Efficacy of Nitric Oxide in Stroke trial

ENOS


2014, October: ENOS has now been published! Many thanks to all who have contributed!

The 'Efficacy of Nitric Oxide in Stroke' (ENOS) study is a collaborative, international, multicentre, prospective, randomised, single-blind, blinded endpoint, parallel-group, controlled trial designed to test the safety and efficacy of:

  1. transdermal glyceryl trinitrate (a nitric oxide donor) or control; and
  2. continuing or temporarily stopping prior anti-hypertensive medication.

4,011 patients with acute ischaemic or haemorrhagic stroke were enrolled within 48 hours of the onset of stroke and treatment given for 7 days. The primary outcome is shift in death or dependency (modified Rankin Scale) determined at 90 days by observers blinded to treatment.

Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial (link to full text) The Lancet, 22 October 2014

Clinical trial could change standard treatment for stroke (link) World Pharma News (Germany), 24 October 2014

Clinical trial sheds new light on BP management during stroke treatment (link) Zee News (India), 23 October 2014

Clinical Trial may Change Standard Treatment for Stroke (link) Medindia.com (India), 23 October 2014 **NEW**

Clinical trial could change standard treatment for stroke (link) Medical News Today, 23 October 2014

Results of ENOS: "No rush to continue oral BP meds in acute stroke", 09/05/2014 (pdf) Medscape: please note an account is required but it is free to sign up

Trial results poster, 19/05/2014 (pdf)

Nerses Sanossian's blog, 07/05/2014, live from ESC 2014 clinical trials session (link)

Trial final protocol (V1.5) (pdf)

Power point presentation, V1.0 (Powerpoint, size=3.9MB)

Brief Information for patients & relatives about the trial, V1.2 (PDF file)
Full information for patients, V2.11 (PDF file, MREC approved)


ENOS trial

Enter ENOS trial web-site


Status

At close (14th October 2013):

Enrolled patients: 4,011 with 2,097 (52.3%) in continue vs. stop pre-stroke antihypertensive therapy

Centres who recruited one or more patients: 168

Countries who recruited one or more patients: 23 - Australia, Canada, China, Denmark, Egypt, Eire, Georgia, Greece, Hong Kong, India, Italy, Malaysia, New Zealand, Norway, Philippines, Poland, Romania, Singapore, Spain, Sri Lanka, Sweden, Turkey, UK

Continents who enrolled one or more patients: 5 - Africa, Asia, Australia-Oceania, Europe, North America


Tweets by @enostrial

Funding


News


ENOS trial

Enter ENOS trial web-site


Documents

Main publication:
Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial (pdf) in The Lancet, 22 October 2014

ENOS protocol - summary, V1.7 (html file)
Expression of interest, V1.1 (PDF file)
Newsletter 73 - January 2014 (PDF file)
Newsletter 72 - October 2013 (PDF file)
Newsletter 71 - July 2013 (PDF file)
Newsletter 70 - April 2013 (PDF file)
Newsletter 69 - January 2013 (PDF file)
Newsletter 68 - October 2012 (PDF file)
Newsletter 67 - August 2012 (PDF file)
Newsletter 66 - June 2012 (PDF file)
Newsletter 65 - April 2012 (PDF file)
Newsletter 64 - February 2012 (PDF file)
Newsletter 63 - December 2011 (PDF file)
Newsletter 62 - October 2011 (PDF file)
Newsletter 61 - August 2011 (PDF file)
Newsletter 60 - June 2011 (PDF file)
Newsletter 59 - April 2011 (PDF file)
Newsletter 58 - February 2011 (PDF file)
Newsletter 57 - December 2010 (PDF file)
Newsletter 56 - October 2010 (PDF file)
Newsletter 55 - August 2010 (PDF file)
Newsletter 54 - June 2010 (PDF file)
Newsletter 53 - April 2010 (PDF file)
Newsletter 52 - February 2010 (PDF file)
Newsletter 51 - December 2009 (PDF file)
Newsletter 50 - October 2009 (PDF file)
Newsletter 49 - August 2009 (PDF file)
Newsletter 48 - June 2009 (PDF file)
Newsletter 47 - April 2009 (PDF file)
Newsletter 46 - February 2009 (PDF file)
Newsletter 45 - December 2008 (PDF file)
Newsletter 44 - October 2008 (PDF file)
Newsletter 43 - August 2008 (PDF file)
Newsletter 42 - June 2008 (PDF file)
Newsletter 41 - April 2008 (PDF file)
Newsletter 40 - February 2008 (PDF file)
Newsletter 39 - December 2007 (PDF file)
Newsletter 38 - October 2007 (PDF file)
Newsletter 37 - August 2007 (PDF file)
Newsletter 36 - June 2007 (PDF file)
Newsletter 35 - April 2007 (PDF file)
Newsletter 34 - February 2007 (PDF file)
Newsletter 33 - December 2006 (PDF file)
Newsletter 32 - October 2006 (PDF file)
Newsletter 31 - August 2006 (PDF file)
Newsletter 30 - June 2006 (PDF file)
Newsletter 29 - April 2006 (PDF file)
Newsletter 28 - February 2006 (PDF file)
MRI study newsletter - December 2005 (PDF file)
Newsletter 27 - December 2005 (PDF file)
Newsletter 26 - October 2005 (PDF file)
Newsletter 25 - August 2005 (PDF file)
Newsletter 24 - June 2005 (PDF file)
Newsletter 23 - April 2005 (PDF file)
Newsletter 22 - February 2005 (PDF file)
Newsletter 21 - December 2004 (PDF file)
Newsletter 20 - October 2004 (PDF file)
Newsletter 19 - August 2004 (PDF file)
Newsletter 18 - June 2004 (PDF file)
Newsletter 17 - April 2004 (PDF file)
Newsletter 16 - February 2004 (PDF file)
Newsletter 15 - December 2003 (PDF file)
Newsletter 14 - October 2003 (PDF file)
Newsletter 13 - August 2003 (PDF file)
Newsletter 12 - June 2003 (PDF file)
Newsletter 11 - April 2003 (PDF file)
Newsletter 10 - February 2003 (PDF file)
Newsletter 9 - December 2002 (PDF file)
Newsletter 8 - October 2002 (PDF file)
Newsletter 7 - August 2002 (PDF file)
Newsletter 6 - June 2002 (PDF file)
Newsletter 5 - April 2002 (PDF file)
Newsletter 4 - February 2002 (PDF file)
Newsletter 3 - November 2001 (PDF file)
Newsletter 2 - September 2001 (PDF file)
Newsletter 1 - July 2001 (PDF file)


