A Randomized Controlled Trial With Resolute Onyx in One Month Dual Antiplatelet Therapy (DAPT) for High-Bleeding Risk Patients

NCT ID: NCT03344653

Last Updated: 2020-12-02

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

NA

Total Enrollment

2000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-02

Study Completion Date

2020-10-09

Brief Summary

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The purpose of this study is to evaluate the clinical safety and effectiveness of the Resolute Onyx stent in subjects deemed at high risk for bleeding and/or medically unsuitable for more than 1 month DAPT treatment receiving reduced duration (1 month) of DAPT following stent implantation.

Detailed Description

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Conditions

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Coronary Artery Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective, multi-center, blinded, randomized, controlled study enrolling eligible subjects at global centers. The enrollment period is anticipated to be approximately 14 months.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
Subjects will be randomized at a 1:1 ratio to treatment with Resolute Onyx stent or the BioFreedom stent (control).

Study Groups

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Resolute Onyx stent

Subjects who fulfill the inclusion criteria and none of the exclusion criteria will be randomly allocated in a 1:1 fashion to treatment with a Resolute Onyx stent or the BioFreedom stent followed by 1-month DAPT. Subjects implanted with the Resolute Onyx stent will be assessed for non-inferiority compared to those implanted with the BioFreedom stent using a composite safety endpoint of cardiac death, myocardial infarction, and definite/probable stent thrombosis, at 1 year post-procedure.

Group Type ACTIVE_COMPARATOR

Medtronic Resolute Onyx Zotarolimus-Eluting Coronary Stent System

Intervention Type DEVICE

Medtronic Resolute Onyx Zotarolimus-Eluting Coronary Stent System Treatment Followed by 1 month DAPT

BioFreedom stent

Subjects who fulfill the inclusion criteria and none of the exclusion criteria will be randomly allocated in a 1:1 fashion to treatment with a Resolute Onyx stent or the BioFreedom stent followed by 1-month DAPT. Subjects implanted with the Resolute Onyx stent will be assessed for non-inferiority compared to those implanted with the BioFreedom stent using a composite safety endpoint of cardiac death, myocardial infarction, and definite/probable stent thrombosis, at 1 year post-procedure.

Group Type ACTIVE_COMPARATOR

Biosensors BioFreedom BA9 Drug Coated Coronary Stent

Intervention Type DEVICE

Biosensors BioFreedom BA9 Drug Coated Coronary Stent Followed by 1 month DAPT

Interventions

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Medtronic Resolute Onyx Zotarolimus-Eluting Coronary Stent System

Medtronic Resolute Onyx Zotarolimus-Eluting Coronary Stent System Treatment Followed by 1 month DAPT

Intervention Type DEVICE

Biosensors BioFreedom BA9 Drug Coated Coronary Stent

Biosensors BioFreedom BA9 Drug Coated Coronary Stent Followed by 1 month DAPT

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 75 years old
* Any prior documented intracerebral bleed
* Any documented stroke in the last 12 months
* Hospital admission for bleeding during the prior 12 months
* Non-skin cancer diagnosed or treated ≤3 years
* Planned surgery within the next 12 months
* Renal failure defined as: Creatinine clearance \<40 ml/min
* Thrombocytopenia (PLT \<100,000/mm3)
* Severe chronic liver disease defined as: subjects who have developed any of the following: variceal hemorrhage, ascites, hepatic encephalopathy or jaundice

Exclusion Criteria

* Pregnant and breastfeeding women
* Subjects requiring a planned PCI procedure after 1 month of index procedure
* Active bleeding at the time of inclusion
* Cardiogenic shock
* A known hypersensitivity or contraindication to aspirin, heparin and bivalirudin, P2Y12 inhibitors, mTOR inhibiting drugs such as zotarolimus, Biolimus A9 (or its derivatives), cobalt, nickel, platinum, iridium, chromium, molybdenum, polymer coatings (eg, BioLinx™), stainless steel (or other metal ions found in 316L stainless steel), zinc, or a sensitivity to contrast media, which cannot be adequately pre-medicated.
* PCI during the previous 6 months for a lesion other than the target lesion of the index procedure
* Participation in another clinical study within 12 months after index procedure
* Subjects with life expectancy of less than 2 years
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medtronic Vascular

