4422(09)70340-0. Epub 2010 Jan 5. PubMed 20056489 ↗
  • Fogelholm R, Murros K, Rissanen A, Avikainen S. Long term survival after primary intracerebral haemorrhage: a retrospective population based study. J Neurol Neurosurg Psychiatry. 2005 Nov;76(11):1534-8. doi: 10.1136/jnnp.2004.055145. PubMed 16227546 ↗
  • WRITING GROUP MEMBERS; Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, Ferguson TB, Ford E, Furie K, Gillespie C, Go A, Greenlund K, Haase N, Hailpern S, Ho PM, Howard V, Kissela B, Kittner S, Lackland D, Lisabeth L, Marelli A, McDermott MM, Meigs J, Mozaffarian D, Mussolino M, Nichol G, Roger VL, Rosamond W, Sacco R, Sorlie P, Roger VL, Thom T, Wasserthiel-Smoller S, Wong ND, Wylie-Rosett J; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 2010 Feb 23;121(7):e46-e215. doi: 10.1161/CIRCULATIONAHA.109.192667. Epub 2009 Dec 17. No abstract available. Erratum In: Circulation. 2010 Mar 30;121(12):e260. Stafford, Randall [corrected to Roger, Veronique L]. Circulation. 2011 Oct 18;124(16):e425. PubMed 20019324 ↗
  • Qureshi AI, Suri MF, Nasar A, Kirmani JF, Ezzeddine MA, Divani AA, Giles WH. Changes in cost and outcome among US patients with stroke hospitalized in 1990 to 1991 and those hospitalized in 2000 to 2001. Stroke. 2007 Jul;38(7):2180-4. doi: 10.1161/STROKEAHA.106.467506. Epub 2007 May 24. PubMed 17525400 ↗
  • Adeoye O, Broderick JP. Advances in the management of intracerebral hemorrhage. Nat Rev Neurol. 2010 Nov;6(11):593-601. doi: 10.1038/nrneurol.2010.146. Epub 2010 Sep 28. PubMed 20877400 ↗
  • Xi G, Keep RF, Hoff JT. Mechanisms of brain injury after intracerebral haemorrhage. Lancet Neurol. 2006 Jan;5(1):53-63. doi: 10.1016/S1474-4422(05)70283-0. PubMed 16361023 ↗
  • Ariesen MJ, Claus SP, Rinkel GJ, Algra A. Risk factors for intracerebral hemorrhage in the general population: a systematic review. Stroke. 2003 Aug;34(8):2060-5. doi: 10.1161/01.STR.0000080678.09344.8D. Epub 2003 Jul 3. PubMed 12843354 ↗
  • Broderick JP, Brott TG, Duldner JE, Tomsick T, Huster G. Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality. Stroke. 1993 Jul;24(7):987-93. doi: 10.1161/01.str.24.7.987. PubMed 8322400 ↗
  • Mould WA, Carhuapoma JR, Muschelli J, Lane K, Morgan TC, McBee NA, Bistran-Hall AJ, Ullman NL, Vespa P, Martin NA, Awad I, Zuccarello M, Hanley DF; MISTIE Investigators. Minimally invasive surgery plus recombinant tissue-type plasminogen activator for intracerebral hemorrhage evacuation decreases perihematomal edema. Stroke. 2013 Mar;44(3):627-34. doi: 10.1161/STROKEAHA.111.000411. Epub 2013 Feb 7. PubMed 23391763 ↗
  • Mendelow AD, Gregson BA, Rowan EN, Murray GD, Gholkar A, Mitchell PM; STICH II Investigators. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial. Lancet. 2013 Aug 3;382(9890):397-408. doi: 10.1016/S0140-6736(13)60986-1. Epub 2013 May 29. PubMed 23726393 ↗
