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Effect of DLBS1033 After Primary PCI in Patients With STE-ACS

Primary Purpose

ST Elevation Myocardial Infarction

Status
Terminated
Phase
Phase 2
Locations
Indonesia
Study Type
Interventional
Intervention
DLBS1033
Placebo
Standard therapy
Sponsored by
Dexa Medica Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for ST Elevation Myocardial Infarction focused on measuring STEMI, acute coronary syndrome, DLBS1033, microvascular resistance index, Left ventricular function

Eligibility Criteria

30 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

KEY Inclusion Criteria:

  1. Signed informed consent.
  2. Men or women of 30-75 years of age.
  3. Evidence of acute ST elevation myocardial infarction (STEMI) at screening, as confirmed by ECG presentation of STEMI: new ST elevation at the J point in two contiguous leads with the cut-points: ≥ 0.1 mV in all leads other than leads V2-V3, where the following cut-points apply: ≥ 0.2 mV in men ≥ 40 years, ≥ 0.25 mV in men < 40 years, or ≥ 0.15 mV in women; or new or presumably new left bundle-branch block (LBBB); and with at least one of the following:

    • Positive plasma biomarkers of myocardial necrosis (cardiac troponin I [cTnI]).
    • Possible ischaemic symptoms include various combinations of chest, upper extremity, mandibular or epigastric discomfort (with exertion or at rest) or an ischaemic equivalent such as dyspnoea or fatigue.
  4. The onset of the STEMI is > 3 hours before undergoing the primary PCI.
  5. Therapy with study medication can be started within 24 hours after primary PCI.
  6. Able to take oral medication.

KEY Exclusion Criteria:

  1. Females of childbearing potential: pregnancy, breast-feeding.
  2. History of hemorrhagic stroke, serious head injury within the last 3 months.
  3. History of major surgery within the last 6 months.
  4. History of PCI or CABG, or previous myocardial infarction.
  5. Ongoing long term need for oral anticoagulants, antiplatelets, fibrinolytic, or antithrombotic agents, other than the study medication.
  6. Having any implanted pacemaker or cardiac resynchronization therapy (CRT) or cardiac resynchronization therapy defibrillators (CRT-D).
  7. Present with cardiogenic shock, 3rd degree atrioventricular (AV) block, complex anatomical coronary condition.
  8. Planned for a staged PCI within 30 days after the current PCI
  9. Inadequate liver function
  10. CRUSADE bleeding score of > 30
  11. Known or suspected allergy to other lumbrokinase products.
  12. Prior experience with DLBS1033 or other oral lumbrokinase products.
  13. Clinical evidence of malignancies with survival period < 1 year.
  14. Any other disease state, including chronic or acute systemic infections, uncontrolled illnesses or other chronic diseases, which judged by the investigator, could jeopardize patient's safety or interfere with trial participation or trial evaluation.
  15. Subjects enrolled in other interventional protocol within 30 days prior to Screening
  16. Any other disease state, including chronic or acute systemic infections, uncontrolled illnesses or other chronic diseases, which judged by the investigator, could jeopardize patient's safety or interfere with trial participation or trial evaluation.

Sites / Locations

  • Binawaluya Cardiac Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

DLBS1033

Placebo

Arm Description

DLBS1033 enteric-coated tablet is administered at the dose of 980 mg (two tablets@490 mg) three times daily, everyday for four weeks of study period

Placebo is administered two tablets three times daily, everyday for four weeks of study period

Outcomes

Primary Outcome Measures

Index of microvascular resistance (IMR)
Improvement in the index of microvascular resistance (IMR) from baseline to week 4th of treatment, measured using the pressure and temperature sensor-tipped guidewire.

Secondary Outcome Measures

Improvement in fractional flow reserve (FFR) from baseline to week 4th of treatment, measured using the pressure and temperature sensor-tipped guidewire
Improvement in fractional flow reserve (FFR) from baseline and to Week 4th of treatment, measured using the pressure and temperature sensor-tipped guidewire.
LV function
Improvement in several parameters of left ventricular (LV) function [EF, ESV, EDV], from baseline and to Week 4th of treatment will be measured by 2D echocardiography.
Routine hematology
Routine hematology, including: RBC, WBC, and platelet count, will be measured at baseline and week 4th of treatment.
Routine hematology (Hemoglobin)
Hemoglobin will be measured at baseline and every interval of 2 weeks over the 4 weeks of treatment.
Routine hematology (Hematocrit)
Hematocrit will be measured at baseline and every interval of 2 weeks over the 4 weeks of treatment.
Liver function
Liver function measured includes: serum ALT (SGPT), serum AST (SGOT), alkaline phosphatase, and total bilirubin.
Renal function
Renal function measured includes: serum creatinine and BUN.
Haemostasis parameter (Prothrombin time (PT))
Prothrombin time (PT) will be measured at baseline and every interval of 2 weeks over the 4 weeks of study treatment.
Haemostasis parameter (International Normalized Ratio (INR))
International Normalized Ratio (INR) will be measured at baseline and every interval of 2 weeks over the 4 weeks of study treatment.
Adverse event
Adverse events (especially major and minor bleeding) are observed and carefully evaluated along the course of the study.

Full Information

First Posted
November 21, 2016
Last Updated
September 6, 2023
Sponsor
Dexa Medica Group
Collaborators
Binawaluya Cardiac Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT02976701
Brief Title
Effect of DLBS1033 After Primary PCI in Patients With STE-ACS
Official Title
The Effect of DLBS1033 in Patients With ST Elevation Acute Coronary Syndrome (STE-ACS) After Primary Percutaneous Coronary Intervention
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Terminated
Why Stopped
The investigational cases were no longer relevant considering the recent implementation of our current national healthcare system.
Study Start Date
November 2016 (undefined)
Primary Completion Date
January 2023 (Actual)
Study Completion Date
March 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Dexa Medica Group
Collaborators
Binawaluya Cardiac Hospital

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a prospective, randomized, double-blind, double-dummy, and controlled clinical study over a total of 4-week therapy with DLBS1033 in the management of STE-ACS after a primary PCI. There will be 40 STE-ACS subjects (20 subjects in each group) planned to complete the study.
Detailed Description
STE-ACS patients who undergo intermediate-delayed (> 3 hours after the onset of the STEMI) primary PCI will be enrolled in the study. Before the intervention, they will be given standard medication for PCI. Right after PCI, all eligible subjects will be assessed for microvascular perfusion, using a pressure-temperature sensor-tipped coronary guidewire. The day after, in addition to the dual antiplatelet therapy, i.e. 80 mg aspirin once daily and clopidogrel 75 mg once daily, DLBS1033 at a dose of 980 mg three times daily or its placebo will be given to the subjects for 4 weeks. Clinical and laboratory examinations to evaluate the investigational drug's efficacy and safety will be performed at Baseline (right after subjects undergo the primary PCI) and at the End of study (week 4th of DLBS1033 therapy).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
ST Elevation Myocardial Infarction
Keywords
STEMI, acute coronary syndrome, DLBS1033, microvascular resistance index, Left ventricular function

