Clinical trial NCT02687399: Determine the Efficacy of TT-173. Reducing the the Total Blood Loss Associated With Total Knee Arthroplasty (HESTAT)
Official title: A Phase II/III, Randomized, Controlled, Single Blind Study to Evaluate the Haemostatic Efficacy and Safety of Topically Applied TT-173 in Patients Undergoing Knee Arthroplasty
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE2
PHASE3
Conditions: Degenerative Osteoarthritis
Keywords: knee arthroplasty
Lead sponsor: Thrombotargets Europe S.L
Sponsor class: INDUSTRY
First posted: 2016-02-22
Enrollment: 210
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to determine the haemostatic efficacy of TT-173, reducing the total blood loss associated with the total knee arthroplasty.

Detailed description: As the TT-173 has been cleared for use as a topical hemostatic agent, the proposed study will further investigate the safety and efficacy of TT-173 in the knee arthroplasty.

Eligibility criteria: Inclusion Criteria:

1. Patients who signed the informed consent.
2. Patients affected of degenerative osteoarthritis of the knee that have to undergo a primary total knee replacement.
3. Patients of both sexes older than 18 years.
4. Female patients in childbearing age\* that are not permanently sterile, should present a negative pregnancy test and should agree to use a medically accepted anti contraceptive method during its participation in the study. This includes oral, intravaginal, transdermal, injectable or implantable hormonal contraceptives, sexual abstinence, bilateral tubal occlusion, intrauterine hormone-releasing system or dispositive and vasectomy of the partner.

   \* Includes the period between menarche and until becoming post-menopausal. A woman is considered post-menopausal when she has gone without a period for 12 consecutive months.
5. Patients must have a haemoglobin concentration ≥ to 12.5 g/dL at the selection visit.

Exclusion Criteria:

1. Patients affected of any kind of congenital or acquired coagulopathies or with personal history of abnormal haemorrhagic episodes.
2. Patients subjected to knee replacement due to rheumatoid or seronegative arthritis, infection or other autoimmune inflammatory causes of join degeneration.
3. Patients subjected to revision procedures of the knee, hemiarthroplasty or that will receive non-cemented knee prosthesis.
4. Subjects affected of a serious medical condition that would compromise their clinical outcome such as hepatic, respiratory, cardiac or renal insufficiency, acute infectious disease and active cancer.
5. Subjects with known history of haematological alterations which are causative of thrombophilia.
6. Subjects with personal history of deep vein thrombosis, pulmonary thromboembolism, retinal vascular occlusion or multiple abortions.
7. Subjects with known hypersensitivity or allergy to any component of the drug.
8. Subjects that are currently under treatment with anticoagulant, antiplatelet or antifibrinolytic drugs. These subjects may be eligible if the treatment is stopped preoperatively according with the conditions indicated in section 9.2.
9. Subjects who have received treatment (erythropoietin, iron, folate) to improve preoperative anaemia.
10. Subjects who are not free to give informed consent or who are mentally incapacitated to the discretion of investigators.
11. Subjects who participate or have participated in the past three months in another clinical trial with drug treatment.
12. Subjects that are the investigators, collaborators, nurses, centre employees or any other person directly related to the development of the protocol.
13. Subjects who are pregnant or lactating.

Primary outcomes:
measure: total blood loss
timeFrame: 2 day
Secondary outcomes:
measure: Maximum decrease in venous haemoglobin concentration
timeFrame: 2 day
measure: Blood collected in the drainage
timeFrame: 1 day
measure: Transfusion rate
timeFrame: 35 days
measure: Number of units of blood concentrates transfused
timeFrame: 35 days
measure: Range of knee motion (Knee flexion and extension)
timeFrame: 35 days
measure: Systemic absorption (detectable increase of TF blood concentration at any time of the pharmacokinetics sampling)
timeFrame: 15 days
measure: Immunogenicity (detectable increase of reactive antibodies against the product )
timeFrame: 35 days
Other outcomes:
Locations:
city: Castelldefels
country: Spain
facility: Thrombotargets Europe SL
state: Barcelona
Study officials:
affiliation: Thrombotargets Europe
name: Santiago Rojas
role: STUDY_DIRECTOR
References:
citation: Lopez-Lopez J, Jane-Salas E, Santamaria A, Gonzalez-Navarro B, Arranz-Obispo C, Lopez R, Miquel I, Arias B, Sanchez P, Rincon E, Rodriguez JR, Rojas S, Murat J. TETIS study: evaluation of new topical hemostatic agent TT-173 in tooth extraction. Clin Oral Investig. 2016 Jun;20(5):1055-63. doi: 10.1007/s00784-015-1586-1. Epub 2015 Sep 15.
citation: Gonzalez-Osuna A, Videla S, Canovas E, Urrutia G, Rojas S, Lopez R, Murat J, Aguilera X. HESTAT: Study protocol for a phase II/III, randomized, placebo-controlled, single blind study to evaluate the new hemostatic agent TT-173 in total knee arthroplasty. Contemp Clin Trials. 2017 Oct;61:16-22. doi: 10.1016/j.cct.2017.07.004. Epub 2017 Jul 4.