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Evaluate the Pharmacokinetics and Safety of MK-4448 in Participants With Nonvalvular Atrial Fibrillation or Atrial Flutter

Primary Purpose

Atrial Fibrillation, Atrial Flutter

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Amiodarone
Betrixaban 60 mg
Betrixaban 90 mg
Betrixaban 30 mg
Sponsored by
Portola Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Atrial Fibrillation focused on measuring Betrixaban, MK-4448, nonvalvular atrial fibrillation

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • In the opinion of the investigator, participant requires long term anticoagulation for stroke prevention in atrial flutter (AF).
  • Men and women ≥18 years of age.
  • Participant has current non-valvular atrial fibrillation (NVAF) or AF or electrocardiogram (ECG) or Holter documentation within past 12 months.
  • Participant has an international normalized ratio (INR) ≤ 2.2 at allocation (Visit 2).
  • A participant who is of reproductive potential agrees to remain abstinent or use (or have their partner use) 2 acceptable methods of birth control for the duration of the study. Acceptable methods of birth control are: intrauterine device (IUD), diaphragm with spermicide, condom, vasectomy, and hormonal contraception.
  • Participant understands the study procedures and risks involved with the study, and voluntarily agree to participate by giving written informed consent.

Exclusion Criteria:

General

  • Participant is currently participating in another drug study or has received an investigational drug within 30 days prior to enrollment.
  • Participant is a woman who is pregnant, lactating or of child-bearing potential who refuses to use a medically acceptable form of contraception throughout the study.
  • Participant has a body weight less than 40 kg (88 lbs) or greater than 200 kg (440 lbs).
  • Participant routinely consumes more than 2 alcoholic drinks per day (average >14 alcoholic drinks per week) or greater than 5 drinks within 2 hours on occasion.

Prohibited Medical Conditions

  • Participant has any condition or situation which, in the opinion of the investigator, might pose a risk to the participant or interfere with participation in the study.
  • Conditions associated with an increased risk of bleeding Active bleeding.
  • Conditions other than AF that require chronic anticoagulation.
  • Severe aortic and mitral valvular disease requiring surgical intervention.
  • Previous known history of coagulopathy (e.g.: Factor V Leiden, Protein C Deficiency, Protein S Deficiency, Antiphospholipid Syndrome, etc.).
  • Active infective endocarditis.
  • Participant has history of familial long QT interval (the QT interval is the portion of an electrocardiogram (ECG) between the onset of the Q wave and the end of the T wave, representing the total time for ventricular depolarization and repolarization) syndrome or prolonged Bazett-corrected QT interval (QTcB) (males > 470 msec; females >480 msec) at baseline as measured on a 12-lead ECG.
  • Participant has serious pulmonary, hepatic, metabolic, gastrointestinal, central nervous system (CNS) or psychiatric disease, end-stage disease states, or any other disease that could interfere with the conduct or validity of the study or compromise participant safety.
  • Participant has a history of malignancy ≤ 5 years prior to signing informed consent, except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer (melanoma, leukemia, lymphoma and myeloproliferative disorders of any duration are excluded).
  • Participant has a history of mental instability, drug/alcohol abuse within the past 5 years, or major psychiatric illness not adequately controlled and stable on pharmacotherapy.
  • Participant has reversible causes of atrial fibrillation (i.e.: cardiac surgery, pulmonary embolism, untreated hyperthyroidism).
  • Participant is to undergo pulmonary vein isolation or surgery for treatment of AF.
  • Participant had a severe, disabling stroke within the previous 6 months, any stroke within the previous 14 days, thromboembolism within previous 30 days or a transient ischemic attack (TIA) within 3 days prior to Visit 1.
  • Participant requires renal replacement therapies (hemo- or peritoneal dialysis).
  • Participant has any of a list of defined laboratory abnormalities.

