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LEADERS FREE II: BioFreedom™ Pivotal Study

Primary Purpose

Acute Coronary Syndrome, High Bleeding Risk

Status
Active
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
BioFreedom™ Drug Coated Coronary Stent System
Antiplatelet Drug
Sponsored by
Biosensors Europe SA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Coronary Syndrome focused on measuring Acute Coronary Syndrome, Percutaneous Coronary Intervention, Drug Coated Stent, Drug Eluting Stent

Eligibility Criteria

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

Inclusion Criteria:

Any indication for percutaneous coronary intervention with stent placement (PCI-S) in patients deemed at high risk for bleeding and candidates for 1 month dual anti-platelet therapy (DAPT). This includes candidates with stable angina, silent ischemia, acute coronary syndrome (STEMI and non-STEMI), non-native lesions and in-stent restenosis. Patients must provide written informed consent.

Reasons of unsuitability for > 1 month dual antiplatelet treatment must include one or more of the following:

  1. Adjunctive oral anticoagulation treatment planned to continue after PCI
  2. Age ≥ 75 years old
  3. Baseline Hgb <11 g/dl (or anemia requiring transfusion during the 4 weeks prior to the index procedure)
  4. Any prior intracerebral bleed
  5. Any stroke in the last 12 months
  6. Hospital admission for bleeding during the prior 12 months
  7. Non skin cancer diagnosed or treated < 3 years, with a perceived increased risk for bleeding
  8. Planned daily Nonsteroidal anti-inflammatory drugs (NSAID) (other than aspirin) or steroids for >30 days after PCI
  9. Planned surgery that would require interruption of DAPT (within next 6 months)
  10. Renal failure defined as: Creatinine clearance <40 ml/min
  11. Thrombocytopenia (PLT <100,000/mm3)
  12. Severe chronic liver disease defined as: patients who have developed any of the following: variceal hemorrhage, ascites, hepatic encephalopathy or jaundice
  13. Expected non-compliance to prolonged DAPT for other medical reasons

Exclusion Criteria:

  1. Pregnant and breastfeeding women
  2. Patients expected not to comply with 1 month DAPT
  3. Patients requiring a planned staged PCI procedure more than one week after the index procedure
  4. Procedure planned to require non-study stents, or stand-alone plain old balloon angioplasty (POBA) or stand-alone atherectomy
  5. Active bleeding at the time of inclusion
  6. Reference vessel diameter <2.25 - >4.0mm
  7. Cardiogenic shock
  8. Compliance with long-term single anti-platelet therapy unlikely
  9. A known hypersensitivity or contraindication to aspirin, clopidogrel (or prasugrel, or ticagrelor if applicable), stainless steel, zinc, Biolimus A9™ or a sensitivity to contrast media, which cannot be adequately pre-medicated
  10. PCI during the previous 12 months for a lesion other than the target lesion of the index procedure
  11. Participation in another clinical trial (12 months after index procedure)
  12. Patients with a life expectancy of < 12 months
  13. Patients under judicial protection, tutorship or curatorship (for France only)

