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    Summary
    EudraCT Number:2009-016818-24
    Sponsor's Protocol Code Number:DRONE_C_03668
    National Competent Authority:UK - MHRA
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2010-04-16
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedUK - MHRA
    A.2EudraCT number2009-016818-24
    A.3Full title of the trial
    A Randomized, international, multi-center, open-label study to document optimal timing of initiation of dronedarone TreatmEnt after conversion with loading dose of aMIodarone in patients with perSistent Atrial Fibrillation requiring conversion of AF
    A.3.2Name or abbreviated title of the trial where available
    ARTEMIS AF Loading
    A.4.1Sponsor's protocol code numberDRONE_C_03668
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of Sponsorsanofi aventis
    B.1.3.4CountryFrance
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing support
    B.4.2Country
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationsanofi-aventis Groupe
    B.5.2Functional name of contact pointMedical Information
    B.5.3 Address:
    B.5.3.1Street AddressOne Onslow Street
    B.5.3.2Town/ cityGuildford - Surrey
    B.5.3.3Post codeGU1 4YS
    B.5.3.4CountryUnited Kingdom
    B.5.4Telephone number00441483505515
    B.5.6E-mailuk-medicalinformation@sanofi-aventis.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Multaq
    D.2.1.1.2Name of the Marketing Authorisation holdersanofi aventis
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDRONEDARONE
    D.3.9.1CAS number 141626360
    D.3.9.2Current sponsor codeSR33589B
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number400
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Persistant atrial fibrillation requiring conversion of AF
    E.1.1.1Medical condition in easily understood language
    Atrial Fibrillation
    E.1.1.2Therapeutic area Diseases [C] - Cardiovascular Diseases [C14]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 14.0
    E.1.2Level PT
    E.1.2Classification code 10003658
    E.1.2Term Atrial fibrillation
    E.1.2System Organ Class 10007541 - Cardiac disorders
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective of the study is to evaluate the rate of AF recurrences one month after randomization according to different timings of initiation of dronedarone.
    E.2.2Secondary objectives of the trial
    The secondary efficacy objective is to evaluate the rate of AF recurrences two months after randomization.
    To assess the safety of the change from amiodarone to dronedarone
    To assess dronedarone safety
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    PK sub-study
    Date: 25-Mar-2010 Version 1.
    Objectives: to explore dronedarone and SR35021 (active metabolite) plasma levels according to different timings of initiation and to explore potential PK interaction between dronedarone and amiodarone.


    Pharmacogenetic sub-study, date: 25-Mar-2010, version 1.
    Objective: to investigate allelic variants of drug metabolism enzymes or drug transporters as intrinsic factors associated with PK or pharmacodynamic variability of the development compound.
    E.3Principal inclusion criteria
    Inclusion criteria at screening:
    - Male or female adult aged 18 years or more,
    - Patient with persistent AF for more than 72 hours (documented by an ECG taken within the last 72 hours) for whom cardioversion, anti-arrhythmic treatment and anticoagulation treatment are indicated in the opinion of the Investigator (Note: patient may already be on anticoagulation treatment),
    - Naive of amiodarone treatment in the last three months prior to screening,
    - QTcB < 500 ms on 12-lead ECG,
    - Patient with at least one cardiovascular risk factor (i.e. age > 70, hypertension, diabetes, prior cerebrovascular disease, left atrial diameter ≥ 50 mm),
    - Signed written informed consent.


    Inclusion Criteria: to be checked at randomization
    - Outpatient and Inpatient. (except patients hospitalized during screening period for SAE).
    - Patient in sinus rhythm (Note: if cardioversion is performed on Day 1 prior to randomization, then the patient must be in sinus rhythm for at least one hour before randomization),
    - Patient under effective anticoagulation according to ACC/AHA/ESC AF treatment
    guidelines [18] verified by INR (target > 2).
    INR should be closely monitored after initiating dronedarone in patients
    taking vitamin K antagonist as per their label.
    - QTcB < 500 ms and PR < 280 ms on 12-lead ECG,
    - Patient having received 28 days ± 2 days of amiodarone.

