GREEN
(2026)Objective
Phase 2/3 RCT testing whether IV glenzocimab (anti-GPVI antibody fragment) adjunct to late-window EVT improves 90-day functional outcome.
Study Summary
• Primary 90-day mRS cOR: 0.58 (0.28-1.19), P=0.14.
• 90d mRS 0-2: 39% vs 55% (NS); mTICI 2b-3: 96% vs 98% (NS).
• 90d mortality 17% vs 8%; any ICH 28% vs 17%; sICH 2% vs 4%.
• Trial stopped for futility; unexpected trend toward harm.
• 90d mRS 0-2: 39% vs 55% (NS); mTICI 2b-3: 96% vs 98% (NS).
• 90d mortality 17% vs 8%; any ICH 28% vs 17%; sICH 2% vs 4%.
• Trial stopped for futility; unexpected trend toward harm.
Intervention
IV glenzocimab 1000 mg over 6 h (1/4 bolus in 15 min + 3/4 continuous infusion) vs IV placebo
Inclusion Criteria
France, multicenter. ICA/M1 occlusion; EVT within 24 h; DEFUSE-3 target mismatch or clinico-radiological mismatch (NIHSS >=10 and ASPECTS >=6); with or without tPA.
Study Design
Arms: Glenzocimab vs placebo (stratified by age, IVT, time to treatment, center)
Patients per Arm: Glenzocimab n=52 vs Placebo n=50 (expanded target 130 vs 130)
Outcome
• Primary 90-day mRS: cOR 0.58 (0.28-1.19), P=0.14.
• 90d mRS 0-2: 39% vs 55% (NS).
• mTICI 2b-3: 96% vs 98% (NS).
• 90d mortality: 17% vs 8%.
• Any ICH 28% vs 17%; sICH 2% vs 4%.
• 90d mRS 0-2: 39% vs 55% (NS).
• mTICI 2b-3: 96% vs 98% (NS).
• 90d mortality: 17% vs 8%.
• Any ICH 28% vs 17%; sICH 2% vs 4%.