敗血症性ショックの成人患者におけるドロトレコギンアルファ(活性化)の有効性と安全性
2012年8月20日 更新者:Eli Lilly and Company
敗血症性ショックの成人患者への連続 96 時間注入として投与されるドロトレコギン アルファ (活性化) の無作為化、二重盲検、プラセボ対照、多施設、第 3 相試験
このプラセボ対照研究の目的は、ドロトレコギン アルファ (活性化) 治療が、敗血症性ショックの現在の標準治療を受けている患者のプラセボ治療と比較して、敗血症性ショック患者の死亡率を大幅に低下させるかどうかを判断することです。
この研究では、敗血症性ショックおよび付随する重度のプロテイン C 欠乏症患者の 28 日死亡率の減少におけるドロトレコギン アルファ (活性化) の有効性も評価します。
調査の概要
研究の種類
介入
入学 (実際)
1696
段階
- フェーズ 3
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
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Alabama
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Birmingham、Alabama、アメリカ、35294
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California
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Loma Linda、California、アメリカ、92350
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Long Beach、California、アメリカ、90806
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San Diego、California、アメリカ、92123
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Colorado
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Colorado Springs、Colorado、アメリカ、80920
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Denver、Colorado、アメリカ、80204
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Idaho
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Idaho Falls、Idaho、アメリカ、83404
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Illinois
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Chicago、Illinois、アメリカ、60611
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Iowa
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Iowa City、Iowa、アメリカ、52242
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Kansas
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Topeka、Kansas、アメリカ、66604
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Kentucky
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Hazard、Kentucky、アメリカ、41701
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Michigan
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Lansing、Michigan、アメリカ、48912
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Missouri
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Chesterfield、Missouri、アメリカ、63017
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St Louis、Missouri、アメリカ、63131
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Montana
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Missoula、Montana、アメリカ、59802
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New York
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Brooklyn、New York、アメリカ、11215
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Staten Island、New York、アメリカ、10305
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North Carolina
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Greensboro、North Carolina、アメリカ、27403
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Oregon
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Portland、Oregon、アメリカ、97239
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Pennsylvania
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Philadelphia、Pennsylvania、アメリカ、19107
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Pittsburgh、Pennsylvania、アメリカ、15240
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Texas
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San Antonio、Texas、アメリカ、78229
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Virginia
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Norfolk、Virginia、アメリカ、23507
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London、イギリス、SW17 0QY
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Avon
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Bristol、Avon、イギリス、BS2 8HW
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Devon
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Plymouth、Devon、イギリス、PL6 8DH
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Essex
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Chelmsford、Essex、イギリス、CM2 5ET
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Hampshire
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Portsmouth、Hampshire、イギリス、P06 3LY
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Hants
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Southampton、Hants、イギリス、SO16 6YD
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Scotland
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Edinburgh、Scotland、イギリス、EH4 2XU
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Glasgow、Scotland、イギリス、G42 9TY
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Surrey
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Guildford、Surrey、イギリス、GU2 7XX
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West Midlands
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Birmingham、West Midlands、イギリス、B15 2TH
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West Sussex
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Chichester、West Sussex、イギリス、PO19 6SE
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Catania、イタリア、95124
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Firenze、イタリア、50143
