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Patients Without a Medical History of Thrombosis or HemorrhageEVIGENCT05422157

Evaluation of the Inter-center Variability of the Measurement of Thrombin Generation by the ST Genesia System

An observational study of Patients Without a Medical History of Thrombosis or Hemorrhage and Hemophilic Patient, run by University Hospital, Clermont-Ferrand at 1 site in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The thrombin generation test is a global test for the study of coagulation that allows the fine study of the balance between procoagulant and anticoagulant factors. For many years, it has been performed in laboratories by semi-automated techniques, sometimes using in-house reagents, which led to a high variability and… Read more about this study

Who is it for?
Ages 18 years and older
How many people
71 participants
Where
1 siteFrance
Study dates
7 Sep 2022to 10 Nov 2023
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patient taken care of at the Clermont-Ferrand University Hospital

Who may be able to join

  • Major patient, male or female
  • Affiliated to a social security system
  • In capacity to express informed consent to participate in research
  • Control group: 5 men, 5 women without oral contraception, 5 women with oral contraception and apparently healthy with a respect to hemostasis (no history of thrombosis or significant bleeding on examination)
  • Hemophilia groups: - 5 hemophiliacs A (treated or untreated), with predictable FVIII:C levels between < 1% and 40%.
  • 5 hemophiliacs B (treated or not), with predictable FIX:C levels between < 1% and 40%.
Show all 15Show fewer
  • FV Leiden group: 5 patients known to be heterozygous or homozygous for the R506Q mutation of the F5 gene (the so-called "Factor V Leiden" mutation)
  • Cirrhosis group: - 5 patients with Child-Pugh A
  • 5 patients with Child-Pugh B
  • 5 patients with Child-Pugh C
  • Anticoagulation group: - 5 patients on anti-vitamin K therapy for at least 1 month, with INR between 2 and 4
  • 5 patients on apixaban for at least 1 week
  • 5 patients on rivaroxaban for at least 1 week
  • 5 patients on dabigatran for at least 1 week
  • 5 patients on low molecular weight heparin for at least 1 day

Who cannot join

  • Refusal to participate
  • Patient under protective measures (guardianship, curatorship) or under judicial protection
  • Minor patients
  • Moderate to end-stage renal failure
  • Proven inflammatory state/infectious syndrome (body temperature > 38°C and/or clinical signs suggestive of infection) during or in the week prior to collection, at the discretion of the investigator
  • Transfusion in the week prior to collection
Show all 22Show fewer
  • Pregnant or breastfeeding woman
  • Contraception by estrogen-progestin, except for the control group concerned
  • Anticoagulation of less than one week, except for the anticoagulation group
  • Control group: - Presence of drug treatment known to interfere with hemostasis
  • Presence of a pathology known to interfere with hemostasis such as renal or hepatic insufficiency
  • Presence of a history of venous thromboembolic disease or diagnosed hemorrhagic disease
  • Predicted inclusion hemoglobin level < 7g/L
  • Hemophilic groups: - Presence of anti FVIII or anti FIX inhibitors
  • Treatment with emicizumab
  • Predicted inclusion hemoglobin level < 7g/L
  • FV Leiden group: - Presence of anticoagulant therapy at the time of collection
  • Predicted baseline hemoglobin < 7g/L
  • Anticoagulation group: - Anticoagulant therapy not stabilized as determined by the practitioner
  • Presence of a therapeutic relaunch in progress
  • Hemoglobin at predicted inclusion < 9-10g/L
  • Cirrhosis group: Predicted inclusion hemoglobin level < 7g/L

Trial locations and contacts

1 site in 1 country.

France1 site
  • CHU clermont-ferrand

    Clermont-Ferrand

Other trials in France

About this study

The thrombin generation test is a global test for the study of coagulation that allows the fine study of the balance between procoagulant and anticoagulant factors. For many years, it has been performed in laboratories by semi-automated techniques, sometimes using in-house reagents, which led to a high variability and did not allow multicenter studies. Recently, an automated device for the evaluation of thrombin generation has been placed on the market (ST-Genesia), allowing a better standardization of the technique. In order to allow multicenter studies, which are essential for the routine positioning of the thrombin generation test, the inter-center variability must be evaluated, as a priority, in the pathologies for which the test is routinely positioned.

Thrombin generation (TG) assays are long-established research tools in hemostasis. They are used for both fundamental and clinical research, but a multiplicity of test methodologies limits the large adoption of TG due to the variability of results despite the attempts to standardize practices.

