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Safety and Efficacy of TAK-442 in Subjects With Acute Coronary Syndromes

Primary Purpose

Acute Coronary Syndrome

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
TAK-442
TAK-442
TAK-442
TAK-442
TAK-442
TAK-442
TAK-442
TAK-442
Placebo
Sponsored by
Takeda
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Coronary Syndrome focused on measuring Unstable Angina, Myocardial Infarction, Thrombolysis, Anticoagulant, Acute Coronary Syndrome

Eligibility Criteria

30 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Has been hospitalized for acute coronary syndrome
  • Is able to initiate study drug if:

    • The index event occurred within the past 7 days (the date of initial hospitalization will be utilized for the date on which the index event occurred), and
    • The final acute medical or cardiac procedural intervention for the treatment of acute coronary syndrome was last administered or performed at least 36 hours before administration of the first dose of study drug.
  • Has at least 1 of the following additional ischemic risk factors:

    • Previous myocardial infarction.
    • The index event was an anterior myocardial infarction.
    • Presence of multivessel coronary disease
    • Left bundle branch block.
    • Left ventricular ejection fraction less than 40% at any time during hospitalization for the index event.
    • Killip class greater than or equal to II at any time during hospitalization for the index event.
    • History of symptomatic congestive heart failure
    • History of ischemic stroke or transient ischemic attack.
    • Presence of peripheral arterial obstructive disease.
    • Diabetes mellitus requiring medical therapy to maintain glycemic control.
    • Current smoker
    • Moderate renal impairment
  • Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from Screening throughout the duration of the study.

Exclusion Criteria:

  • Has low body weight greater than 50 kg.
  • Has severe hypertension.
  • Has a known bleeding/clotting disorder.
  • Has acute pericarditis.
  • Has a history of intracranial or intraocular bleeding.
  • Has a history of gastrointestinal bleeding or gastric or duodenal ulceration.
  • Has a history of ischemic stroke or transient ischemic attack.
  • Has had major surgery, including coronary artery bypass graft or has undergone non-major laparoscopic surgery or non-major minimally invasive surgery, within 2 weeks prior to Randomization.
  • Has a history of cancer that has not been in remission for at least 5 years.
  • Has a condition for which long-term anticoagulation therapy is indicated or requires ongoing use of other excluded medications.
  • Has severe renal dysfunction.
  • Has anemia or thrombocytopenia that has not resolved prior to Randomization.
  • Has alanine aminotransferase or total bilirubin levels greater than 2 times the upper limit of normal, active liver disease or jaundice.
  • Has a history of illicit drug use or excessive alcohol intake.
  • Has any other serious disease or condition that would compromise subject safety, increase the risk of bleeding, or make it difficult to successfully manage and follow the subject according to the protocol.
  • Has received TAK-442 in a previous clinical study or as a therapeutic agent.
  • Has a history of hypersensitivity or allergies to other fXa inhibitors.
  • Has received any investigational compound within 30 days prior to Screening or is currently participating in another study which entails the administration of an investigational or marketed drug, supplement or intervention including, but not limited to diet, exercise, lifestyle or invasive procedure.
  • Is required to take or intends to continue taking any disallowed medication, any prescription medication, herbal treatment or over-the counter medication that may interfere with evaluation of the study medication, including:

    • azole antifungal agents
    • cyclosporine
    • clarithromycin
    • HIV protease inhibitors
    • nefazodone
    • ritonavir
    • quinidine
    • amiodarone
    • verapamil

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

TAK-442 10 mg BID

TAK-442 20 mg BID

TAK-442 40 mg QD

TAK-442 40 mg BID

TAK-442 80 mg QD

TAK-442 80 mg BID

TAK-442 160 mg QD

TAK-442 120 mg BID

Placebo

Arm Description

Added with standard care for recurrent ischemic events.

