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CTRI Number  CTRI/2021/06/034322 [Registered on: 21/06/2021] Trial Registered Prospectively
Last Modified On: 18/11/2023
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Biological 
Study Design  Randomized, Parallel Group, Active Controlled Trial 
Public Title of Study   A Clinical Study to Test the Effectiveness and Side Effects of Hetero-Tenecteplase in Adult patients with Suspected Myocardial Infarction 
Scientific Title of Study   A Prospective, Multicenter, Randomized, Comparative, Parallel Group Clinical Study to Compare The Efficacy, Pharmacokinetics, Pharmacodynamics, Immunogenicity and Safety of Intravenous Injection of Tenecteplase (Hetero Biopharma Limited) and Reference Medicinal Product (RMP-Tenecteplase, Boehringer Ingelheim) in Adults for the Thrombolytic Treatment of Suspected Myocardial Infarction with Persistent ST Elevation 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
HCR/III/TENESTEMI/08/2020; Version 1.0 Dated 05-08-2020  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name   
Designation   
Affiliation   
Address 




 
Phone    
Fax    
Email    
 
Details of Contact Person
Scientific Query
 
Name  Dr Sreenivasa Chary S 
Designation  General Manager 
Affiliation  Hetero Drugs Limited 
Address  Clinical Development and Medical Affairs, 2nd Floor, 7-2-A2, Hetero Corporate, Industrial Estates, Sanath Nagar

Hyderabad
TELANGANA
500018
India 
Phone  04023704923  
Fax    
Email  sreenivasa.chary@heterodrugs.com  
 
Details of Contact Person
Public Query
 
Name  Dr Shubhadeep Sinha 
Designation  Sr. Vice President 
Affiliation  Hetero Drugs Limited 
Address  Clinical Development and Medical Affairs, 2nd Floor, 7-2-A2, Industrial Estates, Sanath Nagar

Hyderabad
TELANGANA
500018
India 
Phone  040-23704923  
Fax  040-23801902  
Email  sd.sinha@heterodrugs.com  
 
Source of Monetary or Material Support  
Hetero Biopharma Limited, H. No. 8-3-166/1,2, 105 to 108, 1st Floor, G Block, East Wing, Challa Estates, Erragadda, Hyderabad, Telangana, India, 500018. Tel No. and Fax No.: 914023810110 
 
Primary Sponsor  
Name  Hetero Biopharma Limited 
Address  Hetero Biopharma Limited, H. No. 8-3-166/1,2, 105 to 108, 1st Floor, G Block, East Wing, Challa Estates, Erragadda, Hyderabad, Telangana, India, 500018. Tel No. and Fax No.: 914023810110 
Type of Sponsor  Pharmaceutical industry-Global 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study
Modification(s)  
No of Sites = 21  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Bhagya Narayan Pandit  Dr. Ram Manohar Lohia Hospital, PGIMER  Baba Khadakh Singh Marg, Near Gurudwara Bangla Sahib, Type III, Connaught Place, New Delhi-110001
New Delhi
DELHI 
9350188470

BNPANDIT1977@rediffmail.com 
Dr Naveen Janwal  Dr. Ram Manohar Lohia Institute of Medical Sciences  Department of Cardiology, Vibhuti Khand, Gomti Nagar, Lucknow-226010
Lucknow
UTTAR PRADESH 
9415112357

drjamwal@yahoo.com 
Dr Vimal Mehta  G. B. Pant Institute of Post graduate Medical Education & Research  Department of Cardiology, G. B. Pant Institute of Post graduate Medical Education & Research, Jawahar Lal Nehru Marg New Delhi -110002
New Delhi
DELHI 
9718599105

drvimalmehta@yahoo.co.in 
Dr Karodi Murali Krishna  Government General Hospital  Department of Cardiology,Government General Hospital,Podila Prasad Superspeciality Block,II Floor,Guntur-522001
Guntur
ANDHRA PRADESH 
9966511955

drmuralikrishnakarodi@gmail.com 
Dr Jaimin Nitinkumar Dave  Hi- Tech Multispeciality Hospital  Cardiology Department, Hi- Tech Multispecialty Hospital, Sector 3-D, Plot No. 1180, Gh Road, Nr.Gh-11/2 Bus stand, Gandhinagar-382003
Gandhinagar
GUJARAT 
9879830955

