Safe and Timely Antithrombotic Removal - Direct Oral Anticoagulants Apixaban & Rivaroxaban (STAR-D)

NCT ID: NCT05093504

Last Updated: 2025-05-04

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

9 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-12-27

Study Completion Date

2024-01-29

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Prospective, Multicenter, Double-blind, Randomized, Study to Evaluate DrugSorb-ATR Removal of Apixaban and Rivaroxaban to Reduce Likelihood of Serious Bleeding in Patients Undergoing Urgent Cardiothoracic Surgery

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The Safe and Timely Antithrombotic Removal - Direct Oral Anticoagulants (DOACs) Apixaban \& Rivaroxaban (STAR-D) study is a prospective, multicenter, double-blind, randomized study that evaluated the DrugSorb™-Antithrombotic Removal (ATR) device for removal of apixaban and rivaroxaban to reduce the likelihood of serious bleeding in patients undergoing urgent cardiothoracic surgery. The objectives were

* To demonstrate reductions in surgical and early post-surgical bleeding with the intraoperative use of DrugSorb-ATR in patients undergoing cardiothoracic surgery ≤36hrs since last apixaban or rivaroxaban dose.
* To demonstrate reductions in apixaban or rivaroxaban blood levels (Δ\[DOAC\]) with the intraoperative use of DrugSorb-ATR.
* To establish the safety of the intraoperative use of DrugSorb-ATR in the intended population.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Hemorrhage, Surgical Hemorrhage Postoperative Blood Loss, Surgical Blood Loss, Postoperative

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Control

Standard of care with Sham set-up

Group Type SHAM_COMPARATOR

Sham comparator

Intervention Type DEVICE

Sham comparator in similar position to the investigational device, but NOT integrated into the cardiopulmonary bypass (CPB) circuit

DrugSorb-ATR Intervention

Standard of care + DrugSorb-ATR system

Group Type EXPERIMENTAL

DrugSorb-ATR system

Intervention Type DEVICE

Sorbent hemoperfusion system integrated into the cardiopulmonary bypass (CPB) circuit

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Sham comparator

Sham comparator in similar position to the investigational device, but NOT integrated into the cardiopulmonary bypass (CPB) circuit

Intervention Type DEVICE

DrugSorb-ATR system

Sorbent hemoperfusion system integrated into the cardiopulmonary bypass (CPB) circuit

Intervention Type DEVICE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Sorbent hemoperfusion system

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Male or female age 18 years or older, with documented full, written informed consent
2. Requiring cardiothoracic (CT) surgery with cardiopulmonary bypass (CPB) within 36 hours from last dose of either apixaban or rivaroxaban (\*note that patients must be taking apixaban or rivaroxaban for one of the following indications: a) reduction of stroke/systemic embolism in nonvalvular atrial fibrillation, or b) initial or extended treatment of venous thromboembolism)

Exclusion Criteria

1. \>48hrs between last apixaban or rivaroxaban dose and start of CT surgery
2. Patients on low dose apixaban or rivaroxaban for prophylactic indications
3. Heart-lung transplant procedures
4. Procedures for ventricular assist device (i.e., implant or revision of left ventricular assist device \[LVAD\] or right ventricular assist device \[RVAD\])
5. Any of the below conditions that pose a known risk for increased bleeding

1. Heparin induced thrombocytopenia
2. Preoperative platelet count \<50,000u/L
3. Hemophilia
4. International normalized ratio (INR) greater than or equal to 1.8
6. Prohibited concomitant antithrombotic medications as defined in the study protocol
7. Acute sickle cell crisis
8. Known allergy to device components
9. Active (untreated) systemic infection
10. History of major organ transplantation and those currently receiving immunosuppressive medication or who are profoundly immune suppressed
11. Women with positive pregnancy test during current admission or who are breast-feeding
12. Life expectancy \<30 days
13. Inability to comply with requirements of the study protocol
14. Treatment with investigational drug or device within 30 days of current surgery
15. Previous enrollment in this trial
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

CytoSorbents, Inc

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Michael J Mack, MD

Role: PRINCIPAL_INVESTIGATOR

Baylor Scott & White The Heart Hospital

C. M Gibson, MD

Role: PRINCIPAL_INVESTIGATOR

Beth Israel Deaconess Medical Center, The Baim Institute, and Harvard Medical School

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University of California, Davis Medical Center

Sacramento, California, United States

Site Status

University of Colorado

Denver, Colorado, United States

Site Status

Yale University

New Haven, Connecticut, United States

Site Status

Baptist Hospital of Miami and its Miami Cardiac and Vascular Institute

Miami, Florida, United States

Site Status

Advent Health

Orlando, Florida, United States

Site Status

University of South Florida

Tampa, Florida, United States

Site Status

Emory University Hospital Midtown/Emory School of Medicine

Atlanta, Georgia, United States

Site Status

Emory Saint Joseph's Hospital

Atlanta, Georgia, United States

Site Status

Lutheran Medical Group

Fort Wayne, Indiana, United States

Site Status

University of Maryland Medical Center

Baltimore, Maryland, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

Henry Ford Health System

Detroit, Michigan, United States

Site Status

University of Mississippi

Jackson, Mississippi, United States

Site Status

St. Luke's Hospital of Kansas City

Kansas City, Missouri, United States

Site Status

Bryan Medical Center

Lincoln, Nebraska, United States

Site Status

Virtua Health

Marlton, New Jersey, United States

Site Status

Jersey Shore University Medical Center

Neptune City, New Jersey, United States

Site Status

NYU Langone Medical Center

New York, New York, United States

Site Status

Bethesda North Hospital, TriHealth, Inc

Cincinnati, Ohio, United States

Site Status

University Hospitals, Cleveland Medical Center

Cleveland, Ohio, United States

Site Status

Rhode Island Hospital

Providence, Rhode Island, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

Baylor Scott & White The Heart Hospital

Plano, Texas, United States

Site Status

VCU Medical Center

Richmond, Virginia, United States

Site Status

University of Wisconsin - Madison

Madison, Wisconsin, United States

Site Status

The Medical College of Wisconsin, Inc.

Milwaukee, Wisconsin, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Tripathi R, Morales J, Lee V, Gibson CM, Mack MJ, Schneider DJ, Douketis J, Sellke FW, Ohman ME, Thourani VH, Storey RF, Deliargyris EN. Antithrombotic drug removal from whole blood using Haemoadsorption with a porous polymer bead sorbent. Eur Heart J Cardiovasc Pharmacother. 2022 Dec 2;8(8):847-856. doi: 10.1093/ehjcvp/pvac036.

Reference Type DERIVED
PMID: 35657375 (View on PubMed)

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2021-02

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.