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ArteriosclerosisPhase 3NCT00050817

Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA)

A Phase 3 study testing clopidogrel (SR25990) in people with Arteriosclerosis, run by Sanofi at 32 sites in 32 countries.

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

RATIONALE: Atherothrombosis is a progressive and generalized vascular disease resulting in events leading to myocardial infarction (heart attack), stroke, and vascular death. In patients at risk for this disease, it is characterized by an unpredictable, sudden disruption of atherosclerotic plaques, which may lead to… Read more about this study

Who is it for?
Ages 45 years and older
Conditions the study is for
Arteriosclerosis
What is being tested?
clopidogrel (SR25990)
How many people
15,603 participants
Where
32 sitesin 32 countries
Study dates
Oct 2002to Aug 2005
Phase
Phase 3
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 45 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Be at least 45 years old and comply with at least one of the four categories of inclusion criteria:
  • Combination of atherothrombotic risk factors (2 major or 3 minor or 1 major + 2 minor risk factors among those listed below)
  • Major atherothrombotic risk factors
  • Type I or II diabetes (under drug therapy)
  • Diabetic nephropathy
  • Ankle brachial index (ABI) < 0.9
Show all 18Show fewer
  • Asymptomatic carotid stenosis >= 70%
  • At least one carotid plaque as evidenced by intima-media thickness (IMT)
  • Minor atherothrombotic risk factors
  • Systolic blood pressure (SBP) >= 150 mmHg, despite appropriate therapy for at least 3 months
  • Primary hypercholesterolemia
  • Current smoking > 15 cigarettes per day
  • Male >= 65 years
  • Female >= 70 years
  • and/or
  • Documented cerebrovascular disease (TIA or IS within 5 years) and/or
  • Documented coronary artery disease (stable angina with documented multivessel coronary disease, previous documented MI, multivessel PCI or CABG within 1 year, multivessel CABG older than 1 year associated with current angina) and/or
  • Documented symptomatic PAD

Who cannot join

  • Absolute indication for the use of clopidogrel, high-dose aspirin (>162 mg), NSAIDs, or oral anti-thrombotic drugs
  • Absolute contraindication to the use of clopidogrel or aspirin
  • Clinical conditions likely to interfere with follow-up leading to inability to complete the trial

Trial locations and contacts

32 sites in 32 countries.

32 sites in 32 countries

United States1 site
  • The Cleveland Clinic Foundation

    Cleveland, Ohio, 44195

Other trials in United States

Argentina1 site
  • Sanofi-aventis Administrative Office

    Buenos Aires

Other trials in Argentina

Australia1 site
  • Sanofi-aventis Administrative Office

    Macquarie Park

Other trials in Australia

Austria1 site
  • Sanofi-aventis Administrative Office

    Vienna

Other trials in Austria

Belgium1 site
  • Sanofi-aventis Administrative Office

    Diegem

Other trials in Belgium

Brazil1 site
  • Sanofi-aventis Administrative Office

    São Paulo

Other trials in Brazil

Canada1 site
  • Sanofi-aventis Administrative Office

    Laval

Other trials in Canada

Chile1 site
  • Sanofi-aventis Administrative Office

    Santiago

Other trials in Chile

Czechia1 site
  • Sanofi-aventis Administrative Office

    Prague

Other trials in Czechia

Denmark1 site
  • Sanofi-aventis Administrative Office

    Hørsholm

Other trials in Denmark

Finland1 site
  • Sanofi-aventis Administrative Office

    Helsinki

Other trials in Finland

France1 site
  • Sanofi-aventis Administrative Office

    Paris

Other trials in France

Germany1 site
  • Sanofi-aventis Administrative Office

    Berlin

Other trials in Germany

Greece1 site
  • Sanofi-aventis Administrative Office

    Athens

Other trials in Greece

Hong Kong1 site
  • Sanofi-aventis Administrative Office

    Causeway Bay

Other trials in Hong Kong

Hungary1 site
  • Sanofi-aventis Administrative Office

    Budapest

Other trials in Hungary

Italy1 site
  • Sanofi-aventis Administrative Office

    Milan

Other trials in Italy

Malaysia1 site
  • Sanofi-aventis Administrative Office

    Kuala Lumpur

Other trials in Malaysia

Mexico1 site
  • Sanofi-aventis Administrative Office

    México

Other trials in Mexico

Netherlands1 site
  • Sanofi-aventis Administrative Office

    Gouda

Other trials in Netherlands

Norway1 site
  • Sanofi-aventis Administrative Office

    Lysaker

Other trials in Norway

Poland1 site
  • Sanofi-aventis Administrative Office

    Warsaw

Other trials in Poland

Portugal1 site
  • Sanofi-aventis Administrative Office

    Porto Salvo

Other trials in Portugal

Russia1 site
  • Sanofi-aventis Administrative Office

    Moscow

Other trials in Russia

Singapore1 site
  • Sanofi-aventis Administrative Office

    Singapore

Other trials in Singapore

South Africa1 site
  • Sanofi-aventis Administrative Office

    Midrand

Other trials in South Africa

Spain1 site
  • Sanofi-aventis Administrative Office

    Barcelona

Other trials in Spain

Sweden1 site
  • Sanofi-aventis Administrative Office

    Bromma

Other trials in Sweden

Switzerland1 site
  • Sanofi-aventis Administrative Office

    Geneva

Other trials in Switzerland

Taiwan1 site
  • Sanofi-aventis Administrative Office

    Taipei

Other trials in Taiwan

Turkey (Türkiye)1 site
  • Sanofi-aventis Administrative Office

    Istanbul

Other trials in Turkey (Türkiye)

