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Efficacy and Safety Study of BERIPLEX® P/N Compared With Plasma in Patients on Anticoagulant Therapy Who Require Emergency Surgery or Invasive Intervention
This study is currently recruiting participants.
Verified by CSL Behring, December 2008
Sponsored by: CSL Behring
Information provided by: CSL Behring
ClinicalTrials.gov Identifier: NCT00803101
  Purpose

The purpose of this study is to evaluate efficacy, safety and tolerance of Beriplex® P/N compared with plasma in regard to rapid reversal of coagulopathy induced by coumarin derivatives in subjects who require immediate correction of INR because of emergency surgery or urgent invasive intervention.


Condition Intervention Phase
Reversal of Coagulopathy
Biological: Beriplex® P/N
Biological: Fresh frozen plasma
Phase III

Genetics Home Reference related topics: hemophilia
MedlinePlus related topics: Bleeding Disorders Blood Thinners
Drug Information available for: Factor IX Vitamin K BaseLine
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Parallel Assignment, Safety/Efficacy Study
Official Title: An Open-Label, Randomized, Multicenter Phase IIIb Study to Assess the Efficacy, Safety and Tolerance of BERIPLEX® P/N Compared With Plasma for Rapid Reversal of Coagulopathy Induced by Coumarin Derivatives in Subjects Requiring Emergency Surgery or Invasive Intervention

Further study details as provided by CSL Behring:

Primary Outcome Measures:
  • Hemostatic efficacy in preventing excessive hemorrhages during emergency surgical or invasive interventions [ Time Frame: Start of infusion until immediately after surgery/intervention ] [ Designated as safety issue: No ]
  • Proportion of subjects who achieve an INR of 1.3 or lower [ Time Frame: 30 minutes after end of infusion ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Response and in vivo recovery (IVR) of coagulation factors II, VII, IX and X, protein C and protein S [ Time Frame: 3 hours after administration ] [ Designated as safety issue: No ]
  • Proportion of subjects who have a rapid decrease of INR, defined as an INR value of 1.3 or less [ Time Frame: 30 minutes from start of infusion ] [ Designated as safety issue: No ]
  • 45 day all cause mortality [ Time Frame: 45 days ] [ Designated as safety issue: No ]
  • Volume of wound drainage [ Time Frame: Until cessation of wound drainage ] [ Designated as safety issue: No ]
  • Time between last suture and cessation of wound drainage [ Time Frame: Until cessation of wound drainage ] [ Designated as safety issue: No ]

Estimated Enrollment: 155
Study Start Date: October 2008
Estimated Study Completion Date: July 2011
Estimated Primary Completion Date: July 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Beriplex® P/N: Experimental Biological: Beriplex® P/N
Intravenous infusion, dosage depending on baseline INR, amount of coagulation factor IX and body-weight.
Fresh frozen plasma: Active Comparator Biological: Fresh frozen plasma
Intravenous infusion, dosage depending on baseline INR and body weight

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male and female subjects ≥ 18 years,
  • Subjects who have received oral anticoagulation therapy (e.g., warfarin, acenocoumarol or phenprocoumon) and in whom either an emergency surgical or an invasive intervention is indicated. Due to the nature of the procedure, withdrawal of anticoagulation therapy and plasma are also indicated,
  • INR ≥ 2 within 3 hours before start of study treatment,
  • Informed consent has been obtained.

