Excellence In Peripheral Artery Disease Thrombin Receptor Antagonist Intervention In Claudication Evaluation (XLPAD-TRACE Trial)

NCT ID: NCT02660866

Last Updated: 2018-05-29

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-07-31

Study Completion Date

2019-07-31

Brief Summary

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This is a Phase 4, randomized clinical trial to evaluate whether addition of Vorapaxar 2.08 mg daily vs. placebo daily on background antiplatelet therapy, prescribed for 6 months to patients with established peripheral artery disease (PAD) and Intermittent Claudication (IC) treated with standard medical therapy (SMT) would lead to an improvement in the peak walking time (PWT).

Detailed Description

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Primary trial objective: To evaluate whether addition of Vorapaxar 2.08 mg daily vs. placebo daily on background antiplatelet therapy, prescribed for 6 months to patients with established PAD and IC treated with standard medical therapy (SMT) would lead to an improvement in the peak walking time (PWT)

Study endpoints Primary endpoint: Change from baseline to 6 months in the PWT on a graded treadmill test (GTT per Gardner protocol) between participants enrolled in the test and control arms of the study

Secondary endpoints

* Change from baseline to 6 months in the claudication onset time (COT) on GTT between participants enrolled in the test and control arms of the study.
* Change from baseline to 6 months in the walking impairment questionnaire distance scores (WIQ) between participants enrolled in the test and control arms of the study.
* Change from baseline to 6 months in self-reported quality of life score using the Medical Outcomes Study 12-Item Short form survey (SF-12) between participants enrolled in the test and control arms of the study

Tertiary endpoints

* The first occurrence of clinically indicated lower extremity endovascular or surgical revascularization procedure during the entire study duration post-randomization in participants enrolled in the test or control arms of the study.
* The first occurrence of all-cause death, MI, ischemic stroke during the entire study duration post-randomization in participants enrolled in the test or control arms of the study.
* The first occurrence of severe bleeding defined according to the Global Utilization of Streptokinase and Tissue plasminogen activator for Occluded coronary arteries (GUSTO) classification during the entire study duration post-randomization in participants enrolled in the test or control arms of the study.

Conditions

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Peripheral Arterial Disease

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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SMT+APT+Placebo

Standard Medical Therapy (SMT): Presence of any two of the listed classes of agents \[angiotensin converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), statin therapy and beta-blocker drugs\] + ability to perform at least 15 min of home walking a day, at least 3 times/week, at ≥20 steps/min

Background Antiplatelet Therapy (APT) :At least one aspirin dose within 5 days prior to randomization at 325 mg dose in aspirin naïve patients (0-5 days of prior aspirin use) or at least one aspirin dose within 5 days prior to randomization at 81 mg dose in patients on chronic (\>5 days of prior use) aspirin therapy.

Group Type PLACEBO_COMPARATOR

Placebo + background APT + SMT

Intervention Type DRUG

Placebo drug therapy combined with standard medical therapy combined with Antiplatelet therapy (Aspirin therapy)

Vorapaxar 2.08 mg/d + background APT + SMT.

Intervention Type DRUG

Vorapaxar 2.08 mg/d combined with standard medical therapy combined with Antiplatelet therapy (Aspirin therapy)

SMT+APT+Vorapaxar

Standard Medical Therapy (SMT): Presence of any two of the listed classes of agents \[angiotensin converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), statin therapy and beta-blocker drugs\] + ability to perform at least 15 min of home walking a day, at least 3 times/week, at ≥20 steps/min

Background Antiplatelet Therapy (APT) :At least one aspirin dose within 5 days prior to randomization at 325 mg dose in aspirin naïve patients (0-5 days of prior aspirin use) or at least one aspirin dose within 5 days prior to randomization at 81 mg dose in patients on chronic (\>5 days of prior use) aspirin therapy.

Vorapaxar: Vorapaxar 2.08mg/day

Group Type ACTIVE_COMPARATOR

Placebo + background APT + SMT

Intervention Type DRUG

Placebo drug therapy combined with standard medical therapy combined with Antiplatelet therapy (Aspirin therapy)

Vorapaxar 2.08 mg/d + background APT + SMT.

Intervention Type DRUG

Vorapaxar 2.08 mg/d combined with standard medical therapy combined with Antiplatelet therapy (Aspirin therapy)

Interventions

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Placebo + background APT + SMT

Placebo drug therapy combined with standard medical therapy combined with Antiplatelet therapy (Aspirin therapy)

Intervention Type DRUG

Vorapaxar 2.08 mg/d + background APT + SMT.