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stephan Windecker, MD

Role: PRINCIPAL_INVESTIGATOR

Bern University Hospital, Bern, Switzerland

Azeem Latib, MD

Role: PRINCIPAL_INVESTIGATOR

San Raffaele Scientific Institute, Milan, Italy

Elvin Kedhi, MD

Role: PRINCIPAL_INVESTIGATOR

Isala Zwolle, Netherlands

Locations

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Royal North Shore Hospital

Saint Leonards, New South Wales, Australia

Site Status

Royal Brisbane and Women's Hospital

Brisbane, Queensland, Australia

Site Status

Bundaberg Cardiology - Friendly Society Private Hospital

Bundaberg, Queensland, Australia

Site Status

Cairns Hospital

Cairns, Queensland, Australia

Site Status

The Prince Charles Hospital

Chermside, Queensland, Australia

Site Status

Princess Alexandra Hospital

Woolloongabba, Queensland, Australia

Site Status

Adelaide Cardiology

Adelaide, South Australia, Australia

Site Status

Flinders Medical Centre

Bedford Park, South Australia, Australia

Site Status

Saint Vincent's Hospital (Melbourne)

Fitzroy, Victoria, Australia

Site Status

The Alfred Hospital

Melbourne, Victoria, Australia

Site Status

Fiona Stanley Hospital

Murdoch, Western Australia, Australia

Site Status

LKH - Universitätsklinikum Graz

Graz, , Austria

Site Status

A.ö. Landeskrankenhaus - Universitätskliniken Innsbruck

Innsbruck, , Austria

Site Status

Allgemeines Krankenhaus - Universitätskliniken Wien

Vienna, , Austria

Site Status

C.H.U. de Charleroi

Charleroi, , Belgium

Site Status

UZ Leuven - Campus Gasthuisberg

Leuven, , Belgium

Site Status

CHU de Liège - Hôpital du Sart Tilman

Liège, , Belgium

Site Status

Acibadem City Clinic

Sofia, , Bulgaria

Site Status

Clinique Axium

Aix-en-Provence, , France

Site Status

Hôpital Privé Jacques Cartier

Massy, , France

Site Status

Queen Elizabeth Hospital (Hong Kong)

Hong Kong, , Hong Kong

Site Status

Queen Mary Hospital

Hong Kong, , Hong Kong

Site Status

Galway University Hospitals - University Hospital Galway (UHG)

Galway, , Ireland

Site Status

Azienda Ospedaliera Bolognini Seriate - Ospedale Bolognini

Seriate, Bergamo, Italy

Site Status

Presidio Ospedaliero Ferrarotto Alessi

Catania, , Italy

Site Status

San Raffaele Scientific Institute

Milan, , Italy

Site Status

Centro Cardiologico Monzino

Milan, , Italy

Site Status

Umberto I - Policlinico di Roma

Roma, , Italy

Site Status

Paula Stradina Kliniska universitates slimnica

Riga, , Latvia

Site Status

Riga East University Hospital

Riga, , Latvia

Site Status

Hospital of Lithuanian University of Health Sciences Kauno Klinikos

Kaunas, , Lithuania

Site Status

Vilnius University Hospital Santariskiu Klinikos

Vilnius, , Lithuania

Site Status

Queen Elizabeth II Hospital

Kota Kinabalu, Sabah, Malaysia

Site Status

Sarawak Heart Centre

Kuching, Sarawak, Malaysia

Site Status

Hospital Serdang

Kajang, Selangor, Malaysia

Site Status

Sarawak Heart Centre

Kota Kinabalu, , Malaysia

Site Status

Institut Jantung Negara - National Heart Institute

Kuala Lumpur, , Malaysia

Site Status

Universitair Medisch Centrum Groningen

Groningen, , Netherlands

Site Status

Zuyderland Medisch Centrum Heerlen

Heerlen, , Netherlands

Site Status

Maastricht Universitair Medisch Centrum (MUMC)

