Randomized Controlled Trial

. 2025 Feb 15;405(10478):560-570.

doi: 10.1016/S0140-6736(25)00194-1.

Efficacy and safety of nerinetide in acute ischaemic stroke in patients undergoing endovascular thrombectomy without previous thrombolysis (ESCAPE-NEXT): a multicentre, double-blind, randomised controlled trial

Michael D Hill¹, Mayank Goyal², Andrew M Demchuk³, Bijoy K Menon³, Thalia S Field⁴, William C Guest⁴, Jorg Berrouschot⁵, Albrecht Bormann⁵, Mirko Pham⁶, Karl G Haeusler⁶, Diedrick W J Dippel⁷, Pieter J van Doormaal⁷, Franziska Dorn⁸, Felix J Bode⁸, Brian A van Adel⁹, Demetrios J Sahlas⁹, Richard H Swartz¹⁰, Leodante Da Costa¹⁰, Johanna M Ospel¹¹, Rosalie V McDonough¹¹, Karla J Ryckborst¹², Mohammed A Almekhlafi¹³, Kathy J Heard¹⁴, David J Garman¹⁴, Corey Adams¹⁴, Yatika Kohli¹⁴, Bridget A Schoon⁷, Brian H Buck¹⁵, Mario Muto¹⁶, Atif Zafar¹⁷, Hauke Schneider¹⁸, Jonathan A Grossberg¹⁹, Leonard L L Yeo²⁰, Jason W Tarpley²¹, Marios-Nikos Psychogios²², Jonathan M Coutinho²³, Nicola Limbucci²⁴, Volker Puetz²⁵, Michael E Kelly²⁶, Bruce C V Campbell²⁷, Sven Poli²⁸, Alexandre Y Poppe²⁹, Jai J Shankar³⁰, Ronil Chandra³¹, Dar Dowlatshahi³², George A Lopez³³, Luigi Cirillo³⁴, Aimen Moussaddy³⁵, Michael Devlin³⁶, Pablo Garcia-Bermejo³⁷, Jennifer L Mandzia³⁸, Mona Skjelland³⁹, Anne Hege Aamodt³⁹, Frank L Silver⁴⁰, Timothy J Kleinig⁴¹, Guglielmo Pero⁴², Jens Minnerup⁴³, Ryan A McTaggart⁴⁴, Ajit S Puri⁴⁵, Albert H Y Chiu⁴⁶, Gernot Reimann⁴⁷, Gordon J Gubitz⁴⁸, Marie-Christine Camden⁴⁹, Seon Kyu Lee⁵⁰, Eric Sauvageau⁵¹, Sibu Mundiyanapurath⁵², Donald F Frei⁵³, Hana Choe⁵⁴, Marcello Rocha⁵⁵, Jan Gralla⁵⁶, Peter Bailey⁵⁷, Sebastian Fischer⁵⁸, Thomas Liebig⁵⁹, Konstantin Dimitriadis⁵⁹, Dheeraj Gandhi⁶⁰, René Chapot⁶¹, Albert Jin⁶², Ameer E Hassan⁶³, Wim van Zwam⁶⁴, Ilko L Maier⁶⁵, Martin Wiesmann⁶⁶, Wolf-Dirk Niesen⁶⁷, Rajiv Advani⁶⁸, Agnethe Eltoft⁶⁹, Negar Asdaghi⁷⁰, Cynthia Murphy⁷¹, Luca Remonda⁷², Darshan Ghia⁷³, Olav Jansen⁷⁴, Markus Holtmannspoetter⁷⁵, Victoria Hellstern⁷⁶, Karsten Witt⁷⁷, Annette Fromme⁷⁸, Shahid M Nimjee⁷⁹, David Turkel-Parella⁸⁰, Dominik Michalski⁸¹, Christian Maegerlein⁸², Carol Huilian Tham⁸³, Michael Tymianski¹⁴; ESCAPE-NEXT Investigators

Collaborators, Affiliations

Collaborators

ESCAPE-NEXT Investigators:
Jose Bastos, Elena D Benu, Elizabeth Cervi, Patrizia Ebano, Razeen Mahroof, Iulia Munteanu, August Palma, Patrick Wilson

