OPTImal Management of Antithrombotic Agents: OPTIMA-5

NCT ID: NCT04116931

Last Updated: 2020-08-25

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

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-22

Study Completion Date

2021-06-30

Brief Summary

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This is a prospective, randomized, open-label clinical trial which will enroll 80 acute coronary syndrome (ACS) patients after Percutaneous Transluminal Coronary Intervention (PCI) in China. Patients on maintenance dosing (MD) of aspirin (100 mg/d) and ticagrelor (90 mg twice daily) will be divided into two groups switching from ongoing ticagrelor to clopidogrel 600 mg loading dose (LD)/ 75 mg MD according to their bleeding risk. Then each group will randomly switch at different times(24 hours/ 12 hours after the last MD of ticagrelor). Pharmacodynamic assessments are performed at baseline, and at 4h, 8h, 24h, 48h, 72h hours with platelet aggregation rate by Light Transmittance Aggregometry method (LTA). All patients are followed-up for 30 days.

Detailed Description

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The primary endpoint of the study was platelet inhibition measured by Light Transmittance Aggregometry method(LTA). Secondary clinical endpoints included a 30-day major adverse cardiovascular endpoint (MACE) defined as a composite of cardiovascular death, recurrent myocardial infarction, target vessel revascularisation or stroke and individual components of the MACE. Safety endpoints of 30-day TIMI major and minor bleed were also evaluated.

Conditions

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Acute Coronary Syndrome (ACS)

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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clopidogrel-600 mg-12h

clopidogrel 600 mg loading dose (LD) 12 hours after the last maintenance dose(MD) of ticagrelor followed by 75 mg MD daily

Group Type EXPERIMENTAL

Switch ticagrelor to clopidogrel

Intervention Type DRUG

Switch ticagrelor to clopidogrel with 600 mg loading dose (LD)/75 mg maintenance dose(MD)12/24 hours after the last MD of ticagrelor

clopidogrel-600 mg-24h

clopidogrel 600 mg loading dose (LD) 24 hours after the last maintenance dose(MD) of ticagrelor followed by 75 mg MD daily

Group Type EXPERIMENTAL

Switch ticagrelor to clopidogrel

Intervention Type DRUG

Switch ticagrelor to clopidogrel with 600 mg loading dose (LD)/75 mg maintenance dose(MD)12/24 hours after the last MD of ticagrelor

clopidogrel-75 mg-12h

clopidogrel 75 mg maintenance dose(MD) 12 hours after the last MD of ticagrelor

Group Type EXPERIMENTAL

Switch ticagrelor to clopidogrel

Intervention Type DRUG

Switch ticagrelor to clopidogrel with 600 mg loading dose (LD)/75 mg maintenance dose(MD)12/24 hours after the last MD of ticagrelor

clopidogrel-75 mg-24h

clopidogrel 75 mg maintenance dose(MD) 24 hours after the last MD of ticagrelor

Group Type EXPERIMENTAL

Switch ticagrelor to clopidogrel

Intervention Type DRUG

Switch ticagrelor to clopidogrel with 600 mg loading dose (LD)/75 mg maintenance dose(MD)12/24 hours after the last MD of ticagrelor

Interventions

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Switch ticagrelor to clopidogrel

Switch ticagrelor to clopidogrel with 600 mg loading dose (LD)/75 mg maintenance dose(MD)12/24 hours after the last MD of ticagrelor

Intervention Type DRUG

Other Intervention Names

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switch

Eligibility Criteria

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Inclusion Criteria

* ≥ 18 years.
* ACS patients.
* Patients who are treated with ticagrelor and do not tolerate it.
* Volunteer to participate and sign informed consent.
* Approved by national regulatory authorities ethics committees.

Exclusion Criteria

* Patients who are contraindicated, intolerant or resistant to clopidogrel.
* History of hematological disease or bleeding tendency; platelet count \< 100 × 10\^9 cells/L, or \> 600 × 10\^9 cells/L, hemoglobin \< 100 g/L.
* Abnormal liver or kidney function (ALT \> 3 ULN; estimated CrCl \< 30 ml/min calculated by Cockcroft-Gault equation); diagnosed severe pulmonary disease.
* Patients in need of drugs which affect the efficacy of clopidogrel such as miconazole, ketoconazole, andfluconazole.
* Malignancies or other comorbid conditions with life expectancy less than 1 year.
* Pregnant or lactating woman.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The First Affiliated Hospital with Nanjing Medical University

OTHER

Sponsor Role lead

Responsible Party

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Chunjian Li

Dr., MD, Ph.D, Director of CCU Ward

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Chunjian Li, Dr, PhD

Role: PRINCIPAL_INVESTIGATOR

Principal Investigator

Locations

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First Affiliated Hospital of Nanjing Medical University

Nanjing, Jiangsu, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Chunjian Li, Dr, PhD

Role: CONTACT

+86-13701465229

Qian Gu

Role: CONTACT

+86-18351972592

Facility Contacts

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Fuming Zhang, M.D.

Role: primary

+86-25-83718836 ext. 6360

Yi Chai, M.D.

Role: backup

+86-25-83718836 ext. 6360

Other Identifiers

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011

Identifier Type: -

Identifier Source: org_study_id

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