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A Study of Rivaroxaban for Early Discharge of Low Risk Pulmonary Embolism From the Emergency Department (MERCURY PE)

4 mai 2018 mis à jour par: Janssen Scientific Affairs, LLC

MulticEnter Trial of Rivaroxaban for Early disCharge of pUlmonaRY Embolism From the Emergency Department

The purpose of the study is to evaluate that low risk Pulmonary Embolism (PE) participants who are discharged from the Emergency Department (ED) to the home environment and treated with rivaroxaban as outpatients have fewer total days in the hospital for bleeding and/or venous thromboembolism (VTE) events through Day 30 compared to participants who are treated with initial hospitalization and standard-of-care.

Aperçu de l'étude

Statut

Complété

Les conditions

Description détaillée

This is a randomized (study medication is assigned by chance), open-label (all people know the identity of the intervention), parallel-group, multicenter (study conducted at multiple sites) study to evaluate that low risk PE participants who are discharged from the ED and treated with rivaroxaban compared to participants who are treated with initial hospitalization and standard-of-care. The study consists of a Screening and Randomization Period, followed by a 90-day open-label treatment period, and an end of study/early withdrawal (EOS) visit. The duration of study participation for each participant is approximately 3 months. The participants will be randomized in a 1:1 ratio to one of two treatments. Safety will be monitored during the study.

Type d'étude

Interventionnel

Inscription (Réel)

114

Phase

  • Phase 4

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

    • Alabama
      • Montgomery, Alabama, États-Unis
    • Arizona
      • Chandler, Arizona, États-Unis
      • Phoenix, Arizona, États-Unis
      • Tucson, Arizona, États-Unis
    • California
      • Los Angeles, California, États-Unis
      • Sacramento, California, États-Unis
      • Sylmar, California, États-Unis
    • Connecticut
      • New Haven, Connecticut, États-Unis
    • District of Columbia
      • Washington, District of Columbia, États-Unis
    • Florida
      • Pensacola, Florida, États-Unis
      • Tampa, Florida, États-Unis
    • Iowa
      • Davenport, Iowa, États-Unis
      • Iowa City, Iowa, États-Unis
    • Maryland
      • Baltimore, Maryland, États-Unis
    • Massachusetts
      • Springfield, Massachusetts, États-Unis
    • Michigan
      • Detroit, Michigan, États-Unis
      • Jackson, Michigan, États-Unis
      • Lansing, Michigan, États-Unis
      • Royal Oak, Michigan, États-Unis
    • Missouri
      • Saint Louis, Missouri, États-Unis
    • New Jersey
      • Atlantic City, New Jersey, États-Unis
      • Camden, New Jersey, États-Unis
    • New York
      • Brooklyn, New York, États-Unis
      • Buffalo, New York, États-Unis
      • New York, New York, États-Unis
      • Stony Brook, New York, États-Unis
    • North Carolina
      • Chapel Hill, North Carolina, États-Unis
      • Charlotte, North Carolina, États-Unis
      • Durham, North Carolina, États-Unis
      • Winston-Salem, North Carolina, États-Unis
    • Ohio
      • Cincinnati, Ohio, États-Unis
      • Cleveland, Ohio, États-Unis
      • Toledo, Ohio, États-Unis
      • Zanesville, Ohio, États-Unis
    • Oregon
      • Portland, Oregon, États-Unis
    • Pennsylvania
      • Allentown, Pennsylvania, États-Unis
      • Bethlehem, Pennsylvania, États-Unis
      • Philadelphia, Pennsylvania, États-Unis
      • Pittsburgh, Pennsylvania, États-Unis
      • West Reading, Pennsylvania, États-Unis
    • South Carolina
      • Charleston, South Carolina, États-Unis
    • Texas
      • Dallas, Texas, États-Unis
      • Fort Worth, Texas, États-Unis
      • Houston, Texas, États-Unis
    • Utah
      • Salt Lake City, Utah, États-Unis
    • Virginia
      • Charlottesville, Virginia, États-Unis
    • Washington
      • Bellingham, Washington, États-Unis
      • Everett, Washington, États-Unis
      • Spokane, Washington, États-Unis
      • Tacoma, Washington, États-Unis

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • Have confirmed acute symptomatic Pulmonary Embolism (PE) with or without symptomatic deep vein thrombosis (DVT)
  • A PE participant diagnosed in the Emergency Department (ED) who is deemed to be at low risk of clinical deterioration as determined by the Hestia criteria
  • Have no contraindications to and be able to complete randomized treatment and all study assessments
  • Have a life expectancy of at least 6 months
  • Must be willing and able to adhere to the prohibitions and restrictions specified in this protocol

Exclusion Criteria:

  • Having received any Combined P-gp (P-glycoprotein) and strong CYP3A4 (Cytochrome P450) inhibitors (such as but not limited to ketoconazole, telithromycin or protease inhibitors) use within 4 days before randomization, or planned use during the study. Itraconazole use within 7 days before randomization or planned use during the study
  • Having received any Combined P-gp and strong CYP3A4 inducers (such as but not limited to rifampin/rifampicin, rifabutin, rifapentine, phenytoin, phenobarbital, carbamazepine, or St. John's Wort) use within 2 weeks before randomization or planned use during the study
  • Who Has contraindications to the use of any anticoagulant therapy (example, bleeding diathesis, history of gastrointestinal bleeding within 1 year or coagulopathy documented at Screening)
  • Who Has known allergies, hypersensitivity, or intolerance to rivaroxaban or its excipients
  • Woman who is pregnant, or breast-feeding, or planning to become pregnant

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Rivaroxaban
Participants will receive Rivaroxaban 15 milligram (mg) orally twice daily with food for the first 21 days followed by 20 mg orally once daily with food, for approximately 69 days for a total treatment duration of 90 days.
Participants will receive Rivaroxaban 15 milligram (mg) twice daily up to Days 21 by orally and Rivaroxaban 20 mg once daily up to Days 90 by orally.
Expérimental: local Standard-of-care
Participants will receive local Standard-of-care as per local protocol and defined by the medical team caring for the participant.
Standard-of-care as per local protocol and defined by the medical team caring for the participant.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Mean Duration of Hospitalization
Délai: Up to Day 30
Mean number of days of initial inpatient hospitalization (beginning from randomization to discharge from the hospital) plus any subsequent hospitalization(s) related to bleeding and/or venous thromboembolism (VTE) events up to 30 days were calculated.
Up to Day 30

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Percentage of Participants With Reoccurrence of Symptomatic Venous Thromboembolism Event (VTE) (Composite of Recurrent PE, New or Recurrent DVT) or VTE-related Death
Délai: Up to 7, 14, 30, and 90 Days
Reoccurrence of symptomatic, objectively confirmed VTE, defined as recurrent pulmonary embolism (PE) or new or recurrent deep vein thrombosis (DVT) (including symptomatic upper extremity DVT) or VTE related death were analyzed.
Up to 7, 14, 30, and 90 Days
Percentage of Participants With Number of Unplanned Hospital Visits or Physician Office for VTE Symptoms and/or Bleeding
Délai: Up to 7, 14, 30 and 90 Days
Percentage of participants of unplanned hospitalization for VTE symptoms or bleeding-related hospital or physician visits were analyzed.
Up to 7, 14, 30 and 90 Days
Mean Combined Duration of Initial and Subsequent Emergency Department (ED) Hospitalization for Any Reason
Délai: Up to 30 and 90 Days
Mean combined duration of Initial and subsequent ED Stay and hospitalization for any reason within 30 and 90 days from randomization was analyzed.
Up to 30 and 90 Days
Treatment Satisfaction Assessment in Participants by Anti-clot Treatment Scale (ACTS)
Délai: Day 90
ACTS is defined as a validated measure for assessing treatment satisfaction. The ACTS comprised of 2 subscales: Burdens (13 items: Item 1 to 13 [how much of limitation from taking part in vigorous physical activities, limitation from usual activities, bothered by bruising, bothered to avoid other medicines, limitation to diet, daily hassle, occasional hassle, difficult to follow treatment, time-consuming, worrying, frustrating, burden, negative impact on life respectively) and Benefits (4 items: Items 14 to 17 for evaluating confidence, reassurance, satisfaction, positive impact respectively) as a result of anti-clot treatment. The treatment experience scores ranged from 'Not at all' to 'Extremely' on a 5-point Likert scale (psychometric rating); higher scores indicate greater satisfaction with treatment.
Day 90
Percentage of Participants Satisfied Using Site-of-Care Satisfaction Questionnaire
Délai: Day 7
The Satisfaction to Site-of-Care Questionnaire (standard-of-care versus early discharge on rivaroxaban therapy) was administered after 7 days on anticoagulant therapy. Satisfaction to Site-of-Care (hospitalization versus home care) rates the participant's level of satisfaction to care and location with care received as well as preference to location of care provided. Participants rated the 3 items of this scale of 1=Very satisfied; 2=Quite satisfied; 3=Neither; 4=Quite dissatisfied; and 5=Very dissatisfied for satisfaction questions and for the 1 preference question responses included 1=In the hospital; 2=In the community; and 3=No preference. Higher score indicates more level of satisfaction.
Day 7

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Collaborateurs

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

15 octobre 2015

Achèvement primaire (Réel)

22 mars 2017

Achèvement de l'étude (Réel)

22 mars 2017

Dates d'inscription aux études

Première soumission

11 septembre 2015

Première soumission répondant aux critères de contrôle qualité

21 octobre 2015

Première publication (Estimation)

22 octobre 2015

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

1 juin 2018

Dernière mise à jour soumise répondant aux critères de contrôle qualité

4 mai 2018

Dernière vérification

1 mai 2018

Plus d'information

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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