Study on Safety and Effectiveness of Three Doses of Argatroban as Anticoagulant in Percutaneous Coronary Intervention (PCI)
Primary Purpose
Coronary Artery Disease, Angina, Unstable
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Argatroban
Argatroban
Argatroban
Heparin
Sponsored by
About this trial
This is an interventional treatment trial for Coronary Artery Disease focused on measuring Argatroban, Direct thrombin inhibitor, Percutaneous coronary intervention, Activated clotting time, PCI, ACT
Eligibility Criteria
Inclusion Criteria:
- Male or female (women of child bearing potential must have a negative pregnancy test prior to entry into the study)
- Aged over 18 years
- Diagnosis of stable coronary artery disease (CAD) or unstable angina (troponin negative, i.e. within the normal range for the study site) with low to moderate anatomic risk and a requirement for elective percutaneous coronary angioplasty or stent insertion with an approved device in one or more de novo-treated or re-stenotic lesions in native vessels
- Signed written informed consent
Exclusion Criteria:
- Any condition which, in the investigator's opinion, contraindicates the use of argatroban, heparin or clopidogrel or endangers the patient if he/she participated in this study.
- Known cirrhosis, hepatitis, clinically significant hepatic disorder, or history of hepatic disorder. Hepatic disorder is defined as having levels of liver function tests (bilirubin, Aspartate Aminotransferase (Serum Glutamate Oxaloacetate Transaminase)(AST (SGOT)), Alanine Aminotransferase (Serum Glutamate Pyruvate Transaminase)(ALT (SGPT)) greater than 3.0 times above the upper limit of the normal range of local laboratory.
- Patients not currently taking aspirin
- Renal insufficiency, defined as serum creatinine greater than 2.0 mg/dL (greater than 177mmol/L)
- Platelets less than 125,000/ml
- If already taking any form of heparin prior to study enrolment, Activated Partial Thromboplastin Time(aPTT) equal or greater than 35 sec or ACT greater than 160 sec
- Use of low molecular heparin (LMWH) during 12 h prior to PCI
- If taking oral anticoagulant medication prior to study enrolment, International Normalised Ratio(INR) greater than 1.2
- Q wave MI with cardiogenic shock or thrombolytic therapy within 72 h of study dosing
- Use of Glycoprotein IIb / IIIa(GPIIb/IIIa) inhibitors within prior 3 weeks
- Documented coagulation disorder or bleeding diathesis
- Lumbar puncture within the past 2 weeks
- History of previous cerebral aneurysm, haemorrhagic stroke, or thrombotic stroke within the past 6 months
- Active, uncontrolled peptic ulcer disease or any gastrointestinal bleeding or genitourinary bleeding within 3 months prior to study enrolment
- Major surgery, serious trauma, puncture of non-compressible vessel, or biopsy of parenchymal organ within prior 2 months
- Planned staged procedure, planned rotational atherectomy, directional coronary atherectomy, brachytherapy, or thrombectomy catheters
- Planned surgical intervention other than study procedure within next 7 days
- Presence of greater than 50% stenosis of unprotected left main coronary artery
- Severe peripheral vascular disease, precluding femoral access
- History of vasculitis
- Uncontrolled hypertension defined as greater than 180/120 mmHg
- Pregnancy (exclusion by routine urine test)
- Lactating woman
- Woman of children bearing age who are or were not using accepted contraceptive methods
- Participation in other clinical trials of investigational products within 3 months prior to study enrolment
- Terminally ill patients with a life expectancy of < 3 months
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Experimental
Experimental
Placebo Comparator
Arm Label
ARG250
ARG300
ARG350
Heparin
Arm Description
Outcomes
Primary Outcome Measures
Activated Clotting Time (ACT) Value After the First Dosing of Study Treatment.
Composite and Each of Death, Myocardial Infarction, and Urgent Revascularisation at Day 30, and Major Bleeding Events During Hospital Stay.
Composite end point (a): all cause death, myocardial infarction and urgent revascularization at Day30
Composite end point (b): all cause death, myocardial infarction and urgent revascularization at Day30 as well as major bleeding events during hospital stay
Secondary Outcome Measures
Full Information
NCT ID
NCT00508924
First Posted
July 26, 2007
Last Updated
November 6, 2012
Sponsor
Mitsubishi Tanabe Pharma Corporation
1. Study Identification
Unique Protocol Identification Number
NCT00508924
Brief Title
Study on Safety and Effectiveness of Three Doses of Argatroban as Anticoagulant in Percutaneous Coronary Intervention (PCI)
Official Title
A Randomised, Open, Parallel-group, Multicentre Study to Examine the Safety and Effectiveness of Three Doses of Argatroban as Anticoagulant in Combination With Clopidogrel and Aspirin in Patients Undergoing Elective Percutaneous Coronary Intervention in Comparison With Unfractionated Heparin, Clopidogrel and Aspirin
Study Type
Interventional
2. Study Status
Record Verification Date
November 2012
Overall Recruitment Status
Completed
Study Start Date
August 2005 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
October 2006 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
Mitsubishi Tanabe Pharma Corporation
4. Oversight
5. Study Description
Brief Summary
This is a phase II multi-centre study in 140 patients undergoing elective PCI to obtain the information on dose-response of argatroban in pharmacodynamic markers and to assess the anticoagulation, safety and efficacy of argatroban in reference to unfractionated heparin, in combination with dual antiplatelet therapy.
