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CompletedNCT04273516AREST-ESUSUpdated Oct 19, 2023

Rivaroxaban Plus ASA in Embolic Stroke of Undetermined Source(AREST-ESUS)

A Phase 2/3 interventional study of Rivaroxaban 2.5 Mg Oral Tablet and Rivaroxaban placebo tablets in Stroke and Prevention, sponsored by Mazandaran University of Medical Sciences. Completed at 1 site in Iran, Islamic Republic of. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-10-19.

Sponsored by Mazandaran University of Medical Sciences · Phase 2/3, Interventional, and Prevention

From the registry’s dates

  • Primary completion was Apr 2023, 3 years 7 months ago, and no results have been posted to the registry.
Phase
Phase 2/3
Study type
Interventional
Enrollment
42
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Approximately 17% of all patients with stroke are classified as having ESUS, which is associated with a considerable rate of stroke recurrence 4-5 % per year.

Despite recent scientific advances in acute ischemic stroke treatment in recent decades,consensus treatment of all guidelines is still ASA

Read the detailed description

This is an outcome assessor blind, randomized, parallel, placebo-controlled pilot study on ischemic stroke of undetermined source which will be conducted in Bu Ali Sina hospital in Sari, Iran.

Patients with recent stroke with criteria of ESUS, will be randomized to Rivaroxaban 2.5 mg BID plus ASA 80 mg daily or ASA 80 mg plus placebo (1:1 ratio) and have visit every 3 month until 1 year

02

Conditions studied

  • Stroke
  • Prevention

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Keywords

  • ESUS
  • DOACS
  • Prevention
03

In context

Stroke

8,255 studies on the registry are indexed under Stroke; 2,056 are open to participants now.

This study's enrollment of 42 is below the median of 49 across 6,024 interventional studies indexed under Stroke.

Browse Stroke studies →

Lead sponsor

Mazandaran University of Medical Sciences is the lead sponsor of 22 studies on the registry; 2 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years and older
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

  1. signing the inform consent
  2. recent ischemic stroke ( 7-60) days with criteria of ESUS
  3. only one risk factors of potential embolic source including:

    1. PTFV1 in standard ≥0.05 mm.s or ≥0.005 mv.s
    2. LVH in standard ECG( Sokolow index≥ 35 mm) or on echocardiography
    3. Moderate or severe valvular disorder on echocardiography (except MS)
    4. PFO without indication of occlusion
    5. Left atrium enlargement in echocardiography

Exclusion criteria

Exclusion Criteria:

  1. History of to the medicinal product
  2. Indication for anticoagulation
  3. Indication for dual antiplatelet therapy
  4. to investigational medications
  5. History of intracranial, intraocular, spinal, retroperitoneal or atraumatic intra-articular bleeding
  6. Gastrointestinal bleed or major surgery within 3 months
  7. Planned or likely revascularization (any angioplasty or vascular surgery) within the next 3 months
  8. HAS-BLED score >3
  9. Severe non-cardiovascular comorbidity with \< 3 months
  10. Severe renal failure, defined as (GFR) \<15ml/min, Dialysis, transplant, Cr >2.26 mg/dL
  11. Severe hepatic insufficiency, Cirrhosis or >2x Normal or /ALT/AP >3x Normal
  12. Modified Rankin Scale of >=4 at time of randomization or inability to swallow medications.
  13. Hemorrhagic transformation of infarction detected by Brain CT or MRI at the time of drug application
  14. Radiological or microbiological evidence of COVID-19 infection
Terms in these criteria, in plain language(8)

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.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

05

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Outcomes assessor)
Enrollment
42 participants (actual)

Study arms

  • Experimental
    Intervention

    Tablet Rivaroxaban 2.5 mg 2 times daily plus ASA 80 mg daily

    Drug: Rivaroxaban 2.5 Mg Oral Tablet

  • Placebo comparator
    Comparator

    Tab ASA 80 mg daily plus placebo ( similar to rivaroxaban tablet) 2 times daily

    Drug: Rivaroxaban placebo tablets

Interventions

  • Tablet Rivaroxaban 2.5 mg 2 times daily add to standard treatment ASA 80 mg daily

    Also known as: Axabin 2.5

  • DrugRivaroxaban placebo tablets

    Placebo tablets add to ASA 80 mg daily that is standard treatment

    Also known as: Placebo

06

What researchers measure

Primary outcomes

  1. Rate of stroke recurrence

    Number of stroke events during 1 year of study

    Time frame: Rate of stroke recurrence during one year fallow up

  2. Rate of major bleeding

    Rate of major bleeding according to criteria of the International Society of Thrombosis and Hemostasis

    Time frame: During 1 year of study

Secondary outcomes

  1. Rate of stroke or systemic embolisms

    Number of stroke or systemic embolisms recurrence during 1 year of study

    Time frame: During 1 year of study

  2. Mortality rate

    Number of all cause mortality during study

    Time frame: During 1year of study

  3. Rate of non-major bleeding

    Rate of non-major bleeding according to criteria of the International Society of Thrombosis and Hemostasis

    Time frame: During 1year of study

  4. Rate of intracranial bleeding

    Rate of ICH during study

    Time frame: During 1year of study

  5. Rate of fatal bleeding

    Rate of fatal bleeding in any site

    Time frame: During 1 year of study

07

Study locations

1 site
  • Bou- Ali Sina Hospital
    Sari, Mazandaran, Iran, Islamic Republic of
08

References and documents

Individual participant data

Plan to share: Yes

Supporting information: Study protocol, Statistical analysis plan, Informed consent form, Clinical study report

Access criteria: Data will be available for researchers and scientific persons after request and review the proposal .

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Aug 2020 to primary completion in Apr 2023, 31 months.

Of 27 phase 2/3 interventional studies under Stroke, half reached primary completion within 33 months of starting (the median), counting those still running; a quarter within 30 and three quarters within 77. This study's 31 months is close to that.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 15, 2020
First posted
Feb 18, 2020
StartActual
Aug 22, 2020
Primary completionActual
Apr 10, 2023
CompletionActual
Apr 30, 2023
Last update
Oct 19, 2023
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Oct 19, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04273516
Lead sponsor
Mazandaran University of Medical Sciences
Responsible party
Athena Sharifi Razavi (Assistant Professor in Neurology, Mazandaran University of Medical Sciences) — Principal investigator
First posted
Feb 18, 2020
Start date
Aug 22, 2020
Primary completion
Apr 10, 2023
Completion
Apr 30, 2023
Last update
Oct 19, 2023

Study contacts

Athena Sharifi-Razvi
principal investigator · mazandaran university of medical science
Monireh Ghazaeian
study director · mazandaran university of medical science

Oversight

Data monitoring committee
Yes
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 Oct 2023. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Rivaroxaban

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