A multi-laboratory preclinical trial in rodents to assess treatment candidates for acute ischemic stroke.
Patrick D LydenMarcio Augusto DinizFrancesca BosettiJessica LambKarisma A NagarkattiAndré RogatkoSungjin KimRyan P CabeenJaroslaw AronowskiKazi AkhterAli Syed ArbabBrooklyn D AveryHannah E BeattyAdnan BibicSuyi CaoLigia Simoes Braga BoisserandÁngel ChamorroAnjali ChauhanSebastian Diaz-PerezKrishnan M DhandapaniNirav DhaneshaAndrew GohAlison L HermanFahmeed HyderTakahiko ImaiConor W JohnsonMohammad Badruzzaman KhanPradip KamatSenthilkumar S KaruppagounderMariia KumskovaJelena M MihailovicJoseph B MandevilleAndréia Albuquerque Cunha Lopes-de-MoraisRakesh B PatelBasavaraju G SanganahalliCameron SmithYanrong ShiBrijesh SutariyaDaniel R ThedensTao QinSofia E VelazquezJaroslaw AronowskiCenk AyataAnil K ChauhanEnrique C LeiraDavid C HessRaymond C KoehlerLouise D McCulloughLauren Hachmann SansingPublished in: Science translational medicine (2023)
Human diseases may be modeled in animals to allow preclinical assessment of putative new clinical interventions. Recent, highly publicized failures of large clinical trials called into question the rigor, design, and value of preclinical assessment. We established the Stroke Preclinical Assessment Network (SPAN) to design and implement a randomized, controlled, blinded, multi-laboratory trial for the rigorous assessment of candidate stroke treatments combined with intravascular thrombectomy. Efficacy and futility boundaries in a multi-arm multi-stage statistical design aimed to exclude from further study highly effective or futile interventions after each of four sequential stages. Six independent research laboratories performed a standard focal cerebral ischemic insult in five animal models that included equal numbers of males and females: young mice, young rats, aging mice, mice with diet-induced obesity, and spontaneously hypertensive rats. The laboratories adhered to a common protocol and efficiently enrolled 2615 animals with full data completion and comprehensive animal tracking. SPAN successfully implemented treatment masking, randomization, prerandomization inclusion and exclusion criteria, and blinded assessment of outcomes. The SPAN design and infrastructure provide an effective approach that could be used in similar preclinical, multi-laboratory studies in other disease areas and should help improve reproducibility in translational science.
Keyphrases
- acute ischemic stroke
- clinical trial
- high fat diet induced
- study protocol
- atrial fibrillation
- randomized controlled trial
- cell therapy
- type diabetes
- physical activity
- endothelial cells
- insulin resistance
- public health
- metabolic syndrome
- phase ii
- bone marrow
- stem cells
- weight loss
- machine learning
- adipose tissue
- oxidative stress
- ischemia reperfusion injury
- weight gain
- mesenchymal stem cells
- coronary artery
- blood brain barrier