Prohibited Medications

  • Anti-platelet agents other than aspirin within 10 days prior to Visit 1 (excluding maintenance dose clopidogrel, prasugrel or ticlopidine) or fibrinolytic agents within 30 days prior to Visit 1.
  • Aspirin greater than 162 mg/day.
  • Daily non-steroidal anti-inflammatory drug (NSAID) use.
  • Dronedarone, verapamil or ketoconazole.
  • Vitamin K antagonists (VKA) or other anticoagulants.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Experimental

    Arm Label

    Amiodarone

    Betrixaban 60 mg

    Betrixaban 90 mg

    Arm Description

    Participants on betrixaban 30 mg and concomitant baseline amiodarone

    Participants with lower weights

    Participants with higher weights

    Outcomes

    Primary Outcome Measures

    Steady-state C12 hr on Days 14, 18, and 21 After Weight-based Dosing
    Betrixaban PK concentration at 12 hr on Days 14, 18, and 21 in low and high weight groups

    Secondary Outcome Measures

    Steady-state C12 hr on Days 14, 18, and 21 After Weight and Amiodarone-based Dosing
    Betrixaban PK concentration at 12 hr on Days 14, 18, and 21 in amiodarone, low and high weight groups

    Full Information

    First Posted
    September 9, 2010
    Last Updated
    August 3, 2023
    Sponsor
    Portola Pharmaceuticals
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01229254
    Brief Title
    Evaluate the Pharmacokinetics and Safety of MK-4448 in Participants With Nonvalvular Atrial Fibrillation or Atrial Flutter
    Official Title
    A Phase II, Open-label, Dose Exposure Confirmation Study to Evaluate the Pharmacokinetics and Safety and Tolerability of Betrixaban (MK-4448) in Adult Patients With Nonvalvular Atrial Fibrillation or Atrial Flutter
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2023
    Overall Recruitment Status
    Completed
    Study Start Date
    September 2010 (undefined)
    Primary Completion Date
    December 2010 (Actual)
    Study Completion Date
    April 2011 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Portola Pharmaceuticals

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The primary purpose of this study is to optimize drug exposure in the target population.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Atrial Fibrillation, Atrial Flutter
    Keywords
    Betrixaban, MK-4448, nonvalvular atrial fibrillation

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    189 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Amiodarone
    Arm Type
    Experimental
    Arm Description
    Participants on betrixaban 30 mg and concomitant baseline amiodarone
    Arm Title
    Betrixaban 60 mg
    Arm Type
    Experimental
    Arm Description
    Participants with lower weights
    Arm Title
    Betrixaban 90 mg
    Arm Type
    Experimental
    Arm Description
    Participants with higher weights
    Intervention Type
    Drug
    Intervention Name(s)
    Amiodarone
    Intervention Description
    Patients on Amiodarone
    Intervention Type
    Drug
    Intervention Name(s)
    Betrixaban 60 mg
    Other Intervention Name(s)
    MK-4448
    Intervention Description
    Betrixaban 60 mg once a day with food on Day 0 through Day 25
    Intervention Type
    Drug
    Intervention Name(s)
    Betrixaban 90 mg
    Other Intervention Name(s)
    MK-4448
    Intervention Description
    Betrixaban 90 mg once a day with food on Day 0 through Day 25
    Intervention Type
    Drug
    Intervention Name(s)
    Betrixaban 30 mg
    Other Intervention Name(s)
    MK-4448
    Intervention Description
    Betrixaban 30 mg once a day with food on Day 0 through Day 25 with concomitant amiodarone treatment.
    Primary Outcome Measure Information:
    Title
    Steady-state C12 hr on Days 14, 18, and 21 After Weight-based Dosing
    Description
    Betrixaban PK concentration at 12 hr on Days 14, 18, and 21 in low and high weight groups
    Time Frame
    Days 14, 18, and 21 of the PK period
    Secondary Outcome Measure Information:
    Title
    Steady-state C12 hr on Days 14, 18, and 21 After Weight and Amiodarone-based Dosing
    Description
    Betrixaban PK concentration at 12 hr on Days 14, 18, and 21 in amiodarone, low and high weight groups
    Time Frame
    Days 14, 18, and 21 of the PK period

