A Study of the Antiplatelet Effects Comparing Ticagrelor (Ticag. - AZD6140) With Clopidogrel (Clop.) Responder and Non-responders (RESPOND)
A Randomised, Double-Blind, Outpatient, Crossover Study of the Anti-platelet Effects of Ticagrelor Compared With Clopidogrel in Patients With Stable Coronary Artery Disease Previously Identified as Clopidogrel Non-responders or Responders [RESPOND]
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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Lachine, Canada
- Research Site
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Ontario
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Hamilton, Ontario, Canada
- Research Site
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Aalborg, Denmark
- Research Site
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Arhus, Denmark
- Research Site
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Esbjerg, Denmark
- Research Site
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Sheffield, United Kingdom
- Research Site
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Arkansas
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Jonesboro, Arkansas, United States
- Research Site
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Florida
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Ormond Beach, Florida, United States
- Research Site
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Maryland
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Baltimore, Maryland, United States
- Research Site
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Ohio
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Cincinnati, Ohio, United States
- Research Site
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with documented stable Coronary Artery Disease (CAD) (stable angina, previous MI history, previous history of revascularization)
- Females of child bearing potential must have a negative pregnancy test prior to receiving study drug and be willing to use a hormonal contraceptive in addition to double barrier contraception
Exclusion Criteria:
- History of Acute Coronary Syndromes within 12 months of screening or need for revascularization (angioplasty or coronary artery bypass graft (CABG))
- Any acute or chronic unstable condition in the past 30 days
- Have increased bleeding risk, eg, recent gastrointestinal bleed, uncontrolled high blood pressure, low platelet count, recent major trauma
- History of intolerance or allergy to aspirin or clopidogrel
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: 1
Aspirin + Ticagrelor
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Tablets, Oral, 90 mg; 180 mg loading dose followed by 90 mg twice daily for 2 weeks
Tablets, Oral, 75 mg to 100 mg once daily.
Aspirin obtained locally by the investigator, according to local practice.
The dose remained constant throughout the study
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Active Comparator: 2
Aspirin + Clopidogrel
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Tablets, Oral, 75 mg to 100 mg once daily.
Aspirin obtained locally by the investigator, according to local practice.
The dose remained constant throughout the study
(over encapsulated) capsule, Oral, 75 mg; 600 mg loading dose followed by 75 mg once daily for 2 weeks
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Proportion of Clopidogrel Non-responders Who Responded to Clopidogrel or Ticagrelor. - Comparing Ticag. (Day 28 of Clop. to Ticag., and Day 14 of Ticag. to Clop.) Versus Clop. (Day 14 of Clop. to Ticag., and Day 28 of Ticag. to Clop.)
Time Frame: Day 14 and Day 28, 4 Hrs Post Dose.
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The primary definition of response to treatment is IPA >10% post treatment.
The response is reported as percentage of participants of each treatment.
Please refer to the protocol section for details about the interventions administered.
IPA(%)=(PAb-PAt)/PAb*100.
PA (platelet aggregation) is measured by LTA (Light Transmittance Aggregometry).
PAb is the response at baseline (last measurement before study drug) and PAt is a response at post-treatment.
IPA=0% means no PA inhibition and 100% means 100% PA inhibition.
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Day 14 and Day 28, 4 Hrs Post Dose.
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Proportion of Clopidogrel Non-responders Who Responded to Clopidogrel or Ticagrelor. - Comparing Ticag. (Day 28 of Clop. to Ticag., and Day 14 of Ticag. to Clop.) Versus Clop. (Day 14 of Clop. to Ticag., and Day 28 of Ticag. to Clop.
Time Frame: Day 14, and day 28, 4 hours post dose
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The secondary definition of response to treatment is IPA >50% post treatment.
The response is reported as percentage of participants of each treatment.
Please refer to the protocol section for details about the interventions administered.
IPA(%)=(PAb-PAt)/PAb*100.
PA (platelet aggregation) is measured by LTA (Light Transmittance Aggregometry).
PAb is the response at baseline (last measurement before study drug) and PAt is a response at post-treatment.
IPA=0% means no PA inhibition and 100% means 100% PA inhibition.
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Day 14, and day 28, 4 hours post dose
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Clopidogrel Responders Final Extent IPA Post Switching Treatment - Comparing Ticagrelor to Ticagrelor Versus Ticagrelor to Clopidogrel on Day 15
Time Frame: Day 15, 4 hrs post switching
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IPA(%)=(PAb-PAt)/PAb*100. PA (platelet aggregation) is measured by LTA (Light Transmittance Aggregometry).
PAb is the response at baseline (last measurement before study drug) and PAt is a response at post-treatment.
IPA=0% means no PA inhibition and 100% means 100% PA inhibition.