Maastricht, , Netherlands

Site Status

St. Antonius Ziekenhuis

Nieuwegein, , Netherlands

Site Status

HagaZiekenhuis - Locatie Leyweg

The Hague, , Netherlands

Site Status

VieCuri Medisch Centrum voor Noord-Limburg - Locatie Venlo

Venlo, , Netherlands

Site Status

Isala Zwolle

Zwolle, , Netherlands

Site Status

Auckland City Hospital

Auckland, , New Zealand

Site Status

Waikato Hospital

Hamilton, , New Zealand

Site Status

Waikato Hospital

Hamilton, , New Zealand

Site Status

Wellington Hospital

Newtown, , New Zealand

Site Status

Oslo Universitetssykehus-Ullevål Universitetssykehus

Oslo, , Norway

Site Status

Stavanger Universitetssjukehus - Helse Stavanger HF

Stavanger, , Norway

Site Status

Górnośląskie Centrum Medyczne im prof Leszka Gieca Śląskiego Uniwersytetu Medycznego w Katowicach

Katowice, , Poland

Site Status

Miedziowe Centrum Zdrowia

Lubin, , Poland

Site Status

Szpital Kliniczny Przemienienia Panskiego

Poznan, , Poland

Site Status

National University Hospital

Singapore, , Singapore

Site Status

Tan Tock Seng Hospital

Singapore, , Singapore

Site Status

Stredoslovensky Ustav Srdcovych a Cievnych Chorob a.s

Banská Bystrica, , Slovakia

Site Status

Keimyung University Dongsan Medical Center

Daegu, , South Korea

Site Status

Chonnam National University Hospital

Gwangju, , South Korea

Site Status

Seoul National University Bundang Hospital

Seongnam-si, , South Korea

Site Status

Severance Hospital

Seoul, , South Korea

Site Status

Seoul National University Hospital

Seoul, , South Korea

Site Status

Samsung Medical Center

Seoul, , South Korea

Site Status

Seoul Saint Mary's Hospital

Seoul, , South Korea

Site Status

Asan Medical Center

Seoul, , South Korea

Site Status

Wonju Severance Christian Hospital

Wŏnju, , South Korea

Site Status

Hospital Clínico Universitario Virgen de la Arrixaca

El Palmar, Murcia, Spain

Site Status

Hospital Universitario de Canarias

San Cristóbal de La Laguna, Tenerife, Spain

Site Status

Hospital General Universitario de Alicante

Alicante, , Spain

Site Status

Hospital del Mar

Barcelona, , Spain

Site Status

Hospital Universitari Bellvitge

Barcelona, , Spain

Site Status

Hospital Universitario La Paz

Madrid, , Spain

Site Status

Hospital Clinico Universitario de Salamanca

Salamanca, , Spain

Site Status

Hospital Universitario Marques de Valdecilla

Santander, , Spain

Site Status

Gävle sjukhus

Gävle, , Sweden

Site Status

Universitetssjukhuset Örebro

Örebro, , Sweden

Site Status

Södersjukhuset

Stockholm, , Sweden

Site Status

Karolinska University Hospital in Solna

Stockholm, , Sweden

Site Status

Västmanlands Sjukhus

Västerås, , Sweden

Site Status

Inselspital - Universitätsspital Bern

Bern, , Switzerland

Site Status

Cardiocentro Ticino

Lugano, , Switzerland

Site Status

Siriraj Hospital

Bangkok, , Thailand

Site Status

Cardiff and Vale University Health Board - University Hospital of Wales (UHW)

Cardiff, , United Kingdom

Site Status

Royal Infirmary of Edinburgh

Edinburgh, , United Kingdom

Site Status

Royal Devon and Exeter NHS Foundation Trust

Exeter, , United Kingdom

Site Status

Golden Jubilee National Hospital - NHS Trust

Glasgow, , United Kingdom

Site Status

Royal Free Hospital

London, , United Kingdom

Site Status

The James Cook University Hospital - South Tees Hospitals NHS

Middlesbrough, , United Kingdom

Site Status

The Newcastle upon Tyne Hospitals NHS Foundation Trust - Freeman Hospital

Newcastle upon Tyne, , United Kingdom

Site Status

Queen Alexandra Hospital

Portsmouth, , United Kingdom

Site Status

Countries

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Australia Austria Belgium Bulgaria France Hong Kong Ireland Italy Latvia Lithuania Malaysia Netherlands New Zealand Norway Poland Singapore Slovakia South Korea Spain Sweden Switzerland Thailand United Kingdom