Affiliations

¹ Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. Electronic address: michael.hill@ucalgary.ca.
² Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
³ Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
⁴ Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
⁵ Klinikum Altenburger Land, Neurology, Altenburg, Germany.
⁶ Würzburg University Hospital, Würzburg, Germany.
⁷ Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.
⁸ Faculty of Medicine, University of Bonn, Bonn, Germany.
⁹ Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
¹⁰ Sunnybrook Health Sciences Centre, North York, ON, Canada.
¹¹ Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
¹² Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
¹³ Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
¹⁴ NoNO, Toronto, ON, Canada.
¹⁵ University of Alberta Hospital, Edmonton, AB, Canada.
¹⁶ Antonio Cardarelli Hospital, Naples, Italy.
¹⁷ St Michael's Hospital, Bristol, UK.
¹⁸ Klinikum Augsburg, Augsburg, Germany.
¹⁹ Emory University School of Medicine, Atlanta, GA, USA.
²⁰ National University Singapore Yong Loo Lin School of Medicine, Singapore.
²¹ Providence Little Company of Mary Medical Center Torrance, Torrance, CA, USA.
²² Universitatsspital Basel, Basel, Switzerland.
²³ UvA-Amsterdam UMC, Amsterdam, Netherlands.
²⁴ University Hospital Careggi, Florence, Italy.
²⁵ Technische Universität Dresden, Dresden, Germany.
²⁶ Royal University Hospital, Saskatoon, SK, Canada.
²⁷ Royal Melbourne Hospital, Parkville, VIC, Australia.
²⁸ University Hospitals Tübingen, Tübingen, Germany.
²⁹ Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
³⁰ Health Sciences Centre Winnipeg, Winnipeg, MB, Canada.
³¹ Monash Medical Centre, Clayton, VIC, Australia.
³² The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
³³ Swedish Neuroscience Institute, Seattle, WA, USA.
³⁴ IRCCS Institute of Neurological Sciences of Bolgna, Bologna, Italy.
³⁵ Montreal Neurological Institute-Hospital, Montreal, QC, Canada.
³⁶ Princess Alexandra Hospital, Harlow, UK.
³⁷ John Hunter Hospital Department of Neurology, Newcastle, NSW, Australia.
³⁸ London Health Sciences Centre University Hospital, London, UK.
³⁹ Oslo University Hospital, Oslo, Norway.
⁴⁰ Toronto Western Hospital, Toronto, ON, Canada.
⁴¹ Royal Adelaide Hospital, Adelaide, SA, Australia.
⁴² Ospedale Niguarda Ca' Granda, Milan, Italy.
⁴³ University Hospital Munster, Munster, Germany.
⁴⁴ Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA.
⁴⁵ University of Massachusetts Medical School, Worcester, MA, USA.
⁴⁶ Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
⁴⁷ Klinikum Dortmund, Dortmund, Germany.
⁴⁸ Dalhousie University Faculty of Medicine, Halifax, NS, Canada.
⁴⁹ CHU de Quebec-Universite Laval, Quebec City, QC, Canada.
⁵⁰ Montefiore Medical Center, Bronx, NY, USA.
⁵¹ Baptist Medical Center Jacksonville, Jacksonville, FL, USA.
⁵² University of Heidelberg, Heidelberg, Germany.
⁵³ Radiology Imaging Associates, Englewood, CO, USA.
⁵⁴ Jefferson Abington Hospital, Abington, PA, USA.
⁵⁵ University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
⁵⁶ University of Berne Faculty of Medicine, Bern, Switzerland.
⁵⁷ Gold Coast University Hospital, Southport QLD, Australia.
⁵⁸ University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
⁵⁹ Ludwig Maximillians University Munich, Munchen, Germany.
⁶⁰ University of Maryland Medical Center, Baltimore, MA, USA.
⁶¹ Alfried Krupp Klinikum Essen, Essen, Germany.
⁶² Kingston Health Sciences Centre, Kingston, ON, Canada.
⁶³ Valley Baptist Medical Center-Harlingen, Harlingen, Netherlands.
⁶⁴ Maastricht University Medical Centre, Maastricht, Germany.
⁶⁵ University Medical Center Göttingen, Göttingen, Germany.
⁶⁶ University Hospital Aachen, Aachen, Germany.
⁶⁷ University Hospital Freiburg Department of Neurology, Freiburg, Germany.
⁶⁸ Oslo University Hospital Ullevaal, Oslo, Norway.
⁶⁹ University Hospital of North Norway, Tromsø, Norway.
⁷⁰ Jackson Memorial Hospital, Miami, FL, USA.
⁷¹ Providence Portland Medical Center, Portland, OR, USA.
⁷² Kantonsspital Aarau, Aarau, Switzerland.
⁷³ Fiona Stanley Hospital, Murdoch, WA, Australia.
⁷⁴ University Hospital Schleswig Holstein, Schleswig Holstein, Germany.
⁷⁵ Nuremberg Hospital, Nuremberg, Germany.
⁷⁶ Klinikum Stuttgart, Stuttgart, Germany.
⁷⁷ Carl von Ossietzky Universitat Oldenburg, Oldenburg, Germany.
⁷⁸ Haukeland University Hospital, Bergen, Norway.
⁷⁹ Ohio State University Wexner Medical Center, Columbus, OH, USA.
⁸⁰ NYU Langone Medical Center and School of Medicine, New York, NY, USA.
⁸¹ University of Leipzig Medical Center, Leipzig, Germany.
⁸² Munich University of Technology Hospital Rechts der Isar Department of Neurology, Munich, Germany.
⁸³ National Neuroscience Institute, Singapore.