Read more

Several publications already exist to evaluate its analytical performances, and thereby demonstrate that the test automation also allows its democratization to reach acceptable performances It also enables the evaluation of the device in various indications such as, for example, the evaluation of the effect of direct oral anticoagulants or the evaluation of the risk of breast cancer recurrence.

The confirmation of these anterior results allows further clinical investigations in larger cohorts. However, the absence of interchangeability between the two systems indicates that the results will need to be more rugged through multicenter studies on ST Genesia.

Read the detailed description

A preliminary step in the development of multi-center protocols is to confirm that inter-center variability is acceptable on ST Genesia, and even more acceptable than it was on Calibrated Automated Thrombogram (CAT). Since the variability of the results can be attributed to analytical, pre-analytical and inter-individual biological variabilities, it has been agreed that the evaluation that we will conduct will focus only on the analytical variability and will therefore be carried out on the same samples, collected and prepared in the sponsoring center of the study, and distributed in the form of frozen aliquots to the different co-investigating centers.

The evaluation of this inter-center variability of this new device will allow, if satisfactory, to propose multicenter studies. These are essential in order to position the thrombin generation test in routine in these various promising clinical contexts.

Keywords
Coagulation, Variability, Hemostasis, Thrombin generation
Medical subject headings
Hemorrhage, Thrombosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT05422157
Study groupRoleWhat they receive
ControlNo intervention. Collection of additional blood volume (50 mL) during blood tests provided as part of the usual medical care.
HemophiliaNo intervention. Collection of additional blood volume (50 mL) during blood tests provided as part of the usual medical care.
FV LeidenNo intervention. Collection of additional blood volume (50 mL) during blood tests provided as part of the usual medical care.
CirrhosisNo intervention. Collection of additional blood volume (50 mL) during blood tests provided as part of the usual medical care.
AnticoagulationNo intervention. Collection of additional blood volume (50 mL) during blood tests provided as part of the usual medical care.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Evaluate the inter-center analytical variability of the thrombin generation measurement on ST Genesia, on different types of normo-, hypo- or hyper-coagulable samples.

    Assessing the analytical variability of the thrombin generation measurement on ST Genesia, compared to that observed on CAT, on different groups of patients

    Measured: at the time of inclusion

Secondary outcomes (2)
  1. Assessment of inter-center analytical variability on ST Genesia related to different reagent lots, for centers with multiple reagent lots.

    Measure of the thrombin generation in absolute value

    Measured: at the time of inclusion

  2. Comparing the analytical variability between centers observed on the same samples on the reference system, the Calibrated Automated Thrombogram, for centers also equipped with this device

    Investigate the differences between thrombin generation measurements on CAT and ST genesia

    Measured: at the time of inclusion

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Jun 2022
  2. Study start7 Sep 2022
  3. Primary completion10 Nov 2023
  4. Study completion10 Nov 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
71 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05422157
Sponsor's protocol ID
RNI 2021 LEBRETON 3 (EVIGE)
Other IDs
2021-A01971-40
Acronym
EVIGE
Status last verified
Jul 2024
First submitted
13 Jun 2022
Last updated
12 Jul 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Hemker HC. Recollections on thrombin generation. J Thromb Haemost. 2008 Feb;6(2):219-26. doi: 10.1111/j.1538-7836.2008.02864.x. Epub 2007 Dec 10.

    PubMed 18088345
  • Baglin T. The measurement and application of thrombin generation. Br J Haematol. 2005 Sep;130(5):653-61. doi: 10.1111/j.1365-2141.2005.05612.x.

    PubMed 16115120
  • de Laat-Kremers RMW, Ninivaggi M, Devreese KMJ, de Laat B. Towards standardization of thrombin generation assays: Inventory of thrombin generation methods based on results of an International Society of Thrombosis and Haemostasis Scientific Standardization Committee survey. J Thromb Haemost. 2020 Aug;18(8):1893-1899. doi: 10.1111/jth.14863. Epub 2020 Jun 3.

    PubMed 32319140
  • Dargaud Y, Wolberg AS, Luddington R, Regnault V, Spronk H, Baglin T, Lecompte T, Ten Cate H, Negrier C. Evaluation of a standardized protocol for thrombin generation measurement using the calibrated automated thrombogram: an international multicentre study. Thromb Res. 2012 Dec;130(6):929-34. doi: 10.1016/j.thromres.2012.07.017. Epub 2012 Aug 19.

