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Novel Oral AnticoagulantsNCT05764356

Imapct of bioMarkers on Pharmacodynamics and Bleeding Risk of Direct Oral AntiCoagulants and Ticagrelor Study II

An observational study of Novel Oral Anticoagulants and NOACs, run by Peking University First Hospital at 6 sites in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Individual differences in drug efficacy and adverse reactions are common in the clinical application of drugs. Individual differences are caused by many factors, among which genetic factors account for more than 20%. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Novel Oral Anticoagulants, NOACs, Rivaroxaban
What is being tested?
Detection of genotype and RNA profile in platelet and white blood cell, Indicators test related to coagulation function and Indicators test related to platelet function
How many people
2,000 participants
Where
6 sitesChina
Study dates
Mar 2023to Dec 2027
Phase
Observational
Are there results?
Not yet: the study is under way

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: Chinese Patients taking NOACs or ticagrelor#In accordance with anticoagulation indications of NOACs or with diagnosis of acute coronary syndrome (ACS)# received NOACs or ticagrelor in a month and intend to take NOACs or ticagrelor, or have received NOACs or ticagrelor for more than one week continuously#1000 patients for each cohort (NOACs or ticagrelor).

Who may be able to join

  • Chinese Patients taking NOACs
  • In accordance with anticoagulation indications of NOACs, include prevention of thrombosis in non valvular atrial fibrillation, prevention and treatment of deep vein thrombosis / pulmonary embolism and prevention of thrombosis after knee / hip replacement;
  • More than 18 years of age, male or female;
  • Never received NOACs in a month and intend to take NOACs or have received NOACs for more than one week continuously;
  • sign informed consent.
  • Chinese Patients taking ticagrelor
Show all 10Show fewer
  • With diagnosis of acute coronary syndrome (ACS), included unstable angina, non ST segment elevation myocardial infarction and ST segment elevation myocardial infarction;
  • More than 18 years of age, male or female;
  • Never received ticagrelor in a month and intend to take ticagrelor or have received ticagrelor for more than one week continuously#
  • sign informed consent.

Who cannot join

  • With history of immunodeficiency disease, including positive HIV index;
  • Positive Hepatitis B surface antigen (HBsAg) and HCV index;
  • Combined therapy of CYP3A4 strong inhibitors and P-gp inhibitors (e.g., systemic pyrrole antifungal agents such as ketoconazole, itraconazole, voriconazole and posaconazole; human immunodeficiency virus (HIV) - protease inhibitors such as ritonavir), CYP3A4 strong inducers and P-gp inducers (e.g., rifampicin, phenytoin, phenobarbital, carbamazepine, St. John's Wort, etc.) in 14 days before treatment with NOACs;
  • Severe liver dysfunction and abnormal renal function;
  • Include contraindications of antithrombosis, such as hypersensitivity, active bleeding, moderate or severe liver disease, previous history of intracranial hemorrhage, gastrointestinal hemorrhage in the past 6 months and major operation within 30 days.

Trial locations and contacts

6 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Qian Xiang, Dr. contact

+86-18610260623

xiangqz@pkufh.com

6 sites in 1 country

China6 sites
  • Peking University First Hospital

    Beijing, Beijing Municipality

    Qian Xiang, PhD, +86-18610260623, xiangqz@pkufh.com

  • The Second Affiliated Hospital Of Chongqing Medical University

    Chongqing, Chongqing Municipality

    Na Wang, MS, +86-13594036081, 182429490@qq.com

  • Anhui Provincial Hospital#The First Affiliated Hospital Of USTC#

    Hefei, Anhui

    Zhaoyi Yang, PhD, +86551-62283379 ext. 800, young2382@163.com

  • Renji Hospital, School of Medicine, Shanghai Jiao Tong University

    Shanghai, Shanghai Municipality

    Mangmang Pan, MS, panmangmang@renjj.com

  • Zhongshan Hospital FuDan University

    Shanghai, Shanghai Municipality

    Xiaoyu Li, +8621-64041990 ext. 5062, li.xiaoye@zs-hospital.sh.cn

  • The 7th People's Hospital of Zhengzhou

    Zhengzhou, Henan

    Dongdong Yuan, MS, +86371-89905878, 44676878@qq.com

Other trials in China

About this study

Official title: Imapct of bioMarkers on Pharmacodynamics and Bleeding Risk of Direct Oral AntiCoagulants and Ticagrelor Study II (IMPACT 2)

Individual differences in drug efficacy and adverse reactions are common in the clinical application of drugs. Individual differences are caused by many factors, among which genetic factors account for more than 20%. Novel oral anticoagulant drugs (NOACs, including rivaroxaban, apixaban, edoxaban, dabigatran, etc.) and novel antiplatelet drug ticagrelor have the advantages of convenient use and no need for monitoring. But novel oral antithrombotic drugs also increase the risk of bleeding, and there is currently a lack of effective antagonists when antithrombosis is excessive or emergency surgery is required. At present, there are few studies on the causes of individual differences in novel antithrombotic drugs, and there is a lack of predictable biomarkers or drug genotypes, especially in China. Therefore, on the basis of previous studies on NOACs and ticagrelor individualized medication cohorts, this study plans to establish a validation cohort for novel antithrombotic drugs bleeding related biomarkers, conduct multi-omics testing and long-term follow-up, and explore markers related to pharmacodynamics of antithrombotic drugs, adverse bleeding reactions and clinical outcomes.