Added with standard care for recurrent ischemic events

Added with standard care for recurrent ischemic events

Added with standard care for recurrent ischemic events

Added with standard care for recurrent ischemic events

Added with standard care for recurrent ischemic events

Added with standard care for recurrent ischemic events

Added with standard care for recurrent ischemic events

Added with standard care for recurrent ischemic events

Outcomes

Primary Outcome Measures

Incidence of Major Bleeding Events defined by the Thrombolysis in Myocardial Infarction Scale.

Secondary Outcome Measures

Composite of Cardiovascular Mortality, non-fatal Myocardial Infarction, non-fatal Stroke, or Myocardial Ischemia requiring hospitalization.
Cardiovascular Mortality.
Non-fatal Myocardial Infarction.
Non-fatal Stroke.
Myocardial Ischemia requiring hospitalization.
All-cause Mortality.
Hemorrhagic Mortality.
Composite of Cardiovascular death, non-fatal Myocardial Infarction, or Myocardial Ischemia requiring hospitalization.
Composite of Cardiovascular death, non-fatal Myocardial Infarction, or non-fatal Stroke.
Hospitalization for Heart Failure.
Incidence of minor bleeding events defined by the Thrombolysis in Myocardial Infarction Scale.
Incidence of minimal bleeding events defined by the Thrombolysis in Myocardial Infarction Scale.
Incidence of major, clinically significant non-major bleeding AND minor bleeding events as defined by the Secondary Bleeding Scale

Full Information

First Posted
May 9, 2008
Last Updated
March 13, 2016
Sponsor
Takeda
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1. Study Identification

Unique Protocol Identification Number
NCT00677053
Brief Title
Safety and Efficacy of TAK-442 in Subjects With Acute Coronary Syndromes
Official Title
A Phase 2, Double-blind, Randomized, Placebo-controlled Study of the Safety and Efficacy of TAK-442 in Subjects With Acute Coronary Syndromes
Study Type
Interventional

2. Study Status

Record Verification Date
March 2016
Overall Recruitment Status
Completed
Study Start Date
March 2008 (undefined)
Primary Completion Date
June 2010 (Actual)
Study Completion Date
June 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Takeda

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the safety and tolerability of multiple doses of TAK-442once daily, (QD) or twice daily (BID), in subjects with acute coronary syndrome (unstable angina, myocardial infarction).
Detailed Description
Acute coronary syndrome, including myocardial infarction with or without ST-segment elevation and stable or unstable angina, is acknowledged to represent collectively a major global healthcare problem. Despite existing treatments, the rates of patient mortality, myocardial infarction and hospital readmissions during follow-up remain very high. Due to its critical role in propagating the blood coagulation cascade, activated factor X now is considered to be a major therapeutic target in the development of novel antithrombotic therapy by blocking thrombin generation and attenuating the formation of fibrin. Therefore, activated factor X inhibitors, exhibiting either indirect or direct modes of action, are among the novel agents under investigation in the treatment of acute coronary syndrome. This study will evaluate the safety and tolerability of TAK-442 compared with placebo in post-acute coronary syndrome subjects who are also receiving standard antiplatelet and other cardiovascular therapy. Individuals who want to participate in this study will be required to provide written informed consent. Study participation is anticipated to be approximately 3.5 months. Multiple procedures will occur at each visit which may include fasting, blood collection, urine collection, physical examinations, electrocardiograms and bilateral venogram.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Coronary Syndrome
Keywords
Unstable Angina, Myocardial Infarction, Thrombolysis, Anticoagulant, Acute Coronary Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
2753 (Actual)