Sites / Locations

  • Heart Center Research, LLC
  • Tri-Lakes Research
  • Scripps Health
  • University of California San Diego
  • Santa Barbara Cottage Hospital
  • MedStar Washington Hospital Center
  • University of Florida Jacksonville
  • Velella Research
  • Tallahassee Research Institute, Inc.
  • North Georgia Heart Foundation
  • St. Luke's Idaho Cardiology Associates
  • Jesse Brown VA Medical Center
  • St. Vincent Heart Center
  • Jewish and St. Mary's Hospital
  • Lahey Clinic
  • McLaren Bay Region
  • MidMichigan Medical Center Midland
  • William Beaumont Hospital
  • Missouri Cardiovascular Specialists, LLP
  • Saint Luke's Hospital of Kansas City
  • University of Buffalo
  • Weill Cornell Medical College-New York Presbyterian
  • Columbia University Medical Center/New York Presbyterian Hospital
  • Novant Health Heart and Vascular Institute
  • LeBauer Cardiovascular Research Foundation
  • NC Heart and Vascular Research
  • Genesis Healthcare System
  • Penn State - Milton S. Hershey Medical Center
  • Penn Presbyterian Medical Center
  • Berks Cardiologists, Ltd.
  • Pinnacle Health Cardiovascular Institute
  • Rhode Island Hospital
  • AnMed Health
  • Black Hills Cardiovascular Research
  • Chattanooga Heart Institute
  • Tennova Healthcare-Turkey Creek Medical Center
  • Houston Methodist Hospital
  • Providence Health Center
  • Carilion Clinic
  • Mazankowski Alberta Heart Institute
  • Fraser Clinical Trials Inc.
  • St. Paul's Hospital
  • Victoria Heart Institute Foundation
  • Hamilton Health Sciences
  • The University of Ottawa Heart Institute
  • Montreal Heart Institute
  • Hôpital Maisonneuve-Rosemont
  • Centre Hospitalier de l'université de Montréal
  • Institut universitaire de cardiologie et de pneumologie de Québec
  • CIUSSS de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke
  • Rigshospitalet Copenhagen University Hospital
  • Clinique Axium
  • Service de Cardiologie Interventionnelle - Pôle Santé République
  • Clinique de Fontaine
  • Groupe Hospitalier Mutualiste de Grenoble
  • Hôpital Privé Jacques Cartier ICPS
  • Hôpital Privé Claude Galien
  • Clinique Saint Hilaire
  • CHU Toulouse Rangeuil
  • Segeberger Kliniken GmbH
  • Herzzentrum Leipzig GmbH
  • Grande Ospedale Metropolitano Niguarda
  • Azienda Ospedaliera San Camillo Forlanini
  • Royal Bournemouth Hospital, Dorset Heart Centre
  • Craigavon Cardiac Centre
  • Golden Jubilee National Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

BioFreedom™ Drug Coated Stent

Arm Description

Outcomes

Primary Outcome Measures

The composite of cardiac death and myocardial infarction at twelve months
The incidence of clinically driven target lesion revascularization at twelve months

Secondary Outcome Measures

The composite of cardiac death and myocardial infarction
The incidence of clinically driven target lesion revascularization
The composite of cardiac death, myocardial infarction and stent thrombosis
Bleeding per Bleeding Academic Research Consortium (BARC) Criteria
Cardiac Death
Myocardial Infarction
Stent Thrombosis per Academic Research Consortium (ARC) Definition
Urgent target lesion revascularization
Clinically driven target lesion revascularization at time points other than primary endpoint
Clinically driven target vessel revascularization
All cause mortality
Primary endpoints, in patients with at least 1 lesion treated with a trial stent of 3mm or less in nominal diameter

Full Information

First Posted
July 15, 2016
Last Updated
February 1, 2021
Sponsor
Biosensors Europe SA
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1. Study Identification

Unique Protocol Identification Number
NCT02843633
Brief Title
LEADERS FREE II: BioFreedom™ Pivotal Study
Official Title
A Prospective Study of the BioFreedom™ Biolimus A9™ Drug Coated Stent in Patients at High Risk for Bleeding
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Active, not recruiting
Study Start Date
February 14, 2017 (Actual)
Primary Completion Date
October 11, 2018 (Actual)
Study Completion Date
March 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Biosensors Europe SA

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study aims to confirm non-inferiority of the BioFreedom™ Drug Coated Stent to the Gazelle™ Bare Metal Stent arm of the Leaders Free study (NCT01623180) in high bleeding risk patients.
Detailed Description
In this study all patients will receive the BioFreedom™ Drug Coated Stent and one month of Dual Anti Platelet Therapy

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Coronary Syndrome, High Bleeding Risk
Keywords
Acute Coronary Syndrome, Percutaneous Coronary Intervention, Drug Coated Stent, Drug Eluting Stent

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
1203 (Actual)