jaimin4842@gmail.com 
Dr Dharmendra Jain  Institute of Medical Sciences BHU  Department of Cardiology, Institute of Medical Sciences, BHU, Varanasi - 221005
Varanasi
UTTAR PRADESH 
9319048929

drjaincard@gmail.com 
Dr Prafulla Kerkar  KEM Hospital & Seth G.S. Medical College  4th Floor/403, Cardiology Department, CVTC Building, KEM Hospital & Seth G.S. Medical College, Parel, Mumbai-400012
Mumbai
MAHARASHTRA 
9820144111

prafullakerkar@rediffmail.com 
Dr Pavan Kumar P Rasalkar  KIMS Heart Centre  Department of Cardiology, KIMS Heart Centre, Krishna Rajendra Road, Bangalore - 560004
Bangalore
KARNATAKA 
9592999649

pavanrasalkar11@gmail.com 
Dr Akhil Sharma  King Georges Medical University  Department of Cardiology, Shahmina Road, Chowk, Lucknow-226003
Lucknow
UTTAR PRADESH 
9198882220

akhil.med@gmail.com 
Dr Sanjay Kumar C Porwal  KLES Dr. Prabhakar Kore Hospital and Medical Research Centre  Department of Cardiology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehrunagar, Belagavi - 590010
Belgaum
KARNATAKA 
9449800639

drsanjayporwal@gmail.com 
Dr P V Raghava Sarma  Lalitha Super Speciality Hospital (P) Ltd  I floor, Cardiology Department, Kothapet Main Rd, Kothapeta, Guntur-522001
Guntur
ANDHRA PRADESH 
9440800355

drpvraghav@gmail.com 
DrMahajan Ajaykumar Umakant  Lokmanya Tilak Municipal Medical College and General Hospital  Department of Cardiology, Lokmanya Tilak Municipal Medical College and General Hospital,Sion,Mumbai-400022
Mumbai
MAHARASHTRA 
9869032639

draum@rediffmail.com 
Dr Vinay Krishna  LPS Institute of Cardiology  LPS Institute of Cardiology, GSVM Medical College, Near Gol Chauraha, G.T. Road, Kanpur -208002
Kanpur Nagar
UTTAR PRADESH 
9415040271

vinaycvts11@rediffmail.com 
Dr Pankaj Harkut  Meditrina Institute of Medical Sciences,  Department of Cardiology, Meditrina Institute of Medical Sciences, 278, Central Bazar Road, Ramadaspeth, Nagpur- 440010
Nagpur
MAHARASHTRA 
9372723376

pankajharkut@rediffmail.com 
Dr Swapan Kumar Halder  NRS Medical College  Department of Cardiology, NRS Medical College, 138 AJC Bose Road, Kolkata - 700014
Kolkata
WEST BENGAL 
9433428031

drskh@rediffmail.com 
Dr Krishna Mala Konda Reddy P  Osmania Medical College and General Hospital  Department of Cardiology, Osmania Medical College and General Hospital, Afzalgunj, Hyderabad - 500012
Hyderabad
TELANGANA 
9848015098

drkmkreddycardio@gmail.com 
Dr Nirav Bhalani  Rhythm Heart Institute A Unit of Synergy Lifecare Pvt.  Cardiology Department, Rhythm Heart Institute A Unit of Synergy Lifecare Pvt. Ltd, Near Siddharth Bunglows, Vadodara-390022
Vadodara
GUJARAT 
8128995863

trial@rhythmheart.com 
Dr Abhijeet Palshikar  Sahyadri Superspeciality Hospital  Cardiology Department, Sahyadri Superspeciality Hospital, 30-C, Erandwane, Karverd, Pune-411004
Pune
MAHARASHTRA 
9890336897

dr_abhijeet@yahoo.com 
Dr Sohan Kumar Sharma  SMS Medical college and Attached Hospitals  Department of Cardiology Ground Floor G-2, Dhanvantri OPD Block SMS Hospital Jaipur-302004
Jaipur
RAJASTHAN 
9680333656

drsohansharma@gmail.com 
Dr Divya Prakash M  Victoria Hospital (PMSSY)  Department of cardiology, Victoria Hospital(PMSSY), Bangalore Medical College and Research Institute, Fort Road, KR Puram
Bangalore
KARNATAKA 
9845860473

