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Observational Study to Characterize Patients Experiencing Major Acute Bleeding Events During Anticoagulation Treatment With Oral Factor Xa Inhibitors. (EMERALD)

3. august 2026 oppdatert av: Fadoi Foundation, Italy

Observational, Prospective, Multicentre, Collaborative Study, to Characterize Patients Experiencing Major Acute Bleeding Events During Anticoagulation Treatment With Oral Factor Xa Inhibitors

Oral factor Xa inhibitors are widely used for the prevention of cardioembolic events in patients with atrial fibrillation and for the treatment of venous thromboembolism, thanks to their good efficacy/safety ratio compared to vitamin K antagonists. However, major bleeding remains a potentially life-threatening event, a relevant complication and real-world treatments are still heterogeneous and there are limited data available in the literature.It is therefore considered particularly important to collect and analyze information on how major bleeding complications are treated in clinical practice and to examine the outcomes.

The objective of this study is to implement a prospective, computerized collection of clinical information, as a basis for identifying and analysing patient characteristics and treatment methods for major acute bleeding events occurring during anticoagulation with oral FXa inhibitors (apixaban, edoxaban, rivaroxaban) documenting the short-term clinical outcomes and those 3 months (90 days) after the acute event.

The main questions the study aims to answer are:

  • What are the severe clinical outcomes for these patients, specifically the composite incidence of death, the need for Intensive Care Unit (ICU) admission, or the need for bleeding-related rescue surgery?
  • What are the characteristics of the patients experiencing these events, and how are these bleeding complications managed in real-world clinical practice? Because this is an observational study, there are no experimental pharmacological interventions. Participants will receive standard clinical care based on the normal practice of each participating hospital. Data will be evaluated during the acute hospitalization phase and at a 3-month (90 days) follow-up after the initial event The study is coordinated by FADOI (Italian Society of Hospital Internal Medicine) in collaboration with AIGO (Italian Association of Hospital Gastroenterologists and Digestive Endoscopists), AII-ISA (Italian Stroke Association) and SIMEU (Italian Society of Emergency Medicine); for this the study involves not fewer than 500 consecutive patients hospitalized in Internal Medicine, Gastroenterology, Neurology and Emergency Medicine in 50 hospital centers distributed throughout Italy.

This is a prospective, observational, multicentre, pharmacological, collaborative study. Information will be collected on patients experiencing major acute bleeding events, with details of the treatment given and the clinical outcome, both in the acute phase and 3 months (90 days) after the index event. Given the observational nature of the study, there are no indications regarding the type of patients' management and/or treatment to be performed. However, major bleeding remains a relevant complication and real-world treatments are still heterogeneous and this study aims to prospectively collect data on the management of these events, including the use of available therapies.

Studieoversikt

Status

Aktiv, ikke rekrutterende

Forhold

Studietype

Observasjonsmessig

Registrering (Faktiske)

503

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

      • Milan, Italia, 20157
        • Antonella Valerio - Centro Studi FADOI

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Prøvetakingsmetode

Sannsynlighetsprøve

Studiepopulasjon

Not fewer than 500 consecutive patients hospitalized in Internal Medicine, Gastroenterology, Neurology and Emergency Medicine in 50 hospital centers distributed throughout Italy.

Beskrivelse

Inclusion Criteria:

  1. Patients currently receiving oral FXa inhibitors (apixaban, edoxaban, rivaroxaban), irrespective of anticoagulant dosage and duration of treatment, and presenting a major acute bleeding complication *

    * Events that qualify patients for the study:

    • Major spontaneous or post-traumatic bleeding, in accordance with the International Society on Thrombosis and Haemostasis (ISTH) definition

  2. Age >18 years
  3. Provision of informed consent prior to any study specific procedures

Exclusion Criteria:

1) None

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Composite Incidence of Death, ICU Admission, or Bleeding-Related Rescue Surgery
Tidsramme: 3 months post-index event
Number of participants experiencing at least one of the following events: all-cause mortality, admission to the Intensive Care Unit (ICU), or need for bleeding-related rescue surgery following an acute major bleeding event while on oral FXa inhibitor therapy.
3 months post-index event

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Patient Age
Tidsramme: Baseline (at enrollment)
Age of participants at baseline
Baseline (at enrollment)
Biological Sex Distribution
Tidsramme: Baseline (at enrollment)
Number of male and female participants enrolled in the study.
Baseline (at enrollment)
Distribution of Oral FXa Inhibitors
Tidsramme: Baseline (at enrollment)
Number of participants receiving apixaban, edoxaban, or rivaroxaban at the time of the index bleeding event.
Baseline (at enrollment)
In-Hospital Composite Incidence of Death, ICU Admission, or Rescue Surgery
Tidsramme: From index event up to hospital discharge (assessed up to 3 months)
Number of participants experiencing death, ICU admission, or need for bleeding-related rescue surgery during the index hospitalization period.
From index event up to hospital discharge (assessed up to 3 months)
Time to Hemostasis
Tidsramme: From treatment initiation up to 24 hours
Time elapsed from initiation of acute bleeding treatment to cessation of active bleeding (door-to-needle time and treatment duration).
From treatment initiation up to 24 hours
Hemostatic Efficacy Grade
Tidsramme: At 24 hours post-treatment
Proportion of participants achieving effective hemostasis evaluated according to specific clinical criteria.
At 24 hours post-treatment
Incidence of Thromboembolic Events and Recurrent Bleeding
Tidsramme: Through 3 months follow-up
Number of participants experiencing ischemic stroke, myocardial infarction, pulmonary embolism, deep vein thrombosis, systemic embolism, or new bleeding episodes.
Through 3 months follow-up
Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs)
Tidsramme: Through 3 months follow-up
Number of participants experiencing any AE or SAE possibly related to the administered hemostatic treatments.
Through 3 months follow-up

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Samarbeidspartnere

Etterforskere

  • Studiestol: Francesco Dentali, Prof., Fadoi Foundation President / Department of Medicine, ASST-Settelaghi, Varese

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

19. desember 2024

Primær fullføring (Faktiske)

29. april 2026

Studiet fullført (Antatt)

29. juli 2026

Datoer for studieregistrering

Først innsendt

19. juni 2026

Først innsendt som oppfylte QC-kriteriene

3. august 2026

Først lagt ut (Faktiske)

4. august 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

4. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

3. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • FADOI.03.2022

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

UBESLUTTE

IPD-planbeskrivelse

there is not a specific reason, simply because it is a study in collaboration with 4 different Italian scientific societies, this decision will also have to be shared

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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