PMID: 39955119
DOI: 10.1016/S0140-6736(25)00194-1

Randomized Controlled Trial

Efficacy and safety of nerinetide in acute ischaemic stroke in patients undergoing endovascular thrombectomy without previous thrombolysis (ESCAPE-NEXT): a multicentre, double-blind, randomised controlled trial

Michael D Hill et al. Lancet. 2025.

. 2025 Feb 15;405(10478):560-570.

doi: 10.1016/S0140-6736(25)00194-1.

Authors

Collaborators

ESCAPE-NEXT Investigators:
Jose Bastos, Elena D Benu, Elizabeth Cervi, Patrizia Ebano, Razeen Mahroof, Iulia Munteanu, August Palma, Patrick Wilson

Affiliations

¹ Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. Electronic address: michael.hill@ucalgary.ca.
² Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
³ Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
⁴ Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
⁵ Klinikum Altenburger Land, Neurology, Altenburg, Germany.
⁶ Würzburg University Hospital, Würzburg, Germany.
⁷ Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.
⁸ Faculty of Medicine, University of Bonn, Bonn, Germany.
⁹ Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
¹⁰ Sunnybrook Health Sciences Centre, North York, ON, Canada.
¹¹ Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
¹² Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
¹³ Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
¹⁴ NoNO, Toronto, ON, Canada.
¹⁵ University of Alberta Hospital, Edmonton, AB, Canada.
¹⁶ Antonio Cardarelli Hospital, Naples, Italy.
¹⁷ St Michael's Hospital, Bristol, UK.
¹⁸ Klinikum Augsburg, Augsburg, Germany.
¹⁹ Emory University School of Medicine, Atlanta, GA, USA.
²⁰ National University Singapore Yong Loo Lin School of Medicine, Singapore.
²¹ Providence Little Company of Mary Medical Center Torrance, Torrance, CA, USA.
²² Universitatsspital Basel, Basel, Switzerland.
²³ UvA-Amsterdam UMC, Amsterdam, Netherlands.
²⁴ University Hospital Careggi, Florence, Italy.
²⁵ Technische Universität Dresden, Dresden, Germany.
²⁶ Royal University Hospital, Saskatoon, SK, Canada.
²⁷ Royal Melbourne Hospital, Parkville, VIC, Australia.
²⁸ University Hospitals Tübingen, Tübingen, Germany.
²⁹ Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
³⁰ Health Sciences Centre Winnipeg, Winnipeg, MB, Canada.
³¹ Monash Medical Centre, Clayton, VIC, Australia.
³² The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
³³ Swedish Neuroscience Institute, Seattle, WA, USA.
³⁴ IRCCS Institute of Neurological Sciences of Bolgna, Bologna, Italy.
³⁵ Montreal Neurological Institute-Hospital, Montreal, QC, Canada.
³⁶ Princess Alexandra Hospital, Harlow, UK.
³⁷ John Hunter Hospital Department of Neurology, Newcastle, NSW, Australia.
³⁸ London Health Sciences Centre University Hospital, London, UK.
³⁹ Oslo University Hospital, Oslo, Norway.
⁴⁰ Toronto Western Hospital, Toronto, ON, Canada.
⁴¹ Royal Adelaide Hospital, Adelaide, SA, Australia.
⁴² Ospedale Niguarda Ca' Granda, Milan, Italy.
⁴³ University Hospital Munster, Munster, Germany.
⁴⁴ Diagnostic Imaging, Rhode Island Hospital, Providence, RI, USA.
⁴⁵ University of Massachusetts Medical School, Worcester, MA, USA.
⁴⁶ Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
⁴⁷ Klinikum Dortmund, Dortmund, Germany.
⁴⁸ Dalhousie University Faculty of Medicine, Halifax, NS, Canada.
⁴⁹ CHU de Quebec-Universite Laval, Quebec City, QC, Canada.
⁵⁰ Montefiore Medical Center, Bronx, NY, USA.
⁵¹ Baptist Medical Center Jacksonville, Jacksonville, FL, USA.
⁵² University of Heidelberg, Heidelberg, Germany.
⁵³ Radiology Imaging Associates, Englewood, CO, USA.
⁵⁴ Jefferson Abington Hospital, Abington, PA, USA.
⁵⁵ University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
⁵⁶ University of Berne Faculty of Medicine, Bern, Switzerland.
⁵⁷ Gold Coast University Hospital, Southport QLD, Australia.
⁵⁸ University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany.
