One-Year Quality-of-Life Outcomes Reported From IMS III Trial

May 13, 2015—In Stroke, Yuko Y. Palesch, PhD, et al published 12-month clinical and quality-of-life (QoL) outcomes from the Interventional Management of Stroke III (IMS III) trial, which concluded that endovascular therapy improves functional outcome and health-related QoL at 12 months after severe ischemic stroke (2015;46:1321–1327).

Lead investigator Joseph P. Broderick, MD, is the sponsor of IMS III, which was conducted in collaboration with the National Institutes for Neurologic Disorders and Stroke (NINDS). In May 2012, NINDS announced that the trial was halted for futility.

As summarized in Stroke, the investigators compared functional and quality-of-life outcomes at 12 months overall and by stroke severity in stroke patients treated with intravenous tissue-type plasminogen activator (IV-tPA) followed by endovascular treatment as compared with IV-tPA alone in the IMS III trial. The key outcome measures were a modified Rankin Scale score ≤ 2 (functional independence) and the Euro-QoL EQ-5D measure.

The study enrolled 656 patients with moderate-to-severe stroke (National Institutes of Health Stroke Scale ≥ 8) at 58 centers in the United States (41 sites), Canada (7), Australia (4), and Europe (6). There was an interaction between treatment group and stroke severity in the repeated measures analysis of modified Rankin Scale ≤ 2 outcome. In the 204 participants with severe stroke (National Institutes of Health Stroke Scale ≥ 20), a greater proportion of the endovascular group had a modified Rankin Scale ≤ 2 (32.5%) at 12 months as compared with the IV-tPA group (18.6%); no difference was seen for the 452 participants with moderately severe strokes (55.6% vs 57.7%). 

In participants with severe stroke, the endovascular group had 35.2 more quality-adjusted days over 12 months as compared with IV-tPA alone, reported the IMS III investigators in Stroke.