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Milano、イタリア、20132
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Monza、イタリア、20052
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Novara、イタリア、28100
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Padova、イタリア、35127
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Rome、イタリア、00168
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Torino、イタリア、10126
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Varese、イタリア、21100
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Bangalore、インド、560 002
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New Delhi、インド、110 025
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Pune、インド、411004
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Arnhem、オランダ、6815 AD
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Ede、オランダ、6716 RP
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Nijmegen、オランダ、8525 GA
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Australian Capital Territory
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Garran、Australian Capital Territory、オーストラリア、2605
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New South Wales
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Newcastle、New South Wales、オーストラリア、2305
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St. Leonards、New South Wales、オーストラリア、2065
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Queensland
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Herston、Queensland、オーストラリア、4029
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South Australia
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Adelaide、South Australia、オーストラリア、5000
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Victoria
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Box Hill、Victoria、オーストラリア、3128
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Epping、Victoria、オーストラリア、3076
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Heidelberg、Victoria、オーストラリア、3084
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Melbourne、Victoria、オーストラリア、3004
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Parkville、Victoria、オーストラリア、3050
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Alberta
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Calgary、Alberta、カナダ、T2N 2T9
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British Columbia
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Vancouver、British Columbia、カナダ、V5Z 1M9
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Manitoba
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Winnipeg、Manitoba、カナダ、R3A 1R9
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Ontario
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Thunder Bay、Ontario、カナダ、P7B 6V4
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Toronto、Ontario、カナダ、M4N 3M5
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Quebec
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Montreal、Quebec、カナダ、H4J 1C5
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Sherbrook、Quebec、カナダ、J1H 5N4
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Lugano、スイス、CH-69100
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St Gallen、スイス、CH-9007
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Zurich、スイス、CH-8091
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Alcala De Henares、スペイン、28805
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Barcelona、スペイン、08035
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Burgos、スペイン、9005
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Getafe、スペイン、28905
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Las Palmas、スペイン、35010
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Madrid、スペイン、28040
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Murcia、スペイン、30008
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Palma De Mallorca、スペイン、7010
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Sabadell、スペイン、8208
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Sevilla、スペイン、41007
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Tortosa、スペイン、43500
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Valladolid、スペイン、47012
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Brno、チェコ共和国、656 91
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Hradec Kralove、チェコ共和国、500 05
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-
Olomouc、チェコ共和国、775 20
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-
Plzen、チェコ共和国、304 60
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-
Prague、チェコ共和国、128 08
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-
Usti Nad Labem、チェコ共和国、40113
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Aachen、ドイツ、52074
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Augsburg、ドイツ、86156
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-
Berlin、ドイツ、13125
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Gottingen、ドイツ、37075
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Hamburg、ドイツ、20246