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: In the opinion of the investigator, participant requires long term anticoagulation for stroke prevention in atrial flutter (AF). Men and women ≥18 years of age. Participant has current non-valvular atrial fibrillation (NVAF) or AF or electrocardiogram (ECG) or Holter documentation within past 12 months. Participant has an international normalized ratio (INR) ≤ 2.2 at allocation (Visit 2). A participant who is of reproductive potential agrees to remain abstinent or use (or have their partner use) 2 acceptable methods of birth control for the duration of the study. Acceptable methods of birth control are: intrauterine device (IUD), diaphragm with spermicide, condom, vasectomy, and hormonal contraception. Participant understands the study procedures and risks involved with the study, and voluntarily agree to participate by giving written informed consent. Exclusion Criteria: General Participant is currently participating in another drug study or has received an investigational drug within 30 days prior to enrollment. Participant is a woman who is pregnant, lactating or of child-bearing potential who refuses to use a medically acceptable form of contraception throughout the study. Participant has a body weight less than 40 kg (88 lbs) or greater than 200 kg (440 lbs). Participant routinely consumes more than 2 alcoholic drinks per day (average >14 alcoholic drinks per week) or greater than 5 drinks within 2 hours on occasion. Prohibited Medical Conditions Participant has any condition or situation which, in the opinion of the investigator, might pose a risk to the participant or interfere with participation in the study. Conditions associated with an increased risk of bleeding Active bleeding. Conditions other than AF that require chronic anticoagulation. Severe aortic and mitral valvular disease requiring surgical intervention. Previous known history of coagulopathy (e.g.: Factor V Leiden, Protein C Deficiency, Protein S Deficiency, Antiphospholipid Syndrome, etc.). Active infective endocarditis. Participant has history of familial long QT interval (the QT interval is the portion of an electrocardiogram (ECG) between the onset of the Q wave and the end of the T wave, representing the total time for ventricular depolarization and repolarization) syndrome or prolonged Bazett-corrected QT interval (QTcB) (males > 470 msec; females >480 msec) at baseline as measured on a 12-lead ECG. Participant has serious pulmonary, hepatic, metabolic, gastrointestinal, central nervous system (CNS) or psychiatric disease, end-stage disease states, or any other disease that could interfere with the conduct or validity of the study or compromise participant safety. Participant has a history of malignancy ≤ 5 years prior to signing informed consent, except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer (melanoma, leukemia, lymphoma and myeloproliferative disorders of any duration are excluded). Participant has a history of mental instability, drug/alcohol abuse within the past 5 years, or major psychiatric illness not adequately controlled and stable on pharmacotherapy. Participant has reversible causes of atrial fibrillation (i.e.: cardiac surgery, pulmonary embolism, untreated hyperthyroidism). Participant is to undergo pulmonary vein isolation or surgery for treatment of AF. Participant had a severe, disabling stroke within the previous 6 months, any stroke within the previous 14 days, thromboembolism within previous 30 days or a transient ischemic attack (TIA) within 3 days prior to Visit 1. Participant requires renal replacement therapies (hemo- or peritoneal dialysis). Participant has any of a list of defined laboratory abnormalities. Prohibited Medications Anti-platelet agents other than aspirin within 10 days prior to Visit 1 (excluding maintenance dose clopidogrel, prasugrel or ticlopidine) or fibrinolytic agents within 30 days prior to Visit 1. Aspirin greater than 162 mg/day. Daily non-steroidal anti-inflammatory drug (NSAID) use. Dronedarone, verapamil or ketoconazole. Vitamin K antagonists (VKA) or other anticoagulants.

    12. IPD Sharing Statement

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    Evaluate the Pharmacokinetics and Safety of MK-4448 in Participants With Nonvalvular Atrial Fibrillation or Atrial Flutter

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