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Mini-StrokeINSPiRE-TMSNCT01586702

Intensified Secondary Prevention Intending a Reduction of Recurrent Events in TIA and Minor Stroke Patients

A study testing Patient centered structured support program in people with Mini-Stroke, run by Charite University, Berlin, Germany at 1 site in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Patients after TIA or Stroke are at high risk of experiencing a new stroke or myocardial infarction. Poor adherence to evidence based secondary prevention regimens is frequently seen. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Mini-Stroke
What is being tested?
Patient centered structured support program
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,082 participants
Where
1 siteGermany
Study dates
Sep 2011to May 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Acute cerebrovascular event (either TIA or minor Stroke within 14 days before study inclusion) according to the following definitions:
  • TIA (clinical restitution within 24 hours and ABCD2-Score ≥3) or visible DWI-lesion in MRI
  • Minor stroke (mRankin ≤2 at time of inclusion)
  • Patients with at least one of the following treatable risk factors:
  • Arterial Hypertension
  • Diabetes mellitus
Show all 10Show fewer
  • Atrial Fibrillation
  • Smoking
  • Written informed consent prior to study inclusion
  • Realistic perspective in keeping the outpatient appointments

Who cannot join

  • Distance from home to study center not in suitable range for keeping the outpatient appointments
  • cognitive impairment jeopardizing adherence to the support program
  • Modified Rankin Score >2 at time of study inclusion
  • Malignant disease with life expectancy of less than 3 years
  • relevant alcohol or other substance abuse (except for nicotine)
  • Stroke or TIA etiology without options for evidence based secondary prevention (e.g. dissection or vasculitis)

Trial locations and contacts

1 site in 1 country.

Germany1 site
  • Dept. of Neurology, Charité Universitätsmedizin Berlin

    Berlin, 12200

Other trials in Germany

About this study

Official title: Intensified Secondary Prevention Intending a Reduction of Recurrent Events in TIA and Minor Stroke Patients (INSPiRE-TMS) A Randomized Trial Comparing a Patient Centered Support Program Versus Conventional Car

Patients after TIA or Stroke are at high risk of experiencing a new stroke or myocardial infarction. Poor adherence to evidence based secondary prevention regimens is frequently seen. Support programs for patients may not only improve adherence to recommended therapies but also reduce the recurrence rate of stroke and heart attack. The investigators hypothesize that compared to regular care, a structured and patient centered secondary prevention program will lead to a relative risk reduction of at least 28% of recurrent vascular events.

Read the detailed description

Although effective methods of secondary prevention after stroke or TIA are available, adherence to recommended evidence-based treatments is often poor. Programs for supported secondary prevention after cerebrovascular events with improved health education are promising but have not been evaluated regarding recurrent event reduction so far.

A prospective randomized trial has been started to assess the effectiveness of a patient centered structured support program intending a reduction of recurrent vascular events. Usual care consists of structured information given at discharge as well as regular outpatient care by general practitioners. The support program additionally employs a stepwise intensified support program with up to eight appointments over two years in outpatient clinics. Results of risk factor measurements and assessed adherence to medical recommendations are shared with the patients. They are also offered assistance in finding appropriate physical activities or smoking cessation programs.

Patients are randomized to regular care or regular care plus support program and will be followed-up until the total number of 317 primary endpoints has been reached. The composite primary endpoint consists of stroke, major coronary event and vascular death.

Conditions
Mini-Stroke
Being tested
Patient centered structured support program
Keywords
Stroke, TIA, secondary prevention, support program, multifactorial intervention
Medical subject headings
Ischemic Attack, Transient, Stroke

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Patient centered structured support programBehavioural

    Also called Intensified secondary prevention

    Behavioural: Structured support program

    Program with up to 8 outpatient appointments focusing on:

    • Measurement of risk factors
    • Assessment of medication intake
    • Monitoring of antithrombotic therapy
    • Joint agreement of an individual target plan

    Target values for risk factors:

    • Blood pressure < 140/85 mmHg (<130/80 in diabetics), normal circadian profile
    • HbA1c <7.5%
    • Nicotine abstinence
    • LDL < 100mg/dl (< 70mg/dl in high risk patients)
    • Physical activity ≥ 30min >2 x / week

    Targets for pharmaceutical treatment:

    • Platelet inhibitors for strokes / TIA of arterial etiology
    • Combined platelet inhibition over 3 months in symptomatic intra- or extracranial stenosis
    • Cumarins (INR 2-3) or new oral anticoagulants in AF patients
    • Statin treatment in patients with LDL >100mg/dl

    Intervention strategies:

    • According to Motivational Interviewing
Study groups in NCT01586702
Study groupRoleWhat they receive
Regular careNo interventionConsisting of structured information given at hospital discharge regarding stroke etiology and recommended secondary prevention plus regular outpatient care by general practitioners or family doctors.
Support programActive comparatorIn addition to regular care: Up to 8 appointments in outpatient clinics. Results of risk factor measurements and assessed adherence to medical recommendations are shared with the patients. In case that a patients fails to meet target values, preventive measures will be modified directly or via recommendation to GPs / family doctors. Patients are also offered assistance in finding appropriate physical activities or smoking cessation programs.
Receives: Behavioral: Patient centered structured support program

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Major vascular event consisting of nonfatal stroke, nonfatal major coronary event and vascular death

    Stroke: Acute (focal-) neurological syndrome, caused by brain infarction or intracerebral hemorrhage Major coronary event:Including instable Angina pectoris, STEMI and non-STEMI Vascular death: Caused by stroke (within 30 days of event), or major coronary event (within 7 days of event), or non-cerebral hemorrhage, or by peripheral arterial disease 30 days after vascular event or vascular intervention (intraarterial or surgical), or by pulmonary embolism or sudden death if death occurs within 24 hours in a patients with previously stable and healthy state if no non-vascular cause is documented

    Measured: Up to 6 years from inclusion

Secondary outcomes (7)
  1. Non vascular death

    Measured: Participants will be followed-up for an average of approximately 3.5 years

  2. Other vascular diseases leading to hospital admission (excl. primary outcome measure)

    Consisting of TIA, Angina pectoris, PAD with vascular intervention

    Measured: Participants will be followed-up for an average of approximately 3.5 years

  3. All hospital admissions with vascular intervention (intraarterial or surgical)

    Measured: Participants will be followed-up for an average of approximately 3.5 years

  4. Bleedings

    All bleedings leading to therapeutic intervention (categorized according to GUSTO definitions)

    Measured: Participants will be followed-up for an average of approximately 3.5 years

  5. Level of dependency

    Assessment according to modified Rankin Score and level of care (German care insurance)

    Measured: Up to 6 years from inclusion

  6. All hospital admissions

    Measured: Participants will be followed-up for an average of approximately 3.5 years

  7. Days alive and at home

    Measured: Participants will be followed-up for an average of approximately 3.5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Apr 2012 (estimated)
  2. Study startSep 2011
  3. Primary completionDec 2018
  4. Study completionMay 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
2,082 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01586702
Sponsor's protocol ID
EA2/084/11
Acronym
INSPiRE-TMS
Status last verified
Jul 2019
First submitted
23 Apr 2012
Last updated
23 Jul 2019
Results posted
No
Data monitoring committee
Yes

Publications

  • Tang Y, Temuulen U, Rios AS, Khalil A, Ahmadi M, Horn A, Endres M, Audebert HJ, Kufner A. Neuroanatomical correlates of stroke-related dizziness and vertigo: secondary analysis from the INSPiRE-TMS trial. J Neurol. 2026 Aug 12;273(9):524. doi: 10.1007/s00415-026-14033-3.

    PubMed 42584697
  • Stegemann A, Rios AS, Khalil A, Grittner U, Temuulen U, Ganeshan R, Braemswig TB, Horn A, Ihl T, Audebert HJ, Kufner A, Endres M. Neuroimaging Correlates of Post-Stroke Pain After Ischemic Stroke: Secondary Analysis of the INSPiRE-TMS Trial. Hum Brain Mapp. 2026 Jul;47(10):e70602. doi: 10.1002/hbm.70602.

