| E.1 Medical condition or disease under investigation |
| E.1.1 | Medical condition(s) being investigated |
| patients requiring treatment with extracorporeal membrane oxygenation |
|
| E.1.1.1 | Medical condition in easily understood language |
| patients requiring a heart-lung machine |
|
| E.1.1.2 | Therapeutic area | Not possible to specify |
| MedDRA Classification |
| 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 |
| • Safety of Argatroban as anticoagulant in ECMO |
|
| E.2.2 | Secondary objectives of the trial |
• Feasibility of Argatroban as anticoagulant in ECMO (study enrollment, study completion and ability to achieve target values (proportion of coagulation tests within range) • Quantification of bleeding events through need of PRBCs (packed red blood cells during ECMO, average/d; transfusion threshold: Hb<8g/dl) • Grading of bleeding • Venous thrombosis after canula removal (sonsography 24h after canula removal) • Number of patients switched to argatroban (confirmed HIT) • Coagulation studies: o Global clotting tests (aPTT, ACT, PTZ, Thrombin Time (TT), Fibrinogen, D-Dimer) o Platelet-factor-4 (PF4) antibodies o Specific coagulation tests o UFH: AntiXa o Argatroban: Hemoclot Assay, Thrombelastometry (ClotPro)
|
|
| E.2.3 | Trial contains a sub-study | No |
| E.3 | Principal inclusion criteria |
• Minimum Age 18 years • VV- or VA-ECMO therapy • Minimum of 24h planned ECMO-therapy
|
|
| E.4 | Principal exclusion criteria |
• History of Heparin-induced thrombocytopenia (HIT) • High risk of bleeding, contraindication for anticoagulation (eg. active GI-bleeding, Intracerebral bleeding; Platelet count <50G/l, congenital bleeding disorder) • Pregnancy • Severe Liver disease (SOFA score liver domain 4 points = Bilirubin >12mg/dl) • Postoperative admission • Strong lupus anticoagulant or acquired intrinsic clotting factor deficiency at admission (APTT >50 sec without anticoagulation). |
|
| E.5 End points |
| E.5.1 | Primary end point(s) |
• Safety of Argatroban as anticoagulant in ECMO
Assessed by a combined endpoint of bleeding and thrombosis compared to patients receiving unfractionated Heparin (UFH)
|
|
| E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
| E.5.2 | Secondary end point(s) |
• Feasibility of Argatroban as anticoagulant in ECMO (study enrollment, study completion and ability to achieve target values (proportion of coagulation tests within range) • Quantification of bleeding events through need of PRBCs (packed red blood cells during ECMO, average/d; transfusion threshold: Hb<8g/dl) • Grading of bleeding • Venous thrombosis after canula removal (sonsography 24h after canula removal) • Number of patients switched to argatroban (confirmed HIT) • Coagulation studies: o Global clotting tests (aPTT, ACT, PTZ, Thrombin Time (TT), Fibrinogen, D-Dimer) o Platelet-factor-4 (PF4) antibodies o Specific coagulation tests o UFH: AntiXa o Argatroban: Hemoclot Assay, Thrombelastometry (ClotPro)
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| E.5.2.1 | Timepoint(s) of evaluation of this end point |
|
| E.6 and E.7 Scope of the trial |
| E.6 | Scope of the trial |
| E.6.1 | Diagnosis | No |
| E.6.2 | Prophylaxis | No |
| E.6.3 | Therapy | Yes |
| E.6.4 | Safety | Yes |
| E.6.5 | Efficacy | Yes |
| E.6.6 | Pharmacokinetic | No |
| E.6.7 | Pharmacodynamic | No |
| E.6.8 | Bioequivalence | No |
| E.6.9 | Dose response | No |
| E.6.10 | Pharmacogenetic | No |
| E.6.11 | Pharmacogenomic | No |
| E.6.12 | Pharmacoeconomic | No |
| E.6.13 | Others | No |
| E.7 | Trial type and phase |
| E.7.1 | Human pharmacology (Phase I) | No |
| E.7.1.1 | First administration to humans | No |
| E.7.1.2 | Bioequivalence study | No |
| E.7.1.3 | Other | No |
| E.7.1.3.1 | Other trial type description | |
| E.7.2 | Therapeutic exploratory (Phase II) | Yes |
| E.7.3 | Therapeutic confirmatory (Phase III) | No |
| E.7.4 | Therapeutic use (Phase IV) | No |
| E.8 Design of the trial |
| E.8.1 | Controlled | Yes |
| E.8.1.1 | Randomised | Yes |
| E.8.1.2 | Open | Yes |
| E.8.1.3 | Single blind | No |
| E.8.1.4 | Double blind | No |
| E.8.1.5 | Parallel group | No |
| E.8.1.6 | Cross over | No |
| E.8.1.7 | Other | No |
| E.8.2 | Comparator of controlled trial |
| E.8.2.1 | Other medicinal product(s) | Yes |
| E.8.2.2 | Placebo | No |
| E.8.2.3 | Other | No |
| E.8.2.4 | Number of treatment arms in the trial | 2 |
| E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
| E.8.4 | The trial involves multiple sites in the Member State concerned | No |
| E.8.5 | The trial involves multiple Member States | No |
| E.8.6 Trial involving sites outside the EEA |
| E.8.6.1 | Trial being conducted both within and outside the EEA | No |
| E.8.6.2 | Trial being conducted completely outside of the EEA | No |
| E.8.7 | Trial has a data monitoring committee | No |
| 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
|
The sponsor has the right to close this study at any time. The IEC and the competent regulatory authority must be informed within 15 days of early termination. The trial or single dose steps will be terminated prematurely in the following cases: • If adverse events occur which are so serious that the risk-benefit ratio is not acceptable
• If the number of dropouts is so high that proper completion of the trial cannot realistically be expected. |
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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 | 2 |
| E.8.9.1 | In the Member State concerned months | |
| E.8.9.1 | In the Member State concerned days | |