Safety and Efficacy of Bivalirudin Versus Heparin for Systemic Anticoagulation in Extracorporeal Membrane Oxygenation

NCT ID: NCT03965208

Last Updated: 2019-05-28

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

34 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-05-23

Study Completion Date

2020-12-31

Brief Summary

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This study will evaluate heparin as compared to bivalirudin for systemic anticoagulation in adult patients that require extracorporeal membrane oxygenation (ECMO). Half of the participants will receive heparin and half will receive bivalirudin.

Detailed Description

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The investigators will randomly assign 34 adult patients requiring ECMO to receive bivalirudin or unfractionated heparin in a 1:1 fashion. There will be 17 patients in each group for a total of 34 patients.

Unfractionated heparin binds to antithrombin thereby causing an anticoagulant effect while bivalirudin binds directly to thrombin. Use of unfractionated heparin in this population is problematic due to reliance on adequate levels of circulating antithrombin, complex pharmacokinetics, and variable clearance. Bivalirudin avoids many of these difficulties.

Conditions

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Extracorporeal Membrane Oxygenation Complication Anticoagulants

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Unfractionated heparin

Patients randomized to this group will receive anticoagulation with unfractionated heparin

Group Type ACTIVE_COMPARATOR

Unfractionated heparin

Intervention Type DRUG

titrated continuous infusion

Bivalirudin

Patients randomized to this group will receive anticoagulation with bivalirudin

Group Type EXPERIMENTAL

Bivalirudin

Intervention Type DRUG

titrated continuous infusion

Interventions

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Bivalirudin

titrated continuous infusion

Intervention Type DRUG

Unfractionated heparin

titrated continuous infusion

Intervention Type DRUG

Other Intervention Names

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Angiomax

Eligibility Criteria

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Inclusion Criteria

1. Age ≥18 years
2. Require ECMO and systemic anticoagulation as determined by the primary treating physician
3. Require anticoagulation to target an activated partial thromboplastin time (aPTT) of 40-60 seconds or 60-80 seconds

Exclusion Criteria

1. Prior inclusion in this study
2. Patients with known or suspected heparin induced thrombocytopenia
3. Systemic anticoagulation at Legacy for ≥ 24 hours during ECMO immediately prior to study enrollment
4. Allergy to heparin or related products or bivalirudin
5. Known anti-thrombin deficiency
6. Selection of a non-standard aPTT target range
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pacific University

OTHER

Sponsor Role collaborator

Legacy Health System

OTHER

Sponsor Role lead

Responsible Party

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R. Brigg Turner

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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R Brigg Turner, PharmD

Role: PRINCIPAL_INVESTIGATOR

Pacific University

Locations

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Legacy Health System

Portland, Oregon, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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R Brigg Turner, PharmD

Role: CONTACT

503-352-7288

Joseph Deng, MD

Role: CONTACT

503-413-2000

Facility Contacts

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Joseph Deng, MD

Role: primary

503-413-2000

Kyle Kojiro, PharmD

Role: backup

503-413-2000

Other Identifiers

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1665-2019

Identifier Type: -

Identifier Source: org_study_id

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