Randomized Trial of COBRA PzF Stenting to Reduce Duration of Triple Therapy (COBRA-REDUCE)
Primary Purpose
Angina, Stable, Angina, Unstable, Anticoagulants
Status
Unknown status
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
COBRA PzF
Drug Eluting Stent
Sponsored by
About this trial
This is an interventional treatment trial for Angina, Stable
Eligibility Criteria
Inclusion Criteria:
- Patients older than age 18 with ischemic symptoms (stable or unstable angina or NSTEMI without thrombosis of the target lesion on coronary angiography) or evidence of myocardial ischemia in the presence of ≥ 50% de novo stenosis located in native coronary vessels (max. 2 lesions in one or 2 separate vessels).
- Patient receiving or with an indication for new treatment with long-term oral anticoagulation with a coumadin derivatives or non-vitamin K oral anticoagulants.
- Written, informed consent
Exclusion Criteria:
- Cardiogenic shock
- Target lesion located in left main trunk
- Bifurcation interventions with a planned 2-stent strategy
- Vessel size too small for implantation of a 2.5 mm stent by visual estimation
- Patient requiring staging PCI procedure within 6 months after the index procedure
- Patients requiring DAPT for more than 2 weeks after the index procedure
- Contraindications or allergy to cobalt, chromium, platinum, polyzene-F, everolimus, zotarolimus or the inability to take triple therapy for at least 6 months
- Relevant hematologic deviations: platelet count <100x10^9 cells/L or >600x10^9 cells/L
- Active bleeding; bleeding diathesis; recent trauma or major surgery in the last month; history of intracranial bleeding or structural abnormalities; suspected aortic dissection
- Malignancies or other co-morbid conditions with life expectancy less than 12 months or that may result in protocol non-compliance
- Pregnancy, present (positive pregnancy test), suspected or planned, breast feeding
- Known allergy or intolerance to the study medications: ASA, clopidogrel, coumadin and its derivatives
- Patient's inability to fully cooperate with the study protocol
Sites / Locations
- Christiana Care Health Services
- University of Florida
- Memorial Hospital Jacksonville
- Sebastian River Medical Center
- Mt Sinai Medical Center
- Augusta University
- University of Maryland St. Joseph Medical Center
- Beth Israel Deaconess Medical Center
- Minneapolis Heart Institute
- Deborah Heart and Lung Center
- Rutgers Robert Wood Johnson Medical Schoo
- Northwell Health
- NYU Winthrop Hospital
- North Ohio Heart Center
- Cleveland Clinic
- Mercy St. Vincent Medical Center
- Einstein Medical Center
- Texas Cardiac Center
- Tyler Cardiovascular Consultants
- Sentara Heart Hospital (Sentara Cardiovascular Research Institute)
- Carilion Medical Center
- Charleston Area Medical Center
- ZNA Middelheim
- Aarhus University Hospital
- Clinique Axium
- Clinique Du Pont De Chaumes
- Clinique du Millénaire
- Hopital Pitie-Salpitierre
- Höpital George Pompidou
- Clinique Pasteur
- Institut Lorrain du Coeur et Vaisseaux, CHU Nancy-Barbois
- Universitats Herzzentrum Freibourg
- Charité - Campus Benjamin Franklin
- Uni-Klinikum Erlangen
- St. Josefskrankenhaus
- Klinikum Fürth
- University of Jena
- MediClin Herzzentrum
- Klinikum Landshut-Achdorf
- Deutsches Herzzentrum München
- Klinikum Rechts der Isar München
- Universitätsklinikum Regensburg
- Hegau Bodensee Klinikum Singen
- Univesitätsklinikum Tübingen
- Ospedale Spaziani
- Paula Stradins Clinical University Hospital
- Hopital Cantonal Fribourg
- Kantonspital St Galen
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
COBRA PzF
Drug Eluting Stent
Arm Description
Cobra PzF plus 14-day DAPT (dual antiplatelet therapy)
standard FDA-approved DES (Xience/Promus or Resolute) plus 3 or 6-month DAPT (dual anti-platelet therapy)
Outcomes
Primary Outcome Measures
BARC class >=2 bleeding after hospital discharge (or beyond 14 days, whichever is "later").
Composite of all cause death, myocardial infarction, definite and probable stent thrombosis or ischemic stroke
Secondary Outcome Measures
Composite of all cause death, myocardial infarction, definite and probable stent thrombosis, ischemia-driven target lesion revascularization or ischemic stroke
Composite of cardiac death and myocardial infarction
Ischemia driven target lesion revascularization
Definite and probable stent thrombosis
Ischemic stroke
BARC class 3-5 bleeding
TIMI major bleeding; TIMI major and minor bleeding
Acute Success Rates
Device success; Lesion success; Procedure success
Health economic utility
Total cardiovascular and bleeding related costs with cost effectiveness based on events avoided
Full Information
NCT ID
NCT02594501
First Posted
October 30, 2015
Last Updated
October 23, 2020
Sponsor
CeloNova BioSciences, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT02594501
Brief Title
Randomized Trial of COBRA PzF Stenting to Reduce Duration of Triple Therapy
Acronym
COBRA-REDUCE
Official Title
COBRA PzF Stenting to Reduce the Duration of Triple Therapy in Patients Treated With Oral Anticoagulation Undergoing Percutaneous Coronary Intervention
Study Type
Interventional
2. Study Status
Record Verification Date
October 2020
Overall Recruitment Status
Unknown status
Study Start Date
February 5, 2016 (undefined)
Primary Completion Date
May 2021 (Anticipated)
Study Completion Date
November 2021 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
CeloNova BioSciences, Inc.
