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Not yet recruitingNCT07511543LEASTUpdated Sep 24, 2026

Glucagon-like Peptide-1 Receptor Agonists for Endovascular Stroke Thrombectomy

A Phase 2 interventional study of Semaglutide in Ischemic Stroke, sponsored by Population Health Research Institute. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-24.

Sponsored by Population Health Research Institute · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Endovascular thrombectomy (EVT) is a procedure that improves recovery for people who suffer from a stroke by removing blood clots from large blood vessels in the brain. However, even with this treatment, over half of the patients either pass away or are left with serious disabilities within three months. This is partly because, even in cases of a successful EVT, brain tissue damage continues to grow. Extent of brain damage is a major factor in how well a patient recovers. Studies in animals have shown that a drug called semaglutide might help protect the brain and improve recovery after a stroke. Semaglutide is currently used for the treatment of diabetes and obesity and is given as a weekly injection under the skin.

The investigators are hoping to test whether giving semaglutide to stroke patients undergoing EVT can improve their recovery. A very large study at many hospitals is needed to answer this question. The investigators are starting with a smaller study to gain information on whether it is possible to perform a larger definitive one, and if so, how best to plan for it. In this first step we will study 100 patients with stroke who are scheduled for EVT in approximately 10 stroke centers across Canada. These patients will be randomly divided (like flipping a coin) into two groups: one will receive weekly semaglutide injections for 12 weeks, while the other will not receive the drug. The investigators will track how many patients agree to participate, how many stay in the study, and how well they follow the treatment plan. The investigators will also monitor the patients' recovery, overall health, and any side effects from the treatment. These results will provide important information to plan our larger study with the goal of reducing death rates and long-term disability in stroke patients undergoing EVT.

Read the detailed description

Background/Importance:

Endovascular thrombectomy (EVT) has substantially improved functional outcomes and decreased mortality in acute ischemic stroke patients with large vessel occlusions (LVOs). However, more than half of the patients die or have significant disability at 90 days after EVT. Studies suggest considerable infarct growth despite successful EVT and infarct volume predicts survival and functional outcome after EVT. There is an unmet need for interventions to reduce infarct growth and improve the functional outcomes of patients with an acute LVO who undergo EVT. Glucagon-Like Peptide-1 receptor agonists (GLP-1 RAs) have been suggested to decrease infarct growth and improve motor and sensory impairments in both diabetic and non-diabetic animal models of stroke. GLP-1 RAs also consistently decreased the risk of major adverse cardiovascular events (MACE), with the most profound effect in stroke prevention, in large-scale randomized clinical trials (RCTs) of patients with and without history of diabetes.

Research Aims:

The overall goal of this study is to test whether semaglutide can improve the functional outcomes of adults with acute ischemic stroke attributed to an intracranial LVO who are planned for treatment with EVT. We are performing a pilot trial to obtain the factual feasibility prerequisites essential for the planning, design, funding and execution of a subsequent main phase trial.

Methods:

Glucagon-like peptide-1 receptor agonists for Endovascular Stroke Thrombectomy (LEAST) is a multicentre, prospective, randomized, open label, blinded endpoint (PROBE) pilot clinical trial. LEAST will recruit a total of 100 adult patients scheduled to receive EVT at approximately 10 high-volume stroke research centres in Canada over 1.5 to 2 years. Participants fulfilling the inclusion and exclusion criteria will be randomly assigned up to 6 hours from the end of the EVT procedure, defined as the time of the last angiographic run, to either receive semaglutide (0.25 mg subcutaneous [SC] weekly for 4 weeks followed by 0.5 mg SC weekly for another 8 weeks) or to no semaglutide treatment.

Outcomes:

The primary feasibility endpoint is recruitment rate.

Secondary feasibility endpoints include retention rates and medication adherence.

Exploratory outcomes include:

Proportion of participants with functional independence (mRS scores 2 or less) at 90±14 days; Absolute difference in the NIHSS scores between randomization and 36±12 hours; Functional outcome at day 7±2, assessed with the ordinal mRS scores; Proportion of participants with functional independence (mRS scores 2 or less) at day 7±2; Functional outcome at day 30±7, assessed with the ordinal mRS scores; Proportion of participants with functional independence (mRS scores 2 or less) at day 30±7; Functional outcome at 90±14 days, assessed with the ordinal mRS scores; Quality of life at 90±14 days, assessed with the EQ-5D-5L scale; Recurrent stroke (ischemic, hemorrhagic or uncertain) by 90±14 days; Occurrence of MACE (any stroke, myocardial infarction cardiovascular death) by 90±14 days.