8. Arms, Groups, and Interventions

Arm Title
TAK-442 10 mg BID
Arm Type
Experimental
Arm Description
Added with standard care for recurrent ischemic events.
Arm Title
TAK-442 20 mg BID
Arm Type
Experimental
Arm Description
Added with standard care for recurrent ischemic events
Arm Title
TAK-442 40 mg QD
Arm Type
Experimental
Arm Description
Added with standard care for recurrent ischemic events
Arm Title
TAK-442 40 mg BID
Arm Type
Experimental
Arm Description
Added with standard care for recurrent ischemic events
Arm Title
TAK-442 80 mg QD
Arm Type
Experimental
Arm Description
Added with standard care for recurrent ischemic events
Arm Title
TAK-442 80 mg BID
Arm Type
Experimental
Arm Description
Added with standard care for recurrent ischemic events
Arm Title
TAK-442 160 mg QD
Arm Type
Experimental
Arm Description
Added with standard care for recurrent ischemic events
Arm Title
TAK-442 120 mg BID
Arm Type
Experimental
Arm Description
Added with standard care for recurrent ischemic events
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Added with standard care for recurrent ischemic events
Intervention Type
Drug
Intervention Name(s)
TAK-442
Intervention Description
Stage I: TAK-442 10 mg, capsules, orally, twice daily and standard care for recurrent ischemic events for up to 24 weeks.
Intervention Type
Drug
Intervention Name(s)
TAK-442
Intervention Description
Stage I: TAK-442 20 mg, capsules, orally, twice daily and standard care for recurrent ischemic events for up to 24 weeks.
Intervention Type
Drug
Intervention Name(s)
TAK-442
Intervention Description
Stage I: TAK-442 40 mg, capsules, orally, once daily and standard care for recurrent ischemic events for up to 24 weeks.
Intervention Type
Drug
Intervention Name(s)
TAK-442
Intervention Description
Stage II: TAK-442 40 mg, capsules, orally, twice daily and standard care for recurrent ischemic events for up to 24 weeks.
Intervention Type
Drug
Intervention Name(s)
TAK-442
Intervention Description
Stage II: TAK-442 80 mg, capsules, orally, once daily and standard care for recurrent ischemic events for up to 24 weeks.
Intervention Type
Drug
Intervention Name(s)
TAK-442
Intervention Description
Stage II: TAK-442 80 mg, capsules, orally, twice daily and standard care for recurrent ischemic events for up to 24 weeks.
Intervention Type
Drug
Intervention Name(s)
TAK-442
Intervention Description
Stage III: TAK-442 160 mg, capsules, orally, once daily and standard care for recurrent ischemic events for up to 24 weeks.
Intervention Type
Drug
Intervention Name(s)
TAK-442
Intervention Description
Stage III: TAK-442 120 mg, capsules, orally, twice daily and standard care for recurrent ischemic events for up to 24 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Stages I, II & III: TAK-442 placebo-matching capsules, orally, twice daily and standard care for recurrent ischemic events for up to 24 weeks.
Primary Outcome Measure Information:
Title
Incidence of Major Bleeding Events defined by the Thrombolysis in Myocardial Infarction Scale.
Time Frame
On Occurrence (Up to 24 weeks)
Secondary Outcome Measure Information:
Title
Composite of Cardiovascular Mortality, non-fatal Myocardial Infarction, non-fatal Stroke, or Myocardial Ischemia requiring hospitalization.
Time Frame
Week 24
Title
Cardiovascular Mortality.
Time Frame
Week 24.
Title
Non-fatal Myocardial Infarction.
Time Frame
Week 24.
Title
Non-fatal Stroke.
Time Frame
Week 24.
Title
Myocardial Ischemia requiring hospitalization.
Time Frame
Week 24.
Title
All-cause Mortality.
Time Frame
Week 24.
Title
Hemorrhagic Mortality.
Time Frame
Week 24.
Title
Composite of Cardiovascular death, non-fatal Myocardial Infarction, or Myocardial Ischemia requiring hospitalization.
Time Frame
Week 24.
Title
Composite of Cardiovascular death, non-fatal Myocardial Infarction, or non-fatal Stroke.
Time Frame
Week 24.
Title
Hospitalization for Heart Failure.
Time Frame
Week 24.
Title
Incidence of minor bleeding events defined by the Thrombolysis in Myocardial Infarction Scale.
