Deep Vein ThrombosisPhase 3NCT00371683
Study of Apixaban for the Prevention of Thrombosis-related Events Following Knee Replacement Surgery
A Phase 3 study of Deep Vein Thrombosis and Pulmonary Embolism, run by Bristol-Myers Squibb at 107 sites in 13 countries.
Trial summary
The purpose of this study is to learn if apixaban can prevent blood clots in the leg (deep vein Thrombosis [DVT]) and lung (pulmonary embolism [PE]) that sometimes occur after knee replacement surgery and to learn how apixaban compares to enoxaparin (Lovenox®) for preventing these clots. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Deep Vein Thrombosis, Pulmonary Embolism
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 3,608 participants
- Where
- 107 sitesin 13 countries
- Study dates
- Nov 2006to May 2008
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
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
Who may be able to join
- Men and non-pregnant, non-breastfeeding women
- 18 years or older
- Scheduled for knee replacement surgery
Who cannot join
- hereditary or acquired bleeding disorders
- clotting disorders
- bleeding or high risk for bleeding
- drugs that affect bleeding or coagulation
- need for ongoing parenteral or oral anticoagulation
Trial locations and contacts
107 sites in 13 countries.
107 sites in 13 countries
United States25 sites
Colorado Orthopedic Consultants, Pc
Aurora, Colorado, 80012
Bay Pines Va Medical Center
Bay Pines, Florida, 33744
Capstone Clinical Trials, Inc
Birmingham, Alabama, 35205
Capstone Clinical Trials, Inc
Birmingham, Alabama, 35209
Americana Orthopedics
Boise, Idaho, 83702
Intermountain Orthopaedics
Boise, Idaho, 83702
Pab Clinical Research
Brandon, Florida, 33511
Charleston Orthopaedic Assocs.
Charleston, South Carolina, 29414
Atlanta Knee And Sports Medicine
Decatur, Georgia, 30033
Colorado Joint Replacement
Denver, Colorado, 80210
Jdpmedical Research
Denver, Colorado, 80230
Orhtopaedic Physicians Of Colorado, P.C.
Englewood, Colorado, 80113
Orthopedics Assocs Of Hartford
Hartford, Connecticut, 06106
Kelsey Seybold Clinic
Houston, Texas, 77025
Bone & Joint Clinic Of Houston
Houston, Texas, 77030
Jacksonville Center For Clinical Research
Jacksonville, Florida, 32216
Bluegrass Orthopaedics/Bmr
Lexington, Kentucky, 40509
Martin Bowen Hefley Orthopedics
Little Rock, Arkansas, 72205
Gill Orthopedic Center
Lubbock, Texas, 79410
Robert R. King, Md
Lubbock, Texas, 79410
Mark W. Hollmann, Md
Orange City, Florida, 32763
Unlimited Research
San Antonio, Texas, 78217
West Alabama Research, Inc.
