Eight pivotal trials across acute ischaemic stroke, multiple sclerosis, epilepsy, and
Parkinson's disease β covering thrombolysis windows, thrombectomy selection, disease-modifying
therapy, and antiepileptic drug comparisons. Tap any trial to expand.
Acute Ischaemic Stroke β Thrombolysis2 trials
01
NINDS rt-PA Trial
IV alteplase within 3 hours of acute ischaemic stroke onset
π Why It's Named So
Sponsored by the National Institute of Neurological Disorders and Stroke (NINDS) to test IV tissue plasminogen activator (rt-PA) within 3 hours of ischaemic stroke onset.
π Drugs & Doses
Alteplase 0.9 mg/kg IV (max 90 mg) β 10% as 1-min bolus, then 90% over 60 min β versus placebo plus standard care, given within 3 hours of symptom onset.
π Key Result
Early IV alteplase improved 3-month functional outcome (NNT β 8) but increased symptomatic ICH; overall mortality was unchanged. Established the <3 h thrombolysis window.
02
ECASS III
Extended alteplase window: 3β4.5 hours after ischaemic stroke
π Why It's Named So
Third European Cooperative Acute Stroke Study β the third in a series of ECASS trials, this one specifically extending the tPA treatment window beyond 3 hours.
π Drugs & Doses
Alteplase 0.9 mg/kg IV (10% bolus, remainder over 60 min) versus placebo, given 3β4.5 hours after ischaemic stroke onset in selected patients.
π Key Result
Alteplase at 3β4.5 h improved 90-day functional independence but increased intracranial haemorrhage; mortality was unchanged. Extended the treatment window to 4.5 h in guidelines.
Acute Ischaemic Stroke β Thrombectomy2 trials
03
MR CLEAN
Mechanical thrombectomy for anterior-circulation LVO within 6 hours
π Why It's Named So
Acronym for Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischaemic Stroke in the Netherlands β the first positive RCT to establish endovascular therapy for LVO stroke.
π§ Intervention & Doses
Intra-arterial thrombectomy (mechanical Β± intra-arterial thrombolysis) plus usual care versus usual care alone for anterior-circulation large-vessel occlusion within 6 hours.
π Key Result
Endovascular therapy significantly improved 90-day disability distribution (common OR β 1.7) without increasing mortality or symptomatic ICH β catalysed global adoption of thrombectomy.
04
DAWN
Late-window thrombectomy 6β24 hours using clinical-imaging mismatch
π Why It's Named So
Acronym for Diffusion-Weighted Imaging or CT Perfusion Assessment With Clinical Mismatch in the Triage of Wake-Up and Late-Presenting Strokes Undergoing Neurointervention With Trevo β a remarkably long name distilled into DAWN, evoking treatment at "the dawn" of the late window.
π§ Intervention
Mechanical thrombectomy with the Trevo retriever plus standard care versus standard care alone in anterior-circulation LVO patients last-known-well 6β24 hours earlier with clinicalβimaging mismatch.
π Key Result
Thrombectomy at 6β24 h increased functional independence at 90 days (β 49% vs 13%; NNT β 3) in carefully selected patients β extending the treatment window beyond 6 hours in guidelines.
Multiple Sclerosis2 trials
05
AFFIRM
Natalizumab monotherapy in relapsing-remitting MS
π Why It's Named So
Acronym for NAtalizumab Safety and EFFIcacy in Relapsing-Remitting MS β the pivotal monotherapy trial for natalizumab (Tysabri) in RRMS.
π Drugs & Doses
Natalizumab 300 mg IV every 4 weeks versus placebo for up to 28 months in relapsing-remitting MS patients.
π Key Result
Natalizumab reduced the annualised relapse rate by β 68% and disability progression by ~40β50% versus placebo β one of the most efficacious DMTs demonstrated in MS.
06
CHAMPS
IFN-Ξ²1a after clinically isolated syndrome to prevent conversion to MS
π Why It's Named So
Controlled High-Risk Avonex Multiple Sclerosis Prevention Study β enrolled patients with a first demyelinating event (CIS) and high-risk MRI findings to test early DMT.
π Drugs & Doses
Interferon beta-1a (Avonex) 30 Β΅g IM weekly versus placebo, given after IV methylprednisolone and oral prednisone taper in clinically isolated syndrome.
π Key Result
Avonex cut the 3-year risk of clinically definite MS by about 44% and reduced new MRI lesions versus placebo β supporting early treatment after a high-risk CIS.
Epilepsy1 trial
07
SANAD
Pragmatic comparison of standard vs newer AEDs for epilepsy monotherapy
π Why It's Named So
Standard And New Antiepileptic Drugs β a pragmatic UK trial comparing older (carbamazepine, valproate) versus newer antiepileptic drugs for first-line monotherapy.
π Drugs & Doses
Arm A (focal seizures): carbamazepine vs lamotrigine, gabapentin, oxcarbazepine, topiramate. Arm B (generalised/unclassified): valproate vs lamotrigine, topiramate. Flexible usual clinical doses throughout.
π Key Result
Lamotrigine was the best-tolerated, cost-effective alternative to carbamazepine for focal epilepsy; valproate remained the most effective drug for generalised/unclassified epilepsy.
Parkinson's Disease1 trial
08
DATATOP
Selegiline and/or vitamin E for neuroprotection in early Parkinson's
π Why It's Named So
Deprenyl And Tocopherol Antioxidative Therapy Of Parkinsonism β "deprenyl" is the older name for selegiline; "tocopherol" is vitamin E. Both were tested as potential neuroprotective agents.
π Drugs & Doses
Selegiline (deprenyl) 10 mg/day and/or Vitamin E 2000 IU/day versus placebo in untreated early Parkinson's disease. Primary endpoint: time to need for levodopa therapy.
π Key Result
Selegiline delayed the need for levodopa; tocopherol showed no benefit. Long-term follow-up found no mortality advantage and the early symptomatic benefit was not sustained β attributed to selegiline's mild symptomatic rather than neuroprotective effect.