  • Morgenstern LB, Hemphill JC 3rd, Anderson C, Becker K, Broderick JP, Connolly ES Jr, Greenberg SM, Huang JN, MacDonald RL, Messe SR, Mitchell PH, Selim M, Tamargo RJ; American Heart Association Stroke Council and Council on Cardiovascular Nursing. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2010 Sep;41(9):2108-29. doi: 10.1161/STR.0b013e3181ec611b. Epub 2010 Jul 22. PubMed 20651276 ↗
  • Babu R, Bagley JH, Di C, Friedman AH, Adamson C. Thrombin and hemin as central factors in the mechanisms of intracerebral hemorrhage-induced secondary brain injury and as potential targets for intervention. Neurosurg Focus. 2012 Apr;32(4):E8. doi: 10.3171/2012.1.FOCUS11366. PubMed 22463118 ↗
  • Zhou Y, Wang Y, Wang J, Anne Stetler R, Yang QW. Inflammation in intracerebral hemorrhage: from mechanisms to clinical translation. Prog Neurobiol. 2014 Apr;115:25-44. doi: 10.1016/j.pneurobio.2013.11.003. Epub 2013 Nov 26. PubMed 24291544 ↗
  • Wang J. Preclinical and clinical research on inflammation after intracerebral hemorrhage. Prog Neurobiol. 2010 Dec;92(4):463-77. doi: 10.1016/j.pneurobio.2010.08.001. Epub 2010 Aug 14. PubMed 20713126 ↗
  • Wang J, Dore S. Inflammation after intracerebral hemorrhage. J Cereb Blood Flow Metab. 2007 May;27(5):894-908. doi: 10.1038/sj.jcbfm.9600403. Epub 2006 Oct 11. PubMed 17033693 ↗
  • Aronowski J, Zhao X. Molecular pathophysiology of cerebral hemorrhage: secondary brain injury. Stroke. 2011 Jun;42(6):1781-6. doi: 10.1161/STROKEAHA.110.596718. Epub 2011 Apr 28. PubMed 21527759 ↗
  • Keep RF, Hua Y, Xi G. Intracerebral haemorrhage: mechanisms of injury and therapeutic targets. Lancet Neurol. 2012 Aug;11(8):720-31. doi: 10.1016/S1474-4422(12)70104-7. Epub 2012 Jun 13. PubMed 22698888 ↗
  • Boche D, Perry VH, Nicoll JA. Review: activation patterns of microglia and their identification in the human brain. Neuropathol Appl Neurobiol. 2013 Feb;39(1):3-18. doi: 10.1111/nan.12011. PubMed 23252647 ↗
  • Lawson LJ, Perry VH, Dri P, Gordon S. Heterogeneity in the distribution and morphology of microglia in the normal adult mouse brain. Neuroscience. 1990;39(1):151-70. doi: 10.1016/0306-4522(90)90229-w. PubMed 2089275 ↗
  • Xiong XY, Liu L, Yang QW. Functions and mechanisms of microglia/macrophages in neuroinflammation and neurogenesis after stroke. Prog Neurobiol. 2016 Jul;142:23-44. doi: 10.1016/j.pneurobio.2016.05.001. Epub 2016 May 7. PubMed 27166859 ↗
  • Wasserman JK, Zhu X, Schlichter LC. Evolution of the inflammatory response in the brain following intracerebral hemorrhage and effects of delayed minocycline treatment. Brain Res. 2007 Nov 14;1180:140-54. doi: 10.1016/j.brainres.2007.08.058. Epub 2007 Sep 5. PubMed 17919462 ↗
  • Taylor RA, Sansing LH. Microglial responses after ischemic stroke and intracerebral hemorrhage. Clin Dev Immunol. 2013;2013:746068. doi: 10.1155/2013/746068. Epub 2013 Oct 10. PubMed 24223607 ↗