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
The purpose of this study is to determine whether patients undergoing coronary intervention that also require oral anticoagulation, treatment with the COBRA PzF stent plus 14-day dual anti-platelet therapy (DAPT) has higher safety and non-inferior outcomes for thrombo-embolic events than compared with standard FDA-approved drug eluting stent (DES) plus 3 or 6-month DAPT.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Angina, Stable, Angina, Unstable, Anticoagulants
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
996 (Actual)
8. Arms, Groups, and Interventions
Arm Title
COBRA PzF
Arm Type
Experimental
Arm Description
Cobra PzF plus 14-day DAPT (dual antiplatelet therapy)
Arm Title
Drug Eluting Stent
Arm Type
Active Comparator
Arm Description
standard FDA-approved DES (Xience/Promus or Resolute) plus 3 or 6-month DAPT (dual anti-platelet therapy)
Intervention Type
Device
Intervention Name(s)
COBRA PzF
Intervention Type
Device
Intervention Name(s)
Drug Eluting Stent
Other Intervention Name(s)
Xience/Promus, Resolute or Synergy
Primary Outcome Measure Information:
Title
BARC class >=2 bleeding after hospital discharge (or beyond 14 days, whichever is "later").
Time Frame
6 months
Title
Composite of all cause death, myocardial infarction, definite and probable stent thrombosis or ischemic stroke
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Composite of all cause death, myocardial infarction, definite and probable stent thrombosis, ischemia-driven target lesion revascularization or ischemic stroke
Time Frame
12 months
Title
Composite of cardiac death and myocardial infarction
Time Frame
12 months
Title
Ischemia driven target lesion revascularization
Time Frame
12 months
Title
Definite and probable stent thrombosis
Time Frame
12 months
Title
Ischemic stroke
Time Frame
12 months
Title
BARC class 3-5 bleeding
Time Frame
6 months
Title
TIMI major bleeding; TIMI major and minor bleeding
Time Frame
6 months
Title
Acute Success Rates
Description
Device success; Lesion success; Procedure success
Time Frame
procedure
Title
Health economic utility
Description
Total cardiovascular and bleeding related costs with cost effectiveness based on events avoided
Time Frame
12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients older than age 18 with ischemic symptoms (stable or unstable angina or NSTEMI without thrombosis of the target lesion on coronary angiography) or evidence of myocardial ischemia in the presence of ≥ 50% de novo stenosis located in native coronary vessels (max. 2 lesions in one or 2 separate vessels).
Patient receiving or with an indication for new treatment with long-term oral anticoagulation with a coumadin derivatives or non-vitamin K oral anticoagulants.
Written, informed consent
Exclusion Criteria:
Cardiogenic shock
Target lesion located in left main trunk
Bifurcation interventions with a planned 2-stent strategy
Vessel size too small for implantation of a 2.5 mm stent by visual estimation
Patient requiring staging PCI procedure within 6 months after the index procedure
Patients requiring DAPT for more than 2 weeks after the index procedure
Contraindications or allergy to cobalt, chromium, platinum, polyzene-F, everolimus, zotarolimus or the inability to take triple therapy for at least 6 months
Relevant hematologic deviations: platelet count <100x10^9 cells/L or >600x10^9 cells/L
Active bleeding; bleeding diathesis; recent trauma or major surgery in the last month; history of intracranial bleeding or structural abnormalities; suspected aortic dissection
Malignancies or other co-morbid conditions with life expectancy less than 12 months or that may result in protocol non-compliance
Pregnancy, present (positive pregnancy test), suspected or planned, breast feeding
Known allergy or intolerance to the study medications: ASA, clopidogrel, coumadin and its derivatives
Patient's inability to fully cooperate with the study protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Adnan Kastrati
Organizational Affiliation
ISAResearch Center Deutsches Herzzentrum München
Official's Role
Study Chair
Facility Information:
Facility Name
Christiana Care Health Services
City
Newark
State/Province
Delaware
ZIP/Postal Code
19718
Country
United States
Facility Name
University of Florida
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32209
Country
United States
Facility Name
Memorial Hospital Jacksonville
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32216
Country
United States
Facility Name
Sebastian River Medical Center
City
Melbourne
State/Province
Florida
ZIP/Postal Code
32901
Country
United States
Facility Name
Mt Sinai Medical Center
City
Miami Beach
