Efficacy and Safety of SP-8203 (Otaplimastat) in Patients With Acute Ischemic Stroke Receiving Thrombolytic Standard of Care

Inclusion Criteria: * Patients with neurologic deficit of ≥ 8 points by National Institute of Health Stroke Scale (NIHSS) score * Patients with pre-stroke modified Rankin Scale (mRS) must be 0 or 1, which means they were able to carry out all usual duties and activities * Adults aged ≥19 years and ≤85 years * Patients who can receive thrombolytic standard of care within 4.5 hours after the onset of early symptoms of acute ischemic stroke * Patients available for brain Magnetic Resonance Imaging (MRI) scanning * Patients who consent to participate in this study Exclusion Criteria: * Patients with systemic allergic diseases or hypersensitivity to specific drugs. * Patients who were diagnosed with myocardial infarction (MI) within the last 6 months. * Patients who had arrhythmia causing clinical symptoms such as dyspnea or palpitation within the last 6 months. * Patients showing the following abnormal ECG findings in stable condition at Emergency Room: * The range of pulse rate - under 55/min or exceed 120/min * 2nd or 3rd degree Atrioventricular (AV) block indicated in ECG * Congenital or acquired QT syndrome indicated in ECG * Pre-excitation syndrome indicated in ECG * Patients with severe heart failure of New York Heart Association (NYHA) Class III or Class IV. * Patients with fever (≥ 38℃) or infection signs which require antibiotic therapy at screening. * Patients with pulmonary diseases (asthma, Chronic Obstruction Pulmonary disease, and active tuberculosis etc.) who have being recently been treated more than 1 month at screening. * Patients with decreased hemoglobin (Hb\< 10g/dL), decreased platelet count (PLT\< 100,000/mm3) or hematocrit of \<25% in complete blood count. * Patients who have undergone hemodialysis and/or treatments due to nephropathies, acute or chronic renal failure at screening. * Patients with a cancer in following conditions: diagnosed within 6 months before the screening time, or any treatment for cancer within the previous 6 months, or with recurrent/ metastatic cancer. * Pregnant and lactating women. However, Women of Childbearing Potential (WOCBP) can participate in the study only when non-pregnancy is confirmed. Women of Childbearing Potential (WOCBP) is defined as woman who is not definitely menopause and did not receive a surgical contraception. * Patients who do not consent to use double barrier contraception until 90 days from the first study intervention administration. * Patients who have participated in other clinical trials of other drugs within the past 3 months. However, if they participated in observational studies and did not take drugs, they can participate in this trial. * Patients who cannot participate in the study at the discretion of investigators * Patients who are unable to receive thrombolytic standard of care, rtPA