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RecruitingNCT07509645IRIS-3Updated Sep 9, 2026

Efficacy and Safety of Interleukin-6 Receptor Inhibitor Combined With Endovascular Treatment in Patients With Acute Posterior Circulation Large Vessel Occlusion Stroke

A Phase 3 interventional study of Tocilizumab and Placebo in Ischemic Stroke, sponsored by Capital Medical University. Recruiting at 13 sites in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-09.

Sponsored by Capital Medical University · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
348
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is an investigator-initiated phase III clinical trial employing a randomized, double-blind, placebo-controlled design. The primary objective of this study is to investigate the efficacy and safety of an interleukin-6 inhibitor (tocilizumab) combined with endovascular therapy in patients with acute posterior circulation large-vessel occlusion stroke.

Read the detailed description

This is an investigator-initiated, prospective, multicenter phase III clinical trial. This trial aims to investigate whether tocilizumab could further improve prognosis for patients with acute posterior circulation large-vessel occlusion stroke receiving endovascular therapy.

02

Conditions studied

  • Ischemic Stroke

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Keywords

  • large vessel occlusion
  • endovascular treatment
  • posterior circulation
  • interleukin-6 inhibitor
  • neuroprotection
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Age 18 years or older, of either sex;
  2. Acute ischemic stroke caused by occlusion of the basilar artery;
  3. Decide to undergo emergency endovascular treatment;
  4. Time from stroke onset to groin puncture within 24 hours;
  5. National Institutes of Health Stroke Scale (NIHSS) ≥ 10;
  6. Posterior circulation Alberta Stroke Program Early computed tomography score (pc-ASPECTS) ≥ 6;
  7. Signed informed consent from the patients or the legally authorized representatives.

Exclusion criteria

Exclusion Criteria:

  1. Intracerebral hemorrhage, epidural hematoma, subdural hematoma, intraventricular hemorrhage, or subarachnoid hemorrhage;
  2. Pre-stroke modified Rankin scale (mRS) score >1;
  3. Known allergy to tocilizumab or excipients;
  4. Known allergy to iodinated contrast agents;
  5. Anticipated difficulty in completing endovascular treatment due to vascular tortuosity;
  6. History of congenital or acquired bleeding disorders, coagulation factor deficiency diseases, or thrombocytopenic diseases;
  7. Systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥110 mmHg despite blood pressure control;
  8. Neutrophils \< 2 × 10\^9 /L;
  9. Platelets \< 100 × 10\^9 /L;
  10. Blood glucose \<2.8 mmol/L (50 mg/dL) or >22.2 mmol/L (400 mg/dL);
  11. Serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels >2 times the upper limit of normal;
  12. Known recent or current serum creatinine >2 times the upper limit of normal or estimated glomerular filtration rate (eGFR) \<60 mL/min;
  13. Pregnant, lactating, or planning pregnancy within 90 days;
  14. Severe mental disorders or inability to comply with informed consent and follow-up requirements due to dementia;
  15. Concurrent malignant tumors or severe systemic diseases with expected survival of less than 90 days;
  16. Presence of autoimmune diseases or use of immunosuppressive drugs;
  17. Systemic infectious diseases;
  18. Participation in another interventional clinical study within 30 days before randomization or currently participating in another interventional clinical study;
  19. Any circumstance that, as assessed by the investigators, might result in harm to the patients if study therapy is initiated;
  20. Other conditions that the investigator considers might affect compliance or preclude participation in this study.
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
348 participants (estimated)

Study arms

  • Experimental
    Tocilizumab

    Endovascular treatment combined with a 240mg tocilizumab injection once

    Drug: Tocilizumab

  • Placebo comparator
    Placebo

    Endovascular treatment combined with placebo

    Drug: Placebo

Interventions

  • DrugTocilizumab

    240 mg of tocilizumab injection will be diluted in 0.9% NaCl to a total volume of 100 mL. The solution will be administered via intravenous infusion immediately after randomization and no later than 30 minutes, with an infusion duration of more than 1 hour.

  • DrugPlacebo

    An equivalent volume of placebo will be diluted in 0.9% NaCl to a total volume of 100 mL. The solution will be administered via intravenous infusion immediately after randomization and no later than 30 minutes, with an infusion duration of more than 1 hour.

05

What researchers measure

Primary outcomes

  1. Proportion of patients with a modified Rankin Scale (mRS) score of 0-3 at 90 days.

    The mRS ranges from 0 to 6, with higher scores indicating worse outcomes.

    Time frame: 90 days

Secondary outcomes

  1. mRS score distribution

    The mRS ranges from 0 to 6, with higher scores indicating worse outcomes.