References

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Campos CM, Mehran R, Capodanno D, Owen R, Windecker S, Varenne O, Stone GW, Valgimigli M, Hajjar LA, Kalil Filho R, Oldroyd K, Morice MC, Urban P, Abizaid A. Risk Burden of Cancer in Patients Treated With Abbreviated Dual Antiplatelet Therapy After PCI: Analysis of Multicenter Controlled High-Bleeding Risk Trials. Circ Cardiovasc Interv. 2024 Apr;17(4):e013000. doi: 10.1161/CIRCINTERVENTIONS.122.013000. Epub 2024 Apr 16.

Reference Type DERIVED
PMID: 38626080 (View on PubMed)

Toth GG, Kandzari DE, Kirtane AJ, Windecker S, Latib A, Kedhi E, Mehran R, Price MJ, Choi JW, Caputo R, Troquay R, Diderholm E, Singh S, Brar SS, Loussararian A, Chetcuti S, Tulli M, Stone GW, Lung TH, Mylotte D. Two-year results from Onyx ONE clear in patients with high bleeding risk on one-month DAPT with and without intracoronary imaging. Cardiovasc Revasc Med. 2024 Jan;58:60-67. doi: 10.1016/j.carrev.2023.07.016. Epub 2023 Jul 24.

Reference Type DERIVED
PMID: 37550123 (View on PubMed)

Windecker S, Latib A, Kedhi E, Kirtane AJ, Kandzari DE, Mehran R, Price MJ, Abizaid A, Simon DI, Worthley SG, Zaman A, Hudec M, Poliacikova P, Kahar Bin Abdul Ghapar A, Selvaraj K, Petrov I, Mylotte D, Pinar E, Moreno R, Fabbiocchi F, Pasupati S, Kim HS, Aminian A, Tie C, Wlodarczak A, Hur SH, Marx SO, Ali ZA, Parke M, Lung TH, Stone GW; Onyx ONE Investigators. Polymer-Based Versus Polymer-Free Stents in High Bleeding Risk Patients: Final 2-Year Results From Onyx ONE. JACC Cardiovasc Interv. 2022 Jun 13;15(11):1153-1163. doi: 10.1016/j.jcin.2022.04.010.

Reference Type DERIVED
PMID: 35680195 (View on PubMed)

Windecker S, Latib A, Kedhi E, Kirtane AJ, Kandzari DE, Mehran R, Price MJ, Abizaid A, Simon DI, Worthley SG, Zaman A, Hudec M, Poliacikova P, Abdul Ghapar AKB, Selvaraj K, Petrov I, Mylotte D, Pinar E, Moreno R, Fabbiocchi F, Pasupati S, Kim HS, Aminian A, Tie C, Wlodarczak A, Hur SH, Marx SO, Jankovic I, Brar S, Bousquette L, Liu M, Stone GW; ONYX ONE Investigators. Polymer-based or Polymer-free Stents in Patients at High Bleeding Risk. N Engl J Med. 2020 Mar 26;382(13):1208-1218. doi: 10.1056/NEJMoa1910021. Epub 2020 Feb 12.

Reference Type DERIVED
PMID: 32050061 (View on PubMed)

Kedhi E, Latib A, Abizaid A, Kandzari D, Kirtane AJ, Mehran R, Price MJ, Simon D, Worthley S, Zaman A, Brar S, Liu M, Stone GW, Windecker S. Rationale and design of the Onyx ONE global randomized trial: A randomized controlled trial of high-bleeding risk patients after stent placement with 1 month of dual antiplatelet therapy. Am Heart J. 2019 Aug;214:134-141. doi: 10.1016/j.ahj.2019.04.017. Epub 2019 May 6.

Reference Type DERIVED
PMID: 31203158 (View on PubMed)

Other Identifiers

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MDT17054RES007

Identifier Type: -

Identifier Source: org_study_id