02

Conditions studied

  • Ischemic Stroke

Keywords

  • semaglutide
  • stroke
  • endovascular thrombectomy
  • large vessel occlusion
  • glucagon-like peptide-1 receptor agonist
  • GLP-1 RA
03

In context

Ischemic Stroke

2,612 studies on the registry are indexed under Ischemic Stroke; 971 are open to participants now.

This study's planned enrollment of 100 is below the median of 120 across 1,776 interventional studies indexed under Ischemic Stroke.

Browse Ischemic Stroke studies →

Lead sponsor

Population Health Research Institute is the lead sponsor of 115 studies on the registry; 26 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 1 (20%) have results posted.

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. Age 18 years or above on the date of randomization.
  2. EVT for an LVO in the anterior circulation, defined as the intracranial segment of the internal carotid artery (ICA) and/or the M1 or proximal M2 segment of the middle cerebral artery (MCA).
  3. National Institutes of Health Stroke Scale (NIHSS) ≥ 6 points at the time of randomization.
  4. Pre-stroke modified Rankin Scale (mRS) 0 or 1.
  5. Ability to randomize within 6 hours from the end of EVT.
  6. Capable of giving signed either independently, or by a legally authorized representative (LAR).

Exclusion criteria

Exclusion Criteria:

  1. Pregnancy or breast-feeding.
  2. Renal insufficiency ( \< 30mL/min).
  3. Cirrhosis or severe hepatic dysfunction, characterized by jaundice, encephalopathy or coagulopathy.
  4. History of pancreatitis in the year prior to randomization or evidence of acute pancreatitis on randomization.
  5. Active sepsis on randomization.
  6. Cancer, regionally advanced or , or for which treatment had been administered within 6 months from randomization, or hematological cancer that is not in complete remission.
  7. Any terminal medical condition with of less than 3 months.
  8. Personal or family history of medullary thyroid carcinoma (MTC) or patients with multiple endocrine neoplasia syndrome type 2 (MEN 2).
  9. (BMI) less than 19.
  10. Known to GLP-1 RAs.
  11. Active treatment with an GLP-1RA prior to randomization.
  12. Refusal or inability to administer subcutaneous (SC) injections by the patient or a caregiver.
  13. Close affiliation with the site.
Terms in these criteria, in plain language(7)

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.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

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.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

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.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
100 participants (estimated)

Study arms

  • Experimental
    Semaglutide

    Semaglutide

    Drug: Semaglutide

  • No intervention
    No Intervention

    No Intervention

Interventions

  • Glucagon-like peptide-1 (GLP-1) receptor agonist

    Also known as: Ozempic, Apo-semaglutide

06

What researchers measure

Primary outcomes

  1. Feasibility - Recruitment

    Recruitment of approximately 7 patients per site per year at approximately 10 Canadian stroke centres

    Time frame: From site activation until the end of recruitment (approximately 24 months)

Secondary outcomes

  1. Medication Adherence

    Target \>75% medication adherence

    Time frame: From randomization to day 90±14

  2. Retention Rate

    Target \>90% of study participants remaining in the trial

    Time frame: From randomization to day 90±14

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: Yes

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

Start is estimated for Oct 2026; primary completion for Oct 2028, 24 months later.

Of 83 non-industry phase 2 interventional studies under Ischemic Stroke, half reached primary completion within 28 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 40. This study's planned 24 months is below that.

Counting every sponsor, half of 124 studies reached it within 28 months; a quarter within 15 and three quarters within 39.

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

Registered
Mar 30, 2026
First posted
Apr 6, 2026
StartEst.
Oct 31, 2026
Primary completionEst.
Oct 31, 2028
CompletionEst.
Jan 31, 2029
Last update
Sep 24, 2026
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 Sep 24, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07511543
Responsible party
Sponsor
First posted
Apr 6, 2026
Start date
Oct 31, 2026 (estimated)
Primary completion
Oct 31, 2028 (estimated)
Completion
Jan 31, 2029 (estimated)
Last update
Sep 24, 2026

Study contacts

Jodi Miller, PhD
Contact
leaststudy@phri.ca
905-521-2100
Amanda Taylor
Contact
leaststudy@phri.ca
905-521-2100
Aristeidis Katsanos, MD
principal investigator · Population Health Research Institute
Mike Sharma, MD
principal investigator · Population Health Research Institute
Ashkan Shoamanesh, MD
principal investigator · Population Health Research Institute

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 not yet recruiting, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Semaglutide

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