  • Mracsko E, Veltkamp R. Neuroinflammation after intracerebral hemorrhage. Front Cell Neurosci. 2014 Nov 20;8:388. doi: 10.3389/fncel.2014.00388. eCollection 2014. PubMed 25477782 ↗
  • Kanazawa M, Ninomiya I, Hatakeyama M, Takahashi T, Shimohata T. Microglia and Monocytes/Macrophages Polarization Reveal Novel Therapeutic Mechanism against Stroke. Int J Mol Sci. 2017 Oct 13;18(10):2135. doi: 10.3390/ijms18102135. PubMed 29027964 ↗
  • Zhao H, Garton T, Keep RF, Hua Y, Xi G. Microglia/Macrophage Polarization After Experimental Intracerebral Hemorrhage. Transl Stroke Res. 2015 Dec;6(6):407-9. doi: 10.1007/s12975-015-0428-4. Epub 2015 Oct 7. No abstract available. PubMed 26446073 ↗
  • Lan X, Han X, Li Q, Yang QW, Wang J. Modulators of microglial activation and polarization after intracerebral haemorrhage. Nat Rev Neurol. 2017 Jul;13(7):420-433. doi: 10.1038/nrneurol.2017.69. Epub 2017 May 19. PubMed 28524175 ↗
  • Zhang Z, Zhang Z, Lu H, Yang Q, Wu H, Wang J. Microglial Polarization and Inflammatory Mediators After Intracerebral Hemorrhage. Mol Neurobiol. 2017 Apr;54(3):1874-1886. doi: 10.1007/s12035-016-9785-6. Epub 2016 Feb 19. PubMed 26894396 ↗
  • Hu X, Leak RK, Shi Y, Suenaga J, Gao Y, Zheng P, Chen J. Microglial and macrophage polarization-new prospects for brain repair. Nat Rev Neurol. 2015 Jan;11(1):56-64. doi: 10.1038/nrneurol.2014.207. Epub 2014 Nov 11. PubMed 25385337 ↗
  • Eggen BJ, Raj D, Hanisch UK, Boddeke HW. Microglial phenotype and adaptation. J Neuroimmune Pharmacol. 2013 Sep;8(4):807-23. doi: 10.1007/s11481-013-9490-4. Epub 2013 Jul 25. PubMed 23881706 ↗
  • Shichita T, Sakaguchi R, Suzuki M, Yoshimura A. Post-ischemic inflammation in the brain. Front Immunol. 2012 May 31;3:132. doi: 10.3389/fimmu.2012.00132. eCollection 2012. PubMed 22833743 ↗
  • Hendrix S, Nitsch R. The role of T helper cells in neuroprotection and regeneration. J Neuroimmunol. 2007 Mar;184(1-2):100-12. doi: 10.1016/j.jneuroim.2006.11.019. Epub 2007 Jan 2. PubMed 17198734 ↗
  • Kivisakk P, Mahad DJ, Callahan MK, Trebst C, Tucky B, Wei T, Wu L, Baekkevold ES, Lassmann H, Staugaitis SM, Campbell JJ, Ransohoff RM. Human cerebrospinal fluid central memory CD4+ T cells: evidence for trafficking through choroid plexus and meninges via P-selectin. Proc Natl Acad Sci U S A. 2003 Jul 8;100(14):8389-94. doi: 10.1073/pnas.1433000100. Epub 2003 Jun 26. PubMed 12829791 ↗
  • Arumugam TV, Granger DN, Mattson MP. Stroke and T-cells. Neuromolecular Med. 2005;7(3):229-42. doi: 10.1385/NMM:7:3:229. PubMed 16247183 ↗
  • Yilmaz G, Arumugam TV, Stokes KY, Granger DN. Role of T lymphocytes and interferon-gamma in ischemic stroke. Circulation. 2006 May 2;113(17):2105-12. doi: 10.1161/CIRCULATIONAHA.105.593046. Epub 2006 Apr 24. PubMed 16636173 ↗
  • Hurn PD, Subramanian S, Parker SM, Afentoulis ME, Kaler LJ, Vandenbark AA, Offner H. T- and B-cell-deficient mice with experimental stroke have reduced lesion size and inflammation. J Cereb Blood Flow Metab. 2007 Nov;27(11):1798-805. doi: 10.1038/sj.jcbfm.9600482. Epub 2007 Mar 28. PubMed 17392692 ↗
