DUAL Antithrombotic Therapy in Patients With AF and ACS
Primary Purpose
Atrial Fibrillation, Acute Coronary Syndromes
Status
Unknown status
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Rivaroxaban 15 MG Oral Tablet
Clopidogrel 75 Mg Oral Tablet
Ticagrelor 90 MG Oral Tablet
Sponsored by
About this trial
This is an interventional treatment trial for Atrial Fibrillation
Eligibility Criteria
Inclusion Criteria:
- Adults with either active or a history of non-valvular atrial fibrillation or flutter with the planned or existing use of an oral anticoagulant for prophylaxis of thromboembolism. In addition, subjects must have had an acute coronary syndrome
- Planned use of antiplatelet agents for at least 12 months
- Males and Females ≥ 18 years of age
- Women of childbearing potential must have a negative serum or urine pregnancy test within 24 hours prior to the start of study drug
Exclusion Criteria:
- Conditions other than atrial fibrillation that require chronic anticoagulation. (e.g. prosthetic mechanical heart valve)
- Severe renal insufficiency (serum creatinine > 2.5 mg/dL or a calculated creatinine clearance < 30 mL/min
- Patients with a history of intracranial hemorrhage
- Patients have had or will undergo Coronary arterial bypass graft (CABG) for their index acute coronary syndrome (ACS) event
- Patients with known ongoing bleeding and patients with known coagulopathies
- Any contraindications or allergies to rivaroxaban, or to intended P2Y12 antagonists
- Have a history of stroke or Transient Ischemic Attack (TIA)
- Have known significant liver disease or liver function test (LFT) abnormalities
- Have any severe condition that would limit life expectancy to less than 12 months
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
rivaroxaban plus ticagrelor
rivaroxaban plus clopidogrel
Arm Description
rivaroxaban 15 mg (or 10 mg for subjects with moderate renal impairment) once daily plus ticagrelor 90 mg tablet twice daily for 12 months
rivaroxaban 15 mg (or 10 mg for subjects with moderate renal impairment) once daily plus clopidogrel 75 mg tablet once daily for 12 months
Outcomes
Primary Outcome Measures
The composite endpoints of death and ischemic events
The composite endpoints of death and ischemic events (stroke, myocardial infarction, stent thrombosis, urgent revascularization )
Secondary Outcome Measures
Clinically significant bleeding
Clinically significant bleeding is a composite of Thrombolysis in Myocardial Infarction (TIMI) major bleeding, minor bleeding, and bleeding requiring medical attention (BRMA)
Full Information
NCT ID
NCT04023630
First Posted
July 16, 2019
Last Updated
July 16, 2019
Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University
1. Study Identification
Unique Protocol Identification Number
NCT04023630
Brief Title
DUAL Antithrombotic Therapy in Patients With AF and ACS
Official Title
An Open-label, Randomized, Controlled, Multicenter Study to Evaluate DUAL Antithrombotic Therapy With Rivaroxaban Plus Ticagrelor vs. Rivaroxaban Plus Clopidogrel in Patients With Atrial Fibrillation and Acute Coronary Syndrome
Study Type
Interventional
2. Study Status
Record Verification Date
July 2019
Overall Recruitment Status
Unknown status
Study Start Date
October 1, 2019 (Anticipated)
Primary Completion Date
September 30, 2020 (Anticipated)
Study Completion Date
September 30, 2021 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Second Affiliated Hospital, School of Medicine, Zhejiang University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The study aims to show inferiority of rivaroxaban plus ticagrelor when compared to rivaroxaban plus clopidogrel in terms of safety. Safety will be determined by comparing the rates of death or ischemic event-including myocardial infarction, definite or probable stent thrombosis, stroke, or urgent revascularization.
Detailed Description
The main objective of this study is to compare a Dual Antithrombotic Therapy (DAT) regimen of rivaroxaban plus ticagrelor with rivaroxaban plus clopidogrel in Patients With Non Valvular Atrial Fibrillation (NVAF) and Acute Coronary Syndrome. The study aims to show inferiority of rivaroxaban plus ticagrelor when compared to rivaroxaban plus clopidogrel in terms of safety. Safety will be determined by comparing the rates of death or ischemic event-including myocardial infarction, definite or probable stent thrombosis, stroke, or urgent revascularization.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Atrial Fibrillation, Acute Coronary Syndromes
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
4000 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
rivaroxaban plus ticagrelor
Arm Type
Experimental
Arm Description
rivaroxaban 15 mg (or 10 mg for subjects with moderate renal impairment) once daily plus ticagrelor 90 mg tablet twice daily for 12 months
Arm Title
rivaroxaban plus clopidogrel
Arm Type
Active Comparator
Arm Description
rivaroxaban 15 mg (or 10 mg for subjects with moderate renal impairment) once daily plus clopidogrel 75 mg tablet once daily for 12 months
Intervention Type
Drug
Intervention Name(s)
Rivaroxaban 15 MG Oral Tablet
Other Intervention Name(s)
Xarelto
Intervention Description
One 15 mg tablet once daily for up to twelve months
Intervention Type
Drug
Intervention Name(s)
Clopidogrel 75 Mg Oral Tablet
Other Intervention Name(s)
P2Y12 antagonists
Intervention Description
One 75 mg tablet once daily for up to twelve months
Intervention Type
Drug
Intervention Name(s)
Ticagrelor 90 MG Oral Tablet
Other Intervention Name(s)
P2Y12 antagonists
Intervention Description
One 90 mg tablet twice daily for up to twelve months
Primary Outcome Measure Information:
Title
The composite endpoints of death and ischemic events
Description
The composite endpoints of death and ischemic events (stroke, myocardial infarction, stent thrombosis, urgent revascularization )
Time Frame
one year
Secondary Outcome Measure Information:
Title
Clinically significant bleeding
Description
Clinically significant bleeding is a composite of Thrombolysis in Myocardial Infarction (TIMI) major bleeding, minor bleeding, and bleeding requiring medical attention (BRMA)
Time Frame
one year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
95 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Adults with either active or a history of non-valvular atrial fibrillation or flutter with the planned or existing use of an oral anticoagulant for prophylaxis of thromboembolism. In addition, subjects must have had an acute coronary syndrome
Planned use of antiplatelet agents for at least 12 months
Males and Females ≥ 18 years of age
Women of childbearing potential must have a negative serum or urine pregnancy test within 24 hours prior to the start of study drug
Exclusion Criteria:
Conditions other than atrial fibrillation that require chronic anticoagulation. (e.g. prosthetic mechanical heart valve)
Severe renal insufficiency (serum creatinine > 2.5 mg/dL or a calculated creatinine clearance < 30 mL/min
Patients with a history of intracranial hemorrhage
Patients have had or will undergo Coronary arterial bypass graft (CABG) for their index acute coronary syndrome (ACS) event
Patients with known ongoing bleeding and patients with known coagulopathies
Any contraindications or allergies to rivaroxaban, or to intended P2Y12 antagonists
Have a history of stroke or Transient Ischemic Attack (TIA)
Have known significant liver disease or liver function test (LFT) abnormalities
Have any severe condition that would limit life expectancy to less than 12 months
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jun Jiang, PhD
Phone
13588706891
Email
hu888po@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jun Jiang, PhD
Organizational Affiliation
Second Affiliated Hospital Zhejiang University School of Medicine
Official's Role
Study Director
12. IPD Sharing Statement
Learn more about this trial
DUAL Antithrombotic Therapy in Patients With AF and ACS
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