    PubMed 22909826
  • Perrin J, Depasse F, Lecompte T; French-speaking CAT group and under the aegis of GEHT; French-speaking CAT group (all in France unless otherwise stated):; French-speaking CAT group all in France unless otherwise stated. Large external quality assessment survey on thrombin generation with CAT: further evidence for the usefulness of normalisation with an external reference plasma. Thromb Res. 2015 Jul;136(1):125-30. doi: 10.1016/j.thromres.2014.12.015. Epub 2014 Dec 24.

    PubMed 25563679
  • Calzavarini S, Brodard J, Quarroz C, Maire L, Nutzi R, Jankovic J, Rotondo LC, Giabbani E, Fiedler GM, Nagler M, Angelillo-Scherrer A. Thrombin generation measurement using the ST Genesia Thrombin Generation System in a cohort of healthy adults: Normal values and variability. Res Pract Thromb Haemost. 2019 Jul 18;3(4):758-768. doi: 10.1002/rth2.12238. eCollection 2019 Oct.

    PubMed 31624796
  • Douxfils J, Morimont L, Bouvy C, de Saint-Hubert M, Devalet B, Devroye C, Dincq AS, Dogne JM, Guldenpfennig M, Baudar J, Larock AS, Lessire S, Mullier F. Assessment of the analytical performances and sample stability on ST Genesia system using the STG-DrugScreen application. J Thromb Haemost. 2019 Aug;17(8):1273-1287. doi: 10.1111/jth.14470. Epub 2019 May 31.

    PubMed 31063645
  • Foulon-Pinto G, Jourdi G, Perrin J, Abdoul J, Paris G, Gouin-Thibault I, Curis E, Lecompte T, Siguret V. Study of thrombin generation with St Genesia to evaluate xaban pharmacodynamics: Analytical performances over 18 months. Int J Lab Hematol. 2021 Aug;43(4):821-830. doi: 10.1111/ijlh.13443. Epub 2020 Dec 28.

    PubMed 33369212
  • Mori F, Genuardo C, Nannizzi S, Farina C. Intra- and interassay variations of two thrombin generation methods. Int J Lab Hematol. 2021 Aug;43(4):O218-O220. doi: 10.1111/ijlh.13524. Epub 2021 Mar 24. No abstract available.

    PubMed 33759358
  • Metze M, Pfrepper C, Kloter T, Stobe S, Siegemund R, Siegemund T, Edel E, Laufs U, Petros S. Inhibition of thrombin generation 12 hours after intake of direct oral anticoagulants. Res Pract Thromb Haemost. 2020 Apr 23;4(4):610-618. doi: 10.1002/rth2.12332. eCollection 2020 May.

    PubMed 32548560
  • Gomez-Rosas P, Pesenti M, Verzeroli C, Giaccherini C, Russo L, Sarmiento R, Masci G, Celio L, Minelli M, Gamba S, Tartari CJ, Tondini C, Giuliani F, Petrelli F, D'Alessio A, Gasparini G, Labianca R, Santoro A, De Braud F, Marchetti M, Falanga A; HYPERCAN Investigators. Validation of the Role of Thrombin Generation Potential by a Fully Automated System in the Identification of Breast Cancer Patients at High Risk of Disease Recurrence. TH Open. 2021 Feb 10;5(1):e56-e65. doi: 10.1055/s-0040-1722609. eCollection 2021 Jan.

    PubMed 33585786
  • Talon L, Sinegre T, Lecompte T, Pereira B, Massoulie S, Abergel A, Lebreton A. Hypercoagulability (thrombin generation) in patients with cirrhosis is detected with ST-Genesia. J Thromb Haemost. 2020 Sep;18(9):2177-2190. doi: 10.1111/jth.14963. Epub 2020 Jul 23.

    PubMed 32558351

Questions about this trial

What is this clinical trial studying?

An observational study of Patients Without a Medical History of Thrombosis or Hemorrhage and Hemophilic Patient, run by University Hospital, Clermont-Ferrand at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 15 inclusion and 22 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Evaluate the inter-center analytical variability of the thrombin generation measurement on ST Genesia, on different types of normo-, hypo- or hyper-coagulable samples. (time frame: at the time of inclusion). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05422157, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jul 2024.

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