Study of Fibrinogen Concentrate (Human) (FCH) to Control Bleeding During Complex Cardiovascular Surgery

NCT ID: NCT01475669

Last Updated: 2014-09-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

152 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-01-31

Study Completion Date

2014-09-30

Brief Summary

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The purpose of this study is to demonstrate that Fibrinogen Concentrate (Human)(FCH) can reduce the amount of donor blood products needed during complex cardiovascular surgery, and that it is safe and well tolerated. Subjects in this study will get either a FCH or placebo infusion during surgery. This will be in addition to the standard treatment, which is donor blood or blood products. Placebo does not contain any effective medicine.

The study is randomised. This means that the likelihood that subjects will get FCH or placebo is 50%. To make the comparison between FCH and placebo as fair as possible, the study is "double blind". This means that neither the subjects nor the study doctor will know if FCH or placebo is administered. If necessary, the study doctor can find out which treatment the subjects are receiving.

Detailed Description

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Conditions

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Surgical Blood Loss Postoperative Blood Loss

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Fibrinogen Concentrate (Human)

Group Type EXPERIMENTAL

Fibrinogen Concentrate (Human) (FCH)

Intervention Type BIOLOGICAL

Single dose infused intravenously within 5 minutes of the completion of the measurement of the 5-minute bleeding mass; the dose is determined individually based on the measured maximum clot firmness (MCF) and subject body weight

Placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type BIOLOGICAL

Single dose of sodium chloride solution infused intravenously within 5 minutes at a volume equivalent to that needed for FCH

Interventions

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Fibrinogen Concentrate (Human) (FCH)

Single dose infused intravenously within 5 minutes of the completion of the measurement of the 5-minute bleeding mass; the dose is determined individually based on the measured maximum clot firmness (MCF) and subject body weight

Intervention Type BIOLOGICAL

Placebo

Single dose of sodium chloride solution infused intravenously within 5 minutes at a volume equivalent to that needed for FCH

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

At Screening:

* Undergoing elective open surgical procedures on any part of the aorta requiring cardiopulmonary bypass (CPB), with or without other cardiac surgical procedures (e.g. valve replacement or repair, coronary artery bypass grafting, etc.).
* 18 years of age or older.
* Written informed consent for study participation obtained before undergoing any study specific procedures.

Intraoperative (at the 1st 5-minute bleeding mass):

* A 5-minute bleeding mass of 60 to 250 g following discontinuation of CPB, administration of protamine, and establishment of surgical hemostasis.
* Minimum core body temperature 35°C, measured according to local practice.
* Activated clotting time ± 25% of baseline levels.
* Blood pH \> 7.3.

Exclusion Criteria

At Screening and/or baseline:

* Undergoing emergency aortic repair surgery.
* Reoperative aortic surgery at the same anatomic site as the original procedure such as replacement of a previously placed aortic graft. Resternotomy and rethoracotomy are permitted.
* Any operation for infection.
* Proof or suspicion of a congenital or acquired coagulation disorder (e.g. Von Willebrand's disease, hemophilia or severe liver disease) or a prothrombotic disorder (e.g. protein C or S deficiency).
* Myocardial infarction (MI), acute coronary syndrome or stroke in the 2 months preceding study surgery.
* Low molecular weight or unfractionated heparin in the 24 hours preceding study surgery.
* Clopidogrel administration within 5 days preceding study surgery or prasugrel administration within 7 days preceding study surgery or ticagrelor administration in the 48 hours preceding study surgery.
* Factor Xa inhibitors within 2 days preceding study surgery.
* IIb/IIIa antagonist administration in the 24 hours preceding study surgery.
* Use of direct thrombin inhibitors: within 3 days preceding study surgery for dabigatran and within 24 hours preceding study surgery for all others.
* An international normalized ratio \> 1.3 immediately preceding the start of surgery.

Intraoperative (at the 1st 5-minute bleeding mass):

* Use of any systemic hemostatic therapy (such as FFP, platelets, prothrombin complex concentrates) from the beginning of surgery until IMP administration.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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CSL Behring

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Niels Rahe-Meyer, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Hannover Medical School

Locations

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Allgemeines Krankenhaus der Stadt Wien - Universitätskliniken

Vienna, , Austria

Site Status

Fundacao Universitaria de Cardiologia - Instituto de Cardiol

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

InCor

São Paulo, São Paulo, Brazil

Site Status

Providence Health-St Paul's Hospital

Vancouver, British Columbia, Canada

Site Status

Hamilton Health Science

Hamilton, Ontario, Canada

Site Status

Ottawa General Hospital

Ottawa, Ontario, Canada

Site Status

University of Toronto - St. Michael's Hospital

Toronto, Ontario, Canada

Site Status

Toronto General Hospital

Toronto, Ontario, Canada

Site Status

Universite Laval - Cardiologie et de Pneumologie de Quebec

Sainte-Foy, Quebec, Canada

Site Status

University Hospital St. Anna Brno

Brno, , Czechia

Site Status

Fakultni nemocnice Ostrava

Ostrava - Poruba, , Czechia

Site Status

Kobenhavns Universitet-Det Sundhedsvidenskabelige Fakultet

Copenhagen, , Denmark

Site Status

HUCH Anaestesia and Surgery

Helsinki, , Finland

Site Status

Klinikum der Universität München

Munich, Bavaria, Germany

Site Status

Klinikum der J.-W.-Goethe-Universität

Frankfurt am Main, Hesse, Germany

Site Status

Study Site

Bielefeld/Hannover, , Germany

Site Status

Policlinico S. Orsola Malpighi

Bologna, , Italy

Site Status

Fondazione Centro San Raffaele

Milan, , Italy

Site Status

Azienda Ospedaliera di Udine

Udine, , Italy

Site Status

Nagoya University Hospital

Nagoya, Aichi-ken, Japan

Site Status

Kurume University Hospital

Kurume, Fukuoka, Japan

Site Status

Hamamatsu University Hospital

Hamamatsu, Higashi-ku, Japan

Site Status

Kobe University Hospital

Kobe, Hyōgo, Japan

Site Status

Kyoto University Hospital

Kyoto, Kamigyo-ku, Japan

Site Status

Tohoku University Hospital

Sendai, Miyagi, Japan

Site Status

Tenri Hospital

Tenri, Nara, Japan

Site Status

National Cerebral and Cardiovascular Center

Suita, Osaka, Osaka, Japan

Site Status

Keio University Hospital

Shinjuku, , Japan

Site Status

Inst. Kardiologii im. Prymasa Tysiaclecia Kard. S. Wyszynskiego

Warszawa - Anin, Masovian Voivodeship, Poland

Site Status

Krakowski Szpital Specjalistyczny im. Jana Pawla II

Krakow, , Poland

Site Status

Samodzielny Publiczny Szpital Kliniczny nr 2

Szczecin, , Poland

Site Status

Papworth Hospital

Cambridge, , United Kingdom

Site Status

University Hospital of Leicester

Leicester, , United Kingdom

Site Status

Liverpool Heart and Chest Hospital

Liverpool, , United Kingdom

Site Status

Southampton General Hospital

Southampton, , United Kingdom

Site Status

Countries

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Austria Brazil Canada Czechia Denmark Finland Germany Italy Japan Poland United Kingdom

References

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Rahe-Meyer N, Levy JH, Mazer CD, Schramko A, Klein AA, Brat R, Okita Y, Ueda Y, Schmidt DS, Gill R. Randomized evaluation of fibrinogen versus placebo in complex cardiovascular surgery: post hoc analysis and interpretation of phase III results. Interact Cardiovasc Thorac Surg. 2019 Apr 1;28(4):566-574. doi: 10.1093/icvts/ivy302.

Reference Type DERIVED
PMID: 30462259 (View on PubMed)

Rahe-Meyer N, Levy JH, Mazer CD, Schramko A, Klein AA, Brat R, Okita Y, Ueda Y, Schmidt DS, Ranganath R, Gill R. Randomized evaluation of fibrinogen vs placebo in complex cardiovascular surgery (REPLACE): a double-blind phase III study of haemostatic therapy. Br J Anaesth. 2016 Jul;117(1):41-51. doi: 10.1093/bja/aew169.

Reference Type DERIVED
PMID: 27317703 (View on PubMed)

Other Identifiers

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2011-002685-20

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

BI3023_3002

Identifier Type: -

Identifier Source: org_study_id

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