BivaLirudin versUS Heparin in Extracorporeal Membrane Oxygenation

NCT ID: NCT05959252

Last Updated: 2024-08-13

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-05-01

Study Completion Date

2026-05-01

Brief Summary

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The goal of this open label randomised clinical trial is to compare Bivalirudin versus Heparin for anticoagulation in patients requiring extracorporeal membrane oxygenation support.

The main question it aims to answer are include the ability to maintain anticoagulation within defined therapeutic range, bleeding and thrombotic complications and a comparison of the total cost of anticoagulation care.

Participants will be randomised to either anticoagulation with Bivalirudin or anticoagulation with Unfractionated Heparin.

Detailed Description

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Rationale:

Anticoagulation whilst on extracorporeal membrane oxygenation (ECMO) is required. Bleeding and thrombotic complications whilst on ECMO are common and may effect the patient outcome. The optimal anticoagulant for ECMO patients is not clear and there exists no randomised control trial data comparing anticoagulants on ECMO. This Phase 2b trial will provide data to enable larger definitive phase III trials to determine the best anticoagulant whilst on ECMO.

Hypothesis: Hypothesis: In adults ECMO patients'; anticoagulation with Bivalirudin results in more samples within therapeutic range than unfractionated Heparin. Total anticoagulation costs with Bivalirudin are similar to unfractionated Heparin.

The objectives of this study is to assess anticoagulation protocol of bivalirudin versus unfractionated heparin and assess the to the cost of each protocol.

Conditions

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Extracorporeal Membrane Oxygenation Complication

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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Bivalirudin

Bivalirudin protocol with target activated thromboplastin time (aPTT) of 50-70 seconds

Group Type ACTIVE_COMPARATOR

Bivalirudin

Intervention Type DRUG

Bivalirudin protocol with target aPTT 50-70 seconds

Unfractionated Heparin

Unfractionated heparin protocol with target anti-Xa of 0.3-0.5 IU/mL

Group Type ACTIVE_COMPARATOR

Unfractionated heparin

Intervention Type DRUG

Unfractionated Heparin protocol with target anti-Xa of 0.3-0.5 IU/mL

Interventions

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Unfractionated heparin

Unfractionated Heparin protocol with target anti-Xa of 0.3-0.5 IU/mL

Intervention Type DRUG

Bivalirudin

Bivalirudin protocol with target aPTT 50-70 seconds

Intervention Type DRUG

Other Intervention Names

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Heparin

Eligibility Criteria

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Inclusion Criteria

* Patients receiving ECMO
* Age: 18 years or older
* Ability to randomise the patient within 4 hours of ECMO support initiation

Exclusion Criteria

* Post-cardiotomy ECMO patients
* Contraindication to heparin or bivalirudin at time of randomisation e.g., active bleeding
* Heparin induced thrombotic thrombocytopenia syndrome
* Where the patient is expected to be disconnected from ECMO in the next day after cannulation.
* Limitations of care put in place either through patient wishes or the treating medical teams
* Other reason where the treating physician deems the study is not in the patient's best interest
* Patients who are suspected or confirmed to be pregnant
* Inherited bleeding or thrombotic disorders, Systemic Lupus Erythematosus patients
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sydney Local Health District

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Royal Prince Alfred Hospital

Sydney, New South Wales, Australia

Site Status RECRUITING

Countries

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Australia

Facility Contacts

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Timothy J Southwood

Role: primary

+61295156111

Mark Dennis, PhD

Role: backup

+61295156111

Other Identifiers

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2023/ETH00443

Identifier Type: -

Identifier Source: org_study_id

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