⁵⁹ Ludwig Maximillians University Munich, Munchen, Germany.
⁶⁰ University of Maryland Medical Center, Baltimore, MA, USA.
⁶¹ Alfried Krupp Klinikum Essen, Essen, Germany.
⁶² Kingston Health Sciences Centre, Kingston, ON, Canada.
⁶³ Valley Baptist Medical Center-Harlingen, Harlingen, Netherlands.
⁶⁴ Maastricht University Medical Centre, Maastricht, Germany.
⁶⁵ University Medical Center Göttingen, Göttingen, Germany.
⁶⁶ University Hospital Aachen, Aachen, Germany.
⁶⁷ University Hospital Freiburg Department of Neurology, Freiburg, Germany.
⁶⁸ Oslo University Hospital Ullevaal, Oslo, Norway.
⁶⁹ University Hospital of North Norway, Tromsø, Norway.
⁷⁰ Jackson Memorial Hospital, Miami, FL, USA.
⁷¹ Providence Portland Medical Center, Portland, OR, USA.
⁷² Kantonsspital Aarau, Aarau, Switzerland.
⁷³ Fiona Stanley Hospital, Murdoch, WA, Australia.
⁷⁴ University Hospital Schleswig Holstein, Schleswig Holstein, Germany.
⁷⁵ Nuremberg Hospital, Nuremberg, Germany.
⁷⁶ Klinikum Stuttgart, Stuttgart, Germany.
⁷⁷ Carl von Ossietzky Universitat Oldenburg, Oldenburg, Germany.
⁷⁸ Haukeland University Hospital, Bergen, Norway.
⁷⁹ Ohio State University Wexner Medical Center, Columbus, OH, USA.
⁸⁰ NYU Langone Medical Center and School of Medicine, New York, NY, USA.
⁸¹ University of Leipzig Medical Center, Leipzig, Germany.
⁸² Munich University of Technology Hospital Rechts der Isar Department of Neurology, Munich, Germany.
⁸³ National Neuroscience Institute, Singapore.

PMID: 39955119
DOI: 10.1016/S0140-6736(25)00194-1

Abstract

Background: In the ESCAPE-NA1 trial, treatment with nerinetide, an eicosapeptide that interferes with post-synaptic density protein 95, was associated with improved functional outcome among patients with acute ischaemic stroke due to large vessel occlusion undergoing endovascular thrombectomy without co-treatment with an intravenous thrombolytic agent. There was no benefit when intravenous thrombolytic agent co-treatment was used. We sought to confirm the clinical benefit of nerinetide in the absence of previous intravenous thrombolytic drug treatment.

Methods: In this multicentre, randomised, double-blind, placebo-controlled study, done in 77 centres in Canada (16), the USA (16), Germany (21), Italy (four), the Netherlands (three), Norway (four), Switzerland (three), Australia (eight), and Singapore (two), we enrolled patients with acute ischaemic stroke due to anterior circulation large vessel occlusion within 12 h from onset. Eligible patients were aged 18 years or older with a disabling ischaemic stroke at the time of randomisation (baseline National Institutes of Health Stroke Scale [NIHSS] score >5), who had been functioning independently in the community (Barthel Index score >90) before the stroke, had Alberta Stroke Program Early CT Score (ASPECTS) greater than 4, and who were not treated with a plasminogen activator. Patients were randomly allocated (1:1) to receive intravenous infusion of nerinetide in a single dose of 2·6 mg/kg, up to a maximum dose of 270 mg, based upon estimated or actual weight (if known) or saline placebo using a real-time, dynamic, internet-based, stratified randomised minimisation procedure. All patients underwent endovascular thrombectomy. The primary outcome was a favourable functional outcome 90 days from randomisation, defined as a modified Rankin Scale (mRS) score of 0-2. The analysis was by intention to treat and adjusted for time from stroke onset to randomisation (≤4·5 h [yes or no]), age, sex, baseline NIHSS score, occlusion location, time from qualifying imaging to randomisation, baseline ASPECTS, and region. Secondary outcomes were measures of mortality, worsening of stroke, improved functional independence, and measures of neurological disability. This trial is registered with ClinicalTrials.gov, NCT04462536.