Tuscaloosa, Alabama, 35406
Anthony S. Unger, Md
Washington D.C., District of Columbia, 20006
Jewett Orthopaedic Clinic
Winter Park, Florida, 32789
Canada20 sites
Local Institution
Ajax, Ontario, L1S 2J5
Local Institution
Burlington, Ontario, L7R 4B7
Local Institution
Cambridge, Ontario, N1R 7L7
Local Institution
Charlottetown, Prince Edward Island, C1A 1L2
Local Institution
Chatham, Ontario, N7L 4T1
Local Institution
Dartmouth, Ontario, B2Y 2N6
Local Institution
Edmonton, Alberta, T6G 2R7
Local Institution
Guelph, Ontario, N1E 6L9
Local Institution
Lindsay, Ontario, K9V 4M8
Local Institution
Montreal, Quebec, H4J 1C5
Local Institution
Newmarket, Ontario, L3Y 5G8
Local Institution
Niagara Falls, Ontario, L2E 6X2
Local Institution
Québec, Quebec, G1L 3L5
Local Institution
Sarnia, Ontario, N7T 6H3
Local Institution
Scarborough Village, Ontario, M1S 4T7
Local Institution
Scarborough Village, Ontario, M3C 1W3
Local Institution
St. Catharines, Ontario, L2R 7P3
Local Institution
Stratford, Ontario, N5A 2N4
Local Institution
Waterloo, Ontario, N2J 1C4
Local Institution
Windsor, Ontario, N8W 1E6
Mexico12 sites
Local Institution
Chihuahua City, Chihuahua, 31000
Local Institution
Ciudad Madero, Tamaulipas, 89240
Local Institution
Df, Mexico City, 01030
Local Institution
Df, Mexico City, 05300
Local Institution
Df, Mexico City, 07760
Local Institution
Guadalajara, Jalisco, 44280
Local Institution
Jalapa, Veracruz, 91020
Local Institution
Mérida, Yucatán, 97070
Local Institution
Mérida, Yucatán, 97133
Local Institution
Monterrey, Nuevo León, 64000
Local Institution
Monterrey, Nuevo León, 64460
Local Institution
Tijuana, Estado de Baja California, 22010
Australia10 sites
Local Institution
Adelaide, South Australia, 5011
Local Institution
Bedford Park, South Australia, 5042
Local Institution
Box Hill, Victoria, 3128
Local Institution
Camperdown, New South Wales, NSW 2050
Local Institution
Caringbah, New South Wales, 2229
Local Institution
Garran, Australian Capital Territory, 2605
Local Institution
Gold Coast, Queensland, 4215
Local Institution
Lismore, New South Wales, 2480
Local Institution
Perth, Western Australia, 6001
Local Institution
Windsor, Victoria, 3181
Israel8 sites
Local Institution
Afula, 18101
Local Institution
Beersheba, 84101
Local Institution
Haifa, 31096
Local Institution
Holon, 58100
Local Institution
Kfar Saba, 44281
Local Institution
Petah Tikva, 49100
Local Institution
Rehovot, 76100
Local Institution
Tsrifin, 70300
Argentina7 sites
Local Institution
Buenos Aires, Buenos Aires, 1280
Local Institution
Buenos Aires, Buenos Aires, 1425
Local Institution
Buenos Aires, Buenos Aires, 7540
Local Institution
Buenos Aires, Buenos Aires, C1181
Local Institution
Capital Federal, Buenos Aires, 1012
Local Institution
Capital Federal, Buenos Aires, 1426
Local Institution
Córdoba, Córdoba Province, 5000
Poland7 sites
Local Institution
Bialystok, 15276
Local Institution
Krakow, 31-826
Local Institution
Lodz, 91002
Local Institution
Lublin, 20954
Local Institution
Szczecin, 71252
Local Institution
Warsaw, 00909
Local Institution
Warsaw, 02005
Brazil5 sites
Local Institution
Campinas, São Paulo, 13083
Local Institution
Curitiba, Paraná, 80060
Local Institution
Porto Alegre, Rio Grande do Sul, 90035
Local Institution
Porto Alegre, Rs, Rio Grande do Sul, 90020
Local Institution
São Paulo, São Paulo, 05403
Turkey (Türkiye)4 sites
Local Institution
Adana, 01330
Local Institution
Bursa, 16059
Local Institution
Mersin, 33163
Local Institution
Trabzon, 61030
Hungary3 sites
Local Institution
Kecskemét, 6000
Local Institution
Székesfehérvár, 8000
Local Institution
Szolnok, 5008
Russia3 sites
Local Institution
Moscow, 117333
Local Institution
Saint Petersburg, 195257
Local Institution
Samara, 443095
Denmark2 sites
Local Institution
Hørsholm, 2970
Local Institution
Kopenhamn S, 2300
About this study
Official title: A Phase 3 Randomized, Double-Blind Active-Controlled (Enoxaparin), Parallel-Group, Multi-Center Study to Evaluate the Safety and Efficacy of Oral Apixaban in Subjects Undergoing Elective Total Knee Replacement Surgery
The purpose of this study is to learn if apixaban can prevent blood clots in the leg (deep vein Thrombosis [DVT]) and lung (pulmonary embolism [PE]) that sometimes occur after knee replacement surgery and to learn how apixaban compares to enoxaparin (Lovenox®) for preventing these clots. The safety of apixaban will also be studied.