  • Liesz A, Suri-Payer E, Veltkamp C, Doerr H, Sommer C, Rivest S, Giese T, Veltkamp R. Regulatory T cells are key cerebroprotective immunomodulators in acute experimental stroke. Nat Med. 2009 Feb;15(2):192-9. doi: 10.1038/nm.1927. Epub 2009 Jan 25. PubMed 19169263 ↗
  • Zhou K, Zhong Q, Wang YC, Xiong XY, Meng ZY, Zhao T, Zhu WY, Liao MF, Wu LR, Yang YR, Liu J, Duan CM, Li J, Gong QW, Liu L, Yang MH, Xiong A, Wang J, Yang QW. Regulatory T cells ameliorate intracerebral hemorrhage-induced inflammatory injury by modulating microglia/macrophage polarization through the IL-10/GSK3beta/PTEN axis. J Cereb Blood Flow Metab. 2017 Mar;37(3):967-979. doi: 10.1177/0271678X16648712. Epub 2016 Jul 20. PubMed 27174997 ↗
  • Loftspring MC, McDole J, Lu A, Clark JF, Johnson AJ. Intracerebral hemorrhage leads to infiltration of several leukocyte populations with concomitant pathophysiological changes. J Cereb Blood Flow Metab. 2009 Jan;29(1):137-43. doi: 10.1038/jcbfm.2008.114. Epub 2008 Oct 1. PubMed 18827833 ↗
  • Guo FQ, Li XJ, Chen LY, Yang H, Dai HY, Wei YS, Huang YL, Yang YS, Sun HB, Xu YC, Yang ZL. [Study of relationship between inflammatory response and apoptosis in perihematoma region in patients with intracerebral hemorrhage]. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2006 May;18(5):290-3. Chinese. PubMed 16700995 ↗
  • Gelderblom M, Leypoldt F, Steinbach K, Behrens D, Choe CU, Siler DA, Arumugam TV, Orthey E, Gerloff C, Tolosa E, Magnus T. Temporal and spatial dynamics of cerebral immune cell accumulation in stroke. Stroke. 2009 May;40(5):1849-57. doi: 10.1161/STROKEAHA.108.534503. Epub 2009 Mar 5. PubMed 19265055 ↗
  • Gu L, Xiong X, Zhang H, Xu B, Steinberg GK, Zhao H. Distinctive effects of T cell subsets in neuronal injury induced by cocultured splenocytes in vitro and by in vivo stroke in mice. Stroke. 2012 Jul;43(7):1941-6. doi: 10.1161/STROKEAHA.112.656611. Epub 2012 Jun 7. PubMed 22678086 ↗
  • Theodorou GL, Marousi S, Ellul J, Mougiou A, Theodori E, Mouzaki A, Karakantza M. T helper 1 (Th1)/Th2 cytokine expression shift of peripheral blood CD4+ and CD8+ T cells in patients at the post-acute phase of stroke. Clin Exp Immunol. 2008 Jun;152(3):456-63. doi: 10.1111/j.1365-2249.2008.03650.x. Epub 2008 Apr 16. PubMed 18422734 ↗
  • Gao L, Lu Q, Huang LJ, Ruan LH, Yang JJ, Huang WL, ZhuGe WS, Zhang YL, Fu B, Jin KL, ZhuGe QC. Transplanted neural stem cells modulate regulatory T, gammadelta T cells and corresponding cytokines after intracerebral hemorrhage in rats. Int J Mol Sci. 2014 Mar 13;15(3):4431-41. doi: 10.3390/ijms15034431. PubMed 24633197 ↗
  • Mao LL, Yuan H, Wang WW, Wang YJ, Yang MF, Sun BL, Zhang ZY, Yang XY. Adoptive Regulatory T-cell Therapy Attenuates Perihematomal Inflammation in a Mouse Model of Experimental Intracerebral Hemorrhage. Cell Mol Neurobiol. 2017 Jul;37(5):919-929. doi: 10.1007/s10571-016-0429-1. Epub 2016 Sep 27. PubMed 27678140 ↗
