- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01896557
Ranitidin Versus Omeprazole in Patients Taking Clopidogrel
Possible Drug Interaction Between Clopidogrel and Ranitidin or Omeprazole in Patients With Stable Coronary Heart Disease: a Comparative Study
Study Overview
Status
Intervention / Treatment
Detailed Description
Study population: 100 patients with Stable Coronary Artery Disease from Heart Institute
Inclusion Criteria:
- Age > 18 years old
- Coronary artery disease, defined as previous myocardial infarction and/or coronary angioplasty and/or Coronary Artery Bypass Graft (CABG) surgery and/or coronariography showing obstruction of at least 50 % in one of major epicardial vessels
- Treatment with Acetylsalicylic Acid (ASA) 100 mg/day
Exclusion Criteria:
- Use in the last 7 days of oral anticoagulant or any other antiplatelet drug beside ASA
- Previous utilization of PPI or ranitidine in the last 7 days before randomization
- Active bleeding
- Pregnancy or woman of childbearing age without contraceptive method
- Hemoglobin < 10 g/dL or hematocrit < 30 %, hematocrit > 50 %, platelets < 100.000/mm3 or > 500.000/mm3; creatinin clearance < 50 ml/minute
- Percutaneous coronary intervention (PCI) on the last 30 days before randomization (or PCI on the last year when drug-eluted stents are used); CABG surgery on the last 90 days; acute coronary syndrome on the last 60 days
- Active malignant neoplasm
- Active peptic ulcer disease on the last 60 days or upper gastrointestinal bleeding any time in life
- Known allergy to the drugs clopidogrel, ranitidine or omeprazole
- Refuse to participate in the study]
Methodology: The study has a double-blind, double-dummy prospective design. Clopidogrel action is evaluated by platelet function tests: VerifyNow, bioimpedance aggregometry and Platelet Function Analyzer-100 (PFA-100). The patients have measurements of platelet function on three moments: before starting clopidogrel; 1 week after DAPT with clopidogrel (without loading dose) plus ASA; and after 1 week of randomization to ranitidin 150 mg bid or omeprazole 20 mg bid.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age > 18 years old
- Coronary artery disease, defined as previous myocardial infarction and/or coronary angioplasty and/or CABG surgery and/or coronariography showing obstruction of at least 50 % in one of major epicardial vessels
- Treatment with Acetylsalicylic Acid (ASA) 100 mg/day
Exclusion Criteria:
- Use on the last 7 days of any other antiplatelet drug beside ASA or oral anticoagulant
- Previous utilization of PPI or ranitidine in the last 7 days before randomization
- Any active bleeding
- Pregnancy or woman of childbearing age without contraceptive method
- Hemoglobin < 10 g/dL or hematocrit < 30 %, hematocrit > 50 %, platelets < 100.000/mm3 or > 500.000/mm3; creatinin clearance < 50 ml/minute
- Percutaneous coronary intervention (PCI) on the last 30 days before randomization (or PCI on the last year when drug-eluted stents are used); CABG surgery on the last 90 days; acute coronary syndrome on the last 60 days
- Active malignant neoplasm
- Active peptic ulcer disease on the last 60 days or upper gastrointestinal bleeding any time in life
- Known allergy to the drugs clopidogrel, ranitidine or omeprazole
- Refuse to participate in the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: omeprazole
Omeprazole 20 mg (oral route) twice a day will be given to the subjects for one week.
This intervention will be compared with ranitidin 150 mg (oral route) twice a day.
|
Influence of omeprazole on clopidogrel pharmacodynamics will be evaluated.
Other Names:
Clopidogrel added to ASA therapy at the first medical visit, Open label 75 mg once a day will be given to all individuals as part of the protocol (since main outcome of interest is clopidogrel effect.
Actual comparison arms are double blind ranitidine and omeprazole
Other Names:
|
Experimental: ranitidine
Ranitidine 150 mg (oral route) twice a day will be given to the subjects for one week.
|
Clopidogrel added to ASA therapy at the first medical visit, Open label 75 mg once a day will be given to all individuals as part of the protocol (since main outcome of interest is clopidogrel effect.
Actual comparison arms are double blind ranitidine and omeprazole
Other Names:
Influence of ranitidine on clopidogrel pharmacodynamics will be evaluated.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Comparing Platelet Function of Patients on Dual Antiplatelet Therapy With ASA + Clopidogrel, Between the Groups Ranitidin and Omeprazole, After One Week of Randomized Treatment
Time Frame: One week after randomized treatment exposure (omeprazole or ranitidine)
|
One week after starting double-blind, double-dummy, randomized therapy with ranitidin or omeprazole on patients treated with DAPT, platelet function will be compared with the method VerifyNow, in P2Y12 Reactivity Units.
|
One week after randomized treatment exposure (omeprazole or ranitidine)
|
Comparing Platelet Function of Patients on Dual Antiplatelet Therapy With ASA + Clopidogrel, Between the Groups Ranitidin and Omeprazole, Using VerifyNow Method.
Time Frame: One week after drug exposure (omeprazole/ranitidine); 2 weeks after baseline
|
One week after starting double-blind, double-dummy, randomized therapy with ranitidin or omeprazole on patients treated with DAPT, platelet function will be compared with the method VerifyNow, in percent Inhibition of Platelet Aggregation (IPA) from baseline.
IPA was calculated as the percent change in aggregability from baseline, with the formula IPA = (on-treatment aggregability minus baseline aggregability)/baseline aggregability.
Since baseline aggregation is always, per definition, equal or more than on-treatment aggregation, there is no possibility that this number might be negative.
|
One week after drug exposure (omeprazole/ranitidine); 2 weeks after baseline
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Comparison of the Primary Outcome With Bioimpedance Aggregometry
Time Frame: 1 week after drug exposure
|
After 1 week of randomization to ranitidin or omeprazole, the platelet function will also be analysed by other method: bioimpedance aggregometry with ADP 10 mcM as reagent
|
1 week after drug exposure
|
Comparing the Main Outcome on Pre-specified Subgroups
Time Frame: 1 week after drug exposure
|
The main outcome will be compared on pre-specified subgroups:
|
1 week after drug exposure
|
Comparison of the Primary Outcome With PFA-100 (Collagen/ADP Cartridge)
Time Frame: 1 week after drug exposure
|
After 1 week of randomization to ranitidin or omeprazole, the platelet function will also be analysed by other method: PFA-100(Collagen/ADP cartridge).
|
1 week after drug exposure
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: José C Nicolau, Professor, Director of Acute Coronary Care Unit
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Myocardial Ischemia
- Heart Diseases
- Cardiovascular Diseases
- Vascular Diseases
- Arteriosclerosis
- Arterial Occlusive Diseases
- Coronary Disease
- Coronary Artery Disease
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Platelet Aggregation Inhibitors
- Purinergic P2 Receptor Antagonists
- Purinergic Antagonists
- Purinergic Agents
- Gastrointestinal Agents
- Anti-Ulcer Agents
- Proton Pump Inhibitors
- Histamine Antagonists
- Histamine Agents
- Histamine H2 Antagonists
- Clopidogrel
- Omeprazole
- Ranitidine
- Ranitidine bismuth citrate
- Purinergic P2Y Receptor Antagonists
Other Study ID Numbers
- 0136/11
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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