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Acquired Antithrombin DeficiencyPhase 3NCT06096116

Phase 3 Study on the Efficacy and Safety of Human Plasma Derived Antithrombin (Atenativ) in Heparin-Resistant Patients Scheduled to Undergo Cardiac Surgery Necessitating Cardiopulmonary Bypass

A Phase 3 study testing Human plasma derived antithrombin in people with Acquired Antithrombin Deficiency, run by Octapharma at 27 sites in 10 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The primary objective of this study is to evaluate the efficacy of two different doses of Atenativ, versus placebo, in restoring and maintaining heparin responsiveness in adult patients undergoing cardiac surgery necessitating cardiopulmonary bypass (CPB) Read more about this study

Who is it for?
Ages 18 to 85 years
Conditions the study is for
Acquired Antithrombin Deficiency
What is being tested?
Human plasma derived antithrombin
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
120 participants
Where
27 sitesin 10 countries
Study dates
21 Aug 2024to Mar 2028
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Planned cardiac surgery with CPB
  • Heparin-resistant patients (pre-CPB Hemochron ACT less than 480 s in the measurement taken between 2-5 minutes following intravenous administration of 500 U/kg UFH)
  • Patients between 18 and 85 years of age, inclusive
  • Freely given written or electronic informed consent
  • In female patients of childbearing potential, a pre-existing negative pregnancy test within 14 days prior to surgery

Who cannot join

  • Receiving, or have received within the timeframes specified, one or more of the following medications prior to the start of surgery:
  • vitamin K antagonists (within 3 days)
  • direct oral anticoagulants (within 2 days)
  • thienopyridines (ticlopidine within 14 days, prasugrel within 7 days, or clopidogrel within 5 days), unless platelet function is satisfactory according to local standard of care assessment
  • ticagrelor (within 5 days), unless platelet function is satisfactory according to local standard of care assessment
  • glycoprotein IIb/IIIa antagonist (within 24 hours)
Show all 14Show fewer
  • Pre-existing coagulopathy, a history of bleeding problems, or a laboratory-diagnosed bleeding disorder (e.g., von Willebrand disease, platelet disorder)
  • Renal insufficiency, defined as serum creatinine level >2.0 mg/dL
  • Thrombocytosis, defined as platelet count >400,000 per μL
  • Known hypersensitivity or allergic reaction to antithrombin or any of the excipients in Atenativ, i.e., human albumin, sodium chloride, acetyl tryptophan, caprylic acid
  • History of anaphylactic reaction(s) to blood or blood components
  • Refusal to receive transfusion of blood or blood-derived products
  • Current participation in another interventional clinical trial or previous participation in the current trial
  • Treatment with any IMP within 30 days prior to screening visit

Trial locations and contacts

27 sites in 10 countries. Contact the study team or a site near you to ask about taking part.

27 sites in 10 countries

United States9 sites, 9 recruiting
  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

    Recruiting
  • Cleveland Clinic

    Cleveland, Ohio, 44195

    Recruiting
  • The Ohio State University

    Columbus, Ohio, 43214

    Recruiting
  • University of Texas Southwestern Medical Center

    Dallas, Texas, 75390

    Recruiting
  • Duke University Medical Center

    Durham, North Carolina, 27710-1000

    Recruiting
  • University of Miami

    Miami, Florida, 33136

    Recruiting
  • OU Health University of Oklahoma Medical Center

    Oklahoma City, Oklahoma, 73104

    Recruiting
  • Stanford University School of Medicine

    Stanford, California, 94305-5101

    Recruiting
  • Atrium Health Wake Forest Baptist

    Winston-Salem, North Carolina, 27157

    Recruiting

Other trials in United States

Canada4 sites, 4 recruiting
  • Kingston Health Sciences Centre

    Kingston, Ontario, K7L2V7

    Recruiting
  • Montreal Heart Institute

    Montreal, Quebec, H1T1C8

    Recruiting
  • Royal Columbian Hospital

    New Westminster, British Columbia, V3L0A4

    Recruiting
  • Toronto General Hospital

    Toronto, Ontario, M5G2C4

    Not yet recruiting

Other trials in Canada

United Kingdom3 sites, 3 recruiting
  • Royal Papworth Hospital

    Cambridge

    Recruiting
  • University Hospital Coventry and Warwickshire

    Coventry

    Recruiting
  • The James Cook University Hospital

    Middlesbrough

    Recruiting

Other trials in United Kingdom

Austria2 sites, 2 recruiting
  • University Hospital Innsbruck

    Innsbruck

    Recruiting
  • Vienna General Hospital AKH, Medical University of Vienna

    Vienna

    Recruiting

Other trials in Austria

Czechia2 sites, 1 recruiting
  • Center of Cardiovascular and Transplant Surgery

    Brno

    Recruiting
  • Institute for Clinical and Experimental Medicine

    Prague

    Terminated

Other trials in Czechia

France2 sites
  • CHU de Reims, Hôpital Robert Debré

    Reims

    Terminated
  • CHU de Rennes

    Rennes

    Withdrawn

Other trials in France

Lithuania2 sites, 1 recruiting
  • Hospital of Lithuanian university of Health sciences Kauno Klinikos

    Kaunas

    Terminated
  • Vilnius University hospital Santaros Klinikos

    Vilnius

    Recruiting

Other trials in Lithuania

Romania1 site, 1 recruiting
  • Institute for Cardiovascular Diseases C.C. Iliescu

    Bucharest

    Recruiting

Other trials in Romania

Serbia1 site, 1 recruiting
  • Institute of Cardiovascular Diseases Vojvodina

    Kamenitz

    Recruiting

Other trials in Serbia

Slovenia1 site, 1 recruiting
  • University Medical Centre Ljubljana

    Ljubljana

    Recruiting

Other trials in Slovenia

About this study

Official title: Phase 3, Double-blind, Placebo-controlled, Multicentre Study on the Efficacy and Safety of Human Plasma Derived Antithrombin (Atenativ) in Heparin-Resistant Patients Scheduled to Undergo Cardiac Surgery Necessitating Cardiopulmonary Bypass

The primary objective of this study is to evaluate the efficacy of two different doses of Atenativ, versus placebo, in restoring and maintaining heparin responsiveness in adult patients undergoing cardiac surgery necessitating cardiopulmonary bypass (CPB)

Being tested
Human plasma derived antithrombin, Placebo
Keywords
heparin resistance, antithrombin deficiency, cardiopulmonary bypass, cardiac surgery
Medical subject headings
Antithrombin III Deficiency

What participants receive

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

  • Human plasma derived antithrombinDrug

    A solvent/detergent and heat-treated antithrombin concentrate derived from human plasma

  • PlaceboDrug

    Half of the patients in the placebo group will be randomised to receive a volume of placebo corresponding to the low dose of Atenativ and the other half to receive a volume of placebo corresponding to a high dose of Atenativ

Study groups in NCT06096116
Study groupRoleWhat they receive
Low-dose AtenativExperimentalPatients will receive a single bolus of 30 international units (IU)/kg body weight (BW) Atenativ.
Receives: Drug: Human plasma derived antithrombin
High-dose AtenativExperimentalPatients will receive a single bolus of 60 international units (IU)/kg body weight (BW) Atenativ.
Receives: Drug: Human plasma derived antithrombin
PlaceboPlacebo comparatorPatients will receive a saline bolus dose
Receives: Drug: Placebo

What is being measured

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

  1. Restoring heparin responsiveness

    The percentage of patients in each group in whom no further therapy containing antithrombin (i.e. frozen plasma or other antithrombin concentrates) is needed for restoring pre-CPB heparin responsiveness after administration of Atenativ or placebo, and for maintaining it during CPB