  • Kappos L, Radue EW, O'Connor P, Polman C, Hohlfeld R, Calabresi P, Selmaj K, Agoropoulou C, Leyk M, Zhang-Auberson L, Burtin P; FREEDOMS Study Group. A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis. N Engl J Med. 2010 Feb 4;362(5):387-401. doi: 10.1056/NEJMoa0909494. Epub 2010 Jan 20. PubMed 20089952 ↗
  • Calabresi PA, Radue EW, Goodin D, Jeffery D, Rammohan KW, Reder AT, Vollmer T, Agius MA, Kappos L, Stites T, Li B, Cappiello L, von Rosenstiel P, Lublin FD. Safety and efficacy of fingolimod in patients with relapsing-remitting multiple sclerosis (FREEDOMS II): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Neurol. 2014 Jun;13(6):545-56. doi: 10.1016/S1474-4422(14)70049-3. Epub 2014 Mar 28. PubMed 24685276 ↗
  • Groves A, Kihara Y, Chun J. Fingolimod: direct CNS effects of sphingosine 1-phosphate (S1P) receptor modulation and implications in multiple sclerosis therapy. J Neurol Sci. 2013 May 15;328(1-2):9-18. doi: 10.1016/j.jns.2013.02.011. Epub 2013 Mar 19. PubMed 23518370 ↗
  • Cohen JA, Chun J. Mechanisms of fingolimod's efficacy and adverse effects in multiple sclerosis. Ann Neurol. 2011 May;69(5):759-77. doi: 10.1002/ana.22426. PubMed 21520239 ↗
  • Chun J, Hartung HP. Mechanism of action of oral fingolimod (FTY720) in multiple sclerosis. Clin Neuropharmacol. 2010 Mar-Apr;33(2):91-101. doi: 10.1097/WNF.0b013e3181cbf825. PubMed 20061941 ↗
  • Chiba K. FTY720, a new class of immunomodulator, inhibits lymphocyte egress from secondary lymphoid tissues and thymus by agonistic activity at sphingosine 1-phosphate receptors. Pharmacol Ther. 2005 Dec;108(3):308-19. doi: 10.1016/j.pharmthera.2005.05.002. Epub 2005 Jun 13. PubMed 15951022 ↗
  • Lee CW, Choi JW, Chun J. Neurological S1P signaling as an emerging mechanism of action of oral FTY720 (fingolimod) in multiple sclerosis. Arch Pharm Res. 2010 Oct;33(10):1567-74. doi: 10.1007/s12272-010-1008-5. Epub 2010 Oct 30. PubMed 21052934 ↗
  • David OJ, Kovarik JM, Schmouder RL. Clinical pharmacokinetics of fingolimod. Clin Pharmacokinet. 2012 Jan 1;51(1):15-28. doi: 10.2165/11596550-000000000-00000. PubMed 22149256 ↗
  • Jin Y, Zollinger M, Borell H, Zimmerlin A, Patten CJ. CYP4F enzymes are responsible for the elimination of fingolimod (FTY720), a novel treatment of relapsing multiple sclerosis. Drug Metab Dispos. 2011 Feb;39(2):191-8. doi: 10.1124/dmd.110.035378. Epub 2010 Nov 2. PubMed 21045201 ↗
  • Zollinger M, Gschwind HP, Jin Y, Sayer C, Zecri F, Hartmann S. Absorption and disposition of the sphingosine 1-phosphate receptor modulator fingolimod (FTY720) in healthy volunteers: a case of xenobiotic biotransformation following endogenous metabolic pathways. Drug Metab Dispos. 2011 Feb;39(2):199-207. doi: 10.1124/dmd.110.035907. Epub 2010 Nov 2. PubMed 21045200 ↗