United Kingdom1 site
  • Sanofi-aventis Administrative Office

    Guildford Surrey

Other trials in United Kingdom

About this study

Official title: A Phase III, Multicenter, Multinational, Randomized, Parallel Group, Double-blind Trial of Clopidogrel Versus Placebo in High-risk Patients Aged 45 Years and Older, at Risk of Atherothrombotic Events, and Who Are Receiving Background Therapy Including Low-dose ASA.

RATIONALE:

  • Atherothrombosis is a progressive and generalized vascular disease resulting in events leading to myocardial infarction (heart attack), stroke, and vascular death.
  • In patients at risk for this disease, it is characterized by an unpredictable, sudden disruption of atherosclerotic plaques, which may lead to total occlusion of artery due to formation of a clot. The use of aspirin (blood thinner agent) for reducing those major ischemic events is either indicated, or recommended by international guidelines. However, aspirin fails to prevent a high percentage of such life-threatening events. Therefore, more effective blood thinning therapy may provide additional clinical benefit to such patients.
  • The results of the CURE trial in patients with unstable angina demonstrate the additional benefit of long-term treatment (up to one year) with clopidogrel, (a blood thinner agent), when administered in combination with standard therapy including aspirin. The purpose of CHARISMA is to investigate whether a similar clinical benefit of clopidogrel may apply to a broad population of high-risk patients receiving low-dose aspirin therapy. Such population includes patients with previous cardiovascular, neurovascular or peripheral arterial manifestations of atherothrombosis and patients with combinations of recognized risk factors for atherosclerosis.
Read more

OBJECTIVES:

  • To assess the efficacy of clopidogrel 75 mg once-daily by comparison with a placebo, in preventing cardiovascular morbidity/mortality. The study will compare the efficacy of the two regimens in preventing the occurrence of major cardiovascular complications (stroke, heart attack, cardiovascular death) in high-risk patients who are otherwise receiving low-dose aspirin therapy (75-162 mg daily).
  • To evaluate the safety of clopidogrel in this population, and more specifically the incidence of fatal or severe bleeding (as per GUSTO definition), in order to estimate the global benefit of clopidogrel in this patient population.
Read the detailed description

TREATMENTS:

  • Clopidogrel (Plavix® and/or Iscover®) is an agent inhibiting platelet aggregation involved in clot formation. Each tablet contains 75mg of clopidogrel. A matching placebo of clopidogrel is an inactive substance that looks similar to the active clopidogrel tablet.

TREATMENT PLAN:

  • There will be two treatment groups; one will receive clopidogrel 75 mg (1 tablet qd), the second matching placebo of clopidogrel (1 tablet qd). These study drugs will be administered on top of low-dose aspirin (75-162 mg qd) systematically prescribed to such patients. In addition, patients enrolled in CHARISMA will be managed as appropriate for their risk factors for atherosclerosis: eg. high blood pressure, high cholesterol, diabetes…etc.

PRIMARY ENDPOINT:

  • Combined endpoint of cardiovascular mortality, stroke, acute myocardial infarction.

STUDY EXECUTION:

  • Some 7,600 patients per group will be recruited within two years. Patients will be observed over a maximum of 3.5 years.

STUDY TERRITORY:

  • Approximately 900 sites throughout North/South America, Europe, Asia, Australia, and South Africa.
Being tested
clopidogrel (SR25990)
Keywords
Embolism
Medical subject headings
Arteriosclerosis, Embolism

What participants receive

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

  • clopidogrel (SR25990)Drug

What is being measured

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

  1. Occurrence of myocardial infarction,stroke or cardiovascular death.

Secondary outcomes (1)
  1. severe bleeding

Timeline

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

  1. First posted23 Dec 2002 (estimated)
  2. Study startOct 2002
  3. Study completionAug 2005

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
15,603 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00050817
Sponsor's protocol ID
EFC4505
Status last verified
Apr 2012
First submitted
20 Dec 2002
Last updated
23 Apr 2012
Results posted
No

Publications

  • Bhatt DL, Fox KA, Hacke W, Berger PB, Black HR, Boden WE, Cacoub P, Cohen EA, Creager MA, Easton JD, Flather MD, Haffner SM, Hamm CW, Hankey GJ, Johnston SC, Mak KH, Mas JL, Montalescot G, Pearson TA, Steg PG, Steinhubl SR, Weber MA, Brennan DM, Fabry-Ribaudo L, Booth J, Topol EJ; CHARISMA Investigators. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med. 2006 Apr 20;354(16):1706-17. doi: 10.1056/NEJMoa060989. Epub 2006 Mar 12.