drdivyaprakashm@gmail.com 
Dr Preeti Gupta  VMCC and Safdarjung Hospital  Department of Cardiology, VMCC and Safdarjung Hospital, Ansari Nagar East, near to AIIMS Metro Station, New Delhi -110029
New Delhi
DELHI 
9350457434

drpreetisjh@gmail.com 
 
Details of Ethics Committee
Modification(s)  
No of Ethics Committees= 21  
Name of Committee  Approval Status 
ETHICS COMMITTEE GMC and GGH  Submittted/Under Review 
Ethics Committee GSVM Medical College  Submittted/Under Review 
Ethics Committee of BMCRI, Bangalore Medical College and Research Institute  Submittted/Under Review 
Ethics Committee of Dr. Ram Manohar Lohia Institute of Medical Sciences  Submittted/Under Review 
Ethics Committee, N.R.S. Medical College  Submittted/Under Review 
Ethics Committee, PGIMER, Dr. Ram Manohar Lohia Hospital, Baba Khadakh Singh Marg, Near Gurudwara Bangla Sahib, Type III, Cannaught Place, New Delhi - 110001   Submittted/Under Review 
Ethics Committee,S.M.S. Medical College and Attached Hospitals,  Submittted/Under Review 
Hi-Tech Ethics Committee Hi-Tech Multispeciality Hospital  Submittted/Under Review 
IEC, Lokmanya Tilak Municipal Hospital College and General Hospital  Submittted/Under Review 
IEC, Maulana Azad Medical College  Submittted/Under Review 
Institutional Ethics Committee of Research cell, KGMU  Submittted/Under Review 
Institutional Ethics Committee VMMC and SJH  Submittted/Under Review 
Institutional Ethics Committee, Institute of Medical Sciences, BHU  Submittted/Under Review 
Institutional Ethics Committee, KLE University  Approved 
Institutional Ethics Committee, Osmania Medical College  Submittted/Under Review 
Institutional Ethics Committee, Seth GS Medical College and KEM Hospital  Submittted/Under Review 
KIMS Institutional Ethics Committee  Submittted/Under Review 
Lalitha SuperSpeciality Hospital Ethics Committee  Submittted/Under Review 
Meditrina Institute Ethics Committee  Submittted/Under Review 
Rhythm Heart Institute Ethics Committee  Approved 
Sahyadri Hospitals Ltd. Ethics committee Sahyadri Clinical Research & Development Center  Submittted/Under Review 
 
Regulatory Clearance Status from DCGI  
Status 
Approved/Obtained 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: I213||ST elevation (STEMI) myocardial infarction of unspecified site,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  Hetero-Tenecteplase  Single dose of Hetero-Tenecteplase on the basis of body weight, with a maximum dose of 10,000 units (50 mg tenecteplase). Tenecteplase is for intravenous administration only. 
Comparator Agent  RMP-Tenecteplase  Single dose of RMP-Tenecteplase on the basis of body weight, with a maximum dose of 10,000 units (50 mg tenecteplase). Tenecteplase is for intravenous administration only. 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  65.00 Year(s)
Gender  Both 
Details  1. Adult male or female patients of age 18-65 years (both inclusive)
2. Patient willing to provide written informed consent. Consent from Legally Acceptable Representative (LAR), if patient is not in the condition to give consent. However, when the patient is stable and is able to give consent, consent would be obtained to confirm his/her willingness to continue in the study
3. Patient presenting with chest pain and/or symptoms of Acute Myocardial Infarction with ST elevation in at least 2 or more contiguous leads (12 Lead ECG) with the following:
a. ST elevation of ≥0.25 mV in men <40 years or ≥0.2 mV in men ≥40 years or ≥0.15 mV in women in leads V2-V3
AND/OR
b. ST elevation of ≥0.1 mV in other contiguous chest leads or limb leads
4. Patient presenting with AMI within 6 hours of occurrence of symptoms
5. Female patient of childbearing potential must agree to get pregnancy test done at the time of enrolment and it should be negative. 
 
