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Incidence of Major Cardiovascular Events in Diabetic Patients With ACS Undergoing Coronary Angioplasty and Treated With Clopidogrel 150 mg Versus 75 mg (IDASCOP 1)

20. december 2019 opdateret af: Laboratoires Teriak

Incidence Des évènements cArdiovasculaires majeurS Chez Les Patients COronariens diabétiques Subissant Une angioPlastie Coronaire et traités Par Clopidogrel à la Dose 150 mg Versus 75 mg

Acute Coronary Syndrome (ACS) is triggered by the rupture of an atherosclerotic plaque that results in a platelet aggregation reaction in the coronary artery. The administration of antiplatelet agents starting from the acute phase of the disease has helped reduce the risk of ischemic relapse both during initial and long-term hospitalization.

Management of clopidogrel following an ischemic event has been the subject of several treatment regimens ranging from a single continuous dose to a sequential double dose of between 7 and 30 days. The CURRENT-OASIS 7 therapeutic trial showed a benefit of clopidogrel double dose in reducing the risk of myocardial intervention (MI) and the composite outcome: cardiovascular mortality, MI, or stroke (CVA/TIA) at 30 days. However, the study protocol was interested in all ACSs, regardless of the Type 2 Diabetes Mellitus (T2DM) status in selected patients. Also, doubling of clopidogrel dose was maintained over 7 days after angioplasty. The literature describes an increased cardiovascular risk in type II diabetics in secondary prevention. No previous study has evaluated the effect of clopidogrel double dose given for 1 month on the reduction of this risk in the long-term in diabetic patients.

Thus, the objective of this study is to evaluate the efficacy and safety of clopidogrel double dose, given for 1 month in ACS in the diabetic patient.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The study is an open label, multicentric clinical trial. Collected data are managed by the DACIMA Clinical Suite®, the electronic data capture platform which complies with the FDA 21 CFR part 11 requirements (Food and Drug Administration 21 Code of Federal Regulations part 11), the HIPAA specifications (Health Insurance Portability and Accountability Act), and the ICH standards (International Conference on Harmonisation).

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

167

Fase

  • Fase 4

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 75 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion criteria:

  • Male or female aged between 18 to 75 years old.
  • Proven ACS requiring PTCA within 1 week of inclusion. The ACS should be without ST-segment elevation (presence of chest pain with ST-segment or T-wave changes without sustained ST segment elevation) with elevation of cardiac biomarkers of MI (positive troponins).
  • Coronary angiography showing at least one coronary lesion, whether mono, bi or multi-truncate
  • Type 2 diabetes confirmed for at least one year
  • Patient candidate for treatment with Clopidogrel
  • Informed consent of patients

Non-Inclusion Criteria:

  • Non-consenting patient and/or participating in another clinical study
  • ACS with ST segment elevation (STEMI)
  • History of digestive or cerebral bleeding with antiplatelet agents or anticoagulants
  • Insulin-dependent diabetes mellitus (IDDM)
  • Diabetic requiring insulin
  • Patient in cardiogenic shock
  • Patient under treatment with anti-glycoprotein IIb/IIIa or stopped less than 72 hours prior to inclusion
  • Previously treated with clopidogrel or thrombolytics
  • Patients programmed for surgery in less than 6 months
  • Ischemic stroke less than 6 weeks old
  • History of haemorrhagic stroke (regardless of time)
  • Patients under or candidates for Vitamin K antagonist (VKA)
  • Patients under another antiplatelet agent (Ticlopidine, Prasugrel)
  • Patients with a contraindication to clopidogrel (hypersensitivity to the active substance or to any of the excipients, severe hepatic impairment, progressive hemorrhagic lesion such as peptic ulcer or intracranial hemorrhage)
  • Under omeprazole treatment, or considered during the study
  • Anemia (Hb <12g/dl)
  • Thrombocytopenia with less than 100000 cells/mm3
  • Serum creatinine greater than 200 μmol/l
  • Pregnancy and/or breast-feeding
  • Severe renal impairment

Exclusion criteria:

  • Non-compliance with treatment (treatment compliance <80%)
  • AE/SAE requiring cessation of treatment
  • Planning a CABG
  • Occurrence of pregnancy during the study

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Arm 1 (single dose)
Will receive a clopidogrel loading dose of 600 mg PO, then a daily dose of clopidogrel 75 mg PO until the angioplasty is performed. After coronary intervention, a daily dose of clopidogrel 150 mg PO for 7 days will be given, followed by a daily single dose of clopidogrel (75 mg PO) for 21 days. Maintenance therapy will be clopidogrel daily dose of 75 mg PO thereafter, until the end of the study.
Medicin: Clopidogrel
COPIGREL® - clopidogrel dosed at 75 mg per tablet
Andre navne:
  • COPIGREL®
Aktiv komparator: Arm 2 (double dose)
Will receive a clopidogrel loading dose of 600 mg PO, then a daily dose of clopidogrel 75 mg PO until the angioplasty is performed. After coronary intervention, a daily dose of clopidogrel 150 mg PO for 7 days will be given, followed by a daily double dose of clopidogrel (150 mg PO) for 21 days. Maintenance therapy will be clopidogrel daily dose of 75 mg PO thereafter, until the end of the study.
Medicin: Clopidogrel
COPIGREL® - clopidogrel dosed at 75 mg per tablet
Andre navne:
  • COPIGREL®

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Major Cardiovascular Events (MACE)
Tidsramme: 1 year after coronary intervention
Incidence of major cardiovascular events including cardiac death, MI, cerebrovascular accident (CVA), revascularization (PTCA, GABG), stent thrombosis.
1 year after coronary intervention

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Bleeding Events
Tidsramme: At 1, 3, 6, 9 and 12 months from patient enrollment
All bleeding events (digestive, cerebral, other locations)
At 1, 3, 6, 9 and 12 months from patient enrollment
Heart Failure Readmission
Tidsramme: At 1, 3, 6, 9 and 12 months from patient enrollment
Incidence of heart failure hospital readmissions
At 1, 3, 6, 9 and 12 months from patient enrollment
Global Death
Tidsramme: At 1, 3, 6, 9 and 12 months from patient enrollment
Incidence of death of all causes (death of cardiovascular origin and death of non-cardiovascular origin)
At 1, 3, 6, 9 and 12 months from patient enrollment
Incidence of Adverse Events
Tidsramme: At 1, 3, 6, 9 and 12 months from patient enrollment
Incidence of Adverse Events (AE) including Serious Adverse Events (SAE)
At 1, 3, 6, 9 and 12 months from patient enrollment

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Laboratoires Teriak

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

7. december 2017

Primær færdiggørelse (Faktiske)

24. marts 2019

Studieafslutning (Faktiske)

20. december 2019

Datoer for studieregistrering

Først indsendt

14. oktober 2017

Først indsendt, der opfyldte QC-kriterier

27. oktober 2017

Først opslået (Faktiske)

1. november 2017

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

23. december 2019

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

20. december 2019

Sidst verificeret

1. december 2019

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • TERIAK-001

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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