Findings: From Dec 6, 2020, to Jan 31, 2023, 850 patients were assigned to receive nerinetide (n=454) or placebo (n=396). 206 (45%) participants in the nerinetide group and 181 (46%) participants in the placebo group achieved an mRS score of 0-2 at 90 days (odds ratio 0·97, 95% CI 0·72-1·30; p=0·82). Serious adverse events occurred equally between groups.

Interpretation: While nerinetide did not improve outcomes in patients with acute ischaemic stroke, it was not associated with excess adverse events. Further study is needed to identify the ideal timing of treatment and the sub-population of stroke patients who might benefit from treatment combined with current reperfusion therapies.

Funding: Canadian Institutes for Health Research and NoNO.

Copyright © 2025 The Author(s). Published by Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies. Published by Elsevier Ltd.. All rights reserved.

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Conflict of interest statement

Declaration of interests AHA reports an unrestricted grant from Boehringer-Ingelheim for the TenCRAOS trial. DJG reports share ownership in NoNO. MAA reports Advisory Board membership for Fluid Biomed and Palmera Medical. NA reports salary support from the American Heart Association for her role as section editor in Stroke and from the Florida Stroke Registry. JMC reports grants from Bayer and AstraZeneca and is a co-founder and shareholder of TrianecT. AMD reports a grant from Medtronic, DSMC membership for the WE TRUST study (sponsored by Phillips), DSMC chairman for the LT 3001-203 and LT3001-205 studies (sponsored by Lumosa), and board chairmanship for the Canadian Stroke Consortium (non-profit sector). DWJD reports grants from Stryker Neurovascular, Medtronic, Cerenovus, Penumbra, and Thrombolytic Science, DSMC chairmanship for the ACT-Global and LATE-MT studies, and past chairmanship of the CONTRAST Consortium. AE reports board membership of the Norwegian Stroke Organization. TSF reports payment for advisory board roles for Bayer, Novartis, HLS Therapeutics, and AstraZeneca and board membership for Destine Health and the Vancouver General Hospital–University of British Columbia Foundation. SF reports consulting fees and honoria from Microvention, Rapid Medical,and Stryker Neurovascular. DG reports grants from Microvention and consulting fees from Navigantis. MG reports grants from Medtronic and Cerenovus; consulting fees from Microvention, Stryker Neurovascular, Medronic, Mentice, Phillips, and Penumbra; and stock ownership in Circle Neurovascular. JG reports consulting fees from Medtronic and Johnson & Johnson/Cerenovus. AEH reports grants from GE Healthcare and Viz.ai, consulting fees or honoraria from Medtronic, Microvention, Stryker Neurovascular, Penumbra, Cerevonus, Xcath, Imperative Care, Perfuze, Route 92, Genentech, GE Healthcare, Scientia, Balt, Viz.ai, Insera Therapeutics, Proximie, NovaSignal, and Vesalio, DSMC membership for the COMMAND study, and is the past-president of the Society of Vascular and Interventional Neurology. KJH reports share ownership in NoNO. VH reports grants and consulting fees from Wallaby/Phenox. MDH reports grants from NoNO and Canadian Institutes of Health Research (CIHR) which directly supported the ESCAPE-NEXT study, past grants from NoNO, Medtronic, Boehringer-Ingelheim, CIHR, and Heart & Stroke Foundation; consulting fees from Sun Pharma and Brainsgate, patents licensed to Circle Neurovascular, DSMC charimanship for the DUMAS and Oncover Hiltonel trials, DSMC membership for the ARTESIA, BRAIN-AF and LAAOS-4 trials, stock ownership in Circle Neurovascular, and is the current president of the Canadian Neurological Sciences Federation (non-profit sector). MH reports consulting fees or honoraria from Balt, Medtronic, Stryker Neurovascular, Microvention, Phenox, Cerenovus, Siemens, and Rapid Medical. MEK reports consulting fees from Medtronic and Penumbra and stock or