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Trial to Assess the Safety of Vorapaxar in Japanese Subjects With Cerebral Infarction (P05005; MK-5348-017)

Primary Purpose

Cerebral Infarction

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Vorapaxar 2.5 mg
Vorapaxar 1 mg
Placebo
Aspirin 75-150 mg
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cerebral Infarction

Eligibility Criteria

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

Inclusion Criteria:

  • Men and women at least 18 years old with last cerebral infarction (excluding cardiogenic cerebral embolism) having occurred from 14 days to less than 1 year after onset (at the time of obtaining consent), with stable nervous system for more than 24 hours and known course of disease.
  • Participants confirmed to have cerebral infarction lesion by brain computerized tomography (CT) or magnetic resonance imaging (MRI).
  • Both of in-participant and out-participant
  • Willing to give appropriate informed consent and complete all study-related procedures and able to adhere to dosing and visit schedules.
  • Women of child-bearing potential (all postmenopausal women who are <1 year menopausal or who have not had surgical sterilization or a hysterectomy are considered to be women of child-bearing potential) must agree to use a medically accepted method of contraception while receiving protocol-specified study drug, and for 60 days after completion or discontinuation of the medication.

Exclusion Criteria:

  • Pregnancy and nursing patients (premenopausal women should have a negative pregnancy test result confirmed before enrollment)
  • Participant with any serious complication or any condition that the investigator feels that would cause a significant hazard to the participant if the study drug is administered.
  • Known hypersensitivity to any component of the study drug.
  • Participation in a study or use of an investigational study drug within 30 days before obtaining consent.
  • Member of the staff personnel directly involved with this study
  • Family member of the study staff.
  • History of a bleeding diathesis, or evidence of active abnormal bleeding within 30 days before obtaining consent.
  • History of cerebral hemorrhage.
  • Severe hypertension (systolic blood pressure >200 mmHg or diastolic blood pressure >110 mmHg).
  • Major surgery within 2 weeks before obtaining consent.
  • Known platelet count <100,000/mm^3
  • Participants confirmed to have cerebral bleeding or any causes of cerebral bleeding by brain CT or MRI.
  • Participants with transient ischemic attack (TIA), progressive stroke or cardiogenic cerebral embolism.
  • Known impairment of renal function (serum creatinine >2.0 mg/dL [>176.8 (umol/L]), dysproteinemia, nephrotic syndrome, or other renal disease
  • Active or chronic hepatobiliary system or hepatic disease, or aspartate aminotransferase (GOT) or alanine aminotransferate (GPT) activity more than two times greater than the upper limit of the laboratory normal range.
  • Participants with contraindictation to aspirin.
  • Scheduled to have PCI (peripheral coronary intervention), peripheral interventional event, carotid endarterectomy, intra- and extra- cranial bypass surgery and intravascular surgery (angioplasty) during the study period.
  • Combination therapy with unfractionated heparin, tissue plasminogen activator, urokinase, warfarin, factor Xa inhibitor, direct thrombin inhibitor or antiplatelet agents other than aspirin after obtaining consent, or scheduled to have the above combination therapy.
  • Any serious impairment which would make detection of new ischemic events difficult (eg, bedridden participants, participants with total nursing care, dementia participants, etc.) or consciousness disturbance which may cause aspiration of the study drug.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Placebo Comparator

    Arm Label

    Vorapaxar 2.5 mg + Aspirin

    Vorapaxar 1 mg + Aspirin

    Placebo + Aspirin

    Arm Description

    Vorapaxar oral tablets; once daily for 60 days + Aspirin.

    Vorapaxar oral tablets; once daily for 60 days + Aspirin.

    Placebo oral tablets; once daily for 60 days + Aspirin

    Outcomes

    Primary Outcome Measures

    Number of Participants Experiencing Non-Major Adverse Cardiac Events (Non-MACE)
    An adverse event (AE) is any unfavorable and unintended change in the structure, function, or chemistry of the body temporarily associated with study drug administration, whether or not considered related to study drug. MACE events were defined as nonfatal myocardial infarction (MI), nonfatal stroke, hospitalization due to recurrent ischemia, or urgent coronary revascularization. All MACE events were excluded from this analysis.

