Platelet inhibition versus direct oral anticoagulation in patients undergoing percutaneous closure of patent foramen ovale or atrial septal defect

2024-517115-70-00 Protocol NL79578.100.21 Therapeutic exploratory (Phase II) Authorised, recruiting

Start 4 May 2022 · Status Authorised, recruiting · 1 EU/EEA countries · 1 sites · Protocol NL79578.100.21

Overview

Sponsor-declared trial summary

Phase Therapeutic exploratory (Phase II)
Status Authorised, recruiting
Participants planned 52
Countries 1
Sites 1

Patent foramen ovale or atrial septum defect

The goal of the study is to evaluate hemostasis, such as coagulation activation, thrombin generation and platelet reactivity following catheter-based closure of patent foramen ovale or atrial septal defect. Differences between post-procedural regimen (i.e. DAPT and rivaroxaban) will be assessed in the current pilot stu…

Key facts

Sponsor
Sint Antonius Ziekenhuis Stichting
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Cardiovascular Diseases [C14]
Trial duration
4 May 2022 → ongoing
Decision date (initial)
2024-08-15
Transition trial
Yes
Low-intervention
No
Rare-disease indication
No
Vulnerable population
No

External identifiers

EU CT number
2024-517115-70-00
EudraCT number
2021-005788-34

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Therapy

The goal of the study is to evaluate hemostasis, such as coagulation activation, thrombin generation and platelet reactivity following catheter-based closure of patent foramen ovale or atrial septal defect. Differences between post-procedural regimen (i.e. DAPT and rivaroxaban) will be assessed in the current pilot study.

Conditions and MedDRA coding

Patent foramen ovale or atrial septum defect

Regulatory references

Plan to share IPD
No
EU CT numberTitleSponsor
2024-514194-22-00 Platelet inhibition versus direct oral anticoagulation in patients undergoing percutaneous closure of patent foramen ovale or atrial septal defect Sint Antonius Ziekenhuis Stichting

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 1

  1. The subject is aged 18 years or older - The subject is scheduled for percutaneous closure of a PFO or ASD as indicated by the treating physician - The subject is able to understand and is willing to provide written informed consent to participate in the trial

Exclusion criteria 1

  1. - Unable or unwilling to return for required follow-up visits - High likelihood of being unavailable for follow-up or psycho-social condition making study participation impractical - Mechanical heart valves or valvular disease requiring surgery or interventional procedure - Ongoing major bleeding or complicated or recent (<72 hours) major surgery - Severe thrombocytopenia (<50.000/ml) - Mitral valve regurgitation grade 3 or more - Aortic valve stenosis (AVA<1.0cm2 or Pmax>50 mmHg) or regurgitation grade 3 or more - Left ventricular ejection fraction <30% - Life expectancy of less than 1 year - Any indication for long-term oral anticoagulation other than presence/closure of a PFO/ASD (such as atrial fibrillation) - Any indication for long-term (dual) antiplatelet therapy other than presence/closure of a PFO/ASD (such as recent coronary stenting) - Contraindication for the use of rivaroxaban or DAPT (e.g. history of intracranial bleeding) in the investigator's opinion - Pregnant or planning to become pregnant during the time of the study - Estimated glomerular filtration rate <50 ml/min/1.73m2 - Use of medication that significantly interacts with rivaroxaban; medication that inhibits cytochrome P450 3A4 or P-glycoprotein (such as ketoconazole, human immunodeficiency virus (HIV) protease inhibitors, clarithromycin, erythromycin and fluconazole) or induces cytochrome P450 3A4 (such as rifampicin and several anti-epileptic drugs).

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. This study will capture the following hemostatic endpoints: • Coagulation activation (e.g. prothrombin fragment 1+2, thrombin antithrombin III complex) • Platelet activation (e.g. P-selectin, CD40 ligand) • Von Willebrand Factor Antigen (VWF Ag) • Beta-thrombglobulin (beta-TG) • Plasminogen activator inhibitor-1 (PAI-1) • D-dimer • Thrombin Generation Test • Anti Xa activity

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Xarelto 20 mg film-coated tablets

PRD2976469 · Product

Active substance
Rivaroxaban
Substance synonyms
BAY59-7939, 5-CHLORO-N-(((5S)-2-OXO-3-(4-(3-OXOMORPHOLIN-4-YL)PHENYL)-1,3-OXAZOLIDIN-5-YL)METHYL)THIOPHENE-2-CARBOXAMIDE, BAY 59-7939, JNJ-39039039
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
660 mg milligram(s)
Max treatment duration
5 Week(s)
Authorisation status
Authorised
ATC code
B01AF01 — -
Marketing authorisation
EU/1/08/472/037
MA holder
BAYER AG
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Comparator 2

Plavix 75 mg film-coated tablets

PRD2912264 · Product

Active substance
Clopidogrel
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Max daily dose
150 mg milligram(s)
Max total dose
25.50 g gram(s)
Max treatment duration
12 Month(s)
Authorisation status
Authorised
ATC code
B01AC04 — CLOPIDOGREL
Marketing authorisation
EU/1/98/069/001
MA holder
SANOFI WINTHROP INDUSTRIE
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Acetylsalicylic Acid

SCP12592488 · ATC

Active substance
Acetylsalicylic Acid
Substance synonyms
ASPIRIN, ACETYLSALICYLIC ACID (ASA), ACIDUM ACETYLSALICYLICUM
Route of administration
ORAL USE
Max daily dose
100 mg milligram(s)
Max total dose
36500 mg milligram(s)
Max treatment duration
5 Week(s)
Authorisation status
Authorised
ATC code
N02BA01 — ACETYLSALICYLIC ACID
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Sint Antonius Ziekenhuis Stichting

Sponsor organisation
Sint Antonius Ziekenhuis Stichting
Address
Koekoekslaan 1
City
Nieuwegein
Postcode
3435 CM
Country
Netherlands

Scientific contact point

Organisation
Sint Antonius Ziekenhuis Stichting
Contact name
Errol Aarnink

Public contact point

Organisation
Sint Antonius Ziekenhuis Stichting
Contact name
Errol Aarnink

Locations

1 EU/EEA country · 1 investigational sites

By country

CountryMS statusPlanned subjectsSites
Netherlands Authorised, recruiting 52 1
Rest of world 0

Investigational sites

Netherlands

1 site · Authorised, recruiting
Sint Antonius Ziekenhuis Stichting
Cardiology, Koekoekslaan 1, 3435 CM, Nieuwegein

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Netherlands 2022-05-04

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 6 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1 Protocol POPular CLOSE redacted 2.3
Recruitment arrangements (for publication) Transition study 1
Subject information and informed consent form (for publication) SIS and ICF_redacted 1.2
Summary of Product Characteristics (SmPC) (for publication) G2 SmPC [clopidogrel] 1
Summary of Product Characteristics (SmPC) (for publication) G2 SmPC [rivaroxaban] 1
Summary of Product Characteristics (SmPC) (for publication) G2 SmPC acetylsalicylic acid 202106

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-08-08 Netherlands Acceptable with conditions
2024-08-15
2024-08-15