CClinicalTrials.gg
CompletedNCT05601999Updated Sep 21, 2026

Study of Efficacy and Safety of GNR-060 vs Metalyse in Patients With ST Elevation Myocardial Infarction

A Phase 3 interventional study of GNR-060 and Metalyse in ST Elevation Myocardial Infarction, sponsored by AO GENERIUM. Completed at 11 sites in Russia. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-09-21.

Sponsored by AO GENERIUM · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
244
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

GNR-060(JSC "GENERIUM", Russia) is a proposed biosimilar to the referent product Metalyse. This study is to compare the clinical efficacy and safety of GNR-060 vs Metalyse as a thrombolitic agent in patients with with ST Elevation Myocardial Infarction (STEMI).

Read the detailed description

The trial is designed as a multicenter randomized single blinded study with the centralized blinded outcome assessment. The patients with diagnosed STEMI will be randomly assigned with one of the treatment options within 4 hours after the symptoms onset. The effectiveness of the tested product GNR-060 or reference product Metalyze will be assessed by the coronarography within 24 hours after the thrombolysis with the following PCI in case of ineffectiveness. The patients will then be followed up for survival and cardiac events for 90 days. The safety assessment will also include any related hemorrhagic complication. The pharmacokinetic parameters and immunogenicity will be also assessed.

02

Conditions studied

  • ST Elevation Myocardial Infarction

Keywords

  • Myocardial Infarction
  • ST Elevation
  • ECG
  • STEMI
  • Myocardial Ischemia
  • Coronary Thrombosis
  • Thrombolysis
  • Thrombolytic
  • Thrombolytic therapy
  • Fibrinolytic therapy
  • Fibrinolysis
  • Bleeding
  • Hemorrhagic syndrome
  • Haemorrhage
  • Hemorrhagic stroke
  • Coronary angiography
  • Revascularization
  • Reperfusion
  • Tenecteplase
  • Metalyse
  • Metalise
  • TNK-tPA
  • Fibrin-specific plasminogen activator
  • Recombinant DNA technology
  • AMI
03

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Myocardial infarction with elevation of the ST segment of the ECG (at point J) in 2 adjacent leads after no more than 6 hours from the onset of pain (lasting at least 20 minutes) in the chest (at the time of screening):

    • ≥ 2.5 mm in male ˂ 40 years, ≥ 2 mm in male ≥ 40 years, or ≥ 1.5 mm in female in leads V2-V3 and/or
    • ≥ 1 mm in other leads in the absence of left ventricular hypertrophy or left bundle branch block.

Exclusion criteria

Exclusion Criteria:

  • Diseases accompanied by significant bleeding, currently or within the last 6 months, hemorrhagic diathesis.
  • Current oral anticoagulant therapy with INR > 1.3.
  • Diseases of the central nervous system at present or in history (neoplasm, aneurysm, surgery on the brain or spinal cord).
  • Severe uncontrolled arterial hypertension.
  • Major surgical interventions, biopsy of a parenchymal organ or significant trauma within the last 2 months (including trauma in combination with AMI at the present time), recent (within the last 3 months) traumatic brain injury.
  • Prolonged or traumatic cardiopulmonary resuscitation (> 2 minutes) within the last 2 weeks.
  • Severe liver dysfunction, including liver failure, cirrhosis, portal hypertension (including esophageal varicose veins), active hepatitis.
  • Peptic ulcer of the stomach or duodenum in the acute stage.
  • Chronic kidney disease or other significant kidney disease with a decrease in glomerular filtration rate ≤30 ml / min / 1.73 m2.
  • Arterial aneurysm or presence of arterial/venous vascular malformation.
  • Neoplasm with an increased risk of bleeding.
  • Acute pericarditis and/or subacute bacterial endocarditis.
  • Acute pancreatitis.
  • Hypersensitivity to the active substance (tenecteplase), gentamicin (residual traces of the manufacturing process) or any excipient.
  • Hemorrhagic stroke or stroke of unknown etiology at present or in history.
  • Intracranial (including subarachnoid) hemorrhage at present or in history.
  • Ischemic stroke or transient ischemic attack (TIA) within the last 6 months.
  • Recent bleeding from the gastrointestinal or genitourinary tract or childbirth (within the last 10 days).
  • A recent (before 24 hours) puncture of an incompressible blood vessel (eg, subclavian or jugular vein).
  • Congenital and hereditary hemorrhagic coagulopathy (hemophilia, etc.) in history.
  • Pregnancy or breastfeeding.
  • Body mass index (BMI) less than 18.5 or more than 40 kg/m2.
  • Participation in another clinical trial currently or within 30 days prior to screening; use of any investigational drug within 30 days or 5 half-lives prior to screening.
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
244 participants (actual)