    Secondary Outcome Measures

    Number of Paticipants Experiencing Thrombolysis in Myocardial Infarction (TIMI) Major, Minor, and Non-TIMI Bleeding Events
    Major TIMI bleeding was defined as any intracranial bleeding (excluding micohemorrhages <10 mm evident on magnetic resonance imaging [MRI]), clinical over signs of hemorrhge associated with a drop in hemoglobin >=5 g/dL, or fatal bleeding (bleeding that directly results in death within 7 days). Minor TIMI bleeding was defined as any clinically overt bleeding resulting in a hemoglobin drop of 3 to <5 g/dL. Non-TIMI bleeding included all bleeding events not covered under Major TIMI or Minor TIMI bleeding.
    Number of Participants With MACE or Death
    The number of participants experiencing major cardiac events or death was evaluated up to Day 121. Major cardiac events were defined as nonfatal stroke, hospitalization due to recurrent ischemia, or urgent coronary revascularization.
    Median High-Sensitivity C-Reactive Protein (Hs-CRP) Levels By Study Visit
    Participant blood samples were collected to determine the median serum level of hs-CRP. hs-cRP levels reflect the underlying level of inflammation. The higher the level, the greater the disease burden.
    Mean CD40 Ligand Levels By Study Visit
    Participant blood samples were collected to determine the mean serum level of CD40 ligand. CD40 ligand values represent the level of disease activation with a higher level of CD40 ligand indicating a greater underlying risk.
    Mean Membrane-Bound P-Selectin Levels By Study Visit
    Participant blood samples were collected at Baseline, Day 30, and Day 60 to determine the mean level of membrane-bound p-selectin in the serum. Membrane-bound P-selectin levels reflect the underlying level of inflammation. Intensity levels are reported in arbitrary units 0 (dark) to 1023 (bright). Higher values correspond to greater membrane-bound P-Selectin levels.

    Full Information

    First Posted
    May 22, 2008
    Last Updated
    August 22, 2018
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00684515
    Brief Title
    Trial to Assess the Safety of Vorapaxar in Japanese Subjects With Cerebral Infarction (P05005; MK-5348-017)
    Official Title
    Phase II Study of SCH 530348 in Subjects With Cerebral Infarction
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2018
    Overall Recruitment Status
    Completed
    Study Start Date
    September 21, 2006 (Actual)
    Primary Completion Date
    November 8, 2007 (Actual)
    Study Completion Date
    November 8, 2007 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The study is designed to assess safety of Vorapaxar when added to standard of care (aspirin) in Japanese subjects with cerebral infarction. The study will assess incidence and tolerability of bleeding, major adverse cardiac events, all adverse events, and effect on expression of markers of inflammation.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Cerebral Infarction

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    Vorapaxar 2.5 mg + Aspirin
    Arm Type
    Experimental
    Arm Description
    Vorapaxar oral tablets; once daily for 60 days + Aspirin.
    Arm Title
    Vorapaxar 1 mg + Aspirin
    Arm Type
    Experimental
    Arm Description
    Vorapaxar oral tablets; once daily for 60 days + Aspirin.
    Arm Title
    Placebo + Aspirin
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo oral tablets; once daily for 60 days + Aspirin
    Intervention Type
    Drug
    Intervention Name(s)
    Vorapaxar 2.5 mg
    Intervention Description
    Oral tablets; once daily for 60 days.
    Intervention Type
    Drug
    Intervention Name(s)
    Vorapaxar 1 mg
    Intervention Description
    Oral tablets; once daily for 60 days
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    oral tablets; once daily for 60 days
    Intervention Type
    Drug
    Intervention Name(s)
    Aspirin 75-150 mg
    Intervention Description
    oral tablets; once daily for 60 days
    Primary Outcome Measure Information:
    Title
    Number of Participants Experiencing Non-Major Adverse Cardiac Events (Non-MACE)
    Description
    An adverse event (AE) is any unfavorable and unintended change in the structure, function, or chemistry of the body temporarily associated with study drug administration, whether or not considered related to study drug. MACE events were defined as nonfatal myocardial infarction (MI), nonfatal stroke, hospitalization due to recurrent ischemia, or urgent coronary revascularization. All MACE events were excluded from this analysis.
    Time Frame
    Up to Day 121
    Secondary Outcome Measure Information:
    Title
    Number of Paticipants Experiencing Thrombolysis in Myocardial Infarction (TIMI) Major, Minor, and Non-TIMI Bleeding Events
    Description
    Major TIMI bleeding was defined as any intracranial bleeding (excluding micohemorrhages <10 mm evident on magnetic resonance imaging [MRI]), clinical over signs of hemorrhge associated with a drop in hemoglobin >=5 g/dL, or fatal bleeding (bleeding that directly results in death within 7 days). Minor TIMI bleeding was defined as any clinically overt bleeding resulting in a hemoglobin drop of 3 to <5 g/dL. Non-TIMI bleeding included all bleeding events not covered under Major TIMI or Minor TIMI bleeding.
    Time Frame
    Up to Day 60
    Title
    Number of Participants With MACE or Death
    Description
    The number of participants experiencing major cardiac events or death was evaluated up to Day 121. Major cardiac events were defined as nonfatal stroke, hospitalization due to recurrent ischemia, or urgent coronary revascularization.
    Time Frame
    Up to Day 121
    Title
    Median High-Sensitivity C-Reactive Protein (Hs-CRP) Levels By Study Visit
    Description
    Participant blood samples were collected to determine the median serum level of hs-CRP. hs-cRP levels reflect the underlying level of inflammation. The higher the level, the greater the disease burden.
    Time Frame
    Up to Day 60
    Title
    Mean CD40 Ligand Levels By Study Visit
    Description
    Participant blood samples were collected to determine the mean serum level of CD40 ligand. CD40 ligand values represent the level of disease activation with a higher level of CD40 ligand indicating a greater underlying risk.
    Time Frame
    Up to Day 60
    Title
    Mean Membrane-Bound P-Selectin Levels By Study Visit
    Description
    Participant blood samples were collected at Baseline, Day 30, and Day 60 to determine the mean level of membrane-bound p-selectin in the serum. Membrane-bound P-selectin levels reflect the underlying level of inflammation. Intensity levels are reported in arbitrary units 0 (dark) to 1023 (bright). Higher values correspond to greater membrane-bound P-Selectin levels.
    Time Frame
    Up to Day 60