- Conditions
- Deep Vein Thrombosis, Pulmonary Embolism
- Being tested
- Enoxaparin + Placebo, Apixaban + Placebo
- Keywords
- Prevention of deep vein thrombosis and pulmonary embolism after total knee replacement surgery
- Medical subject headings
- Venous Thrombosis, Pulmonary Embolism
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Enoxaparin + PlaceboDrug
Also called Lovenox®
Syringes + tablets, Subcutaneous + Oral, 30mg, twice daily, 12 day treatment period
Apixaban + PlaceboDrug
Tablet + Syringes, Oral + subcutaneous, 2.5 mg, twice daily, 12 day treatment period
| Study group | Role | What they receive |
|---|---|---|
| A1 | Active comparator | + placebo Receives: Drug: Enoxaparin + Placebo |
| A2 | Experimental | + placebo Receives: Drug: Apixaban + Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Event Rate of the Composite of Adjudicated Venous Thromboembolism (VTE) Events and All-Cause Death With Onset During the Intended Treatment Period - Primary Subjects
An Independent Central Adjudication Committee (ICAC) adjudicated all venograms, suspected symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE), acute clinically overt bleeding events, suspected thrombocytopenia, suspected acute MI, suspected acute stroke, and cause of death. Event rate was number of participants with the composite endpoint divided by the number of participants analyzed and reported as percentage (%). Surgery=Day 1; Randomization/Treatment started on Day of Surgery or the next day (Day 1 or Day 2). A mandatory bilateral ascending contrast venogram was performed on all participants after 12 days (±2 days) of study treatment. Intended Treatment Period=starts on the day of randomization; for treated participants, the period ends at the latter of 2 days after last dose of study drug or 14 days after the first dose of study drug; for randomized participants who were not treated, the period ends 14 days after randomization.
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With Major Bleeding, Clinically Relevant Non-Major Bleeding, Major or Clinically Relevant Non-Major Bleeding, Any Bleeding With Onset During the Treatment Period - Treated Population
ICAC adjudicated acute clinically overt bleeding events as per International Society on Thrombosis and Hemostasis (ISTH) guidelines modified for surgical patients. Event rate was number of participants with the composite endpoint divided by the number of participants analyzed (%). Clinically relevant (CR); Non-Major (N-M) Bleeding. Day 1=Day of surgery. Treatment started (first dose) day of surgery or next day. Treatment continued for 12 days.
Measured: First dose of study drug to last dose, plus 2 days post last dose
Event Rate for Participants With Major Bleeding, Clinically Relevant (CR) Non-Major (N-M) Bleeding , Major or Clinically Relevant (CR) Non-Major (N-M) Bleeding, Any Bleeding With Onset During the Follow-Up Period
ICAC adjudicated acute clinically overt bleeding events as per International Society on Thrombosis and Hemostasis (ISTH) guidelines modified for surgical patients. Event rate was number of participants with the composite endpoint divided by the number of participants analyzed (%). Follow up Period was from the end of the treatment period (last dose) up to 60 days post last dose, Day 72.
Measured: Last dose of study drug to Day 72 (60 days)
Secondary outcomes (21)
Event Rate of Composite of Adjudicated Proximal DVT, Non-Fatal PE and All-Cause Death With Onset During the Intended Treatment Period PE and All-cause Death During the Intended Treatment Period
A mandatory bilateral ascending contrast venogram was performed on all participants after 12 days (±2 days) of study treatment. An ICAC adjudicated all venograms, suspected proximal DVT and non-fatal PE, and all-cause of death. Event rate was number of participants with the composite endpoint divided by the number of participants analyzed and reported as percentage (%).
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate of Adjudicated VTE / VTE-related Death With Onset During the Treatment Period
VTE / VTE-related death was defined as the combination of fatal or non-fatal PE, and symptomatic or asymptomatic DVT. A mandatory bilateral ascending contrast venogram was performed on all participants after 12 days (±2 days) of study treatment. An ICAC adjudicated all venograms, suspected symptomatic DVT and PE, and cause of death. Event rate was number of participants with the endpoint divided by the number of participant's analyzed (%).