Vorapaxar 2.08 mg/d combined with standard medical therapy combined with Antiplatelet therapy (Aspirin therapy)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Treadmill PWT= 2-10 min on Gardner protocol
* Estimated survival ≥1 year in the judgment of the site investigator
* Use of at least one aspirin dose within at least 5 days prior to randomization at 325 mg dose in aspirin naïve patients (0-5 days of prior aspirin use) or at least one aspirin dose prior to randomization at 81 mg dose in patients on chronic (\>5 days) aspirin therapy (at clinically indicated doses).
* Presence of any one of the listed classes of agents \[angiotensin converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), lipid lowering therapy, aspirin and beta-blocker drugs\]

Exclusion Criteria

* MI or percutaneous coronary intervention (PCI) with DES within the past 11 months
* Positive pregnancy test
* Planned surgical or endovascular procedures other than for the treatment of IC
* Warfarin or other chronic oral anticoagulant use within 14 days
* Use of Ticagrelor, Clopidogrel, Prasugrel or Ticlopidine within 7 days
* Contraindication(s) to the use of antithrombin or antiplatelet agents (history of intra-cerebral hemorrhage or ICH, presence of intracerebral mass, recent or \<12 weeks gastrointestinal bleed requiring blood transfusion, any blood transfusion within the last 6 weeks, any trauma requiring surgery within the last 4 weeks or any surgical or endovascular procedure within the last 4 weeks
* Use of cilostazol and/or pentoxyphilline within 7 days
Minimum Eligible Age

40 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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North Texas Veterans Healthcare System

FED

Sponsor Role lead

Responsible Party

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Subhash Banerjee

Chief, Cardiology Division

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Southern Arizona VA Health Care System

Tucson, Arizona, United States

Site Status RECRUITING

San Diego VA Medical center

San Diego, California, United States

Site Status RECRUITING

VA Eastern Colorado Healthcare System

Denver, Colorado, United States

Site Status RECRUITING

Atlanta Heart Specialists

Atlanta, Georgia, United States

Site Status RECRUITING

Minneapolis Heart Institute Foundation

Minneapolis, Minnesota, United States

Site Status RECRUITING

Minneapolis VA Medical center

Minneapolis, Minnesota, United States

Site Status RECRUITING

Creighton University

Omaha, Nebraska, United States

Site Status RECRUITING

Northwell Health

Manhasset, New York, United States

Site Status RECRUITING

OKlahoma VA Medical Center

Oklahoma City, Oklahoma, United States

Site Status RECRUITING

VA Portland Health Care System

Portland, Oregon, United States

Site Status RECRUITING

VA North Texas Health Care System

Dallas, Texas, United States

Site Status RECRUITING

Texas Tech University Health Science Center

Lubbock, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Ishita Tejani, BDS, MS, MSPH

Role: CONTACT

214-857-3048

Facility Contacts

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Madhan Shanmugasundaram, MD

Role: primary

520-792-1450 ext. 4624

Sandra Velasquez

Role: backup

520-792-1450 ext. 5691

Matthew Allison, MD

Role: primary

858-552-8585 ext. 3289

Amelia Parnell

Role: backup

Ehrin Armstrong, MD

Role: primary

916-762-2666

Caitlin Hutchinson

Role: backup

303-399-8020 ext. 4019

Narendra Singh, MD

Role: primary

678-679-1065

Kati Raynes

Role: backup

Nedaa Skeik, MD

Role: primary

612-863-6800

Laura Onstot

Role: backup

612-863-6120

Santiago Garcia, MD

Role: primary

612-467-3670

Rebekah Hermann, RN

Role: backup

612-467-3668

Syed Mohiuddin, MD

Role: primary

402-280-4635

Brittni Gochnauer

Role: backup

402-280-4448

Mitchell Weinberg, MD

Role: primary

516-562-4100

Vidya Seeratan

Role: backup

516-562-2653

Faisal Latif, MD

Role: primary

405-456-3686

Cheryl Adams, RN

Role: backup

405-456-1775

Matthew Koopmann, MD

Role: primary

310-478-3711

Joy Usih

Role: backup

503-220-8262 ext. 58388

Subhash Banerjee, MD

Role: primary

214-857-1608

Ishita Tejani, BDS, MS, MSPH

Role: backup

214-857-3048

Mac Ansari, MD

Role: primary

806-743-1501

Ronnie Orozco, MS

Role: backup

806-743-6900

References

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Hirsch AT, Hiatt WR; PARTNERS Steering Committee. PAD awareness, risk, and treatment: new resources for survival--the USA PARTNERS program. Vasc Med. 2001;6(3 Suppl):9-12. doi: 10.1177/1358836X0100600i103.

Reference Type RESULT
PMID: 11789964 (View on PubMed)

McBurney CR, Eagle KA, Kline-Rogers EM, Cooper JV, Mani OC, Smith DE, Erickson SR. Health-related quality of life in patients 7 months after a myocardial infarction: factors affecting the Short Form-12. Pharmacotherapy. 2002 Dec;22(12):1616-22. doi: 10.1592/phco.22.17.1616.34121.

Reference Type RESULT
PMID: 12495171 (View on PubMed)

Tsai S, Liu Y, Alaiti MA, Gutierrez JA, Brilakis ES, Banerjee S. No benefit of vorapaxar on walking performance in patients with intermittent claudication. Vasc Med. 2022 Feb;27(1):33-38. doi: 10.1177/1358863X211042082. Epub 2021 Oct 5.

Reference Type DERIVED
PMID: 34609939 (View on PubMed)

Other Identifiers

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xlpadtrace

Identifier Type: -

Identifier Source: org_study_id

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