Clinical trial NCT00839826: ODiXahip - a Phase IIa Dose Escalating Proof of Principle Trial
Official title: Oral Direct Factor Xa Inhibitor BAY 59-7939 in the Prevention of VTE in Patients Undergoing Total Hip Replacement. ODiXahip - a Phase IIa Dose Escalating Proof of Principle Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Thromboembolism
Prevention
Keywords: Prevention of Thromboembolism after total hip replacement
Lead sponsor: Bayer
Sponsor class: INDUSTRY
First posted: 2009-02-10
Enrollment: 641
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: Patients undergoing surgery, especially hip and knee surgery, are at high risk for VTE (up to 60 % without prophylaxis). The administration of drugs for thromboprophylaxis, such as heparins, significantly lowers that risk, but heparins have to be applied below the skin (subcutaneously). Additionally, there is a chance of developing a heparin-induced thrombocytopenia (decrease in platelets). Therefore, there is still a need for new agents which are safer and more efficient and which are easier to apply.The purpose of this study is to compare the safety and efficacy of BAY 59-7939 with the safety and efficacy of the licensed drug Enoxaparin. Enoxaparin, a so-called low molecular heparin, is approved and widely used in the area of thromboprophylaxis and will be given once daily subcutaneously.Another important purpose of the study is to find the optimal dose of BAY 59-7939 for thromboprophylaxis after hip replacement surgery. Therefore, there are several dose steps planned.


Eligibility criteria: 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.

Exclusion Criteria:

* DVT or PE within the previous 6 months prior to study entry.
* Myocardial infarction (MI) or cerebrovascular attack (CVA), TIA or ischaemic stroke within the last 6 months prior to study entry.
* History of heparin-induced thrombocytopenia, allergy to heparins.
* Intracerebral or intraocular bleeding within the last 6 months prior to study entry.
* 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
* Amputation of one leg.Related to current symptoms or findings
* Heart insufficiency NYHA III-IV.
* Congenital or acquired haemorrhagic diathesis (PT INR/aPTT not within normal limits).
* Thrombocytopenia (platelets \< 50.000/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).
* 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

  * Therapy with oral anticoagulants (e.g. phenprocoumon, warfarin-sodium).
  * Therapy with acetylic salicylic acid or other thrombocyte aggregation inhibitors (e.g. clopidogrel, dipyridamole and ticlopidine) should be stopped one week before enrolment
  * Treatment with heparins or Factor Xa Inhibitors other than study medication.
  * All other drugs influencing coagulation, (exception: NSAIDs with half life \< 17 hrs will be allowed).

Primary outcomes:
measure: 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 5 - 9 days after surgery.
timeFrame: Assymptomatic DVT will be measured 5-9 days after surgery Symptomatc DVT , non-fatal PE and Death from all causes will be measured 41 days after surgery
Secondary outcomes:
measure: Incidence of DVTs (total, proximal, distal)
timeFrame: will be evaluated 5 - 9 days after surgery.
measure: Incidence of symptomatic VTEs
timeFrame: 41 days after surgery
measure: The composite endpoint that results from the primary endpoint by using alternative definition of deaths (i.e. VTE related death)
timeFrame: 41 days after surgery
measure: Incidence of symptomatic VTEs (total, PE, DVT) within 30 days after stop of treatment with the study drug.
timeFrame: 41 days after surgery
Other outcomes:
Locations:
city: Wiener Neustadt
country: Austria
state: Niederösterreich
city: Linz
country: Austria
state: Oberösterreich
city: Wien
country: Austria
city: Baudour
country: Belgium
city: Bruxelles
country: Belgium
city: Gent
country: Belgium
city: HUY
country: Belgium
city: Hellerup
country: Denmark
city: Herlev
country: Denmark
city: Hørsholm
country: Denmark
city: Silkeborg
country: Denmark
city: Amiens
country: France
city: Lille Cedex
country: France
city: Nancy
country: France
city: Rheinfelden
country: Germany
state: Baden-Württemberg
city: Fürth
country: Germany
state: Bayern
city: Garmisch-Partenkirchen
country: Germany
state: Bayern
city: Frankfurt
country: Germany
state: Hessen
city: Frankfurt
country: Germany
state: Hessen
city: Dresden
country: Germany
state: Sachsen
city: Berlin
country: Germany
city: Haifa
country: Israel
city: Tel Aviv
country: Israel
city: Tel Hashomer
country: Israel
city: Zerifin
country: Israel
city: Amersfoort
country: Netherlands
city: Zwolle
country: Netherlands
city: Notodden
country: Norway
city: Oslo
country: Norway
city: Rjukan
country: Norway
city: Bialystok
country: Poland
city: Gdansk
country: Poland
city: Krakow
country: Poland
city: Lodz
country: Poland
city: Lublin
country: Poland
city: Lublin
country: Poland
city: Warszawa
country: Poland
city: Göteborg
country: Sweden
city: Jönköping
country: Sweden
city: Kungälv
country: Sweden
city: London
country: United Kingdom
state: Greater London
Study officials:
affiliation: Bayer
name: Bayer Study Director
role: STUDY_DIRECTOR
References: