Atrial FibrillationPhase 3PIONEER AF-PCINCT01830543
A Study Exploring Two Strategies of Rivaroxaban (JNJ39039039; BAY-59-7939) and One of Oral Vitamin K Antagonist in Patients With Atrial Fibrillation Who Undergo Percutaneous Coronary Intervention
A Phase 3 study testing rivaroxaban 2.5 mg, rivaroxaban 15 mg and rivaroxaban 10 mg in people with Atrial Fibrillation and Percutaneous Coronary Intervention, run by Janssen Scientific Affairs, LLC at 348 sites in 25 countries.
Trial summary
The primary purpose of this study is to evaluate the safety for 2 different rivaroxaban treatment strategies and one Vitamin K Antagonist (VKA) treatment strategy utilizing various combinations of dual antiplatelet therapy (DAPT) or low-dose aspirin (ASA) or clopidogrel (or prasugrel or ticagrelor). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Atrial Fibrillation, Percutaneous Coronary Intervention
- What is being tested?
- rivaroxaban 2.5 mg, rivaroxaban 15 mg and rivaroxaban 10 mg
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 2,124 participants
- Where
- 348 sitesin 25 countries
- Study dates
- 10 May 2013to 28 Jul 2016
- 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
- Have a documented medical history of paroxysmal, persistent, or permanent non-valvular atrial fibrillation (AF)
- Have undergone percutaneous coronary intervention (PCI) procedure (with stent placement) for primary atherosclerotic disease
- Must have an international normalized ratio (INR) of 2.5 or below to be randomized
- Women must be postmenopausal before entry or practicing a highly effective method of birth control when heterosexually active
- Be willing and able to adhere to the prohibitions and restrictions specified in the study protocol
Who cannot join
- Have any condition that contraindicates anticoagulant or antiplatelet therapy or would have an unacceptable risk of bleeding, such as, but not limited to: platelet count <90,000/microliter at screening, history of intracranial hemorrhage, 12 month history of clinically significant gastrointestinal bleeding, non-VKA induced elevated prothrombin time (PT) at screening
- Have anemia of unknown cause with a hemoglobin level <10 g/dL (<6.21 mmol/L)
- Have a history of stroke or Transient Ischemic Attack (TIA)
- Have a calculated Creatinine Clearance (CrCl) <30 mL/min at screening
- Have known significant liver disease or liver function test (LFT) abnormalities
- Have any severe condition that would limit life expectancy to less than 12 months
Trial locations and contacts
348 sites in 25 countries.
348 sites in 25 countries
United States86 sites
Study site
Abington, Pennsylvania
Study site
Albuquerque, New Mexico
Study site
Atlantis, Florida
Study site
Auburn, Maine
Study site
Austin, Texas
Study site
Baltimore, Maryland
Study site
Bangor, Maine
Study site
Bartlesville, Oklahoma
Study site
Bellevue, Washington
Study site
Bend, Oregon
Study site
Boise, Idaho
Study site
Camp Hill, Pennsylvania
Study site
Charlottesville, Virginia
Study site
Clearwater, Florida
Study site
Colorado Springs, Colorado
Study site
Columbus, Georgia
Study site
Danbury, Connecticut
Study site
Daytona Beach, Florida
Study site
Detroit, Michigan
Study site
Doylestown, Pennsylvania
Study site
Erie, Pennsylvania
Study site
Fort Worth, Texas
Study site
Greenville, South Carolina
Study site
Hackensack, New Jersey
Study site
Haddon Heights, New Jersey
Study site
Hammond, Louisiana
Study site
Hazel Crest, Illinois
Study site
Humble, Texas
Study site
Huntsville, Alabama
Study site
Indianapolis, Indiana
Study site
Jackson, Tennessee
Study site
Jacksonville, Florida
Study site
Kalispell, Montana
Study site
Kansas City, Missouri
Study site
Knoxville, Tennessee
Study site
Lake Charles, Louisiana
Study site
Lakewood, Colorado
Study site
Lansing, Michigan
Study site
Las Vegas, Nevada
Study site
Layton, Utah
Study site
Littleton, Colorado
Study site
Los Alamitos, California
Study site
Macon, Georgia
Study site
Manassas, Virginia
Study site
Marietta, Georgia
Study site
Midlothian, Virginia
Study site
Milwaukee, Wisconsin
Study site
Mission Viejo, California
Study site
Mount Clemens, Michigan
Study site
Mt. Pleasant, South Carolina
Study site
Munster, Indiana
Study site
New Brunswick, New Jersey
Study site
New York, New York
Study site
Newark, New Jersey
Study site
Oceanside, California
Study site
Odessa, Texas
Study site
Oklahoma City, Oklahoma
Study site
Peekskill, New York
Study site
Petoskey, Michigan
Study site
Philadelphia, Pennsylvania
Study site
Plano, Texas
Study site
Port Charlotte, Florida
Study site
Portland, Oregon
Study site
Rapid City, South Dakota
Study site
Richmond, Virginia
Study site
Ridgewood, New Jersey
Study site
Riverside, California
Study site
Sacramento, California
Study site
Safety Harbor, Florida
Study site
San Francisco, California
Study site
Sanford, North Carolina
Study site
Sayre, Pennsylvania
Study site
Seattle, Washington
Study site
Slidell, Louisiana
Study site
St Louis, Missouri
Study site
St. Petersburg, Florida
Study site
Stockton, California
Study site
Tallahassee, Florida
Study site
Tampa, Florida
Study site
Thousand Oaks, California
Study site
Torrance, California
Study site
Tulsa, Oklahoma
Study site
Washington D.C., District of Columbia
Study site
Weston, Wisconsin
Study site
York, Pennsylvania
Study site
Ypsilanti, Michigan
United Kingdom23 sites
Study site
Bath
Study site
Birmingham
Study site
Blackburn
Study site
Bradford
Study site
Clydebank
Study site
Cottingham
Study site
Coventry
Study site
Dorchester
Study site
Dundee
Study site
Edinburgh
Study site
Exeter
Study site
Hampshire
Study site
Harrow
Study site
High Wycombe
Study site
London
Study site
Middlesbrough
Study site
Norwich
Study site
Nottingham
Study site
Plymouth
Study site
Portsmouth
Study site
Torquay
Study site
Truro
Study site
Worcester
Poland22 sites
Study site
Będzin
Study site
Bielsko-Biala
Study site
Chrzanów
Study site
Gdynia
Study site
Grodzisk Mazowiecki
Study site
Katowice
Study site
Krakow
Study site
Lodz
Study site
Mielec
Study site
Nowy Targ
Study site
Ostrowiec Świętokrzyski
Study site
Oświęcim
Study site
Płock
Study site
Rzeszow Poland
Study site
Starachowice
Study site
Starogard Gdański
Study site
Szczecin
Study site
Torun
Study site
Tychy
Study site
Ustroń
Study site
Warsaw
Study site
Zamość
Germany16 sites
Study site
Bad Friedrichshall
Study site
Bad Nauheim
Study site
Berlin
Study site
Cologne
Study site
Dresden
Study site
Esslingen am Neckar
Study site
Frankfurt am Main
Study site
Freiburg im Breisgau
Study site
Göttingen
Study site
Greifswald
Study site
Hamburg
Study site
Heidelberg
Study site
Limburg
Study site
Mannheim
Study site
Ulm
Study site
Witten
Russia16 sites
Study site
Arkhangelsk
Study site
Barnaul
Study site
Chita
Study site
Kemerovo
Study site
Krasnodar
Study site
Krasnoyarsk
Study site
Moscow
Study site
Nizhny Novgorod
Study site
Perm
Study site
Rostov-on-Don
Study site
Saint Petersburg
Study site
Samara
Study site
Saratov
Study site
Syktyvkar
Study site
Tyumen
Study site
Yekaterinburg
Canada15 sites
Study site
Chicoutimi
Study site
Edmonton, Alberta
Study site
Greater Sudbury, Ontario
Study site
London, Ontario
Study site
Maple Ridge, British Columbia
Study site
Montreal, Quebec
Study site
New Westminster, British Columbia
Study site
Ottawa, Ontario
Study site
Québec, Quebec
Study site
Saint John
Study site
Sherbrooke, Quebec
Study site
St. John's, Newfoundland and Labrador
Study site
Toronto, Ontario
Study site
Vancouver, British Columbia
Study site
Victoria, British Columbia
France15 sites
Study site
Besancon Cedex Franche-Comté
Study site
Caen
Study site
Centrès
Study site
Chartres
Study site
Lille
Study site
Limoges
Study site
Marseille
Study site
Montfermeil
Study site
Nantes
Study site
Nîmes
Study site
Paris
Study site
Pau
Study site
Pessac
Study site
Poitiers
Study site
Toulouse
Brazil14 sites
Study site
Belo Horizonte
Study site
Blumenau
Study site
Brasília
Study site
Campina Grande do Sul
Study site
Campinas
Study site
Curitiba
Study site
Marília
Study site
Passo Fundo
Study site
Porto Alegre
Study site
Recife
Study site
São José do Rio Preto
Study site
São Paulo
Study site
Uberlândia
Study site
Votuporanga
Belgium12 sites
Study site
Aalst
Study site
Bonheiden
Study site
Brasschaat
Study site
Bruges
Study site
Brussels
Study site
Genk
Study site
Ghent
Study site
Liège
Study site
Mechelen
Study site
Mol
Study site
Roeselare
Study site
Turnhout
Czechia12 sites
Study site
Brno
Study site
Hradec Králové
Study site
Jablonec Na Nisou
Study site
Karlovy Vary
Study site
Kladno
Study site
Litomyšl
Study site
Olomouc
Study site
Pilsen
Study site
Prague
Study site
Praha 10 N/A
Study site
Slaný
Study site
Uherské Hradiště
Denmark12 sites
Study site
Aalborg
Study site
Copenhagen
Study site
Esbjerg
Study site
Herlev
Study site
Herning
Study site
Hvidovre
Study site
Koege
Study site
Næstved
Study site
Odense
Study site
Roskilde
Study site
Svendborg
Study site
Vejle
Netherlands12 sites
Study site
's-Hertogenbosch
Study site
Alkmaar
Study site
Amsterdam
Study site
Amsterdam-Zuidoost
Study site
Breda
Study site
Delft
Study site
Gorinchem
Study site
Leiden
Study site
Maastricht
Study site
Nieuwegein
Study site
Sneek
Study site
Uden
Ukraine11 sites
Study site
Cherkassy
Study site
Dnipro
Study site
Ivano-Frankivsk
Study site
Kharkiv
Study site
Khemelnitskiy
Study site
Kyiv
Study site
Lviv
Study site
Odesa
Study site
Rivne
Study site
Uzhhorod
Study site
Zaporizhzhya
Argentina10 sites
Study site
Bahía Blanca
Study site
Buenos Aires
Study site
C.a.b.a.
Study site
Córdoba
Study site
Corrientes
Study site
La Plata
Study site
Resistencia
Study site
Rosario
Study site
Santa Fe
Study site
Vicente López
Mexico9 sites
Study site
Aguascalientes
Study site
Guadalajara
Study site
León
Study site
México
Study site
Pachuca
Study site
Puebla City
Study site
Querétaro
Study site
Villahermosa
Study site
Zapopan
South Korea9 sites
Study site
Busan
Study site
Daejeon
Study site
Gyeonggi-do
Study site
Incheon
Study site
Seongnam
Study site
Seoul
Study site
Suwon
Study site
Uijeongbu-si
Study site
Wŏnju
Turkey (Türkiye)9 sites
Study site
Ankara
Study site
Antalya
Study site
Bursa
Study site
Gaziantep
Study site
Istanbul
Study site
Istanbul Nap
Study site
Izmir
Study site
Kayseri
Study site
Sivas
Bulgaria8 sites
Study site
Blagoevgrad
Study site
Burgas
Study site
Pazardzhik
Study site
Pleven
Study site
Plovdiv
Study site
Sofia
Study site
Varna
Study site
Veliko Tarnovo
Sweden8 sites
Study site
Falun
Study site
Gothenburg
Study site
Jönköping
Study site
Lund
Study site
Malmö
Study site
Örebro
Study site
Stockholm
Study site
Umeå
Australia7 sites
Study site
Chermside
Study site
Epping
Study site
Hobart
Study site
Kogarah
Study site
Liverpool
Study site
New Lambton
Study site
Wollongong
Chile5 sites
Study site
Alto
Study site
Concepción
Study site
Punta Arenas
Study site
Santiago
Study site
Temuco
Taiwan5 sites
Study site
Kaohsiung City
Study site
Taichung
Study site
Tainan
Study site
Taipei
Study site
Taoyuan
Malaysia4 sites
Study site
George Town
Study site
Johor Bahru
Study site
Kajang
Study site
Kuala Lumpur
Romania4 sites
Study site
Bucharest
Study site
Cluj-Napoca
Study site
Târgu Mureş
Study site
Tg Mures
South Africa4 sites
Study site
Cape Town
Study site
Centurion
Study site
Linksfield West, Johannesburg
Study site
Somerset West
About this study
Official title: An Open-label, Randomized, Controlled, Multicenter Study Exploring Two Treatment Strategies of Rivaroxaban and a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy in Subjects With Atrial Fibrillation Who Undergo Percutaneous Coronary Intervention
The primary purpose of this study is to evaluate the safety for 2 different rivaroxaban treatment strategies and one Vitamin K Antagonist (VKA) treatment strategy utilizing various combinations of dual antiplatelet therapy (DAPT) or low-dose aspirin (ASA) or clopidogrel (or prasugrel or ticagrelor).
Read the detailed description
This is an open-label (both physician and participant know the treatment that the participant receives), randomized (study medication is assigned by chance), multicenter clinical study assessing the safety of 2 rivaroxaban treatment strategies and one vitamin K antagonist (VKA) treatment strategy in participants, who have paroxysmal, persistent, or permanent non-valvular atrial fibrillation (AF) and have had a percutaneous coronary intervention (PCI) with stent placement.
A target of 2,100 participants will be randomized into the study, with approximately 700 participants in each treatment strategy group. The randomization will be stratified by the intended duration of DAPT (1, 6, or 12 months).
The study consists of a screening phase, a 12-month open-label treatment phase, and an end-of-treatment/early withdrawal visit. The total duration of participation in the study for each participant is approximately 12 months.
- Being tested
- rivaroxaban 2.5 mg, rivaroxaban 15 mg, rivaroxaban 10 mg, aspirin (ASA), vitamin K antagonist (VKA)
- Keywords
- Atrial Fibrillation, Irregular heart beat, rivaroxaban, aspirin, clopidogrel, prasugrel, ticagrelor, vitamin K antagonist
- Medical subject headings
- Atrial Fibrillation, Arrhythmias, Cardiac
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
rivaroxaban 2.5 mgDrug
One 2.5 mg tablet twice daily for up to twelve months
rivaroxaban 15 mgDrug
One 15 mg tablet once daily for up to twelve months
rivaroxaban 10 mgDrug
One 10 mg tablet once daily for up to twelve months
aspirin (ASA)Drug
Low-dose aspirin tablet once daily for twelve months
vitamin K antagonist (VKA)Drug
Dose-adjusted VKA tablet (target International Normalized Ratio (INR) 2.0 to 3.0) once daily for twelve months
clopidogrelDrug
One 75 mg tablet once daily for up to twelve months
prasugrelDrug
One 10 mg tablet once daily for up to twelve months
ticagrelorDrug
One 90 mg tablet twice daily for up to twelve months
| Study group | Role | What they receive |
|---|---|---|
| rivaroxaban 2.5 mg twice daily | Experimental | rivaroxaban 2.5 mg tablet twice daily plus low-dose aspirin (ASA) 75 to 100 mg once daily and clopidogrel 75 mg tablet once daily (or prasugrel 10 mg tablet once daily or ticagrelor 90 mg tablet twice daily) followed by rivaroxaban 15 mg tablet (or 10 mg for subjects with moderate renal impairment) once daily plus low-dose ASA for 12 months Receives: Drug: rivaroxaban 2.5 mg; Drug: rivaroxaban 15 mg; Drug: rivaroxaban 10 mg; Drug: aspirin (ASA); Drug: clopidogrel; Drug: prasugrel; Drug: ticagrelor |
| vitamin K antagonist (VKA) | Experimental | dose-adjusted vitamin K antagonist (VKA) once daily (target International Normalized Ratio (INR) 2.0 to 3.0) plus low-dose ASA, 75 to 100 mg per day, and clopidogrel 75 mg once daily (or prasugrel 10 mg tablet once daily or ticagrelor 90 mg tablet twice daily) followed by dose-adjusted VKA once daily (target INR 2.0 to 3.0 or 2.0 to 2.5 at the investigator discretion) plus low-dose ASA for 12 months Receives: Drug: aspirin (ASA); Drug: vitamin K antagonist (VKA); Drug: clopidogrel; Drug: prasugrel; Drug: ticagrelor |
| rivaroxaban 15 mg once daily | Experimental | rivaroxaban 15 mg (or 10 mg for subjects with moderate renal impairment) once daily plus clopidogrel 75 mg tablet once daily (or prasugrel 10 mg tablet once daily or ticagrelor 90 mg tablet twice daily) for 12 months Receives: Drug: rivaroxaban 15 mg; Drug: rivaroxaban 10 mg; Drug: clopidogrel; Drug: prasugrel; Drug: ticagrelor |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants With Clinically Significant Bleeding
Clinically significant bleeding is a composite of Thrombolysis in Myocardial Infarction (TIMI) major bleeding, minor bleeding, and bleeding requiring medical attention (BRMA). TIMI major bleeding is defined as any symptomatic intracranial hemorrhage, clinically overt signs of hemorrhage (including imaging) associated with a drop in hemoglobin of greater than or equal to (>=) 5 grams per deciliter (g/dL) (or when the hemoglobin concentration is not available, an absolute drop in hematocrit of >=15 percent (%)). TIMI minor bleeding event is defined as any clinically overt sign of hemorrhage (including imaging) that is associated with a fall in hemoglobin concentration of 3 to less than (<) 5 g/dL (or, when hemoglobin concentration is not available, a fall in hematocrit of 9 percent to <15 percent). A BRMA event is defined as any bleeding event that requires medical treatment, surgical treatment, or laboratory evaluation, and does not meet criteria for a major or minor bleeding event.
Measured: Up to Month 12
Secondary outcomes (8)
Percentage of Participants With Thrombolysis in Myocardial Infarction (TIMI) Major Bleeding
TIMI major bleeding is defined as any symptomatic intracranial hemorrhage, Clinically overt signs of hemorrhage (including imaging) associated with a drop in hemoglobin of >= 5 g/dL (or when the hemoglobin concentration is not available, an absolute drop in hematocrit of >=15 percent).
Measured: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Thrombolysis in Myocardial Infarction (TIMI) Minor Bleeding
TIMI minor bleeding event is defined as any clinically overt sign of hemorrhage (including imaging) that is associated with a fall in hemoglobin concentration of 3 to <5 g/dL (or, when hemoglobin concentration is not available, a fall in hematocrit of 9 percent to <15 percent).
Measured: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Bleeding Requiring Medical Attention (BRMA)
A BRMA event is defined as any bleeding event that requires medical treatment, surgical treatment, or laboratory evaluation, and does not meet criteria for a major or minor bleeding event.
Measured: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Composite of Adverse Cardiovascular Events (Cardiovascular Death, Myocardial Infarction (MI) and Stroke)
Percentage of participants who experienced adverse cardiovascular events (cardiovascular death, myocardial Infarction (MI) and stroke) collectively, were assessed.
Measured: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Cardiovascular Death
The percentage of participants with the first occurrence of cardiovascular death were evaluated.
Measured: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Myocardial Infarction
The percentage of participants with the first occurrence of Myocardial Infarction were evaluated.
Measured: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Stroke
The percentage of participants with the first occurrence of Stroke were evaluated.
Measured: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Stent Thrombosis
The percentage of participants with the first occurrence of stent thrombosis were evaluated.
Measured: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Apr 2013 (estimated)
- Study start10 May 2013
- Primary completion28 Jul 2016
- Study completion28 Jul 2016
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 (9)Papers the sponsor has linked to this study.
- Other trials for Atrial FibrillationStudies of the same condition, open and under way.
- 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
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 2,124 participants (actual)
Sponsor and investigators
- Lead sponsor
- Janssen Scientific Affairs, LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Bayer
- Responsible party
- Sponsor
- Investigators
- Janssen Scientific Affairs, LLC Clinical Trial, Study director, Janssen Scientific Affairs, LLC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01830543
- Sponsor's protocol ID
- CR100758
- Other IDs
- RIVAROXAFL3003, 2012-001491-11
- Acronym
- PIONEER AF-PCI
- Status last verified
- Aug 2017
- First submitted
- 19 Mar 2013
- Last updated
- 19 Sep 2017
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated device
- No
Publications
Kerneis M, Yee MK, Mehran R, Nafee T, Bode C, Halperin JL, Peterson ED, Verheugt FWA, Wildgoose P, van Eickels M, Lip GYH, Cohen M, Fox KAA, Gibson CM. Novel Oral Anticoagulant Based Versus Vitamin K Antagonist Based Double Therapy Among Stented Patients With Atrial Fibrillation: Insights From the PIONEER AF-PCI Trial. Circ Cardiovasc Interv. 2019 Nov;12(11):e008160. doi: 10.1161/CIRCINTERVENTIONS.119.008160. Epub 2019 Nov 11.
PubMed 31707805Gibson WJ, Nafee T, Travis R, Yee M, Kerneis M, Ohman M, Gibson CM. Machine learning versus traditional risk stratification methods in acute coronary syndrome: a pooled randomized clinical trial analysis. J Thromb Thrombolysis. 2020 Jan;49(1):1-9. doi: 10.1007/s11239-019-01940-8.
PubMed 31535314Kerneis M, Yee MK, Mehran R, Nafee T, Bode C, Halperin JL, Peterson ED, Verheugt FWA, Wildgoose P, van Eickels M, Lip GYH, Cohen M, Fox KAA, Gibson CM. Association of International Normalized Ratio Stability and Bleeding Outcomes Among Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention. Circ Cardiovasc Interv. 2019 Feb;12(2):e007124. doi: 10.1161/CIRCINTERVENTIONS.118.007124.
PubMed 30704287Chi G, Kerneis M, Kalayci A, Liu Y, Mehran R, Bode C, Halperin JL, Verheugt FWA, Wildgoose P, van Eickels M, Lip GYH, Cohen M, Peterson ED, Fox KAA, Gibson CM. Safety and efficacy of non-vitamin K oral anticoagulant for atrial fibrillation patients after percutaneous coronary intervention: A bivariate analysis of the PIONEER AF-PCI and RE-DUAL PCI trial. Am Heart J. 2018 Sep;203:17-24. doi: 10.1016/j.ahj.2018.06.003. Epub 2018 Jun 13.
PubMed 30015064Chi G, Yee MK, Kalayci A, Kerneis M, AlKhalfan F, Mehran R, Bode C, Halperin JL, Verheugt FWA, Wildgoose P, van Eickels M, Lip GYH, Cohen M, Peterson ED, Fox KAA, Gibson CM. Total bleeding with rivaroxaban versus warfarin in patients with atrial fibrillation receiving antiplatelet therapy after percutaneous coronary intervention. J Thromb Thrombolysis. 2018 Oct;46(3):346-350. doi: 10.1007/s11239-018-1703-5.
PubMed 29943350Kerneis M, Gibson CM, Chi G, Mehran R, AlKhalfan F, Talib U, Pahlavani S, Mir M, Bode C, Halperin JL, Nafee T, Peterson ED, Verheugt FWA, Wildgoose P, van Eickels M, Lip GYH, Fox KAA, Cohen M. Effect of Procedure and Coronary Lesion Characteristics on Clinical Outcomes Among Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention: Insights From the PIONEER AF-PCI Trial. JACC Cardiovasc Interv. 2018 Apr 9;11(7):626-634. doi: 10.1016/j.jcin.2017.11.009. Epub 2018 Mar 14.
PubMed 29550085Gibson CM, Mehran R, Bode C, Halperin J, Verheugt FW, Wildgoose P, Birmingham M, Ianus J, Burton P, van Eickels M, Korjian S, Daaboul Y, Lip GY, Cohen M, Husted S, Peterson ED, Fox KA. Prevention of Bleeding in Patients with Atrial Fibrillation Undergoing PCI. N Engl J Med. 2016 Dec 22;375(25):2423-2434. doi: 10.1056/NEJMoa1611594. Epub 2016 Nov 14.
PubMed 27959713Gibson CM, Pinto DS, Chi G, Arbetter D, Yee M, Mehran R, Bode C, Halperin J, Verheugt FW, Wildgoose P, Burton P, van Eickels M, Korjian S, Daaboul Y, Jain P, Lip GY, Cohen M, Peterson ED, Fox KA. Recurrent Hospitalization Among Patients With Atrial Fibrillation Undergoing Intracoronary Stenting Treated With 2 Treatment Strategies of Rivaroxaban or a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy. Circulation. 2017 Jan 24;135(4):323-333. doi: 10.1161/CIRCULATIONAHA.116.025783. Epub 2016 Nov 14.
PubMed 27881555Gibson CM, Mehran R, Bode C, Halperin J, Verheugt F, Wildgoose P, van Eickels M, Lip GY, Cohen M, Husted S, Peterson E, Fox K. An open-label, randomized, controlled, multicenter study exploring two treatment strategies of rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment strategy in subjects with atrial fibrillation who undergo percutaneous coronary intervention (PIONEER AF-PCI). Am Heart J. 2015 Apr;169(4):472-8.e5. doi: 10.1016/j.ahj.2014.12.006. Epub 2014 Dec 20.
PubMed 25819853
Study at a glance
From the registry record, last updated by the sponsor on 19 Sep 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- An Open-label, Randomized, Controlled, Multicenter Study Exploring Two Treatment Strategies of Rivaroxaban and a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy in Subjects With Atrial Fibrillation Who Undergo Percutaneous Coronary Intervention
- ClinicalTrials.gov ID
- NCT01830543
- Acronym / sponsor ID
- PIONEER AF-PCI / CR100758
- Keywords
- Atrial Fibrillation, Irregular heart beat, rivaroxaban, aspirin, clopidogrel, prasugrel, ticagrelor, vitamin K antagonist
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 2,124 participants (actual)
- Lead sponsor
- Janssen Scientific Affairs, LLCIndustry (pharma, biotech, devices)
- Collaborators
- Bayer
- Study start
- 10 May 2013 (actual)
- Primary completion
- 28 Jul 2016 (actual)
- Study completion
- 28 Jul 2016 (actual)
- First posted
- 12 Apr 2013 (estimated)
- Results
- Posted 31 Jul 2017
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary purpose of this study is to evaluate the safety for 2 different rivaroxaban treatment strategies and one Vitamin K Antagonist (VKA) treatment strategy utilizing various combinations of dual antiplatelet therapy (DAPT) or low-dose aspirin (ASA) or clopidogrel (or prasugrel or ticagrelor).
Detailed description
This is an open-label (both physician and participant know the treatment that the participant receives), randomized (study medication is assigned by chance), multicenter clinical study assessing the safety of 2 rivaroxaban treatment strategies and one vitamin K antagonist (VKA) treatment strategy in participants, who have paroxysmal, persistent, or permanent non-valvular atrial fibrillation (AF) and have had a percutaneous coronary intervention (PCI) with stent placement.
A target of 2,100 participants will be randomized into the study, with approximately 700 participants in each treatment strategy group. The randomization will be stratified by the intended duration of DAPT (1, 6, or 12 months).
The study consists of a screening phase, a 12-month open-label treatment phase, and an end-of-treatment/early withdrawal visit. The total duration of participation in the study for each participant is approximately 12 months.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| rivaroxaban 2.5 mg twice daily | Experimental | Drug: rivaroxaban 2.5 mg, Drug: rivaroxaban 15 mg, Drug: rivaroxaban 10 mg, Drug: aspirin (ASA), Drug: clopidogrel, Drug: prasugrel, Drug: ticagrelorrivaroxaban 2.5 mg tablet twice daily plus low-dose aspirin (ASA) 75 to 100 mg once daily and clopidogrel 75 mg tablet once daily (or prasugrel 10 mg tablet once daily or ticagrelor 90 mg tablet twice daily) followed by rivaroxaban 15 mg tablet (or 10 mg for subjects with moderate renal impairment) once daily plus low-dose ASA for 12 months |
| vitamin K antagonist (VKA) | Experimental | Drug: aspirin (ASA), Drug: vitamin K antagonist (VKA), Drug: clopidogrel, Drug: prasugrel, Drug: ticagrelordose-adjusted vitamin K antagonist (VKA) once daily (target International Normalized Ratio (INR) 2.0 to 3.0) plus low-dose ASA, 75 to 100 mg per day, and clopidogrel 75 mg once daily (or prasugrel 10 mg tablet once daily or ticagrelor 90 mg tablet twice daily) followed by dose-adjusted VKA once daily (target INR 2.0 to 3.0 or 2.0 to 2.5 at the investigator discretion) plus low-dose ASA for 12 months |
| rivaroxaban 15 mg once daily | Experimental | Drug: rivaroxaban 15 mg, Drug: rivaroxaban 10 mg, Drug: clopidogrel, Drug: prasugrel, Drug: ticagrelorrivaroxaban 15 mg (or 10 mg for subjects with moderate renal impairment) once daily plus clopidogrel 75 mg tablet once daily (or prasugrel 10 mg tablet once daily or ticagrelor 90 mg tablet twice daily) for 12 months |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Have a documented medical history of paroxysmal, persistent, or permanent non-valvular atrial fibrillation (AF)
- Have undergone percutaneous coronary intervention (PCI) procedure (with stent placement) for primary atherosclerotic disease
- Must have an international normalized ratio (INR) of 2.5 or below to be randomized
- Women must be postmenopausal before entry or practicing a highly effective method of birth control when heterosexually active
- Be willing and able to adhere to the prohibitions and restrictions specified in the study protocol
Key exclusion criteria (6 listed)
- Have any condition that contraindicates anticoagulant or antiplatelet therapy or would have an unacceptable risk of bleeding, such as, but not limited to: platelet count <90,000/microliter at screening, history of intracranial hemorrhage, 12 month history of clinically significant gastrointestinal bleeding, non-VKA induced elevated prothrombin time (PT) at screening
- Have anemia of unknown cause with a hemoglobin level <10 g/dL (<6.21 mmol/L)
- Have a history of stroke or Transient Ischemic Attack (TIA)
- Have a calculated Creatinine Clearance (CrCl) <30 mL/min at screening
- Have known significant liver disease or liver function test (LFT) abnormalities
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 |
|---|---|---|
| rivaroxaban 2.5 mgOne 2.5 mg tablet twice daily for up to twelve months | Drug | rivaroxaban 2.5 mg twice daily |
| rivaroxaban 15 mgOne 15 mg tablet once daily for up to twelve months | Drug | rivaroxaban 15 mg once daily, rivaroxaban 2.5 mg twice daily |
| rivaroxaban 10 mgOne 10 mg tablet once daily for up to twelve months | Drug | rivaroxaban 15 mg once daily, rivaroxaban 2.5 mg twice daily |
| aspirin (ASA)Low-dose aspirin tablet once daily for twelve months | Drug | rivaroxaban 2.5 mg twice daily, vitamin K antagonist (VKA) |
| vitamin K antagonist (VKA)Dose-adjusted VKA tablet (target International Normalized Ratio (INR) 2.0 to 3.0) once daily for twelve months | Drug | vitamin K antagonist (VKA) |
| clopidogrelOne 75 mg tablet once daily for up to twelve months | Drug | rivaroxaban 15 mg once daily, rivaroxaban 2.5 mg twice daily, vitamin K antagonist (VKA) |
| prasugrelOne 10 mg tablet once daily for up to twelve months | Drug | rivaroxaban 15 mg once daily, rivaroxaban 2.5 mg twice daily, vitamin K antagonist (VKA) |
| ticagrelorOne 90 mg tablet twice daily for up to twelve months | Drug | rivaroxaban 15 mg once daily, rivaroxaban 2.5 mg twice daily, vitamin K antagonist (VKA) |
Primary outcome
Percentage of Participants With Clinically Significant Bleeding
Time frame: Up to Month 12
Clinically significant bleeding is a composite of Thrombolysis in Myocardial Infarction (TIMI) major bleeding, minor bleeding, and bleeding requiring medical attention (BRMA). TIMI major bleeding is defined as any symptomatic intracranial hemorrhage, clinically overt signs of hemorrhage (including imaging) associated with a drop in hemoglobin of greater than or equal to (>=) 5 grams per deciliter (g/dL) (or when the hemoglobin concentration is not available, an absolute drop in hematocrit of >=15 percent (%)). TIMI minor bleeding event is defined as any clinically overt sign of hemorrhage (including imaging) that is associated with a fall in hemoglobin concentration of 3 to less than (<) 5 g/dL (or, when hemoglobin concentration is not available, a fall in hematocrit of 9 percent to <15 percent). A BRMA event is defined as any bleeding event that requires medical treatment, surgical treatment, or laboratory evaluation, and does not meet criteria for a major or minor bleeding event.
8 secondary outcomes
Percentage of Participants With Thrombolysis in Myocardial Infarction (TIMI) Major Bleeding
Time frame: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Thrombolysis in Myocardial Infarction (TIMI) Minor Bleeding
Time frame: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Bleeding Requiring Medical Attention (BRMA)
Time frame: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Composite of Adverse Cardiovascular Events (Cardiovascular Death, Myocardial Infarction (MI) and Stroke)
Time frame: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Cardiovascular Death
Time frame: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Myocardial Infarction
Time frame: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Stroke
Time frame: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Percentage of Participants With Stent Thrombosis
Time frame: Up to Month 12 and end of DAPT-Month 1, 6 and 12
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Sep 2017.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 31707805Kerneis M, Yee MK, Mehran R, Nafee T, Bode C, Halperin JL, Peterson ED, Verheugt FWA, Wildgoose P, van Eickels M, Lip GYH, Cohen M, Fox KAA, Gibson CM. Novel Oral Anticoagulant Based Versus Vitamin K Antagonist Based Double Therapy Among Stented Patients With Atrial Fibrillation: Insights From the PIONEER AF-PCI Trial. Circ Cardiovasc Interv. 2019 Nov;12(11):e008160. doi: 10.1161/CIRCINTERVENTIONS.119.008160. Epub 2019 Nov 11.
- Derived from this study: PubMed 31535314Gibson WJ, Nafee T, Travis R, Yee M, Kerneis M, Ohman M, Gibson CM. Machine learning versus traditional risk stratification methods in acute coronary syndrome: a pooled randomized clinical trial analysis. J Thromb Thrombolysis. 2020 Jan;49(1):1-9. doi: 10.1007/s11239-019-01940-8.
- Derived from this study: PubMed 30704287Kerneis M, Yee MK, Mehran R, Nafee T, Bode C, Halperin JL, Peterson ED, Verheugt FWA, Wildgoose P, van Eickels M, Lip GYH, Cohen M, Fox KAA, Gibson CM. Association of International Normalized Ratio Stability and Bleeding Outcomes Among Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention. Circ Cardiovasc Interv. 2019 Feb;12(2):e007124. doi: 10.1161/CIRCINTERVENTIONS.118.007124.