Being tested
Detection of genotype and RNA profile in platelet and white blood cell, Indicators test related to coagulation function, Indicators test related to platelet function
Medical subject headings
Hemorrhage

What participants receive

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

  • Detection of genotype and RNA profile in platelet and white blood cellGenetic

    Detection of genotype by next generation sequencing Detection of RNA profile in platelet and white blood cell by RNA sequencing

  • Indicators test related to coagulation functionOther

    Indicators test including prothrombin time (PT), activated partial thrombin time (APTT), thrombin time (TT), diluted TT (dTT), snake vein enzyme coagulation time (ECT), anti-XA or IIa activity, etc.

  • Indicators test related to platelet functionOther

    Indicators test related to platelet function. Platelet reactivity was measured by VASP. Platelet aggregation rate was measured by turbidimetric method. Platelet and fibrinolytic function were measured by thrombologram, etc.

Study groups in NCT05764356
Study groupRoleWhat they receive
Novel oral anticoagulants cohortNot described
Receives: Genetic: Detection of genotype and RNA profile in platelet and white blood cell; Other: Indicators test related to coagulation function
Ticagrelor cohortNot described
Receives: Genetic: Detection of genotype and RNA profile in platelet and white blood cell; Other: Indicators test related to platelet function

What is being measured

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

  1. Incidence of new bleeding events

    During the observation time, record the incidence of new bleeding events after NOACs(rivaroxaban, apixaban, edoxaban, dabigatran) or ticagrelor administration by telephone and out-patient clinic, including subcutaneous bleeding, gingival bleeding, gastrointestinal bleeding, intracranial hemorrhage, etc.

    Measured: Within 1 month after enrollment

  2. Incidence of new bleeding events

    During the observation time, record the incidence of new 'bleeding events after NOACs(rivaroxaban, apixaban, edoxaban, dabigatran) or ticagrelor administration by telephone and out-patient clinic, including subcutaneous bleeding, gingival bleeding, gastrointestinal bleeding, intracranial hemorrhage, etc.

    Measured: From 1 month to 6 months after enrollment

  3. Incidence of new bleeding events

    During the observation time, record the incidence of new bleeding events after NOACs(rivaroxaban, apixaban, edoxaban, dabigatran) or ticagrelor administration by telephone and out-patient clinic, including subcutaneous bleeding, gingival bleeding, gastrointestinal bleeding, intracranial hemorrhage, etc.

    Measured: From 6 months to 1 year after enrollment

  4. Incidence of new bleeding events

    During the observation time, record the incidence of new bleeding events after NOACs(rivaroxaban, apixaban, edoxaban, dabigatran) or ticagrelor administration by telephone and out-patient clinic, including subcutaneous bleeding, gingival bleeding, gastrointestinal bleeding, intracranial hemorrhage, etc.

    Measured: From 1 year to 2 years after enrollment

  5. Incidence of new major cardiovascular events and all-cause death

    During the observation time, record the new incidence of major cardiovascular events (MACEs) and all-cause death after NOACs(rivaroxaban, apixaban, edoxaban, dabigatran) or ticagrelor administration by telephone and out-patient clinic. MACEs including cardiac death, myocardial infarction (MI), stroke or transient cerebral thrombus (TIA), ischemic-driven coronary revascularization(PCI, CABG, thrombolysis, etc.), etc.

    Measured: Within 1 month after enrollment

  6. Incidence of new major cardiovascular events and all-cause death

    During the observation time, record the new incidence of major cardiovascular events (MACEs) and all-cause death after NOACs(rivaroxaban, apixaban, edoxaban, dabigatran) or ticagrelor administration by telephone and out-patient clinic. MACEs including cardiac death, myocardial infarction (MI), stroke or transient cerebral thrombus (TIA), ischemic-driven coronary revascularization(PCI, CABG, thrombolysis, etc.), etc.

    Measured: From 1 month to 6 months after enrollment

  7. Incidence of new major cardiovascular events and all-cause death

    During the observation time, record the new incidence of major cardiovascular events (MACEs) and all-cause death after NOACs(rivaroxaban, apixaban, edoxaban, dabigatran) or ticagrelor administration by telephone and out-patient clinic. MACEs including cardiac death, myocardial infarction (MI), stroke or transient cerebral thrombus (TIA), ischemic-driven coronary revascularization(PCI, CABG, thrombolysis, etc.), etc.

    Measured: From 6 months to 1 year after enrollment

  8. Incidence of new major cardiovascular events and all-cause death

    During the observation time, record the new incidence of major cardiovascular events (MACEs) and all-cause death after NOACs(rivaroxaban, apixaban, edoxaban, dabigatran) or ticagrelor administration by telephone and out-patient clinic. MACEs including cardiac death, myocardial infarction (MI), stroke or transient cerebral thrombus (TIA), ischemic-driven coronary revascularization(PCI, CABG, thrombolysis, etc.), etc.

    Measured: From 1 year to 2 years after enrollment

  9. Incidence of new thromboembolic events

    During the observation time, record the incidence of new thromboembolic events after NOACs(rivaroxaban, apixaban, edoxaban, dabigatran) or ticagrelor administration by telephone and out-patient clinic, including stroke or TIA, systemic embolism (SE), deep vein thrombosis (DVT), pulmonary embolism, left auricular thrombus, stent thrombosis, stent stenosis and stent endothelial hyperplasiastent, etc.

    Measured: Within 1 month after enrollment

  10. Incidence of new thromboembolic events

    During the observation time, record the incidence of new thromboembolic events after NOACs(rivaroxaban, apixaban, edoxaban, dabigatran) or ticagrelor administration by telephone and out-patient clinic, including stroke or TIA, systemic embolism (SE), deep vein thrombosis (DVT), pulmonary embolism, left auricular thrombus, stent thrombosis, stent stenosis and stent endothelial hyperplasiastent, etc.

    Measured: From 1 month to 6 months after enrollment

  11. Incidence of new thromboembolic events

    During the observation time, record the incidence of new thromboembolic events after NOACs(rivaroxaban, apixaban, edoxaban, dabigatran) or ticagrelor administration by telephone and out-patient clinic, including stroke or TIA, systemic embolism (SE), deep vein thrombosis (DVT), pulmonary embolism, left auricular thrombus, stent thrombosis, stent stenosis and stent endothelial hyperplasiastent, etc.

    Measured: From 6 months to 1 year after enrollment

  12. Incidence of new thromboembolic events

    During the observation time, record the incidence of new thromboembolic events after NOACs(rivaroxaban, apixaban, edoxaban, dabigatran) or ticagrelor administration by telephone and out-patient clinic, including stroke or TIA, systemic embolism (SE), deep vein thrombosis (DVT), pulmonary embolism, left auricular thrombus, stent thrombosis, stent stenosis and stent endothelial hyperplasiastent, etc.

    Measured: From 1 year to 2 years after enrollment

Secondary outcomes (4)
  1. Genotype detected by next generation sequencing

    Collect blood specimen before NOACs administration, then detect genotype of NOACs by next generation sequencing.

    Measured: Through study completion, collection only once

  2. Expression level of RNA in platelet and white blood cell

    Before and after NOACs or ticagrelor administration, detect the expression level of RNA in platelet and white blood cell .

    Measured: NOACs: Once each before administration, before and after administration at stable concentration (at least 48h for rivaroxaban, 72h for apixaban or edoxaban). Ticagrelor: Once before administration and once after stable concentration (at least 48h).

  3. Anticoagulantion activity evaluation (for NOACs only)

    Before and after NOACs administration, record anti-factor Xa activity(for rivaroxaban, apixaban, edoxaban) or anti-factor IIa activity (for dabigatran only) detected by blood coagulation tests.

    Measured: Once each before administration, before and after administration at stable concentration (at least 48h for rivaroxaban, 72h for apixaban or edoxaban) .

  4. Platelet reactivity evaluation (for Ticagrelor only)

    Before and after ticagrelor administration, record PRI detected by one or more following methods: 1)LTA; 2)VASP ELISA test; 3)TEG.

    Measured: Once before administration and once after stable concentration.

Timeline

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

  1. First posted10 Mar 2023
  2. Study startMar 2023 (estimated)
  3. Primary completionDec 2026 (estimated)
  4. Study completionDec 2027 (estimated)

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
Cohort
Time perspective
Prospective
Enrolment
2,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05764356
Sponsor's protocol ID
2022CR67
Status last verified
Mar 2023
First submitted
16 Feb 2023
Last updated
10 Mar 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

An observational study of Novel Oral Anticoagulants and NOACs, run by Peking University First Hospital at 6 sites in China.

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 10 inclusion and 5 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: opening soon, as of the sponsor's last update on 10 Mar 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in China. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Qian Xiang, Dr. (+86-18610260623, xiangqz@pkufh.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of new bleeding events (time frame: Within 1 month after enrollment). The study lists 12 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 10 Mar 2023.

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