  • Kovarik JM, Schmouder R, Barilla D, Wang Y, Kraus G. Single-dose FTY720 pharmacokinetics, food effect, and pharmacological responses in healthy subjects. Br J Clin Pharmacol. 2004 May;57(5):586-91. doi: 10.1111/j.1365-2125.2003.02065.x. PubMed 15089811 ↗
  • Budde K, Schmouder RL, Brunkhorst R, Nashan B, Lucker PW, Mayer T, Choudhury S, Skerjanec A, Kraus G, Neumayer HH. First human trial of FTY720, a novel immunomodulator, in stable renal transplant patients. J Am Soc Nephrol. 2002 Apr;13(4):1073-1083. doi: 10.1681/ASN.V1341073. PubMed 11912269 ↗
  • Tham CS, Lin FF, Rao TS, Yu N, Webb M. Microglial activation state and lysophospholipid acid receptor expression. Int J Dev Neurosci. 2003 Dec;21(8):431-43. doi: 10.1016/j.ijdevneu.2003.09.003. PubMed 14659994 ↗
  • Okada T, Kajimoto T, Jahangeer S, Nakamura S. Sphingosine kinase/sphingosine 1-phosphate signalling in central nervous system. Cell Signal. 2009 Jan;21(1):7-13. doi: 10.1016/j.cellsig.2008.07.011. Epub 2008 Jul 22. PubMed 18694820 ↗
  • Melendez AJ. Sphingosine kinase signalling in immune cells: potential as novel therapeutic targets. Biochim Biophys Acta. 2008 Jan;1784(1):66-75. doi: 10.1016/j.bbapap.2007.07.013. Epub 2007 Aug 14. PubMed 17913601 ↗
  • Nayak D, Huo Y, Kwang WX, Pushparaj PN, Kumar SD, Ling EA, Dheen ST. Sphingosine kinase 1 regulates the expression of proinflammatory cytokines and nitric oxide in activated microglia. Neuroscience. 2010 Mar 10;166(1):132-44. doi: 10.1016/j.neuroscience.2009.12.020. Epub 2009 Dec 28. PubMed 20036321 ↗
  • Noda H, Takeuchi H, Mizuno T, Suzumura A. Fingolimod phosphate promotes the neuroprotective effects of microglia. J Neuroimmunol. 2013 Mar 15;256(1-2):13-8. doi: 10.1016/j.jneuroim.2012.12.005. Epub 2013 Jan 3. PubMed 23290828 ↗
  • Rothhammer V, Kenison JE, Tjon E, Takenaka MC, de Lima KA, Borucki DM, Chao CC, Wilz A, Blain M, Healy L, Antel J, Quintana FJ. Sphingosine 1-phosphate receptor modulation suppresses pathogenic astrocyte activation and chronic progressive CNS inflammation. Proc Natl Acad Sci U S A. 2017 Feb 21;114(8):2012-2017. doi: 10.1073/pnas.1615413114. Epub 2017 Feb 6. PubMed 28167760 ↗
  • Qin C, Fan WH, Liu Q, Shang K, Murugan M, Wu LJ, Wang W, Tian DS. Fingolimod Protects Against Ischemic White Matter Damage by Modulating Microglia Toward M2 Polarization via STAT3 Pathway. Stroke. 2017 Dec;48(12):3336-3346. doi: 10.1161/STROKEAHA.117.018505. Epub 2017 Nov 7. PubMed 29114096 ↗
  • Das A, Arifuzzaman S, Kim SH, Lee YS, Jung KH, Chai YG. FTY720 (fingolimod) regulates key target genes essential for inflammation in microglial cells as defined by high-resolution mRNA sequencing. Neuropharmacology. 2017 Jun;119:1-14. doi: 10.1016/j.neuropharm.2017.03.034. Epub 2017 Mar 31. PubMed 28373076 ↗
  • Sucksdorff M, Rissanen E, Tuisku J, Nuutinen S, Paavilainen T, Rokka J, Rinne J, Airas L. Evaluation of the Effect of Fingolimod Treatment on Microglial Activation Using Serial PET Imaging in Multiple Sclerosis. J Nucl Med. 2017 Oct;58(10):1646-1651. doi: 10.2967/jnumed.116.183020. Epub 2017 Mar 23. PubMed 28336784 ↗
