E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Deep Venous Thrombosis prophylaxis |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 7.0 |
E.1.2 | Classification code | 10012108 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The objective of this dose-ranging trial is to assess the efficacy and safety of BAY 59-7939 5 mg – 40 mg once daily dosing in prevention of VTE in men and in postmenopausal women aged 18 years or above undergoing elective primary total hip replacement. Population pharmacokinetics and pharmacodynamics (Factor Xa activity, PT, PT INR, aPTT and HepTest) will also be assessed. |
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E.2.2 | Secondary objectives of the trial | |
E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
- Male patients aged 18 years or above and postmenopausal female patients. - Patients scheduled for elective primary total hip replacement (cemented or non-cemented prosthesis). - Patients’ written informed consent for participation after receiving detailed written and oral previous information to any study specific procedures.
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E.4 | Principal exclusion criteria |
Related to medical history -DVT or PE within the previous 6 month prior to study entry. -Myocardial infarction (MI) or TIA or ischaemic stroke within the last 6 months prior to randomisation. - History of heparin-induced thrombocytopenia, allergy to heparins. - Intracerebral or intraocular bleeding within the last 6 months prior to randomisation. - History of gastrointestinal disease with gastrointestinal bleeding within the last 6 months prior to the study . - History or presence of gastrointestinal disease which could result in an impaired absorption of the study drug (e.g. severe active inflammatory bowel disease, short gut syndrome). - Amputation of one leg. Related to current symptoms or findings - Heart insufficiency NYHA class III-IV. - Congenital or acquired haemorrhagic diathesis (PT INR/aPTT not within normal limits) including patients with acquired or congenital thrombopathy. - Thrombocytopenia (platelets < 100.000/µl). - Macroscopic haematuria. - Allergy to contrast media. - Severe hypertension (SBP > 200mmHg, DBP > 100 mmHg). - Impaired liver function (transaminases > 2 x ULN). - Impaired renal function (serum creatinine > 1.5 x ULN or creatinine clearance < 30 ml/min). - Active malignant disease - Presence of active peptic ulcer or gastrointestinal disease with increased risk of gastrointestinal bleeding. - Body weight < 45 kg. - Drug- or alcohol abuse. Related to current treatment - Patients who cannot stop therapy (in the opinion of the investigator/physician) with anticoagulants (eg phenprocoumon, warfarin-sodium, heparins and factor Xa inhibitors other than study medication) should be excluded from the study. - Fibrinolytic therapy. - Therapy with acetylic salicylic acid or other platelet aggregation inhibitors (e.g. clopidogrel, dipyridamole and ticlopidine) should be stopped one week before enrolment. Patients not able to stop ASA therapy will be excluded. - All other drugs influencing coagulation, (exception: NSAIDs with half life < 17 hrs) will be not allowed during the study treatment period. - Systemic and topical treatment with azole compounds (e.g. ketoconazol, fluconazol, itraconazol) and otherstrong CYP3A4-inhibitors eg HIV-protease inhibitors. Azole compounds and other strong CYP3A4-inhibitors eg HIV-protease should be stopped at least four days before enrolment. - Therapy with another investigational product within 30 days prior start of study.
Miscellaneous - Planned intermittent pneumatic compression during active treatment period. - Planned epidural anaesthesia with indwelling epidural catheter (spinal or epidural anaesthesia without indwelling catheter are allowed). - If traumatic or repeated epidural and spinal puncture occur the patient should be excluded from study. - Concomitant participation in another trial or study.
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy endpoint is a composite endpoint of: - Any DVT (proximal and/or distal) and - Non fatal PE and - Death from all causes. - The primary endpoint will be evaluated 6 - 10 days after surgery (or in case of symptoms indicating VTE). The analysis of the primary efficacy endpoint will be solely based on the assessments made by the Venography and the VTE Adjudication Committees.
Secondary efficacy endpoints are: - Incidence of DVTs (total, proximal, distal) - Incidence of symptomatic VTEs - Incidence of major VTE (ie. Proximal DVT, PE or VTE-related death) - The composite endpoint that results from the primary endpoint by substituting VTE related death for all death - Incidence of symptomatic VTEs (total, PE, DVT) within 30 days after stop of treatment with the study drug. - The analysis of the secondary efficacy endpoints related to VTE will be solely based on the assessments made by the venography and VTE Adjudication committees. Safety Variables - The main safety endpoint is the incidence of major bleeding observed after the first post-operative intake of study drug and not later than 2 days after last intake of study drug. Major bleeding observed before or after this period will be considered separately. - The analysis of the primary safety endpoint will solely be based on the classification made by the Bleeding Adjudication Committee.
Other safety variables are: - Incidence of non-major bleeding (clinically significant and minor bleeding) - Treatment-emergent adverse events - Treatment-emergent serious adverse events - Deaths - Adverse events starting more than 7 days after stop of treatment - Incidence of (prolonged) hospitalisation - Transfusion requirements (heterologous and autologous transfusions). - Amount of blood loss (intraoperative blood loss) - Post-operative volume in drainage - Laboratory parameters.
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Information not present in EudraCT |
E.6.2 | Prophylaxis | Yes |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | Information not present in EudraCT |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | Information not present in EudraCT |
E.6.12 | Pharmacoeconomic | Information not present in EudraCT |
E.6.13 | Others | Information not present in EudraCT |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Information not present in EudraCT |
E.7.1.1 | First administration to humans | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
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E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | Information not present in EudraCT |
E.7.4 | Therapeutic use (Phase IV) | Information not present in EudraCT |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
parallel-group, active comparator controlled |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.2.3.1 | Comparator description |
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E.8.3 |
The trial involves single site in the Member State concerned
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E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 8 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 8 |