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
DLBS1033
Arm Type
Experimental
Arm Description
DLBS1033 enteric-coated tablet is administered at the dose of 980 mg (two tablets@490 mg) three times daily, everyday for four weeks of study period
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo is administered two tablets three times daily, everyday for four weeks of study period
Intervention Type
Drug
Intervention Name(s)
DLBS1033
Other Intervention Name(s)
Disolf
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Type
Drug
Intervention Name(s)
Standard therapy
Other Intervention Name(s)
Asp-Clopi
Intervention Description
Standard therapy which consists of: aspirin enteric-coated tablet 1 x 80 mg and clopidogrel film-coated tablet 1 x 75 mg daily for four weeks will be given to both arms.
Primary Outcome Measure Information:
Title
Index of microvascular resistance (IMR)
Description
Improvement in the index of microvascular resistance (IMR) from baseline to week 4th of treatment, measured using the pressure and temperature sensor-tipped guidewire.
Time Frame
Week 4
Secondary Outcome Measure Information:
Title
Improvement in fractional flow reserve (FFR) from baseline to week 4th of treatment, measured using the pressure and temperature sensor-tipped guidewire
Description
Improvement in fractional flow reserve (FFR) from baseline and to Week 4th of treatment, measured using the pressure and temperature sensor-tipped guidewire.
Time Frame
Week 4
Title
LV function
Description
Improvement in several parameters of left ventricular (LV) function [EF, ESV, EDV], from baseline and to Week 4th of treatment will be measured by 2D echocardiography.
Time Frame
Week 4
Title
Routine hematology
Description
Routine hematology, including: RBC, WBC, and platelet count, will be measured at baseline and week 4th of treatment.
Time Frame
Week 0 and 4
Title
Routine hematology (Hemoglobin)
Description
Hemoglobin will be measured at baseline and every interval of 2 weeks over the 4 weeks of treatment.
Time Frame
Week 0, 2 and 4
Title
Routine hematology (Hematocrit)
Description
Hematocrit will be measured at baseline and every interval of 2 weeks over the 4 weeks of treatment.
Time Frame
Week 0, 2 and 4
Title
Liver function
Description
Liver function measured includes: serum ALT (SGPT), serum AST (SGOT), alkaline phosphatase, and total bilirubin.
Time Frame
Week 0 and 4
Title
Renal function
Description
Renal function measured includes: serum creatinine and BUN.
Time Frame
Week 0 and 4
Title
Haemostasis parameter (Prothrombin time (PT))
Description
Prothrombin time (PT) will be measured at baseline and every interval of 2 weeks over the 4 weeks of study treatment.
Time Frame
Week 0, 2, and 4
Title
Haemostasis parameter (International Normalized Ratio (INR))
Description
International Normalized Ratio (INR) will be measured at baseline and every interval of 2 weeks over the 4 weeks of study treatment.
Time Frame
Week 0, 2, and 4
Title
Adverse event
Description
Adverse events (especially major and minor bleeding) are observed and carefully evaluated along the course of the study.
Time Frame
Week 0 - 4

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
KEY Inclusion Criteria: Signed informed consent. Men or women of 30-75 years of age. Evidence of acute ST elevation myocardial infarction (STEMI) at screening, as confirmed by ECG presentation of STEMI: new ST elevation at the J point in two contiguous leads with the cut-points: ≥ 0.1 mV in all leads other than leads V2-V3, where the following cut-points apply: ≥ 0.2 mV in men ≥ 40 years, ≥ 0.25 mV in men < 40 years, or ≥ 0.15 mV in women; or new or presumably new left bundle-branch block (LBBB); and with at least one of the following: Positive plasma biomarkers of myocardial necrosis (cardiac troponin I [cTnI]). Possible ischaemic symptoms include various combinations of chest, upper extremity, mandibular or epigastric discomfort (with exertion or at rest) or an ischaemic equivalent such as dyspnoea or fatigue. The onset of the STEMI is > 3 hours before undergoing the primary PCI. Therapy with study medication can be started within 24 hours after primary PCI. Able to take oral medication. KEY Exclusion Criteria: Females of childbearing potential: pregnancy, breast-feeding. History of hemorrhagic stroke, serious head injury within the last 3 months. History of major surgery within the last 6 months. History of PCI or CABG, or previous myocardial infarction. Ongoing long term need for oral anticoagulants, antiplatelets, fibrinolytic, or antithrombotic agents, other than the study medication. Having any implanted pacemaker or cardiac resynchronization therapy (CRT) or cardiac resynchronization therapy defibrillators (CRT-D). Present with cardiogenic shock, 3rd degree atrioventricular (AV) block, complex anatomical coronary condition. Planned for a staged PCI within 30 days after the current PCI Inadequate liver function CRUSADE bleeding score of > 30 Known or suspected allergy to other lumbrokinase products. Prior experience with DLBS1033 or other oral lumbrokinase products. Clinical evidence of malignancies with survival period < 1 year. Any other disease state, including chronic or acute systemic infections, uncontrolled illnesses or other chronic diseases, which judged by the investigator, could jeopardize patient's safety or interfere with trial participation or trial evaluation. Subjects enrolled in other interventional protocol within 30 days prior to Screening Any other disease state, including chronic or acute systemic infections, uncontrolled illnesses or other chronic diseases, which judged by the investigator, could jeopardize patient's safety or interfere with trial participation or trial evaluation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Muhammad Munawar, SpJP(K), MD
Organizational Affiliation
Binawaluya Cardiac Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Binawaluya Cardiac Hospital
City
Jakarta
ZIP/Postal Code
13570
Country
Indonesia

12. IPD Sharing Statement

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Effect of DLBS1033 After Primary PCI in Patients With STE-ACS

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