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With Proximal DVT/Non-Fatal PE/ VTE-Related Death With Onset During the Intended Treatment Period
An ICAC adjudicated all venograms, suspected symptomatic DVT and PE, and cause of death. Event rate was number of participants with the endpoint divided by the number of participant's analyzed (%).
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Total Participants With Adjudicated VTE/All-Cause Death With Onset During the Intended Treatment Period
ICAC adjudicated all venograms, suspected symptomatic DVT and PE, and cause of death. Event rate was number of participants with the endpoint divided by the number of participant's analyzed (%).
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Total Participants With VTE/ VTE-Related Death With Onset During the Intended Treatment Period
ICAC adjudicated all venograms, suspected symptomatic DVT and PE, and cause of death. VTE includes DVT and PE. Event rate was number of participants with the endpoint divided by the number of participant's analyzed (%).
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With All-Cause Death During the Intended Treatment Period
Event rate was number of participants with all-cause death divided by the number of participant's analyzed (%).
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With VTE-Related Death With Onset During the Intended Treatment Period
ICAC adjudicated cause of death. Event rate was number of participants with the endpoint divided by the number of participant's analyzed (%).
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With Symptomatic VTE/ All-Cause Death With Onset During the Intended Treatment Period
ICAC adjudicated suspected symptomatic DVT and PE, and cause of death. Event rate was number of participants with the endpoint divided by the number of participant's analyzed (%).
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With Symptomatic VTE/ VTE-Related Death With Onset During the Intended Treatment Period
ICAC adjudicated suspected symptomatic DVT and PE, and cause of death. Event rate was number of participants with the endpoint divided by the number of participant's analyzed (%).
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With VTE/Major Bleeding/All-Cause Death With Onset During the Intended Treatment Period
ICAC adjudicated VTE, acute clinically overt bleeding events, suspected thrombocytopenia, and cause of death. Event rate was number of participants with the composite endpoint divided by the number of participants analyzed (%).
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With PE (Fatal or Non-Fatal), DVT (All, Symptomatic Proximal, and Distal, Asymptomatic) With Onset During the Intended Treatment Period
An ICAC adjudicated all venograms, suspected symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE), acute clinically overt bleeding events, suspected thrombocytopenia, suspected acute MI, suspected acute stroke, and cause of death. Event rate was number of participants with the composite endpoint divided by the number of participants analyzed (%).
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With Proximal DVT, Distal DVT, Asymptomatic Proximal DVT, Asymptomatic Distal DVT With Onset During the Intended Treatment Period
ICAC adjudicated all venograms and suspected symptomatic DVT. Event rate was number of participants with the endpoint divided by the number of participant's analyzed (%).
Measured: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With Adjudicated Myocardial Infarction (MI) Acute Ischemic Stroke and Thromboembolic Events With Onset During the Treatment Period
ICAC adjudicated acute clinically overt bleeding events, suspected thrombocytopenia, suspected acute MI, suspected acute stroke per International Society on Thrombosis and Hemostasis (ISTH) guidelines modified for surgical patients. Event rate was number of participants with the composite endpoint divided by the number of participants analyzed (%).
Measured: From first dose to last dose, plus 2 days (12 days, plus 2)
Event Rate of Adjudicated MI, Stroke, and Thrombocytopenia Events During the Follow-Up Period
A 60-day follow-up period started after the last dose of study drug and continued until the End of Study Visit on Day 72 (60 days ± 3 days, after the last dose of study drug). Event rate was number of participants with the endpoint divided by the number of participants analyzed (%). ICAC adjudicated acute clinically overt bleeding events, suspected thrombocytopenia, suspected acute MI, suspected acute stroke per ISTH guidelines modified for surgical patients.