Presentations/publications/listings

Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial (link to full text) The Lancet 22 October 2014

ENOS has been presented regularly at stroke conferences since 2001, including:

Recent attendances include:

Trial protocol: Other selected presentations, publications and listings include: The Virtual Medical Centre has produced some videos with Lesley Cala, scan adjudicator on ENOS, which involve ENOS:
        'Improving Stroke Outcomes' (link), 10/09/2015
For the following video you will need to sign up here: this is free but only registered health professionals (who input the required registration numbers) will be able to view this video.
        ENOS trial (link), 10/09/2015.

Demo/practice website and database

Enter demo/practice ENOS trial web-site

Please note that data entered into the demo/practice website and database is not entered into the main/full trial database and does not contribute to trial data. However, this website and database replicates and demonstrates the functions of the main trial website and database.


Study personnel

Trial Steering Committee:

Independent Chairman - Graham Venables (Sheffield); Independent experts - Pierre Amarenco (Paris, France), Keith Muir (Glasgow); Members - Philip Bath (Nottingham), Kennedy Lees (Glasgow), Stuart Pocock (London), Joanna Wardlaw (Edinburgh), David Whynes (Nottingham), Eivind Berge (Oslo, Norway); EME/MRC representative - Jane Sinclair (Southampton); University of Nottingham/sponsor representative - Angela Shone

International Advisory Committee:

Chair - Philip Bath, Australia - TBA, Canada - Stephen Phillips, China - Yong-Jun Wang, Egypt - Anwar El Etribi, Republic of Ireland - Ronan Collins, Georgia - Maia Beridze, Greece - George Ntaios, Hong Kong - Lawrence Wong, India - Kameshwar Prasad, Italy - Valeria Caso, Malaysia - Abdul Raman Ghani, New Zealand - John Gommans, Norway - Eivind Berge, Poland - Anna Czlonkowska, Romania - Szabolcs Szatmari, Saudi Arabia - Mohammed Al Jumah, Singapore - Hui Meng Chang, Spain - Exuperio de Tejedor, Sri Lanka - Asita de Silva, Sweden - Ann Charlotte Laske, UK - Kennedy Lees

Trial Management Committee (Nottingham):

Chief Investigator - Philip Bath, Trial Manager - Sally Utton, Assistant Trial Manager - Hayley Foster, Medic - Kailash Krishnan, UK Coordinators - Tanya Payne & Margaret Adrian, International Coordinators - Alice Durham & Sarah Grant, Outcome Coordinator - Joanne Keeling, Statisticians - Lisa Woodhouse & Polly Scutt, Data/Imaging Coordinator - Tanya Jones, Programming - Lee Haywood, Liz Walker, Finance - Wim Clarke, Secretary - Yvonne Smallwood

Independent Data Monitoring Committee:

Chairman - Peter Sandercock (UK); Members - Kjell Asplund (Sweden), Colin Baigent (UK); Statistician - Lucy Bradshaw (UK)

Independent Events Adjudicator:

Daniel Bereczki (Hungary), Nikola Sprigg (UK)

Scan Adjudicators:

Joanna Wardlaw (Chair), Alessandro Adami (Italy), Jennifer Becker (USA), Lesley Cala (Australia), Ana Casado (UK), Rob Dineen (UK), Panayiotis Koumellis (UK)

Programming/database management:

Lee Haywood, Liz Walker (UK)

Contact details

ENOS Trial Office
Stroke, Division of Clinical Neuroscience
University of Nottingham
Clinical Sciences Building
City Hospital campus
Hucknall Road
Nottingham NG5 1PB
UK
 
Telephone: +44 (0)115 823 1770
Fax: +44 (0)115 823 1771
E-mail:enos@nottingham.ac.uk

Written by Philip Bath, last updated by Dawn Hazle 11th September 2015

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