stock options from Basecamp Vascular, Radical Catheter Technology, and Endostream. TL reports grants from Cerus, Stryker Neurovascular, and Phenox and DSMC membership in the CLOT OUT study. NL reports consulting fees from Medtronic and honoraria from Medtronic, Penumbra, Balt, Cerenovus, Microvention, and Stryker Neurovascular. JLM reports advisory board membership for the SECRET study and board membership for the Canadian Stroke Consortium (non-profit sector). BKM reports grants for the CIHR. MM reports consulting fees from Stryker Neurovascular. MP reports grants from German Research Foundation and honoraria from Merck. SP reports grants from BMS/Pfizer, Boehringer-Ingelheim, Danichi-Sankyo, EU, German Federal Joint Committee Innovation Fund, German Federal Ministry of Education of Research, Helena Laboratories, and Werfen; consulting fees from Alexion, AstraZeneca, Daichi-Sankyo, and Werfen; and honoraria from Alexion, Bayer, Boehringer-Ingelheim, BMS/Pfizer, and Portola. AYP reports grants from Brain Canada, Heart & Stroke Foundation Canada, and CIHR, honoraria from Roche Canada, safety committee chairmanship for the ACT trial, and fellowship certification committee chairmanship for the Canadian Stroke Consortium (non-profit sector). M-NP reports grants from Swiss National Science Foundation, Bangerter-Rhyner Stiftung, Stryker Neurovascular, Phenox, Medtronic, Penumbra, and Siemens Healthineers and honoraria from Stryker Neurovascular, Medtronic, Pneumbra, Acandis, and Siemens Healthineers. ASP reports DSMC membership for Cerevasc and Keep, stock or stock options in NTI, Galaxy, Agile, and Perfuse, and a consultancy role for Cerenovus, Agile, Arsenal, Route 92, Stryker Neurovascular, Rapid, and Spryte. MR reports grants from the National Institutes of Health (NIH). RHS reports grants from the NIH, CIHR, and Ontario Brain Institute, DSMC membership for Hoffman La Roche, and stock or stock options in FollowMD. JWT reports consulting fees from Medtronic, Stryker Neurovascular, and Qure.ai. MT reports stock and CEO role in NoNO. PJvD reports consulting fees from Stryker Neurovascular, Phillips, Medtronic, and Siemens. WvZ reports consulting fees or honoraria from Phillips, Bayer, Stryker Neurovascular, Medtronic, Nico Lab, Cerenovus, and DSMC membership in the WeTrust, Athena, and InExtremis trials. MW reports grants from Ab medica, Acandis, Cerenovus, Kaneka Pharmaceuticals, Medtronic, Microvention, Phenox, Siemens Healthcare, and Stryker Neurovascular, consulting fees from Stryker Neurovascular, honoraria from Bracco Imaging, Medtronic, Siemens Healthcare, and Stryker Neurovascular. LLLY reports grants from National Medical Research Council (Singapore) and the Ministry of Education, advisory board membership for AstraZeneca, vice-president role for the Society of Neurointerventional Surgery, stock or stock options in Cereflo and medical advisor roles for Sunbird-bio, Cortirio, and See-mode. All other authors declare no competing interests.

Comment in

Ischaemic brain neuroprotection: a true therapeutic frontier?
Liberman AL, Levine SR. Liberman AL, et al. Lancet. 2025 Feb 15;405(10478):519-521. doi: 10.1016/S0140-6736(25)00164-3. Lancet. 2025. PMID: 39955108 No abstract available.

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Efficacy and safety of nerinetide in acute ischaemic stroke in patients undergoing endovascular thrombectomy without previous thrombolysis (ESCAPE-NEXT): a multicentre, double-blind, randomised controlled trial

Collaborators

Affiliations

Efficacy and safety of nerinetide in acute ischaemic stroke in patients undergoing endovascular thrombectomy without previous thrombolysis (ESCAPE-NEXT): a multicentre, double-blind, randomised controlled trial

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Comment in

References

Publication types

MeSH terms

Substances

Associated data

LinkOut - more resources

Full Text Sources

Medical

Research Materials