    Measured: During surgery (from the time of the first surgical incision to the time at which the final suture or staple is placed)

Secondary outcomes (20)
  1. Amounts of further therapy for restoring heparin responsiveness

    The comparison between the amounts of further therapy containing antithrombin (i.e., FP or antithrombin concentrates) needed for restoring pre-CPB heparin responsiveness, after administration of Atenativ or placebo, and for maintaining it during CPB

    Measured: During surgery (from the time of the first surgical incision to the time at which the final suture or staple is placed)

  2. Change in activated clotting time (ACT) values

    The comparison between the change in ACT values following infusion of each of the Atenativ doses and placebo

    Measured: Within 5 minutes following intravenous administration of 500 U/kg unfractionated heparin (UFH) and between 2-10 minutes after IMP infusion

  3. Change in antithrombin plasma levels

    The comparison between the change in antithrombin plasma levels following infusion of each of the Atenativ doses and placebo

    Measured: Within 10 minutes before IMP infusion and between 2 and 10 minutes after IMP infusion, within 10 minutes after the end of CPB, at the end of surgery, and at 24 hours after the start of IMP infusion

  4. Change in heparin usage

    The comparison between heparin usage following the infusion of each of the Atenativ doses and infusion of placebo

    Measured: From end of IMP infusion to the end of surgery

  5. FP unit use

    The comparison between the number of units of FP transfused for reasons other than restoring or maintaining heparin responsiveness, both intraoperatively (from the start of Atenativ or placebo infusion until the start of CPB, during CPB, and from the end of CPB until the end of surgery) and postoperatively (from the end of surgery until 24 hours after the start of Atenativ or placebo infusion and until discharge or 7 days after surgery, whichever comes first), as well as cumulatively

    Measured: From the start of IMP infusion until 24 hours following IMP infusion, and until discharge or 7 days after surgery, whichever comes first

  6. Amounts of further antithrombin concentrate for maintaining heparin responsiveness

    The comparison between postoperative use of antithrombin concentrates for reasons other than restoring heparin responsiveness (from the end of surgery until 24 hours after the start of Atenativ or placebo infusion and until discharge or 7 days after surgery, whichever comes first)

    Measured: From placement of the final suture or staple until 24 hours following IMP infusion, to discharge or 7 days after surgery, whichever comes first

  7. Transfusion of allogenic blood products

    The comparison between transfusion of other allogeneic blood products (e.g., red blood cells [RBCs], platelets, cryoprecipitate, whole blood, albumin, other transfusion), both intraoperatively (from the start of Atenativ or placebo infusion until the start of CPB, during CPB, and from the end of CPB until the end of surgery) and postoperatively (from the end of surgery until 24 hours after the start of Atenativ or placebo infusion and until discharge or 7 days after surgery, whichever comes first), as well as cumulatively

    Measured: From the start of IMP infusion until 24 hours after the start of Atenativ or placebo infusion and until discharge or 7 days after surgery, whichever comes first

  8. Administration of coagulation factor concentrates

    The comparison between administration of coagulation factor concentrates (fibrinogen concentrate, factor XIII concentrate, recombinant activated factor VII, other therapy)", both intraoperatively (from the start of Atenativ or placebo infusion until the start of CPB, during CPB, and from the end of CPB until the end of surgery) and postoperatively (from the end of surgery until 24 hours after the start of Atenativ or placebo infusion and until discharge or 7 days after surgery, whichever comes first), as well as cumulatively

    Measured: From the start of IMP infusion until 24 hours after the start of Atenativ or placebo infusion and until discharge or 7 days after surgery, whichever comes first

  9. Administration of other haemostatic-relevant therapies

    The comparison between administration of other haemostatic-relevant therapies (i.e., tranexamic acid, aminocaproic acid, protamine, other therapies), both intraoperatively (from the start of Atenativ or placebo infusion until the start of CPB, during CPB, and from the end of CPB until the end of surgery) and postoperatively (from the end of surgery until 24 hours after the start of Atenativ or placebo infusion and until discharge or 7 days after surgery, whichever comes first), as well as cumulatively