- Derived from this study: PubMed 30015064Chi G, Kerneis M, Kalayci A, Liu Y, Mehran R, Bode C, Halperin JL, Verheugt FWA, Wildgoose P, van Eickels M, Lip GYH, Cohen M, Peterson ED, Fox KAA, Gibson CM. Safety and efficacy of non-vitamin K oral anticoagulant for atrial fibrillation patients after percutaneous coronary intervention: A bivariate analysis of the PIONEER AF-PCI and RE-DUAL PCI trial. Am Heart J. 2018 Sep;203:17-24. doi: 10.1016/j.ahj.2018.06.003. Epub 2018 Jun 13.
- Derived from this study: PubMed 29943350Chi G, Yee MK, Kalayci A, Kerneis M, AlKhalfan F, Mehran R, Bode C, Halperin JL, Verheugt FWA, Wildgoose P, van Eickels M, Lip GYH, Cohen M, Peterson ED, Fox KAA, Gibson CM. Total bleeding with rivaroxaban versus warfarin in patients with atrial fibrillation receiving antiplatelet therapy after percutaneous coronary intervention. J Thromb Thrombolysis. 2018 Oct;46(3):346-350. doi: 10.1007/s11239-018-1703-5.
- Derived from this study: PubMed 29550085Kerneis M, Gibson CM, Chi G, Mehran R, AlKhalfan F, Talib U, Pahlavani S, Mir M, Bode C, Halperin JL, Nafee T, Peterson ED, Verheugt FWA, Wildgoose P, van Eickels M, Lip GYH, Fox KAA, Cohen M. Effect of Procedure and Coronary Lesion Characteristics on Clinical Outcomes Among Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention: Insights From the PIONEER AF-PCI Trial. JACC Cardiovasc Interv. 2018 Apr 9;11(7):626-634. doi: 10.1016/j.jcin.2017.11.009. Epub 2018 Mar 14.
- Derived from this study: PubMed 27959713Gibson CM, Mehran R, Bode C, Halperin J, Verheugt FW, Wildgoose P, Birmingham M, Ianus J, Burton P, van Eickels M, Korjian S, Daaboul Y, Lip GY, Cohen M, Husted S, Peterson ED, Fox KA. Prevention of Bleeding in Patients with Atrial Fibrillation Undergoing PCI. N Engl J Med. 2016 Dec 22;375(25):2423-2434. doi: 10.1056/NEJMoa1611594. Epub 2016 Nov 14.
- Derived from this study: PubMed 27881555Gibson CM, Pinto DS, Chi G, Arbetter D, Yee M, Mehran R, Bode C, Halperin J, Verheugt FW, Wildgoose P, Burton P, van Eickels M, Korjian S, Daaboul Y, Jain P, Lip GY, Cohen M, Peterson ED, Fox KA. Recurrent Hospitalization Among Patients With Atrial Fibrillation Undergoing Intracoronary Stenting Treated With 2 Treatment Strategies of Rivaroxaban or a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy. Circulation. 2017 Jan 24;135(4):323-333. doi: 10.1161/CIRCULATIONAHA.116.025783. Epub 2016 Nov 14.
- Derived from this study: PubMed 25819853Gibson CM, Mehran R, Bode C, Halperin J, Verheugt F, Wildgoose P, van Eickels M, Lip GY, Cohen M, Husted S, Peterson E, Fox K. An open-label, randomized, controlled, multicenter study exploring two treatment strategies of rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment strategy in subjects with atrial fibrillation who undergo percutaneous coronary intervention (PIONEER AF-PCI). Am Heart J. 2015 Apr;169(4):472-8.e5. doi: 10.1016/j.ahj.2014.12.006. Epub 2014 Dec 20.
Related trials for Atrial Fibrillation
Active, not recruiting
Horizon 360 Protocol for the Treatment of Paroxysmal Atrial Fibrillation With the Sphere-360™ Catheter and Affera™ Mapping and Ablation System (Horizon 360)
Paroxysmal AF
Active, not recruitingObservational study
Concomitant Left Atrial Appendage Closure and Pulsed Field Ablation-Asia
Concomitant Procedures, Atrial Fibrillation
Active, not recruiting
CONVERGE Post-Approval Study (PAS)
Chronic Atrial Fibrillation
Recruiting
Early Closure of Left Atrial Appendage for Patients With Atrial Fibrillation and Ischemic Stroke Despite Anticoagulation Therapy
Ischemic Stroke, Atrial Fibrillation
RecruitingPhase 2
Safety in Adult Participants With Atrial Fibrillation Who Are Treated With Anticoagulation
Atrial Fibrillation (AF)
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.
Janssen Scientific Affairs, LLC Clinical Trial study director
Janssen Scientific Affairs, LLC
348 sites in 25 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing rivaroxaban 2.5 mg, rivaroxaban 15 mg and rivaroxaban 10 mg in people with Atrial Fibrillation and Percutaneous Coronary Intervention, run by Janssen Scientific Affairs, LLC at 348 sites in 25 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 5 inclusion and 6 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 19 Sep 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 348 sites in United States, United Kingdom, Poland, Germany, Russia and 20 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 31 Jul 2017). 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?
Percentage of Participants With Clinically Significant Bleeding (time frame: Up to Month 12). 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 NCT01830543, 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 19 Sep 2017.