ExclusionCriteria 
Details  1. Patient with new onset Left Bundle Branch Block (LBBB)
2. Patient with history/evidence of hypersensitivity to thrombolytics or any of the components of formulation including gentamicin
3. Patient planned for primary percutaneous coronary intervention (PCI).
4. Patient receiving oral anticoagulant treatments with INR >1.3
5. Patient with history of prolonged cardiopulmonary resuscitation (>2 minutes) within the past 2 weeks
6. Patient with history/ active internal bleeding disorder within 6 months
7. Patient with history of recent gastrointestinal or genitourinary bleeding (within the past 10 days)
8. Patient with known hemorrhagic diathesis
9. Patient with known history of hemorrhagic stroke or stroke of unknown origin
10. Patient with history of ischemic stroke or transient ischemic attack in the preceding 6 months
11. Patient with history of intracranial tumor, arteriovenous malformation, cerebral aneurysm, intracranial or spinal surgery
12. Patient of known arterial/venous malformations
13. Patient with history of trauma to the head or cranium within 6 months
14. Patient with history of major surgery, parenchymal biopsy, ocular surgery and/or significant trauma within the past 2 months (this includes any trauma associated with the current AMI).
15. Patient of uncontrolled hypertension of systolic BP >160 mm of Hg and diastolic BP >110 mm of Hg
16. Patient administered Tenecteplase in the last 14 days prior to screening.
17. Patient administered of any glycoprotein IIb/IIIa inhibitor (including abciximab, eptifibatide, sibrafiban and tirofiban) in the 24 hours prior to screening.
18. Patient with subacute bacterial endocarditis and clinical pericarditis including pericarditis after this episode of acute myocardial Infarction.
19. Patient with high risk as per TIMI risk scoring.
20. Where, in the opinion of the investigator, participation in this study will not be in the best interest of the patient, or any other circumstances that prevent the patient from participating in the study safely. 
 
Method of Generating Random Sequence   Permuted block randomization, fixed 
Method of Concealment   On-site computer system 
Blinding/Masking   Participant, Investigator, Outcome Assessor and Date-entry Operator Blinded 
Primary Outcome  
Outcome  TimePoints 
Rate of TIMI grade 3 flow (Thrombolysis In Myocardial Infarction) of the infarct related artery  At 90 minutes 
 
Secondary Outcome  
Outcome  TimePoints 
50% resolution of elevated ST segment  At day 7, 14 and 30 or EOS if its earlier 
All cause 30 day mortality rate  Day 30 
Changes in left ventricular ejection fraction assessed by 2D-Echocardiography  At day 7, 14 and 30 or EOS if its earlier 
Events of ventricular tachyarrhythmias  At day 7, 14 and 30 or EOS if its earlier 
Pharmacokinetic parameters comparisons of Cmax, AUC0-t and AUC0-inf  After Single Dose Administration 
Change in cardiac enzymes level  At hours 24 and 48 
Immunogenicity assessment  At baseline and day 30 or EOS, if its earlier 
Treatment emergent adverse events (clinical and laboratory)  Throughout the study period 
Events of myocardial re-infarction(s)  At day 7, 14 and 30 or EOS if its earlier 
 
Target Sample Size   Total Sample Size="198"
Sample Size from India="198" 
Final Enrollment numbers achieved (Total)= "198"
Final Enrollment numbers achieved (India)="198" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   21/06/2021 
Date of Study Completion (India) 15/09/2022 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Date Missing 
Estimated Duration of Trial   Years="0"
Months="9"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Applicable 
Recruitment Status of Trial (India)  Completed 
Publication Details   NIL 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary   This is a multicentric, prospective, double blind, active control, randomized, comparative, parallel, clinical study to compare the efficacy, pharmacokinetics, pharmacodynamics, immunogenicity and safety of intravenous injection of Tenecteplase (Hetero Biopharma Limited) and Reference Medicinal Product (RMP-Tenecteplase, Boehringer Ingelheim) in adults patients with suspected myocardial infarction with persistent ST elevation. Patients will be screened for study eligibility based on the inclusion and exclusion criteria. Patients eligible for the study will be randomized to either Hetero-Tenecteplase or RMP-Tenecteplase based on the randomization schedule. All patients shall be administered on the basis of body weight, with a maximum dose of 10,000 units i.e., 50 mg of tenecteplase. All patients will be followed up for 30 days for efficacy and safety assessments. The study is expected to be completed in approximately 8 - 12 months after dosing of the first patient. 
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