8. Arms, Groups, and Interventions

Arm Title
BioFreedom™ Drug Coated Stent
Arm Type
Experimental
Intervention Type
Device
Intervention Name(s)
BioFreedom™ Drug Coated Coronary Stent System
Other Intervention Name(s)
Coronary Angioplasty
Intervention Description
a non-surgical procedure that uses a catheter to place a stent to open up coronary arteries that have been narrowed by atherosclerosis
Intervention Type
Drug
Intervention Name(s)
Antiplatelet Drug
Intervention Description
Dual antiplatelet therapy for one month followed by single antiplatelet therapy indefinitely. Aspirin and clopidogrel (or other P2Y12 inhibitor) will be used and dosing is according to standard institutional practice
Primary Outcome Measure Information:
Title
The composite of cardiac death and myocardial infarction at twelve months
Time Frame
12 months
Title
The incidence of clinically driven target lesion revascularization at twelve months
Time Frame
12 months
Secondary Outcome Measure Information:
Title
The composite of cardiac death and myocardial infarction
Time Frame
1, 2, and 6 months and 2 and 3 years
Title
The incidence of clinically driven target lesion revascularization
Time Frame
1, 2, and 6 months and 2 and 3 years
Title
The composite of cardiac death, myocardial infarction and stent thrombosis
Time Frame
1, 2, and 6 months and 1, 2, and 3 years
Title
Bleeding per Bleeding Academic Research Consortium (BARC) Criteria
Time Frame
1, 2, and 6 months and 1, 2, and 3 years
Title
Cardiac Death
Time Frame
1, 2, and 6 months and 1, 2, and 3 years
Title
Myocardial Infarction
Time Frame
1, 2, and 6 months and 1, 2, and 3 years
Title
Stent Thrombosis per Academic Research Consortium (ARC) Definition
Time Frame
1, 2, and 6 months and 1, 2, and 3 years
Title
Urgent target lesion revascularization
Time Frame
1, 2, and 6 months and 1, 2, and 3 years
Title
Clinically driven target lesion revascularization at time points other than primary endpoint
Time Frame
followed for all target lesion revascularizations, up to 3 years
Title
Clinically driven target vessel revascularization
Time Frame
1, 2, and 6 months and 1, 2, and 3 years
Title
All cause mortality
Time Frame
1, 2, and 6 months and 1, 2, and 3 years
Title
Primary endpoints, in patients with at least 1 lesion treated with a trial stent of 3mm or less in nominal diameter
Time Frame
1, 2, and 6 months and 1, 2, and 3 years