    Measured: From the start of IMP infusion until 24 hours after the start of Atenativ or placebo infusion and until discharge or 7 days after surgery, whichever comes first

  10. Postoperative chest tube drainage

    The comparison between postoperative chest tube drainage volume at 24 hours after the start of Atenativ or placebo infusion, and the comparison between total chest tube drainage volume until discharge or 7 days after surgery, whichever comes first

    Measured: From the start of IMP infusion to 24 hours after infusion and until discharge or 7 days after surgery, whichever comes first

  11. Need for reoperation due to bleeding

    Comparison of the need for reoperation for bleeding, including description of the cause of bleeding (surgical vs. non-surgical)

    Measured: 24 hours after the start of IMP infusion

  12. Cell saver volume

    The comparison between cell saver volume until the end of surgery

    Measured: During surgery (from the time of the first surgical incision to the time at which the final suture or staple is placed)

  13. Adverse events

    Incidence of adverse events, including all related and non-related, non-serious adverse events

    Measured: From the start of IMP infusion until hospital discharge or 7 days after IMP administration, whichever comes first

  14. Serious adverse events

    Incidence of serious adverse events

    Measured: From the start of IMP infusion until 28 days after IMP administration

  15. Survival status

    Number of patients surviving in all three cohorts

    Measured: At hospital discharge or 7 days after IMP administration (whichever comes first) and at 28 days (+ 4 days) after IMP administration

  16. Red Blood Cell count

    Standard haematological parameter

    Measured: Within 10 minutes before IMP infusion, between 2-10 minutes after IMP infusion, within 10 minutes after the end of CPB, at the end of surgery, and at 24 hours after infusion

  17. White Blood Cell count

    Standard haematological parameter

    Measured: Within 10 minutes before IMP infusion, between 2-10 minutes after IMP infusion, within 10 minutes after the end of CPB, at the end of surgery, and at 24 hours after infusion

  18. Haemoglobin levels

    Standard haematological parameter

    Measured: Within 10 minutes before IMP infusion, between 2-10 minutes after IMP infusion, within 10 minutes after the end of CPB, at the end of surgery, and at 24 hours after infusion

  19. Haematocrit

    Standard haematological parameter

    Measured: Within 10 minutes before IMP infusion, between 2-10 minutes after IMP infusion, within 10 minutes after weaning from CPB, at the end of surgery, and at 24 hours after infusion

  20. Platelet count

    Standard haematological parameter

    Measured: Within 10 minutes before IMP infusion, between 2-10 minutes after IMP infusion, within 10 minutes after weaning from CPB, at the end of surgery, and at 24 hours after infusion

Timeline

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

  1. First posted23 Oct 2023
  2. Study start21 Aug 2024
  3. Primary completionMar 2028 (estimated)
  4. Study completionMar 2028 (estimated)

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
Triple blind
Who is masked
Participant, Care provider, Outcomes assessor
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06096116
Sponsor's protocol ID
ATN-108
Status last verified
Sep 2026
First submitted
17 Oct 2023
Last updated
28 Sep 2026
Results posted
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Human plasma derived antithrombin in people with Acquired Antithrombin Deficiency, run by Octapharma at 27 sites in 10 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 14 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: looking for participants now, as of the sponsor's last update on 28 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 27 sites in United States, Canada, United Kingdom, Austria, Czechia and 5 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. Some participants in this study may receive a placebo. 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?

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

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

Contact Cristina Solomon, MD (+41 79 585 90 42, Cristina.Solomon@octapharma.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Restoring heparin responsiveness (time frame: During surgery (from the time of the first surgical incision to the time at which the final suture or staple is placed)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Sep 2026.

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