Please refer to the protocol section for details about the interventions administered.
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Day 15, 4 hrs post switching
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Clopidogrel Responders Final Extent IPA Post Switching Treatment - Comparing Ticagrelor to Ticagrelor Versus Ticagrelor to Clopidogrel on Day 28
Time Frame: 4 hrs post first dose on day 28
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IPA(%)=(PAb-PAt)/PAb*100. PA (platelet aggregation) is measured by LTA (Light Transmittance Aggregometry).
PAb is the response at baseline (last measurement before study drug) and PAt is a response at post-treatment.
IPA=0% means no PA inhibition and 100% means 100% PA inhibition.
Please refer to the protocol section for details about the interventions administered.
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4 hrs post first dose on day 28
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Clopidogrel Responders Final Extent IPA Post Switching Treatment - Comparing Clopidogrel to Clopidogrel Versus Clopidogrel to Ticagrelor on Day 15
Time Frame: Day 15, 4 hrs post switching
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IPA(%)=(PAb-PAt)/PAb*100. PA (platelet aggregation) is measured by LTA (Light Transmittance Aggregometry).
PAb is the response at baseline (last measurement before study drug) and PAt is a response at post-treatment.
IPA=0% means no PA inhibition and 100% means 100% PA inhibition.
Please refer to the protocol section for details about the interventions administered.
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Day 15, 4 hrs post switching
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Clopidogrel Responders Final Extent IPA Post Switching Treatment - Comparing Clopidogrel to Clopidogrel Versus Clopidogrel to Ticagrelor on Day 28
Time Frame: 4 hrs post first dose on day 28
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IPA(%)=(PAb-PAt)/PAb*100. PA (platelet aggregation) is measured by LTA (Light Transmittance Aggregometry).
PAb is the response at baseline (last measurement before study drug) and PAt is a response at post-treatment.
IPA=0% means no PA inhibition and 100% means 100% PA inhibition.
Please refer to the protocol section for details about the interventions administered.
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4 hrs post first dose on day 28
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Jay Horrow, MD, AstraZeneca
- Principal Investigator: Paul Gurbel, MD, Platelet & Thrombosis Research, LLC
Publications and helpful links
General Publications
- Jeong YH, Bliden KP, Antonino MJ, Park KS, Tantry US, Gurbel PA. Usefulness of the VerifyNow P2Y12 assay to evaluate the antiplatelet effects of ticagrelor and clopidogrel therapies. Am Heart J. 2012 Jul;164(1):35-42. doi: 10.1016/j.ahj.2012.03.022. Epub 2012 Jun 13.
- Jeong YH, Bliden KP, Tantry US, Gurbel PA. High on-treatment platelet reactivity assessed by various platelet function tests: is the consensus-defined cut-off of VASP-P platelet reactivity index too low? J Thromb Haemost. 2012 Mar;10(3):487-9. doi: 10.1111/j.1538-7836.2011.04604.x. No abstract available.
- Tantry US, Bliden KP, Wei C, Storey RF, Armstrong M, Butler K, Gurbel PA. First analysis of the relation between CYP2C19 genotype and pharmacodynamics in patients treated with ticagrelor versus clopidogrel: the ONSET/OFFSET and RESPOND genotype studies. Circ Cardiovasc Genet. 2010 Dec;3(6):556-66. doi: 10.1161/CIRCGENETICS.110.958561. Epub 2010 Nov 15.
- Gurbel PA, Bliden KP, Butler K, Antonino MJ, Wei C, Teng R, Rasmussen L, Storey RF, Nielsen T, Eikelboom JW, Sabe-Affaki G, Husted S, Kereiakes DJ, Henderson D, Patel DV, Tantry US. Response to ticagrelor in clopidogrel nonresponders and responders and effect of switching therapies: the RESPOND study. Circulation. 2010 Mar 16;121(10):1188-99. doi: 10.1161/CIRCULATIONAHA.109.919456. Epub 2010 Mar 1.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Arteriosclerosis
- Arterial Occlusive Diseases
- Coronary Artery Disease
- Myocardial Ischemia
- Coronary Disease
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Analgesics
- Sensory System Agents
- Anti-Inflammatory Agents, Non-Steroidal
- Analgesics, Non-Narcotic
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Fibrinolytic Agents
- Fibrin Modulating Agents
- Platelet Aggregation Inhibitors
- Cyclooxygenase Inhibitors
- Antipyretics
- Purinergic P2Y Receptor Antagonists
- Purinergic P2 Receptor Antagonists
- Purinergic Antagonists
- Purinergic Agents
- Aspirin
- Ticagrelor
- Clopidogrel
Other Study ID Numbers
Other Study ID Numbers
- D5130C00030
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