    PubMed 16531616
  • Bhatt DL, Pare G, Eikelboom JW, Simonsen KL, Emison ES, Fox KA, Steg PG, Montalescot G, Bhakta N, Hacke W, Flather MD, Mak KH, Cacoub P, Creager MA, Berger PB, Steinhubl SR, Murugesan G, Mehta SR, Kottke-Marchant K, Lincoff AM, Topol EJ; CHARISMA Investigators. The relationship between CYP2C19 polymorphisms and ischaemic and bleeding outcomes in stable outpatients: the CHARISMA genetics study. Eur Heart J. 2012 Sep;33(17):2143-50. doi: 10.1093/eurheartj/ehs059. Epub 2012 Mar 26.

    PubMed 22450429
  • Natale P, Palmer SC, Saglimbene VM, Ruospo M, Razavian M, Craig JC, Jardine MJ, Webster AC, Strippoli GF. Antiplatelet agents for chronic kidney disease. Cochrane Database Syst Rev. 2022 Feb 28;2(2):CD008834. doi: 10.1002/14651858.CD008834.pub4.

    PubMed 35224730
  • Bangalore S, Bhatt DL, Steg PG, Weber MA, Boden WE, Hamm CW, Montalescot G, Hsu A, Fox KA, Lincoff AM. beta-blockers and cardiovascular events in patients with and without myocardial infarction: post hoc analysis from the CHARISMA trial. Circ Cardiovasc Qual Outcomes. 2014 Nov;7(6):872-81. doi: 10.1161/CIRCOUTCOMES.114.001073. Epub 2014 Sep 30.

    PubMed 25271049
  • Berger PB, Bhatt DL, Fuster V, Steg PG, Fox KA, Shao M, Brennan DM, Hacke W, Montalescot G, Steinhubl SR, Topol EJ; CHARISMA Investigators. Bleeding complications with dual antiplatelet therapy among patients with stable vascular disease or risk factors for vascular disease: results from the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) trial. Circulation. 2010 Jun 15;121(23):2575-83. doi: 10.1161/CIRCULATIONAHA.109.895342. Epub 2010 Jun 1.

    PubMed 20516378
  • Steinhubl SR, Bhatt DL, Brennan DM, Montalescot G, Hankey GJ, Eikelboom JW, Berger PB, Topol EJ; CHARISMA Investigators. Aspirin to prevent cardiovascular disease: the association of aspirin dose and clopidogrel with thrombosis and bleeding. Ann Intern Med. 2009 Mar 17;150(6):379-86. doi: 10.7326/0003-4819-150-6-200903170-00006.

    PubMed 19293071
  • Mak KH, Bhatt DL, Shao M, Haffner SM, Hamm CW, Hankey GJ, Johnston SC, Montalescot G, Steg PG, Steinhubl SR, Fox KA, Topol EJ. The influence of body mass index on mortality and bleeding among patients with or at high-risk of atherothrombotic disease. Eur Heart J. 2009 Apr;30(7):857-65. doi: 10.1093/eurheartj/ehp037. Epub 2009 Feb 20.

    PubMed 19233855
  • Eikelboom JW, Hankey GJ, Thom J, Bhatt DL, Steg PG, Montalescot G, Johnston SC, Steinhubl SR, Mak KH, Easton JD, Hamm C, Hu T, Fox KA, Topol EJ; Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) Investigators. Incomplete inhibition of thromboxane biosynthesis by acetylsalicylic acid: determinants and effect on cardiovascular risk. Circulation. 2008 Oct 21;118(17):1705-12. doi: 10.1161/CIRCULATIONAHA.108.768283. Epub 2008 Oct 6.

    PubMed 18838564
  • Bhatt DL, Flather MD, Hacke W, Berger PB, Black HR, Boden WE, Cacoub P, Cohen EA, Creager MA, Easton JD, Hamm CW, Hankey GJ, Johnston SC, Mak KH, Mas JL, Montalescot G, Pearson TA, Steg PG, Steinhubl SR, Weber MA, Fabry-Ribaudo L, Hu T, Topol EJ, Fox KA; CHARISMA Investigators. Patients with prior myocardial infarction, stroke, or symptomatic peripheral arterial disease in the CHARISMA trial. J Am Coll Cardiol. 2007 May 15;49(19):1982-8. doi: 10.1016/j.jacc.2007.03.025. Epub 2007 Apr 11.

    PubMed 17498584

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing clopidogrel (SR25990) in people with Arteriosclerosis, run by Sanofi at 32 sites in 32 countries.

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 18 inclusion and 3 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 23 Apr 2012. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 32 sites in United States, Argentina, Australia, Austria, Belgium and 27 more countries. 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.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

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?

Occurrence of myocardial infarction,stroke or cardiovascular death.. 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 NCT00050817, which also lists 9 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 23 Apr 2012; AzTrials last refreshed its copy on 6 Nov 2026.

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