Exclusion Criteria:

  • Subjects with emergency surgical procedures in which, according to the surgeon's clinical judgment, an accurate estimate of blood loss is not possible (e.g., ruptured aneurysm).
  • Administration of intravenous vitamin K more than 3 hours or administration of oral vitamin K more than 6 hours prior to infusion of study treatment,
  • Expected survival of less than 3 days,
  • Acute trauma for which reversal of vitamin K antagonists alone would not be expected to control an acute bleeding complication and/or control the acute bleeding event,
  • History of thrombotic event, myocardial infarction, unstable angina pectoris, cerebral vascular accident, transient ischemic attack, severe peripheral vascular disease, disseminated intravascular coagulation within 3 months of enrolment,
  • Known history of antiphospholipid antibody syndrome or lupus anticoagulant antibodies,
  • Suspected or confirmed sepsis at time of enrolment,
  • A previous thromboembolic event within 30 days prior to the inclusion into the study,
  • Administration of whole blood, plasma, plasma fractions or platelets within 2 weeks prior to inclusion into study. Note: Administration of packed red blood cells is not an exclusion criterion,
  • Pre-existing progressive fatal disease with a life expectancy of less than 2 months,
  • Known inhibitors to coagulation factors II, VII, IX, or X; or hereditary protein C or protein S deficiency; or heparin-induced, type II thrombocytopenia,
  • Treatment with any other investigational medicinal product within 30 days prior to inclusion into the study,
  • Presence or history of hypersensitivity to components of study medication,
  • Pregnant or breast-feeding women,
  • Prior inclusion in this study or any other CSL Behring sponsored Beriplex study,
  • For subjects with intracranial hemorrhage with:Glasgow Coma Score <10, modified Rankin Score > 3 prior to ICH,Intracerebral hemorrhage, Epidural hematomas, Infratentorial hemorrhage, Subarachnoid hemorrhage (SAH) subjects with a Hunt and Hess scale > 2, Subdural hematomas that:are judged to be an acute subdural hematoma (based on neurosurgeon review)or have a concurrent SAH or parenchymal contusion
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00803101

Contacts
Contact: Clinical Trials Registration Coordinator +49 6421 393548 clinicaltrials@cslbehring.com

Locations
United States, Delaware
Contact CSL Behring for facility details Recruiting
Newark, Delaware, United States, 19718
United States, Maryland
Contact CSL Behring for facility details Not yet recruiting
Baltimore, Maryland, United States, 21201
Armenia
Contact CSL Behring for facility details Not yet recruiting
Yerevan, Armenia, 0087
Russian Federation
Contact CSL Behring for facility details Recruiting
Kemerovo, Russian Federation, 650002
Contact: Clinical Trials Registration Coordinator         clinicaltrials@cslbehring.com    
Contact CSL Behring for facility details Recruiting
Arkhangelsk, Russian Federation, 163061
Contact CSL Behring for facility details Not yet recruiting
Barnaul, Russian Federation, 656024
Contact CSL Behring for facility details Not yet recruiting
Nizhny Novgorod, Russian Federation, 603001
Contact CSL Behring for facility details Not yet recruiting
Moscow, Russian Federation, 105203
Ukraine
Contact CSL Behring for facility details Not yet recruiting
Kharkov, Ukraine, 61018
Sponsors and Collaborators
CSL Behring
  More Information

Responsible Party: CSL Behring ( Global Head Clinical Research & Development )
Study ID Numbers: 1474, BE1116_3003, EUDRACT-Number 2007-007862-39
Study First Received: December 4, 2008
Last Updated: December 4, 2008
ClinicalTrials.gov Identifier: NCT00803101  
Health Authority: United States: Food and Drug Administration;   Russia: Federal Service for Surveillance in Healthcare and Social Development;   Armenia: Ministry of Health;   Ukraine: State Pharmacological Center - Ministry of Health

Keywords provided by CSL Behring:
Anticoagulant reversal
Prothrombin Complex Concentrate
Coagulopathy
Coumarin derivatives
Emergency surgery
Invasive procedures
Vitamin K
Reversal of coagulopathy induced by coumarin derivatives

Study placed in the following topic categories:
Thrombin
Hemorrhagic Disorders
Hematologic Diseases
Blood Coagulation Disorders
Vitamin K
Vascular Diseases
Emergencies
Hemostatic Disorders

Additional relevant MeSH terms:
Disease Attributes
Pathologic Processes
Cardiovascular Diseases

ClinicalTrials.gov processed this record on January 16, 2009