Time Frame
On Occurrence (Up to 24 weeks).
Title
Incidence of minimal bleeding events defined by the Thrombolysis in Myocardial Infarction Scale.
Time Frame
On Occurrence (Up to 24 weeks).
Title
Incidence of major, clinically significant non-major bleeding AND minor bleeding events as defined by the Secondary Bleeding Scale
Time Frame
On Occurrence (Up to 24 weeks)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Has been hospitalized for acute coronary syndrome Is able to initiate study drug if: The index event occurred within the past 7 days (the date of initial hospitalization will be utilized for the date on which the index event occurred), and The final acute medical or cardiac procedural intervention for the treatment of acute coronary syndrome was last administered or performed at least 36 hours before administration of the first dose of study drug. Has at least 1 of the following additional ischemic risk factors: Previous myocardial infarction. The index event was an anterior myocardial infarction. Presence of multivessel coronary disease Left bundle branch block. Left ventricular ejection fraction less than 40% at any time during hospitalization for the index event. Killip class greater than or equal to II at any time during hospitalization for the index event. History of symptomatic congestive heart failure History of ischemic stroke or transient ischemic attack. Presence of peripheral arterial obstructive disease. Diabetes mellitus requiring medical therapy to maintain glycemic control. Current smoker Moderate renal impairment Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from Screening throughout the duration of the study. Exclusion Criteria: Has low body weight greater than 50 kg. Has severe hypertension. Has a known bleeding/clotting disorder. Has acute pericarditis. Has a history of intracranial or intraocular bleeding. Has a history of gastrointestinal bleeding or gastric or duodenal ulceration. Has a history of ischemic stroke or transient ischemic attack. Has had major surgery, including coronary artery bypass graft or has undergone non-major laparoscopic surgery or non-major minimally invasive surgery, within 2 weeks prior to Randomization. Has a history of cancer that has not been in remission for at least 5 years. Has a condition for which long-term anticoagulation therapy is indicated or requires ongoing use of other excluded medications. Has severe renal dysfunction. Has anemia or thrombocytopenia that has not resolved prior to Randomization. Has alanine aminotransferase or total bilirubin levels greater than 2 times the upper limit of normal, active liver disease or jaundice. Has a history of illicit drug use or excessive alcohol intake. Has any other serious disease or condition that would compromise subject safety, increase the risk of bleeding, or make it difficult to successfully manage and follow the subject according to the protocol. Has received TAK-442 in a previous clinical study or as a therapeutic agent. Has a history of hypersensitivity or allergies to other fXa inhibitors. Has received any investigational compound within 30 days prior to Screening or is currently participating in another study which entails the administration of an investigational or marketed drug, supplement or intervention including, but not limited to diet, exercise, lifestyle or invasive procedure. Is required to take or intends to continue taking any disallowed medication, any prescription medication, herbal treatment or over-the counter medication that may interfere with evaluation of the study medication, including: azole antifungal agents cyclosporine clarithromycin HIV protease inhibitors nefazodone ritonavir quinidine amiodarone verapamil
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Executive Medical Director Clinical Science
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
City
Birmingham
State/Province
Alabama
Country
United States