State/Province
Florida
ZIP/Postal Code
33140
Country
United States
Facility Name
Augusta University
City
Augusta
State/Province
Georgia
ZIP/Postal Code
30912
Country
United States
Facility Name
University of Maryland St. Joseph Medical Center
City
Towson
State/Province
Maryland
ZIP/Postal Code
21204
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Minneapolis Heart Institute
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55407
Country
United States
Facility Name
Deborah Heart and Lung Center
City
Browns Mills
State/Province
New Jersey
ZIP/Postal Code
08015
Country
United States
Facility Name
Rutgers Robert Wood Johnson Medical Schoo
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08901
Country
United States
Facility Name
Northwell Health
City
Manhasset
State/Province
New York
ZIP/Postal Code
11030
Country
United States
Facility Name
NYU Winthrop Hospital
City
Mineola
State/Province
New York
ZIP/Postal Code
11501
Country
United States
Facility Name
North Ohio Heart Center
City
Elyria
State/Province
Ohio
ZIP/Postal Code
44035
Country
United States
Facility Name
Cleveland Clinic
City
Fairview Park
State/Province
Ohio
ZIP/Postal Code
44126
Country
United States
Facility Name
Mercy St. Vincent Medical Center
City
Toledo
State/Province
Ohio
ZIP/Postal Code
43608
Country
United States
Facility Name
Einstein Medical Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19141
Country
United States
Facility Name
Texas Cardiac Center
City
Lubbock
State/Province
Texas
ZIP/Postal Code
79410
Country
United States
Facility Name
Tyler Cardiovascular Consultants
City
Tyler
State/Province
Texas
ZIP/Postal Code
75701
Country
United States
Facility Name
Sentara Heart Hospital (Sentara Cardiovascular Research Institute)
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23507
Country
United States
Facility Name
Carilion Medical Center
City
Roanoke
State/Province
Virginia
ZIP/Postal Code
24014
Country
United States
Facility Name
Charleston Area Medical Center
City
Charleston
State/Province
West Virginia
ZIP/Postal Code
25304
Country
United States
Facility Name
ZNA Middelheim
City
Antwerp
ZIP/Postal Code
2020
Country
Belgium
Facility Name
Aarhus University Hospital
City
Aarhus
Country
Denmark
Facility Name
Clinique Axium
City
Aix
Country
France
Facility Name
Clinique Du Pont De Chaumes
City
Montauban
Country
France
Facility Name
Clinique du Millénaire
City
Montpellier
ZIP/Postal Code
34000
Country
France
Facility Name
Hopital Pitie-Salpitierre
City
Paris
ZIP/Postal Code
75013
Country
France
Facility Name
Höpital George Pompidou
City
Paris
Country
France
Facility Name
Clinique Pasteur
City
Toulouse
ZIP/Postal Code
31300
Country
France
Facility Name
Institut Lorrain du Coeur et Vaisseaux, CHU Nancy-Barbois
City
Vandœuvre-lès-Nancy
Country
France
Facility Name
Universitats Herzzentrum Freibourg
City
Bad Krozingen
ZIP/Postal Code
79819
Country
Germany
Facility Name
Charité - Campus Benjamin Franklin
City
Berlin
ZIP/Postal Code
12203
Country
Germany
Facility Name
Uni-Klinikum Erlangen
City
Erlangen
Country
Germany
Facility Name
St. Josefskrankenhaus
City
Freiburg
Country
Germany
Facility Name
Klinikum Fürth
City
Fürth
Country
Germany
Facility Name
University of Jena
City
Jena
Country
Germany
Facility Name
MediClin Herzzentrum
City
Lahr
Country
Germany
Facility Name
Klinikum Landshut-Achdorf
City
Landshut
Country
Germany
Facility Name
Deutsches Herzzentrum München
City
Munich
Country
Germany
Facility Name
Klinikum Rechts der Isar München
City
Munich
Country
Germany
Facility Name
Universitätsklinikum Regensburg
City
Regensburg
Country
Germany
Facility Name
Hegau Bodensee Klinikum Singen
City
Singen
Country
Germany
Facility Name
Univesitätsklinikum Tübingen
City
Tübingen
ZIP/Postal Code
72076
Country
Germany
Facility Name
Ospedale Spaziani
City
Frosinone
Country
Italy
Facility Name
Paula Stradins Clinical University Hospital
City
Riga
ZIP/Postal Code
LV-1002
Country
Latvia
Facility Name
Hopital Cantonal Fribourg
City
Fribourg
Country
Switzerland
Facility Name
Kantonspital St Galen
City
St Gallen
Country
Switzerland
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
33608239
Citation
Colleran R, Joner M, Cutlip D, Urban P, Maeng M, Jauhar R, Barakat M, Michel JM, Mehran R, Kirtane AJ, Maillard L, Kastrati A, Byrne RA; COBRA-REDUCE investigators. Design and Rationale of a Randomized Trial of COBRA PzF Stenting to REDUCE Duration of Triple Therapy (COBRA-REDUCE). Cardiovasc Revasc Med. 2022 Jan;34:17-24. doi: 10.1016/j.carrev.2021.01.022. Epub 2021 Jan 22.
Results Reference
derived
Learn more about this trial
Randomized Trial of COBRA PzF Stenting to Reduce Duration of Triple Therapy
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