Measured: Post last dose of study drug to Day 72 (60 days)
Number of Participants With Serious Adverse Events (SAEs), Bleeding Adverse Events (AEs), AEs Leading to Discontinuation, and Deaths - Treated Population
AE=any new unfavorable symptom, sign, or disease or worsening of a preexisting condition that may not have a causal relationship with treatment. SAE=a medical event that at any dose results in death, persistent or significant disability/incapacity, or drug dependency/abuse; is life-threatening, an important medical event, or a congenital anomaly/birth defect; or requires or prolongs hospitalization.
Measured: First dose to last dose, plus 2 days for AEs (12 + 2 days) or plus 30 days for SAEs (12 + 30 days)
Mean Change From Baseline in Systolic and Diastolic Blood Pressure During the Treatment Period
Treatment Period=the period from first dose of study drug through 2 days after discontinuation of study drug (12 + 2 days). Baseline=measurement prior to first dose of study drug. Blood pressures (BP) were measured during screening (pre-operative, post-operative) and in the treatment period on Days 1 (day of first dose), 2, 3, 4,12 (end of treatment). Systolic and diastolic pressures were measured in millimeters of mercury (mmHg).
Measured: Baseline to last dose of study drug, plus 2 days
Mean Change From Baseline in Heart Rate During the Treatment Period
Treatment Period=the period from first dose of study drug through 2 days after discontinuation of study drug (12 + 2 days). Baseline=measurement prior to first dose of study drug. Heart rate was measured during screening (pre-operative, post-operative) and in the treatment period on Days 1 (day of first dose), 2, 3, 4,12 (end of treatment). Heart rate was measured in beats per minute (bpm).
Measured: Baseline to last dose of study drug, plus 2 days
Number of Participants With Hematology Laboratory Marked Abnormality During the Treatment Period
Treatment Period=the period from first dose of study drug through 2 days after discontinuation of study drug. Hematology profile was measured during screening (pre-operative, post-operative) and in the Treatment Period on Days 2, 3, 4, 12 (end of treatment). Upper limit of normal (ULN); lower limit of normal (LLN). Platelet Count low: < 100,000/mm^3 (or < 100*109 cells/L). Erythrocytes low: < 0.75 *pre-dose. Hemoglobin low: > 2 g/dL decrease compared to pre-dose or Value ≤ 8 g/dL. Hematocrit low: < 0.75*pre-dose . Leukocytes: < 0.75*LLN or > 1.25* ULN, or if pre-dose < LLN then use < 0.8*predose or > ULN if pre-dose > ULN then use > 1.2*predose or < LLN. Lymphocytes (absolute): < 0.750*10^3 cells/µL or > 7.50*10^3 cells/ µL. Eosinophils (absolute) high: > 0.750*10^3 cells/µL. Basophils(absolute) high: > 400/mm^3 (or > 0.4*103 cells/µL). Monocytes (absolute) high: > 2000/mm^3 (or > 2*103 cells/µL). Neutrophils(absolute) high: < 1.0*103 cells/µL.
Measured: First dose to last dose of study drug (12 days), plus 2 days
Number of Participants With Liver and Kidney Function Chemistry Laboratory Marked Abnormalities During the Treatment Period
Treatment Period=the period from first dose of study drug through 2 days after discontinuation of study drug. Laboratory Chemistry profile was measured during screening (pre-operative, post-operative) and in the Treatment Period on Days 4, and 12 (end of treatment). Bilirubin (direct) high: > 1.5*ULN. Total bilirubin: : > 2*ULN, Alanine Aminotransferase (ALT) high: > 3*ULN. Alkaline Phosphatase (ALP): > 2*ULN. Aspartate Aminotransferase (AST): > 3*ULN. Creatinine: > 1.5*ULN.