City
Tucson
State/Province
Arizona
Country
United States
City
Newark
State/Province
Delaware
Country
United States
City
Washington
State/Province
District of Columbia
Country
United States
City
Pensecola
State/Province
Florida
Country
United States
City
West Des Moines
State/Province
Iowa
Country
United States
City
Salisbury
State/Province
Maryland
Country
United States
City
Minneapolis
State/Province
Minnesota
Country
United States
City
Cherry Hill
State/Province
New Jersey
Country
United States
City
Toledo
State/Province
Ohio
Country
United States
City
Sayre
State/Province
Pennsylvania
Country
United States
City
Houston
State/Province
Texas
Country
United States
City
Victoria
State/Province
Texas
Country
United States
City
Layton
State/Province
Utah
Country
United States
City
Roanoke
State/Province
Virginia
Country
United States
City
Buenos Aires
Country
Argentina
City
Bonheiden
Country
Belgium
City
Genk
Country
Belgium
City
Liège
Country
Belgium
City
Porto Algere
Country
Brazil
City
Recife
Country
Brazil
City
Haskovo
Country
Bulgaria
City
Pazardjik
Country
Bulgaria
City
Pleven
Country
Bulgaria
City
Plovdiv
Country
Bulgaria
City
Rouse
Country
Bulgaria
City
Silistra
Country
Bulgaria
City
Sofia
Country
Bulgaria
City
Stara Zagora
Country
Bulgaria
City
Varna
Country
Bulgaria
City
Sudbury
State/Province
Ontario
Country
Canada
City
Toronto
State/Province
Ontario
Country
Canada
City
Chilliwack
Country
Canada
City
Saint-Charles Borromée
Country
Canada
City
Vancouver
Country
Canada
City
Santiago
Country
Chile
City
Temuco
Country
Chile
City
Tallinn
Country
Estonia
City
Bad Nauheim
Country
Germany
City
Langen
Country
Germany
City
Budapest
Country
Hungary
City
Debrecen
Country
Hungary
City
Nyíregyháza
Country
Hungary
City
Szeged
Country
Hungary
City
Szolnok
Country
Hungary
City
Székesfehérvár
Country
Hungary
City
Zalaegerszeg
Country
Hungary
City
Ahmedabad
Country
India
City
Bikaner
Country
India
City
Calicut
Country
India
City
Indore
Country
India
City
Jaipur
Country
India
City
Mangalor
Country
India
City
Mumbai
Country
India
City
Nagpur
Country
India
City
New Delhi
Country
India
City
Pune
Country
India
City
Shimoga
Country
India
City
Thrissur
Country
India
City
Trivandrum
Country
India
City
Vadodara
Country
India
City
Busan
Country
Korea, Republic of
City
Daegu
Country
Korea, Republic of
City
Jeonrabukdo
Country
Korea, Republic of
City
Seoul
Country
Korea, Republic of
City
Amsterdam
Country
Netherlands
City
Den Haag
Country
Netherlands
City
Hardenberg
Country
Netherlands
City
Hoorn
Country
Netherlands
City
Tilburg
Country
Netherlands
City
Arequipa
Country
Peru
City
Lima
Country
Peru
City
Bacau
Country
Romania
City
Baia Mare
Country
Romania
City
Braila
Country
Romania
City
Brasov
Country
Romania
City
Bucuresti
Country
Romania
City
Cluj-Napoca
Country
Romania
City
Suceava
Country
Romania
City
Targoviste
Country
Romania
City
Barnaul
Country
Russian Federation
City
Kemerovo
Country
Russian Federation
City
Krasnoyarsk
Country
Russian Federation
City
Moscow
Country
Russian Federation
City
Novosibirsk
Country
Russian Federation
City
Samara
Country
Russian Federation
City
Saratov
Country
Russian Federation
City
St. Petersburg
Country
Russian Federation
City
Tomsk
Country
Russian Federation
City
Tyumen
Country
Russian Federation
City
Voronezh
Country
Russian Federation
City
Yaroslavl
Country
Russian Federation
City
Kamenica
Country
Serbia
City
Sremska
Country
Serbia
City
Bloemfontein
Country
South Africa
City
CapeTown
Country
South Africa
City
Goodwood
Country
South Africa
City
Johannesburg
Country
South Africa
City
Parow
Country
South Africa
City
Pinelands
Country
South Africa
City
Pretoria
Country
South Africa
City
Randburg
Country
South Africa
City
Airdrie
State/Province
North Lanarkshire
Country
United Kingdom

12. IPD Sharing Statement

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Safety and Efficacy of TAK-442 in Subjects With Acute Coronary Syndromes

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