    Time frame: 90 days and 1 year

  2. Early neurological improvement at 24 hours

    Defined as a reduction in NIHSS score of at least 8 points from baseline or a score of 0 to 2

    Time frame: 24 hours

  3. NIHSS score at 7 days or at early discharge

    The NIHSS ranges from 0 to 42, with higher scores indicating worse outcomes

    Time frame: 7 days

  4. Proportion of patients with mRS score 0-1

    The mRS ranges from 0 to 6, with higher scores indicating worse outcomes.

    Time frame: 90 days and 1 year

  5. Proportion of patients with mRS score 0-2

    The mRS ranges from 0 to 6, with higher scores indicating worse outcomes.

    Time frame: 90 days and 1 year

  6. Proportion of patients with mRS score 0-4

    The mRS ranges from 0 to 6, with higher scores indicating worse outcomes.

    Time frame: 90 days and 1 year

  7. EQ-5D-5L

    The EQ-5D-5L comprises the same five dimensions: MOBILITY, SELF-CARE, USUAL ACTIVITIES, PAIN / DISCOMFORT and ANXIETY / DEPRESSION, each dimension has five response levels: no problems, slight problems, moderate problems, severe problems, unable to/extreme problems.

    Time frame: 90 days and 1 year

  8. Proportion of Barthel Index (BI) 95-100

    Time frame: 90 days and 1 year

Other outcomes

  1. Incidence of symptomatic intracranial hemorrhage within 24 hours

    Time frame: 24 hours

  2. Incidence of any intracranial hemorrhage within 24 hours

    Time frame: 24 hours

  3. Proportion of patients with pneumonia at 7 days or at early discharge

    Time frame: 7 days

  4. Mortality

    Time frame: 90 days and 1 year

  5. Proportion of patients with a modified Rankin Scale (mRS) score of 0-3

    The mRS ranges from 0 to 6, with higher scores indicating worse outcomes.

    Time frame: 1 year

06

Study locations

13 of 13 sites recruiting
  • Suzhou Municipal Hospital
    Suzhou, Anhui 234000, China
    • Zhengfei Ma · Contact
    Recruiting
  • Anyang People's Hospital
    Anyang, Henan 455000, China
    • Jiangang Zhang · Contact
    Recruiting
  • Nanyang Central Hospital
    Nanyang, Henan 473000, China
    • Yifeng Liu · Contact
    Recruiting
  • The First Affiliated Hospital of Henan Medical University
    Xinxiang, Henan 453000, China
    • Hongkai Cui · Contact
    Recruiting
  • People's Hospital of Xihua
    Zhoukou, Henan 466600, China
    • Chaoqun Li · Contact
    Recruiting
  • People's Hospital of Linyi
    Linyi, Shandong 276000, China
    • Hao Wang · Contact
    Recruiting
  • Zibo Central Hospital
    Zibo, Shandong 255000, China
    • Liangjie Wang · Contact
    Recruiting
  • Xianyang First People's Hospital
    Xianyang, Shanxi 712000, China
    • Xingyun Yuan · Contact
    Recruiting
  • Yuncheng Central Hospital
    Yuncheng, Shanxi 044000, China
    • Bin Wang · Contact
    Recruiting
  • Lishui Central Hospital
    Lishui, Zhejiang 323000, China
    • Xiao Peng · Contact
    Recruiting
  • Taizhou enze Hospital
    Taizhou, Zhejiang 318000, China
    • Shaoqing Jiang · Contact
    Recruiting
  • People's Hospital of Yueqing
    Yueqing, Zhejiang 325600, China
    • Saizhen Wu · Contact
    Recruiting
  • Capital Medical Univercity Xuanwu Hospital
    Beijing, 100053, China
    Recruiting
07

References and documents

Individual participant data

Plan to share: Yes — Related data will be shared if full study protocol and statistical analysis plan are provided with reasonable design.

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07509645
Lead sponsor
Capital Medical University
Responsible party
Ji Xunming,MD,PhD (Professor of Neurology, Capital Medical University Xuanwu Hospital, Capital Medical University) — Principal investigator
First posted
Apr 3, 2026
Start date
Apr 22, 2026
Primary completion
Apr 20, 2027 (estimated)
Completion
Apr 20, 2027 (estimated)
Last update
Sep 9, 2026

Study contacts

Xunming Ji
Contact
jixm@ccmu.edu.cn
01083198962
Chuanjie Wu
Contact
wuchuanjie@ccmu.edu.cn
01083199439

Oversight

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

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