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Any indication for percutaneous coronary intervention with stent placement (PCI-S) in patients deemed at high risk for bleeding and candidates for 1 month dual anti-platelet therapy (DAPT). This includes candidates with stable angina, silent ischemia, acute coronary syndrome (STEMI and non-STEMI), non-native lesions and in-stent restenosis. Patients must provide written informed consent. Reasons of unsuitability for > 1 month dual antiplatelet treatment must include one or more of the following: Adjunctive oral anticoagulation treatment planned to continue after PCI Age ≥ 75 years old Baseline Hgb <11 g/dl (or anemia requiring transfusion during the 4 weeks prior to the index procedure) Any prior intracerebral bleed Any stroke in the last 12 months Hospital admission for bleeding during the prior 12 months Non skin cancer diagnosed or treated < 3 years, with a perceived increased risk for bleeding Planned daily Nonsteroidal anti-inflammatory drugs (NSAID) (other than aspirin) or steroids for >30 days after PCI Planned surgery that would require interruption of DAPT (within next 6 months) Renal failure defined as: Creatinine clearance <40 ml/min Thrombocytopenia (PLT <100,000/mm3) Severe chronic liver disease defined as: patients who have developed any of the following: variceal hemorrhage, ascites, hepatic encephalopathy or jaundice Expected non-compliance to prolonged DAPT for other medical reasons Exclusion Criteria: Pregnant and breastfeeding women Patients expected not to comply with 1 month DAPT Patients requiring a planned staged PCI procedure more than one week after the index procedure Procedure planned to require non-study stents, or stand-alone plain old balloon angioplasty (POBA) or stand-alone atherectomy Active bleeding at the time of inclusion Reference vessel diameter <2.25 - >4.0mm Cardiogenic shock Compliance with long-term single anti-platelet therapy unlikely A known hypersensitivity or contraindication to aspirin, clopidogrel (or prasugrel, or ticagrelor if applicable), stainless steel, zinc, Biolimus A9™ or a sensitivity to contrast media, which cannot be adequately pre-medicated PCI during the previous 12 months for a lesion other than the target lesion of the index procedure Participation in another clinical trial (12 months after index procedure) Patients with a life expectancy of < 12 months Patients under judicial protection, tutorship or curatorship (for France only)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Martin Leon
Organizational Affiliation
Cardiovascular Research Foundation, New York
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Mitchell Krucoff
Organizational Affiliation
Duke University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Philip Urban
Organizational Affiliation
Hôpital de la Tour
Official's Role
Principal Investigator
Facility Information:
Facility Name
Heart Center Research, LLC
City
Huntsville
State/Province
Alabama
ZIP/Postal Code
35801
Country
United States
Facility Name
Tri-Lakes Research
City
Hot Springs
State/Province
Arkansas
ZIP/Postal Code
71901
Country
United States
Facility Name
Scripps Health
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
University of California San Diego
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
Santa Barbara Cottage Hospital
City
Santa Barbara
State/Province
California
ZIP/Postal Code
93102
Country
United States
Facility Name
MedStar Washington Hospital Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Facility Name
University of Florida Jacksonville
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32209
Country
United States
Facility Name
Velella Research
City
Sarasota
State/Province
Florida
ZIP/Postal Code
34239
Country
United States
Facility Name
Tallahassee Research Institute, Inc.
City
Tallahassee
State/Province
Florida
ZIP/Postal Code
32308
Country
United States
Facility Name
North Georgia Heart Foundation
City
Gainesville
State/Province
Georgia
ZIP/Postal Code
30501
Country
United States
Facility Name
St. Luke's Idaho Cardiology Associates
City
Boise
State/Province
Idaho
ZIP/Postal Code
83712
Country
United States
Facility Name
Jesse Brown VA Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
St. Vincent Heart Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46290
Country
United States
Facility Name
Jewish and St. Mary's Hospital
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
Lahey Clinic
City
Burlington
State/Province
Massachusetts
ZIP/Postal Code
01805
Country
United States
Facility Name
McLaren Bay Region
City
Bay City
State/Province
Michigan
ZIP/Postal Code
48708
Country
United States
Facility Name
MidMichigan Medical Center Midland
City
Midland
State/Province
Michigan
ZIP/Postal Code
48670
Country
United States
Facility Name
William Beaumont Hospital
City
Royal Oak
State/Province
Michigan
ZIP/Postal Code
48073
Country
United States
Facility Name
Missouri Cardiovascular Specialists, LLP
City
Columbia
State/Province
Missouri
ZIP/Postal Code
65201
Country
United States
Facility Name
Saint Luke's Hospital of Kansas City
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Facility Name
University of Buffalo
City
Buffalo
State/Province
New York
ZIP/Postal Code
14203
Country
United States
Facility Name
Weill Cornell Medical College-New York Presbyterian
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Columbia University Medical Center/New York Presbyterian Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Novant Health Heart and Vascular Institute