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Men and women at least 18 years old with last cerebral infarction (excluding cardiogenic cerebral embolism) having occurred from 14 days to less than 1 year after onset (at the time of obtaining consent), with stable nervous system for more than 24 hours and known course of disease. Participants confirmed to have cerebral infarction lesion by brain computerized tomography (CT) or magnetic resonance imaging (MRI). Both of in-participant and out-participant Willing to give appropriate informed consent and complete all study-related procedures and able to adhere to dosing and visit schedules. Women of child-bearing potential (all postmenopausal women who are <1 year menopausal or who have not had surgical sterilization or a hysterectomy are considered to be women of child-bearing potential) must agree to use a medically accepted method of contraception while receiving protocol-specified study drug, and for 60 days after completion or discontinuation of the medication. Exclusion Criteria: Pregnancy and nursing patients (premenopausal women should have a negative pregnancy test result confirmed before enrollment) Participant with any serious complication or any condition that the investigator feels that would cause a significant hazard to the participant if the study drug is administered. Known hypersensitivity to any component of the study drug. Participation in a study or use of an investigational study drug within 30 days before obtaining consent. Member of the staff personnel directly involved with this study Family member of the study staff. History of a bleeding diathesis, or evidence of active abnormal bleeding within 30 days before obtaining consent. History of cerebral hemorrhage. Severe hypertension (systolic blood pressure >200 mmHg or diastolic blood pressure >110 mmHg). Major surgery within 2 weeks before obtaining consent. Known platelet count <100,000/mm^3 Participants confirmed to have cerebral bleeding or any causes of cerebral bleeding by brain CT or MRI. Participants with transient ischemic attack (TIA), progressive stroke or cardiogenic cerebral embolism. Known impairment of renal function (serum creatinine >2.0 mg/dL [>176.8 (umol/L]), dysproteinemia, nephrotic syndrome, or other renal disease Active or chronic hepatobiliary system or hepatic disease, or aspartate aminotransferase (GOT) or alanine aminotransferate (GPT) activity more than two times greater than the upper limit of the laboratory normal range. Participants with contraindictation to aspirin. Scheduled to have PCI (peripheral coronary intervention), peripheral interventional event, carotid endarterectomy, intra- and extra- cranial bypass surgery and intravascular surgery (angioplasty) during the study period. Combination therapy with unfractionated heparin, tissue plasminogen activator, urokinase, warfarin, factor Xa inhibitor, direct thrombin inhibitor or antiplatelet agents other than aspirin after obtaining consent, or scheduled to have the above combination therapy. Any serious impairment which would make detection of new ischemic events difficult (eg, bedridden participants, participants with total nursing care, dementia participants, etc.) or consciousness disturbance which may cause aspiration of the study drug.

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    https://www.merck.com/clinical-trials/pdf/ProcedureAccessClinicalTrialData.pdf
    IPD Sharing URL
    http://engagezone.msd.com/ds_documentation.php
    Citations:
    PubMed Identifier
    20947374
    Citation
    Shinohara Y, Goto S, Doi M, Jensen P. Safety of the novel protease-activated receptor-1 antagonist vorapaxar in Japanese patients with a history of ischemic stroke. J Stroke Cerebrovasc Dis. 2012 May;21(4):318-24. doi: 10.1016/j.jstrokecerebrovasdis.2010.09.005. Epub 2010 Oct 14.
    Results Reference
    result
    Available IPD and Supporting Information:
    Available IPD/Information Type
    CSR Synopsis
    Available IPD/Information URL
    http://www.merck.com/clinical-trials/study.html?id=P05005&kw=P05005&tab=access

    Learn more about this trial

    Trial to Assess the Safety of Vorapaxar in Japanese Subjects With Cerebral Infarction (P05005; MK-5348-017)

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