Measured: First dose to last dose of study drug (12 days), plus 2 days
Number of Participants With Electrolyte Chemistry Laboratory Marked Abnormalities During the Treatment Period
Laboratory Chemistry profile was measured during screening (pre-operative, post-operative) and in the Treatment Period on Days 4, and 12 (end of treatment). Potassium: < 0.9*LLN or > 1.1*ULN, or if pre-dose < LLN then use < 0.9*predose or > ULN if pre-dose > ULN then use > 1.1*predose or < LLN. Calcium: < 0.8*LLN or > 1.2*ULN, or if pre-dose < LLN then use < 0.75*predose or > ULN If pre-dose > ULN then use > 1.25*predose or < LLN. Chloride: < 0.9*LLN or > 1.1*ULN, or if pre-dose < LLN then use < 0.9*predose or > ULN if pre-dose > ULN then use > 1.1*predose or < LLN. Sodium: < 0.95*LLN or > 1.05*ULN, or if pre-dose < LLN then use < 0.95*predose or >ULN if pre-dose > ULN then use > 1.05*predose or < LLN. Bicarbonate: < 0.75*LLN or > 1.25*ULN, or if pre-dose < LLN then use < 0.75*predose or > ULN if pre-dose > ULN then use > 1.25*predose or < LLN.
Measured: First dose to last dose of study drug (12 days), plus 2 days
Number of Participants With Other Chemistry Laboratory Marked Abnormalities During the Treatment Period
Treatment Period=the period from first dose of study drug through 2 days after discontinuation of study drug. Laboratory Chemistry profile was measured during screening (pre-operative, post-operative) and in the Treatment Period on Days 4, and 12 (end of treatment). Fasting Glucose: if pre-dose < LLN then use < 0.8*predose; or > ULN if pre-dose > ULN then use > 2.0*predose or <LLN. Total Protein: < 0.9*LLN or > 1.1*ULN, or if pre-dose < LLN then use 0.9*predose or > ULN if pre-dose > ULN then use 1.1*predose or < LLN. Uric Acid: > 1.5*ULN, or if pre-dose > ULN then use > 2*predose. Creatine Kinase (CK): > 5*ULN.
Measured: First dose to last dose of study drug (12 days), plus 2 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Sep 2006 (estimated)
- Study startNov 2006
- Primary completionMay 2008
- Study completionMay 2008
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Deep Vein ThrombosisStudies of the same condition, open and under way.
- More trials run by Bristol-Myers SquibbThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 3,608 participants (actual)
Sponsor and investigators
- Lead sponsor
- Bristol-Myers Squibb
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Bristol-Myers Squibb, Study director, Bristol-Myers Squibb
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00371683
- Sponsor's protocol ID
- CV185-034
- Status last verified
- Nov 2015
- First submitted
- 30 Aug 2006
- Last updated
- 30 Dec 2015
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Jamieson MJ, Byon W, Dettloff RW, Crawford M, Gargalovic PS, Merali SJ, Onorato J, Quintero AJ, Russ C. Apixaban Use in Obese Patients: A Review of the Pharmacokinetic, Interventional, and Observational Study Data. Am J Cardiovasc Drugs. 2022 Nov;22(6):615-631. doi: 10.1007/s40256-022-00524-x. Epub 2022 May 16.
PubMed 35570249Lassen MR, Raskob GE, Gallus A, Pineo G, Chen D, Portman RJ. Apixaban or enoxaparin for thromboprophylaxis after knee replacement. N Engl J Med. 2009 Aug 6;361(6):594-604. doi: 10.1056/NEJMoa0810773.