Detailed Description
This is a phase II multi-centre study in Europe in patients with stable coronary artery disease or troponin negative unstable angina undergoing elective PCI, to obtain the information on the safety and effects on various pharmacodynamic markers, of three doses of argatroban in combination with clopidogrel and aspirin, and to assess the results of argatroban and unfractionated heparin, both used in combination with clopidogrel and aspirin, on clinical outcomes, adequacy of anticoagulation, various pharmacodynamic markers (approximately 35 patients per group).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease, Angina, Unstable
Keywords
Argatroban, Direct thrombin inhibitor, Percutaneous coronary intervention, Activated clotting time, PCI, ACT
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
140 (Actual)
8. Arms, Groups, and Interventions
Arm Title
ARG250
Arm Type
Experimental
Arm Title
ARG300
Arm Type
Experimental
Arm Title
ARG350
Arm Type
Experimental
Arm Title
Heparin
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Argatroban
Intervention Type
Drug
Intervention Name(s)
Argatroban
Intervention Type
Drug
Intervention Name(s)
Argatroban
Intervention Type
Drug
Intervention Name(s)
Heparin
Primary Outcome Measure Information:
Title
Activated Clotting Time (ACT) Value After the First Dosing of Study Treatment.
Time Frame
5 - 10 min after initial bolus
Title
Composite and Each of Death, Myocardial Infarction, and Urgent Revascularisation at Day 30, and Major Bleeding Events During Hospital Stay.
Description
Composite end point (a): all cause death, myocardial infarction and urgent revascularization at Day30
Composite end point (b): all cause death, myocardial infarction and urgent revascularization at Day30 as well as major bleeding events during hospital stay
Time Frame
30 Days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female (women of child bearing potential must have a negative pregnancy test prior to entry into the study)
Aged over 18 years
Diagnosis of stable coronary artery disease (CAD) or unstable angina (troponin negative, i.e. within the normal range for the study site) with low to moderate anatomic risk and a requirement for elective percutaneous coronary angioplasty or stent insertion with an approved device in one or more de novo-treated or re-stenotic lesions in native vessels
Signed written informed consent
Exclusion Criteria:
Any condition which, in the investigator's opinion, contraindicates the use of argatroban, heparin or clopidogrel or endangers the patient if he/she participated in this study.
Known cirrhosis, hepatitis, clinically significant hepatic disorder, or history of hepatic disorder. Hepatic disorder is defined as having levels of liver function tests (bilirubin, Aspartate Aminotransferase (Serum Glutamate Oxaloacetate Transaminase)(AST (SGOT)), Alanine Aminotransferase (Serum Glutamate Pyruvate Transaminase)(ALT (SGPT)) greater than 3.0 times above the upper limit of the normal range of local laboratory.
Patients not currently taking aspirin
Renal insufficiency, defined as serum creatinine greater than 2.0 mg/dL (greater than 177mmol/L)
Platelets less than 125,000/ml
If already taking any form of heparin prior to study enrolment, Activated Partial Thromboplastin Time(aPTT) equal or greater than 35 sec or ACT greater than 160 sec
Use of low molecular heparin (LMWH) during 12 h prior to PCI
If taking oral anticoagulant medication prior to study enrolment, International Normalised Ratio(INR) greater than 1.2
Q wave MI with cardiogenic shock or thrombolytic therapy within 72 h of study dosing
Use of Glycoprotein IIb / IIIa(GPIIb/IIIa) inhibitors within prior 3 weeks
Documented coagulation disorder or bleeding diathesis
Lumbar puncture within the past 2 weeks
History of previous cerebral aneurysm, haemorrhagic stroke, or thrombotic stroke within the past 6 months
Active, uncontrolled peptic ulcer disease or any gastrointestinal bleeding or genitourinary bleeding within 3 months prior to study enrolment
Major surgery, serious trauma, puncture of non-compressible vessel, or biopsy of parenchymal organ within prior 2 months
Planned staged procedure, planned rotational atherectomy, directional coronary atherectomy, brachytherapy, or thrombectomy catheters
Planned surgical intervention other than study procedure within next 7 days
Presence of greater than 50% stenosis of unprotected left main coronary artery
Severe peripheral vascular disease, precluding femoral access
History of vasculitis
Uncontrolled hypertension defined as greater than 180/120 mmHg
Pregnancy (exclusion by routine urine test)
Lactating woman
Woman of children bearing age who are or were not using accepted contraceptive methods
Participation in other clinical trials of investigational products within 3 months prior to study enrolment
Terminally ill patients with a life expectancy of < 3 months
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Professor
Organizational Affiliation
Information at Mitsubishi Pharma Europe
Official's Role
Principal Investigator
Facility Information:
City
Aalst
Country
Belgium
City
Bad Nauheim
Country
Germany
City
Cologne
Country
Germany
City
Dachau
Country
Germany
City
Dueren
Country
Germany
City
Frankfurt
Country
Germany
City
Halle
Country
Germany
City
Mainz
Country
Germany
12. IPD Sharing Statement
Citations:
PubMed Identifier
20226548
Citation
Rossig L, Genth-Zotz S, Rau M, Heyndrickx GR, Schneider T, Gulba DC, Desaga M, Buerke M, Harder S, Zeiher AM; ARG-E04 study group. Argatroban for elective percutaneous coronary intervention: the ARG-E04 multi-center study. Int J Cardiol. 2011 Apr 14;148(2):214-9. doi: 10.1016/j.ijcard.2010.02.044. Epub 2010 Mar 11.
Results Reference
result
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Study on Safety and Effectiveness of Three Doses of Argatroban as Anticoagulant in Percutaneous Coronary Intervention (PCI)
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