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Heidelberg、ドイツ、69120
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Kiel、ドイツ、24105
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Munich、ドイツ、81377
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Auckland、ニュージーランド、1640
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-
Christchurch、ニュージーランド、8011
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Grafton、ニュージーランド、1023
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Hamilton、ニュージーランド、3204
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Wellington、ニュージーランド、6022
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Helsinki、フィンランド、00029
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Jyvaskyla、フィンランド、40620
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Kuopio、フィンランド、70211
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Lahti、フィンランド、15850
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Seinajoki、フィンランド、60220
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Tampere、フィンランド、33520
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Angers、フランス、49933
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Argenteuil、フランス、95107
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Bobigny、フランス、93009
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Bordeaux、フランス、33076
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Dijon、フランス、21079
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La Roche Sur Yon、フランス、85000
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Le Kremlin Bicetre、フランス、94275
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Limoges、フランス、87042
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Lyon、フランス、69437
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Montpellier、フランス、34295
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Nantes、フランス、44093
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Nice、フランス、06202
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Nimes、フランス、30029
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Paris、フランス、75010
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Poissy、フランス、78300
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Poitiers、フランス、86021
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Pringy、フランス、74370
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Rennes、フランス、35033
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Saint Michel、フランス、16 470
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Saint-Etienne、フランス、42055
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Toulon、フランス、83056
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Tours、フランス、37044
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Vandoeuvre-Les-Nancy、フランス、54500
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Belo Horizonte、ブラジル、30140-093
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Joinville、ブラジル、89202-050
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Londrina、ブラジル、86038
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Porto Alegre、ブラジル、90610-970
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Sao Jose Rio Preto、ブラジル、15090
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São Paulo、ブラジル、05403-000
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Antwerp、ベルギー、2020
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Antwerpen、ベルギー、2060
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Brussels、ベルギー、1200
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Edegem、ベルギー、2650
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Genk、ベルギー、3600
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Leuven、ベルギー、3000
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Liège、ベルギー、4000
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Ottignies、ベルギー、1340
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Roeselare、ベルギー、8800
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Wilrijk、ベルギー、2610
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Yvoir、ベルギー、5530
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Lisbon、ポルトガル、1449-005
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Porto、ポルトガル、4202-451
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Mexico City、メキシコ、07760
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Tlalpan、メキシコ、14000
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参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
18年歳以上 (大人、高齢者)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
説明
包含基準:
- 18歳以上である必要があります
- 感染の証拠が必要
- -全身性炎症反応症候群(SIRS)を持っている必要があります
- -昇圧剤依存性の敗血症性ショックが必要です
除外基準:
- -治験薬の開始前に24時間以上昇圧療法(任意の用量)を受けている
- -治験薬注入の開始前に36時間以上敗血症による臓器機能障害がある
- -単一の臓器機能不全と最近の手術がある(研究登録から30日以内)
- -治験薬注入の直前の12時間以内に手術が行われたか、手術後に活発な出血の証拠があるか、または注入期間中に手術を計画または予想していた
- 既存の矯正不可能な病状を考慮して、28日間生存することは期待されていません
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:ダブル
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
プラセボコンパレーター:プラセボ
|
0.9% 塩化ナトリウム、静脈内、96 時間
|
実験的:ドロトレコギン アルファ (活性化)
|
24 マイクログラム/キログラム/時間、静脈内、96 時間 (hr)
他の名前:
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
28 日間の全死因死亡率
時間枠:28日目
|
28 日目のエンドポイントで何らかの原因で死亡した参加者の割合として表されます。
|
28日目
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
重度のプロテイン C 欠乏症の参加者における 28 日間の全死因死亡率
時間枠:28日目
|
28 日目のエンドポイントで何らかの原因で死亡した参加者の割合として表されます。
重度のプロテイン C 欠乏症の参加者は、プロテイン C レベルが正常下限 (LLN) の半分以下 (40% 以下) であった人です。
|
28日目
|
平均心血管逐次臓器不全評価 (SOFA) スコア 1 日目から 28 日目まで
時間枠:1日目から28日目
|
スコアの範囲は 0 (正常) から 4 (臓器不全) で、スコアが増加するほど心血管機能障害が増加していることを示します。
生存していない参加者は、死亡した日とその後毎日、スコア 4 (最悪のスコア) を受け取ります。
|
1日目から28日目
|
平均呼吸器逐次臓器不全評価 (SOFA) スコア 1 日目から 28 日目まで
時間枠:1日目から28日目
|
スコアの範囲は 0 (正常) から 4 (臓器不全) で、スコアが高くなるほど呼吸機能障害が増加していることを示します。
生存していない参加者は、死亡した日とその後毎日、スコア 4 (最悪のスコア) を受け取ります。
|
1日目から28日目
|
1日目から28日目までの平均腎順次臓器不全評価(SOFA)スコア
時間枠:1日目から28日目
|
スコアの範囲は 0 (正常) から 4 (臓器不全) で、スコアが高くなるほど腎機能障害が進行していることを示します。
生存していない参加者は、死亡した日とその後毎日、スコア 4 (最悪のスコア) を受け取ります。
|
1日目から28日目
|
90日死亡率
時間枠:90日目
|
90 日目のエンドポイントで何らかの原因で死亡した参加者のパーセンテージとして表されます。
|
90日目
|
180日死亡率
時間枠:180日目
|
180 日目のエンドポイントで何らかの原因で死亡した参加者の割合として表されます。
|
180日目
|
平均生存時間
時間枠:180日目
|
180日目
|
|
EuroQoL Questionnaire-5 ディメンション (EQ-5D) ベースラインでの Visual Analog Scale (VAS) スコア、28 日目、90 日目、180 日目
時間枠:ベースラインと 28 日目、90 日目、180 日目
|
EQ-5D VAS は、参加者の全体的な健康状態に対する介護者の印象を評価します。
スコアの範囲は 0 (最悪の健康状態) から 100 (最高の健康状態) で、スコアが高いほど健康状態が良好であることを示します。
|
ベースラインと 28 日目、90 日目、180 日目
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EuroQoL Questionnaire-5 ディメンション (EQ-5D) ベースラインでの合計スコア、28、90、および 180 日目
時間枠:ベースラインと 28 日目、90 日目、180 日目
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EQ-5D は、参加者の全体的な健康状態を評価するために使用されます。
可動性、セルフケア、普段の活動、痛み・不快感、不安・抑うつの5項目で構成。
各項目には 3 つの重大度レベル (いいえ、一部、深刻な問題) があります。
EQ-5D から計算された合計スコア (米国 [US] インデックス スコア) は、0 (生活の質が最悪) から 1.00 (生活の質が最高) の範囲です。
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ベースラインと 28 日目、90 日目、180 日目
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QOL Short Form-12 (SF-12) ベースラインでのスコア、28、90、および 180 日目
時間枠:ベースラインと 28 日目、90 日目、180 日目
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SF-12 は、参加者の身体的健康 (身体的要素) と精神的健康 (精神的要素) を測定するための手段として使用されました。
各コンポーネントのスコアは 0 ~ 100 の範囲で、0 = 最低の健康状態、100 = 最高の健康状態です。
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ベースラインと 28 日目、90 日目、180 日目
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ベースラインから 28 日目のエンドポイントまでの任意の時点で、有害事象のために中止された参加者の割合
時間枠:28日目までのベースライン
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28日目までのベースライン
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
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ベースラインから28日目までの任意の時点でシステムオルガンクラス内で重篤な出血イベントを起こした参加者の割合
時間枠:28日目までのベースライン
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重篤な出血イベントを経験した参加者の割合は、MedDRA 14.0 に基づいて System Organ Class (SOC) 用語で報告されています。
出血が重篤な事象として認定されるためには、重篤な有害事象の標準的な定義を満たすか、中枢神経系の出血または 2 日間で 1 日あたり 3 単位以上の赤血球の投与につながる出血事象である必要があります。連日。
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28日目までのベースライン
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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
スポンサー
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
一般刊行物
- Povoa P, Salluh JI, Martinez ML, Guillamat-Prats R, Gallup D, Al-Khalidi HR, Thompson BT, Ranieri VM, Artigas A. Clinical impact of stress dose steroids in patients with septic shock: insights from the PROWESS-Shock trial. Crit Care. 2015 Apr 28;19(1):193. doi: 10.1186/s13054-015-0921-x.
- Ranieri VM, Thompson BT, Barie PS, Dhainaut JF, Douglas IS, Finfer S, Gardlund B, Marshall JC, Rhodes A, Artigas A, Payen D, Tenhunen J, Al-Khalidi HR, Thompson V, Janes J, Macias WL, Vangerow B, Williams MD; PROWESS-SHOCK Study Group. Drotrecogin alfa (activated) in adults with septic shock. N Engl J Med. 2012 May 31;366(22):2055-64. doi: 10.1056/NEJMoa1202290. Epub 2012 May 22.
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始
2008年3月1日
一次修了 (実際)
2011年9月1日
研究の完了 (実際)
2012年2月1日
試験登録日
最初に提出
2008年1月24日
QC基準を満たした最初の提出物
2008年1月24日
最初の投稿 (見積もり)
2008年1月30日
学習記録の更新
投稿された最後の更新 (見積もり)
2012年9月18日
QC基準を満たした最後の更新が送信されました
2012年8月20日
最終確認日
2012年8月1日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
ドロトレコギン アルファ (活性化)の臨床試験
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Shire完了
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Chiesi Farmaceutici S.p.A.Cromsource完了アルファマンノシドーシスフランス, デンマーク, オーストリア, ドイツ, イタリア
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Novo Nordisk A/S完了先天性出血性疾患 | 血友病A | 血友病Bアメリカ, スペイン, 台湾, 七面鳥, ポーランド, クロアチア, イタリア, マレーシア, ブラジル, イギリス, ハンガリー, イスラエル, タイ, 日本, 南アフリカ, カナダ, フランス, アルゼンチン
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ANRS, Emerging Infectious DiseasesFlamel Technologiesわからない
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Shire完了ゴーシェ病、1型アメリカ, イスラエル, アルゼンチン, インド, 大韓民国, パラグアイ, ポーランド, ロシア連邦, スペイン, チュニジア, イギリス
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Swedish Orphan Biovitrum完了
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Bayer完了血友病A、血友病Bイタリア, 中国, ニュージーランド, ロシア連邦, 台湾, シンガポール, ブルガリア, アメリカ, デンマーク, ドイツ, ハンガリー, 南アフリカ, イギリス, ルーマニア, コロンビア, メキシコ, 七面鳥, フランス, インド, 日本, オーストラリア, オランダ, ポーランド, スウェーデン, ウクライナ, 大韓民国, ブラジル, イスラエル, チリ