  • Delbridge MS, Shrestha BM, Raftery AT, El Nahas AM, Haylor JL. Reduction of ischemia-reperfusion injury in the rat kidney by FTY720, a synthetic derivative of sphingosine. Transplantation. 2007 Jul 27;84(2):187-95. doi: 10.1097/01.tp.0000269794.74990.da. PubMed 17667810 ↗
  • Man K, Ng KT, Lee TK, Lo CM, Sun CK, Li XL, Zhao Y, Ho JW, Fan ST. FTY720 attenuates hepatic ischemia-reperfusion injury in normal and cirrhotic livers. Am J Transplant. 2005 Jan;5(1):40-9. doi: 10.1111/j.1600-6143.2004.00642.x. PubMed 15636610 ↗
  • Hasegawa Y, Suzuki H, Sozen T, Rolland W, Zhang JH. Activation of sphingosine 1-phosphate receptor-1 by FTY720 is neuroprotective after ischemic stroke in rats. Stroke. 2010 Feb;41(2):368-74. doi: 10.1161/STROKEAHA.109.568899. Epub 2009 Nov 25. PubMed 19940275 ↗
  • Wei Y, Yemisci M, Kim HH, Yung LM, Shin HK, Hwang SK, Guo S, Qin T, Alsharif N, Brinkmann V, Liao JK, Lo EH, Waeber C. Fingolimod provides long-term protection in rodent models of cerebral ischemia. Ann Neurol. 2011 Jan;69(1):119-29. doi: 10.1002/ana.22186. Epub 2010 Nov 12. PubMed 21280082 ↗
  • Fu Y, Zhang N, Ren L, Yan Y, Sun N, Li YJ, Han W, Xue R, Liu Q, Hao J, Yu C, Shi FD. Impact of an immune modulator fingolimod on acute ischemic stroke. Proc Natl Acad Sci U S A. 2014 Dec 23;111(51):18315-20. doi: 10.1073/pnas.1416166111. Epub 2014 Dec 8. PubMed 25489101 ↗
  • Zhu Z, Fu Y, Tian D, Sun N, Han W, Chang G, Dong Y, Xu X, Liu Q, Huang D, Shi FD. Combination of the Immune Modulator Fingolimod With Alteplase in Acute Ischemic Stroke: A Pilot Trial. Circulation. 2015 Sep 22;132(12):1104-1112. doi: 10.1161/CIRCULATIONAHA.115.016371. Epub 2015 Jul 22. PubMed 26202811 ↗
  • Lu L, Barfejani AH, Qin T, Dong Q, Ayata C, Waeber C. Fingolimod exerts neuroprotective effects in a mouse model of intracerebral hemorrhage. Brain Res. 2014 Mar 25;1555:89-96. doi: 10.1016/j.brainres.2014.01.048. Epub 2014 Feb 3. PubMed 24502984 ↗
  • Rolland WB, Lekic T, Krafft PR, Hasegawa Y, Altay O, Hartman R, Ostrowski R, Manaenko A, Tang J, Zhang JH. Fingolimod reduces cerebral lymphocyte infiltration in experimental models of rodent intracerebral hemorrhage. Exp Neurol. 2013 Mar;241:45-55. doi: 10.1016/j.expneurol.2012.12.009. Epub 2012 Dec 21. PubMed 23261767 ↗
  • Sun N, Shen Y, Han W, Shi K, Wood K, Fu Y, Hao J, Liu Q, Sheth KN, Huang D, Shi FD. Selective Sphingosine-1-Phosphate Receptor 1 Modulation Attenuates Experimental Intracerebral Hemorrhage. Stroke. 2016 Jul;47(7):1899-906. doi: 10.1161/STROKEAHA.115.012236. Epub 2016 May 12. PubMed 27174529 ↗
  • Fu Y, Hao J, Zhang N, Ren L, Sun N, Li YJ, Yan Y, Huang D, Yu C, Shi FD. Fingolimod for the treatment of intracerebral hemorrhage: a 2-arm proof-of-concept study. JAMA Neurol. 2014 Sep;71(9):1092-101. doi: 10.1001/jamaneurol.2014.1065. PubMed 25003359 ↗
