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

4 mei 2018 bijgewerkt door: 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.

Studie Overzicht

Toestand

Voltooid

Conditie

Gedetailleerde beschrijving

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.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

114

Fase

  • Fase 4

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

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

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: 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.
Experimenteel: 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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Mean Duration of Hospitalization
Tijdsspanne: 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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Percentage of Participants With Reoccurrence of Symptomatic Venous Thromboembolism Event (VTE) (Composite of Recurrent PE, New or Recurrent DVT) or VTE-related Death
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

15 oktober 2015

Primaire voltooiing (Werkelijk)

22 maart 2017

Studie voltooiing (Werkelijk)

22 maart 2017

Studieregistratiedata

Eerst ingediend

11 september 2015

Eerst ingediend dat voldeed aan de QC-criteria

21 oktober 2015

Eerst geplaatst (Schatting)

22 oktober 2015

Updates van studierecords

Laatste update geplaatst (Werkelijk)

1 juni 2018

Laatste update ingediend die voldeed aan QC-criteria

4 mei 2018

Laatst geverifieerd

1 mei 2018

Meer informatie

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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