PubMed 19657123
Study at a glance
From the registry record, last updated by the sponsor on 30 Dec 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3 Randomized, Double-Blind Active-Controlled (Enoxaparin), Parallel-Group, Multi-Center Study to Evaluate the Safety and Efficacy of Oral Apixaban in Subjects Undergoing Elective Total Knee Replacement Surgery
- ClinicalTrials.gov ID
- NCT00371683
- Acronym / sponsor ID
- CV185-034
- Conditions
- Deep Vein Thrombosis, Pulmonary Embolism
- Keywords
- Prevention of deep vein thrombosis and pulmonary embolism after total knee replacement surgery
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 3,608 participants (actual)
- Lead sponsor
- Bristol-Myers SquibbIndustry (pharma, biotech, devices)
- Study start
- Nov 2006
- Primary completion
- May 2008 (actual)
- Study completion
- May 2008 (actual)
- First posted
- 4 Sep 2006 (estimated)
- Results
- Posted 30 Dec 2015
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to learn if apixaban can prevent blood clots in the leg (deep vein Thrombosis [DVT]) and lung (pulmonary embolism [PE]) that sometimes occur after knee replacement surgery and to learn how apixaban compares to enoxaparin (Lovenox®) for preventing these clots. The safety of apixaban will also be studied.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| A1 | Active comparator | Drug: Enoxaparin + Placebo+ placebo |
| A2 | Experimental | Drug: Apixaban + Placebo+ placebo |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Men and non-pregnant, non-breastfeeding women
- 18 years or older
- Scheduled for knee replacement surgery
Key exclusion criteria (5 listed)
- hereditary or acquired bleeding disorders
- clotting disorders
- bleeding or high risk for bleeding
- drugs that affect bleeding or coagulation
- need for ongoing parenteral or oral anticoagulation
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Enoxaparin + PlaceboAlso: Lovenox®Syringes + tablets, Subcutaneous + Oral, 30mg, twice daily, 12 day treatment period | Drug | A1 |
| Apixaban + PlaceboTablet + Syringes, Oral + subcutaneous, 2.5 mg, twice daily, 12 day treatment period | Drug | A2 |
Primary outcome
Event Rate of the Composite of Adjudicated Venous Thromboembolism (VTE) Events and All-Cause Death With Onset During the Intended Treatment Period - Primary Subjects
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
An Independent Central Adjudication Committee (ICAC) adjudicated all venograms, suspected symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE), acute clinically overt bleeding events, suspected thrombocytopenia, suspected acute MI, suspected acute stroke, and cause of death. Event rate was number of participants with the composite endpoint divided by the number of participants analyzed and reported as percentage (%). Surgery=Day 1; Randomization/Treatment started on Day of Surgery or the next day (Day 1 or Day 2). A mandatory bilateral ascending contrast venogram was performed on all participants after 12 days (±2 days) of study treatment. Intended Treatment Period=starts on the day of randomization; for treated participants, the period ends at the latter of 2 days after last dose of study drug or 14 days after the first dose of study drug; for randomized participants who were not treated, the period ends 14 days after randomization.
Event Rate for Participants With Major Bleeding, Clinically Relevant Non-Major Bleeding, Major or Clinically Relevant Non-Major Bleeding, Any Bleeding With Onset During the Treatment Period - Treated Population
Time frame: First dose of study drug to last dose, plus 2 days post last dose
ICAC adjudicated acute clinically overt bleeding events as per International Society on Thrombosis and Hemostasis (ISTH) guidelines modified for surgical patients. Event rate was number of participants with the composite endpoint divided by the number of participants analyzed (%). Clinically relevant (CR); Non-Major (N-M) Bleeding. Day 1=Day of surgery. Treatment started (first dose) day of surgery or next day. Treatment continued for 12 days.
Event Rate for Participants With Major Bleeding, Clinically Relevant (CR) Non-Major (N-M) Bleeding , Major or Clinically Relevant (CR) Non-Major (N-M) Bleeding, Any Bleeding With Onset During the Follow-Up Period
Time frame: Last dose of study drug to Day 72 (60 days)
ICAC adjudicated acute clinically overt bleeding events as per International Society on Thrombosis and Hemostasis (ISTH) guidelines modified for surgical patients. Event rate was number of participants with the composite endpoint divided by the number of participants analyzed (%). Follow up Period was from the end of the treatment period (last dose) up to 60 days post last dose, Day 72.