    E.4Principal exclusion criteria
    •Exclusion criteria at screening:
    - Contraindication to oral anticoagulation,
    - Any documented AF episode motivating inclusion in the study after an acute condition known to cause AF (e.g. alcohol intake, thyrotoxicosis, acute infection, pericarditis, pulmonary embolism, cardiac surgery),
    - Patient with permanent AF defined as patients with an AF duration ≥ 6
    months (or duration unknown) and attempts to restore sinus rhythm no
    longer considered by the physician.,
    - Patient with paroxysmal AF in whom cardioversion is not indicated,
    - Bradycardia < 50 beats per minute (bpm) at rest on the 12-lead ECG,
    - Clinically overt congestive heart failure:
    o with New York Heart Association (NYHA) class III and IV heart failure,
    o with LVEF < 35%,
    o or NYHA class II with a recent decompensation requiring hospitalization or referral to a specialized heart failure clinic,
    o as well any patient in unstable hemodynamic conditions.
    - Women of childbearing potential without adequate birth control (e.g. oral contraception or intra-uterine device [IUD]) or not menopaused, not sterile or not hysterectomized,
    - Pregnant women,
    - Breastfeeding women,
    - Previous (2 preceding months) or current participation in another clinical trial with an investigational drug or with an investigational device,
    - Clinically relevant hematologic, underlying hepatobiliary disease, gastrointestinal, pulmonary, endocrinologic, psychiatric, neurological or dermatological disease,
    - Severe hepatic impairment,
    - Severe renal impairment (creatinine clearance < 30 mL/min),
    - Serum potassium <3.5 millimol/liter (mmol/L) (in patients with hypokalemia, potassium deficiency must be corrected before randomization) or > 5.5 mmol/l,
    - Magnesemia < 0.8 mml/l (in patient with hypo-magnesemia, magnesium deficiency must be corrected before randomization),
    - Unstable angina pectoris (ischemic symptoms during the last 7 days) or recent myocardial infarction (MI) (< 6 weeks),
    - First degree family history of sudden cardiac death below age 50 years in the absence of coronary heart disease,
    - Second- or third- degree Atrio-Ventricular block or sick sinus syndrome (except when used in conjunction with a functioning pacemaker),
    - Ongoing potentially severe symptoms when in AF such as angina pectoris, transient ischemic attacks, stroke, syncope, as judged by the investigator,
    - Wolff-Parkinson-White Syndrome,
    - Previous ablation for atrial fibrillation or any planned ablation in the next following 2 months.

    Exclusion criteria to be checked at randomization
    - Bradycardia < 50 bpm on the 12-lead ECG before randomization,
    - Clinically overt congestive heart failure:
    o with New York Heart Association (NYHA) class III and IV heart failure,
    o with LVEF < 35%,
    o or NYHA class II with a recent decompensation requiring hospitalization or referral to a specialized heart failure clinic,
    o as well any patients in unstable hemodynamic conditions.

    - Serum potassium <3.5 millimol/liter (mmol/L) (in patients with hypokalemia, potassium deficiency must have been corrected before randomization) or > 5.5 mmol/l,

    - Magnesemia < 0.8 mml/l (in patient with hypo-magnesemia, magnesium deficiency must have been corrected before randomization)

    - Women of childbearing potential without adequate birth control (e.g. oral contraception or intra-uterine device [IUD]) or not menopaused, not sterile or not hysterectomized,

    - Severe hepatic impairment.

    - Patients with permanent AF defined as patients with an AF duration ≥ 6
    months (or duration unknown) and attempts to restore sinus rhythm no
    longer considered by the physician.



    E.5 End points
    E.5.1Primary end point(s)
    The primary efficacy criterion is the rate of AF recurrences documented by two consecutive scheduled or unscheduled 12-lead ECG or TTEM performed approximately 10 minutes apart.
    E.5.1.1Timepoint(s) of evaluation of this end point
    The primary efficacy criterion is the rate of AF recurrences one month after randomization according to different timings of initiation of dronedarone.
    E.5.2Secondary end point(s)
    The secondary efficacy endpoint is the rate of AF recurrences.
    Secondary safety endpoints
    E.5.2.1Timepoint(s) of evaluation of this end point
    The secondary efficacy endpoint is AF recurrences two months after randomization.
    Bradycardia/tachycardia: from V5 to V10
    Laboratory tests:
    haematology:at V1 and V10.
    creatinine: V1, V7 and V10.
    INR: V1, V2, V3, V4, V5, V7, V8, V9 and V10.
    Thyroid function tests: at V1 and V10
    Hepatic laboratory assessment:V1, V4, V5, V7, V9 and V10.
    ECG parameters: at each visit
    Adverse events, adverse events of special interest (AESIs), SAEs: all along the study.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) Yes
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Information not present in EudraCT
    E.8.2.2Placebo Information not present in EudraCT
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Arm C
    E.8.2.4Number of treatment arms in the trial3
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA84
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Austria
    Estonia
    Finland
    France
    Greece
    Hungary
    Israel
    Italy
    Korea, Republic of
    Netherlands
    Portugal
    Spain
    Switzerland
    Taiwan
    Turkey
    United Kingdom
    E.8.7Trial has a data monitoring committee Yes
    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
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months2
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months2
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero Information not present in EudraCT
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) Information not present in EudraCT
    F.1.1.3Newborns (0-27 days) Information not present in EudraCT
    F.1.1.4Infants and toddlers (28 days-23 months) Information not present in EudraCT
    F.1.1.5Children (2-11years) Information not present in EudraCT
    F.1.1.6Adolescents (12-17 years) Information not present in EudraCT
    F.1.2Adults (18-64 years) Yes
    F.1.3Elderly (>=65 years) Yes
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 600
    F.4.2.2In the whole clinical trial 768
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2010-05-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2010-08-26
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2012-12-14
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
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