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Facility Name
LeBauer Cardiovascular Research Foundation
City
Greensboro
State/Province
North Carolina
ZIP/Postal Code
27401
Country
United States
Facility Name
NC Heart and Vascular Research
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
Genesis Healthcare System
City
Zanesville
State/Province
Ohio
ZIP/Postal Code
43701
Country
United States
Facility Name
Penn State - Milton S. Hershey Medical Center
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Facility Name
Penn Presbyterian Medical Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Berks Cardiologists, Ltd.
City
Reading
State/Province
Pennsylvania
ZIP/Postal Code
19610
Country
United States
Facility Name
Pinnacle Health Cardiovascular Institute
City
Wormleysburg
State/Province
Pennsylvania
ZIP/Postal Code
17043
Country
United States
Facility Name
Rhode Island Hospital
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02903
Country
United States
Facility Name
AnMed Health
City
Anderson
State/Province
South Carolina
ZIP/Postal Code
29621
Country
United States
Facility Name
Black Hills Cardiovascular Research
City
Rapid City
State/Province
South Dakota
ZIP/Postal Code
57701
Country
United States
Facility Name
Chattanooga Heart Institute
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37404
Country
United States
Facility Name
Tennova Healthcare-Turkey Creek Medical Center
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37934
Country
United States
Facility Name
Houston Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Providence Health Center
City
Waco
State/Province
Texas
ZIP/Postal Code
76712
Country
United States
Facility Name
Carilion Clinic
City
Roanoke
State/Province
Virginia
ZIP/Postal Code
24014
Country
United States
Facility Name
Mazankowski Alberta Heart Institute
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G 2B7
Country
Canada
Facility Name
Fraser Clinical Trials Inc.
City
New Westminster
State/Province
British Columbia
ZIP/Postal Code
V3L 3W4
Country
Canada
Facility Name
St. Paul's Hospital
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6E 1M7
Country
Canada
Facility Name
Victoria Heart Institute Foundation
City
Victoria
State/Province
British Columbia
ZIP/Postal Code
V8R 4R2
Country
Canada
Facility Name
Hamilton Health Sciences
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8L 2X2
Country
Canada
Facility Name
The University of Ottawa Heart Institute
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1Y 4W7
Country
Canada
Facility Name
Montreal Heart Institute
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H1T 1C8
Country
Canada
Facility Name
Hôpital Maisonneuve-Rosemont
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H1T 2M4
Country
Canada
Facility Name
Centre Hospitalier de l'université de Montréal
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H2W 1T8
Country
Canada
Facility Name
Institut universitaire de cardiologie et de pneumologie de Québec
City
Québec
State/Province
Quebec
ZIP/Postal Code
G1V 4G5
Country
Canada
Facility Name
CIUSSS de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke
City
Sherbrooke
State/Province
Quebec
ZIP/Postal Code
J1H 5N4
Country
Canada
Facility Name
Rigshospitalet Copenhagen University Hospital
City
Copenhagen
ZIP/Postal Code
2100
Country
Denmark
Facility Name
Clinique Axium
City
Aix-en-Provence
ZIP/Postal Code
13097
Country
France
Facility Name
Service de Cardiologie Interventionnelle - Pôle Santé République
City
Clermont-Ferrand
ZIP/Postal Code
63050
Country
France
Facility Name
Clinique de Fontaine
City
Fontaine-lès-Dijon
ZIP/Postal Code
21121
Country
France
Facility Name
Groupe Hospitalier Mutualiste de Grenoble
City
Grenoble
ZIP/Postal Code
38000
Country
France
Facility Name
Hôpital Privé Jacques Cartier ICPS
City
Massy
ZIP/Postal Code
91300
Country
France
Facility Name
Hôpital Privé Claude Galien
City
Quincy-sous-Sénart
ZIP/Postal Code
91480
Country
France
Facility Name
Clinique Saint Hilaire
City
Rouen
ZIP/Postal Code
76000
Country
France
Facility Name
CHU Toulouse Rangeuil
City
Toulouse
Country
France
Facility Name
Segeberger Kliniken GmbH
City
Bad Segeberg
Country
Germany
Facility Name
Herzzentrum Leipzig GmbH
City
Leipzig
ZIP/Postal Code
04289
Country
Germany
Facility Name
Grande Ospedale Metropolitano Niguarda
City
Milan
ZIP/Postal Code
20162
Country
Italy
Facility Name
Azienda Ospedaliera San Camillo Forlanini
City
Rome
ZIP/Postal Code
00152
Country
Italy
Facility Name
Royal Bournemouth Hospital, Dorset Heart Centre
City
Bournemouth
Country
United Kingdom
Facility Name
Craigavon Cardiac Centre
City
Craigavon
ZIP/Postal Code
BT63 5QQ
Country
United Kingdom
Facility Name
Golden Jubilee National Hospital
City
Glasgow
ZIP/Postal Code
G81 4DY
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
The emphasis in all scientific publications and presentations will be placed on the 1-year endpoint
Citations:
PubMed Identifier
32432718
Citation
Mehran R, Chandrasekhar J, Urban P, Lang IM, Windhoevel U, Spaulding C, Copt S, Stoll HP, Morice MC; LEADERS FREE Investigators. Sex-Based Outcomes in Patients With a High Bleeding Risk After Percutaneous Coronary Intervention and 1-Month Dual Antiplatelet Therapy: A Secondary Analysis of the LEADERS FREE Randomized Clinical Trial. JAMA Cardiol. 2020 Aug 1;5(8):939-947. doi: 10.1001/jamacardio.2020.0285.
Results Reference
derived

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LEADERS FREE II: BioFreedom™ Pivotal Study

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