21 secondary outcomes
Event Rate of Composite of Adjudicated Proximal DVT, Non-Fatal PE and All-Cause Death With Onset During the Intended Treatment Period PE and All-cause Death During the Intended Treatment Period
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate of Adjudicated VTE / VTE-related Death With Onset During the Treatment Period
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With Proximal DVT/Non-Fatal PE/ VTE-Related Death With Onset During the Intended Treatment Period
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Total Participants With Adjudicated VTE/All-Cause Death With Onset During the Intended Treatment Period
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Total Participants With VTE/ VTE-Related Death With Onset During the Intended Treatment Period
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With All-Cause Death During the Intended Treatment Period
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With VTE-Related Death With Onset During the Intended Treatment Period
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With Symptomatic VTE/ All-Cause Death With Onset During the Intended Treatment Period
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With Symptomatic VTE/ VTE-Related Death With Onset During the Intended Treatment Period
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With VTE/Major Bleeding/All-Cause Death With Onset During the Intended Treatment Period
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With PE (Fatal or Non-Fatal), DVT (All, Symptomatic Proximal, and Distal, Asymptomatic) With Onset During the Intended Treatment Period
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With Proximal DVT, Distal DVT, Asymptomatic Proximal DVT, Asymptomatic Distal DVT With Onset During the Intended Treatment Period
Time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization
Event Rate for Participants With Adjudicated Myocardial Infarction (MI) Acute Ischemic Stroke and Thromboembolic Events With Onset During the Treatment Period
Time frame: From first dose to last dose, plus 2 days (12 days, plus 2)
Event Rate of Adjudicated MI, Stroke, and Thrombocytopenia Events During the Follow-Up Period
Time frame: Post last dose of study drug to Day 72 (60 days)
Number of Participants With Serious Adverse Events (SAEs), Bleeding Adverse Events (AEs), AEs Leading to Discontinuation, and Deaths - Treated Population
Time frame: First dose to last dose, plus 2 days for AEs (12 + 2 days) or plus 30 days for SAEs (12 + 30 days)
Mean Change From Baseline in Systolic and Diastolic Blood Pressure During the Treatment Period
Time frame: Baseline to last dose of study drug, plus 2 days
Mean Change From Baseline in Heart Rate During the Treatment Period
Time frame: Baseline to last dose of study drug, plus 2 days
Number of Participants With Hematology Laboratory Marked Abnormality During the Treatment Period
Time frame: First dose to last dose of study drug (12 days), plus 2 days
Number of Participants With Liver and Kidney Function Chemistry Laboratory Marked Abnormalities During the Treatment Period
Time frame: First dose to last dose of study drug (12 days), plus 2 days
Number of Participants With Electrolyte Chemistry Laboratory Marked Abnormalities During the Treatment Period
Time frame: First dose to last dose of study drug (12 days), plus 2 days
Number of Participants With Other Chemistry Laboratory Marked Abnormalities During the Treatment Period
Time frame: First dose to last dose of study drug (12 days), plus 2 days
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Dec 2015.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 35570249Jamieson MJ, Byon W, Dettloff RW, Crawford M, Gargalovic PS, Merali SJ, Onorato J, Quintero AJ, Russ C. Apixaban Use in Obese Patients: A Review of the Pharmacokinetic, Interventional, and Observational Study Data. Am J Cardiovasc Drugs. 2022 Nov;22(6):615-631. doi: 10.1007/s40256-022-00524-x. Epub 2022 May 16.
- Derived from this study: PubMed 19657123Lassen MR, Raskob GE, Gallus A, Pineo G, Chen D, Portman RJ. Apixaban or enoxaparin for thromboprophylaxis after knee replacement. N Engl J Med. 2009 Aug 6;361(6):594-604. doi: 10.1056/NEJMoa0810773.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Bristol-Myers Squibb study director
Bristol-Myers Squibb
107 sites in 13 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study of Deep Vein Thrombosis and Pulmonary Embolism, run by Bristol-Myers Squibb at 107 sites in 13 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 3 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: finished, as of the sponsor's last update on 30 Dec 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 107 sites in United States, Canada, Mexico, Australia, Israel and 8 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?
Yes. Results are posted in the registry (first posted 30 Dec 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
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?
Event Rate of the Composite of Adjudicated Venous Thromboembolism (VTE) Events and All-Cause Death With Onset During the Intended Treatment Period - Primary Subjects (time frame: From Day 1 or Day 2 to last dose, plus 2 days or 14 days post randomization). The study lists 3 primary outcomes in all. 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 NCT00371683, which also lists 2 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 30 Dec 2015.