  • Murthy SB, Moradiya Y, Shah J, Merkler AE, Mangat HS, Iadacola C, Hanley DF, Kamel H, Ziai WC. Nosocomial Infections and Outcomes after Intracerebral Hemorrhage: A Population-Based Study. Neurocrit Care. 2016 Oct;25(2):178-84. doi: 10.1007/s12028-016-0282-6. PubMed 27350549 ↗
  • Lord AS, Gilmore E, Choi HA, Mayer SA; VISTA-ICH Collaboration. Time course and predictors of neurological deterioration after intracerebral hemorrhage. Stroke. 2015 Mar;46(3):647-52. doi: 10.1161/STROKEAHA.114.007704. Epub 2015 Feb 5. PubMed 25657190 ↗
  • Dobin A, Davis CA, Schlesinger F, Drenkow J, Zaleski C, Jha S, Batut P, Chaisson M, Gingeras TR. STAR: ultrafast universal RNA-seq aligner. Bioinformatics. 2013 Jan 1;29(1):15-21. doi: 10.1093/bioinformatics/bts635. Epub 2012 Oct 25. PubMed 23104886 ↗
  • Liao Y, Smyth GK, Shi W. featureCounts: an efficient general purpose program for assigning sequence reads to genomic features. Bioinformatics. 2014 Apr 1;30(7):923-30. doi: 10.1093/bioinformatics/btt656. Epub 2013 Nov 13. PubMed 24227677 ↗
  • Love MI, Huber W, Anders S. Moderated estimation of fold change and dispersion for RNA-seq data with DESeq2. Genome Biol. 2014;15(12):550. doi: 10.1186/s13059-014-0550-8. PubMed 25516281 ↗
  • Ching T, Huang S, Garmire LX. Power analysis and sample size estimation for RNA-Seq differential expression. RNA. 2014 Nov;20(11):1684-96. doi: 10.1261/rna.046011.114. Epub 2014 Sep 22. PubMed 25246651 ↗
  • Benjamini Y, Hochberg Y. Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing. Journal of the Royal Statistical Society Series B (Methodological). 1995;57(1):289-300
  • Kramer A, Green J, Pollard J Jr, Tugendreich S. Causal analysis approaches in Ingenuity Pathway Analysis. Bioinformatics. 2014 Feb 15;30(4):523-30. doi: 10.1093/bioinformatics/btt703. Epub 2013 Dec 13. PubMed 24336805 ↗
  • Huang DW, Sherman BT, Tan Q, Kir J, Liu D, Bryant D, Guo Y, Stephens R, Baseler MW, Lane HC, Lempicki RA. DAVID Bioinformatics Resources: expanded annotation database and novel algorithms to better extract biology from large gene lists. Nucleic Acids Res. 2007 Jul;35(Web Server issue):W169-75. doi: 10.1093/nar/gkm415. Epub 2007 Jun 18. PubMed 17576678 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No — There is no plan to make individual participant data available to other researchers.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 23, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04088630
Responsible party
Sponsor
First posted
Sep 13, 2019
Start date
Aug 7, 2020
Primary completion
Jun 30, 2023
Completion
Jun 5, 2024
Results posted
Jan 14, 2025
Last update
Jan 23, 2025

Study contacts

Stacey Q Wolfe, MD
principal investigator · Wake Forest University Health Sciences

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2024. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drug tested here: Fingolimod

Start the discussion