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
About this trial
This is an interventional treatment trial for Cerebral Infarction
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.
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
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)
We'll reach out to this number within 24 hrs