    PubMed 42420807
  • Roesen P, Temuulen U, Rios AS, Ganeshan R, Braemswig TB, Khalil A, Villringer K, Ihl T, Ali HF, Gebert P, Grittner U, Ahmadi M, Puy L, Cordonnier C, Endres M, Audebert HJ, Kufner A. Baseline Cerebral Small Vessel Disease Predicting Long-Term Cognitive Decline in Transient Ischemic Attack Patients. Eur J Neurol. 2026 Apr;33(4):e70578. doi: 10.1111/ene.70578.

    PubMed 41885058
  • Stegemann A, Rios AS, Khalil A, Grittner U, Temuulen U, Ganeshan R, Braemswig TB, Horn A, Ihl T, Audebert HJ, Kufner A, Endres M. Neuroimaging Correlates of Post-Stroke Pain After Ischemic Stroke: Secondary Analysis of the INSPiRE-TMS Trial. medRxiv [Preprint]. 2025 Aug 11:2025.08.07.25333248. doi: 10.1101/2025.08.07.25333248.

    PubMed 40832386
  • Ihl T, Ahmadi M, Laumeier I, Steinicke M, Ferse C, Klyscz P, Endres M, Hastrup S, Poppert H, Palm F, Kandil FI, Weber JE, von Weitzel-Mudersbach P, Wimmer MLJ, Audebert HJ. Patient-Centered Outcomes in a Randomized Trial Investigating a Multimodal Prevention Program After Transient Ischemic Attack or Minor Stroke: The INSPiRE-TMS Trial. Stroke. 2022 Sep;53(9):2730-2738. doi: 10.1161/STROKEAHA.120.037503. Epub 2022 Jun 15.

    PubMed 35703097
  • Ahmadi M, Laumeier I, Ihl T, Steinicke M, Ferse C, Endres M, Grau A, Hastrup S, Poppert H, Palm F, Schoene M, Seifert CL, Kandil FI, Weber JE, von Weitzel-Mudersbach P, Wimmer MLJ, Algra A, Amarenco P, Greving JP, Busse O, Kohler F, Marx P, Audebert HJ. A support programme for secondary prevention in patients with transient ischaemic attack and minor stroke (INSPiRE-TMS): an open-label, randomised controlled trial. Lancet Neurol. 2020 Jan;19(1):49-60. doi: 10.1016/S1474-4422(19)30369-2. Epub 2019 Nov 7.

    PubMed 31708447
  • Leistner S, Michelson G, Laumeier I, Ahmadi M, Smyth M, Nieweler G, Doehner W, Sobesky J, Fiebach JB, Marx P, Busse O, Kohler F, Poppert H, Wimmer ML, Knoll T, Von Weitzel-Mudersbach P, Audebert HJ. Intensified secondary prevention intending a reduction of recurrent events in TIA and minor stroke patients (INSPiRE-TMS): a protocol for a randomised controlled trial. BMC Neurol. 2013 Jan 24;13:11. doi: 10.1186/1471-2377-13-11.

    PubMed 23347503
  • Leistner S, Benik S, Laumeier I, Ziegler A, Nieweler G, Nolte CH, Heuschmann PU, Audebert HJ. Secondary prevention after minor stroke and TIA - usual care and development of a support program. PLoS One. 2012;7(12):e49985. doi: 10.1371/journal.pone.0049985. Epub 2012 Dec 17.

    PubMed 23284630

Questions about this trial

What is this clinical trial studying?

A study testing Patient centered structured support program in people with Mini-Stroke, run by Charite University, Berlin, Germany at 1 site in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 23 Jul 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Major vascular event consisting of nonfatal stroke, nonfatal major coronary event and vascular death (time frame: Up to 6 years from inclusion). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01586702, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Jul 2019.

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