Indobufen versus aspirin in acute ischaemic stroke (INSURE): rationale and design of a multicentre randomised trial

• Published in: Stroke and vascular neurology 2022-10, Vol.7 (5), p.457-461
• Main Authors: Pan, Yuesong, Meng, Xia, Chen, Weiqi, Jing, Jing, Lin, Jinxi, Jiang, Yong, Johnston, S Claiborne, Bath, Philip M, Dong, Qiang, Xu, An-Ding, Li, Hao, Wang, Yongjun
• Format: Article
• Language: English
• Subjects: Aneurysms; Angioplasty; Anticoagulants; Aspirin; Aspirin - adverse effects; Blood platelets; Brain Ischemia - diagnosis; Brain Ischemia - drug therapy; cerebral infarction; clinical trial; Clinical trials; Disease prevention; Heart attacks; Hemorrhage; Hemorrhage - chemically induced; Humans; Informed consent; Ischemia; Ischemic Stroke - diagnosis; Ischemic Stroke - drug therapy; Mortality; Neurology; Patients; Platelet Aggregation Inhibitors - adverse effects; Protocol; Stroke; Stroke - diagnosis; Stroke - drug therapy; Stroke - prevention & control; Thrombosis; Treatment Outcome; Vascular surgery
• ISSN: 2059-8688; 2059-8696
• DOI: 10.1136/svn-2021-001480

BackgroundIndobufen can reversibly inhibit platelet aggregation and showed to be effective in the treatment of ischaemic heart and peripheral vascular diseases. However, it is unclear whether indobufen is an alternative antiplatelet agent for treatment of patients with ischaemic stroke.AimTo test whether indobufen is non-inferior to aspirin in reducing the risk of new stroke at 3 months in patients with moderate to severe ischaemic stroke.DesignThe Indobufen vs Aspirin in Acute Ischaemic Stroke (INSURE) is a randomised, double-blind, double-dummy, positive drug control, non-inferior multicentre clinical trial conducted in 200 hospitals in China. Participants will be randomised at a 1:1 ratio to receive either 100 mg indofufen two times daily or 100 mg aspirin once daily within 72 hours of the onset of symptoms from day 1 to 3 months.Study outcomesThe primary efficacy outcome is a new stroke (ischaemic or haemorrhagic) within 3 months and the primary safety outcome is a severe or moderate bleeding event within 3 months.DiscussionThe INSURE trial will evaluate whether indobufen is non-inferior to aspirin in reducing the risk of new stroke at 3 months in patients with moderate to severe ischaemic stroke.Trial registration numberNCT03871517.