Study arms

  • Experimental
    GNR-060

    Main group (122 patients) - GNR-060

    Biological: GNR-060

  • Active comparator
    Metalyse

    Control group (122 patients) - Metalyse

    Biological: Metalyse

Interventions

  • BiologicalGNR-060

    GNR-060 will be administered in an individual dose depending on body weight as a single intravenous bolus

    Also known as: Tenecteplase

  • BiologicalMetalyse

    Metalyse will be administered in an individual dose depending on body weight as a single intravenous bolus

    Also known as: Tenecteplase

05

What researchers measure

Primary outcomes

  1. Frequency of the complete myocardial reperfusion based on the independent assessment of coronary angiography

    TIMI Grade 3 coronary blood flow after the trombolisis

    Time frame: up to 24 hours

Secondary outcomes

  1. Frequency of the complete+partial myocardial reperfusion based on the independent assessment of coronary angiography

    TIMI Grade 2 or 3 coronary blood flow after the trombolisis

    Time frame: up to 24 hours

  2. Frequency of myocardial reperfusion based on ECG data

    Resolution of the ST segment by 30%, 50%, 70% or more

    Time frame: after 90 minutes

  3. Changes in troponin T and creatine kinase MB levels

    Time frame: 7 days

  4. 90-Day mortality

    Mortality within 90 days after myocardial infarction

    Time frame: 90 days

  5. 30-Day and 90-Day cardiovascular mortality

    Cardiovascular mortality up to 30 and 90 days after myocardial infarction

    Time frame: 30 and 90 days

  6. Frequency of the postinfarction complications

    Frequency of any postifarction complication except for arrythmias

    Time frame: up to 30 days

  7. Frequency of the combined events "cardiovascular death + recurrent myocardial infarction + stroke" and "cardiovascular death + recurrent myocardial infarction + stroke + heart failure"

    Time frame: 30 days

Other outcomes

  1. Frequency and severity of hemorrhagic complications

    Hemorragies will be classified based on BARC, ISTH and TIMI definitions

    Time frame: up to 30 days

  2. Incidence of the hemorrhagic stroke

    Any case of treatment-related hemorrhagic stroke

    Time frame: up to 30 days

  3. Frequency and severity of the adverse drug reactions

    Any adverse events related to the trombolisis

    Time frame: up to 30 days

  4. Proportion of patients with the antidrug antibodies

    Anti-tenecteplaze antibody will be measured before trombolisis and 7 days after.

    Time frame: 7 days

06

Study locations

11 sites
  • Regional State Budgetary Health Institution "Regional Clinical Emergency Hospital"
    Barnaul, Altai Territory 656038, Russia
  • Regional State Budgetary Institution of Health Care "Altai Territorial Cardiology Dispensary"
    Barnaul, Altai Territory 656055, Russia
  • State Budgetary Institution of Health Care of the Arkhangelsk Region "First City Clinical Hospital named after E.E. Volosevich"
    Arkhangelsk, Arkhangelskaya oblast 163001, Russia
  • Regional State Budgetary Health Institution "Belgorod Regional Clinical Hospital of St. Joasaph"
    Belgorod, Belgorod Oblast 308007, Russia
  • State Autonomous Healthcare Institution of the Perm Territory "City Clinical Hospital No. 4"
    Perm, Perm Territory 614107, Russia
  • Municipal budgetary health care institution "City emergency hospital of the city of Rostov-on-Don"
    Rostov-on-Don, Rostov Oblast 344068, Russia
  • State Budgetary Institution of the Ryazan Region "Regional Clinical Hospital"
    Ryazan, Ryazan Oblast 390039, Russia
  • State budgetary health care institution of the Sverdlovsk region "Scientific and practical center for specialized types of medical care" Ural Institute of Cardiology "
    Yekaterinburg, Sverdlovsk Oblast 620144, Russia
  • State Autonomous Healthcare Institution "Interregional Clinical and Diagnostic Center"
    Kazan', Tatarstan Republic 420101, Russia
  • State Health Institution "City Clinical Emergency Hospital No. 25"
    Volgograd, Volgograd Oblast 400138, Russia
  • State Budgetary Health Institution of the Yaroslavl Region "Regional Clinical Hospital"
    Yaroslavl, Yaroslavl Oblast 150062, Russia
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT05601999
Lead sponsor
AO GENERIUM
Responsible party
Sponsor
First posted
Nov 1, 2022
Start date
Sep 3, 2021
Primary completion
May 6, 2024
Completion
Jan 15, 2025
Last update
Sep 21, 2026

Study contacts

Oksana A. Markova, MD, MSc
study chair · AO GENERIUM

Oversight

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

Not currently enrolling

This study is completed, as verified in Sep 2026. 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.

Start the discussion