Summary

Eligibility
for people ages 18 years and up (full criteria)
Location
at UC Davis UCLA
Dates
study started
completion around
Principal Investigator
by Sean Campbell, MD (ucdavis)Brant Putnam, MD (ucla)

Description

Summary

The aim of this study is to find out the effects of TAK-330 compared with four-factor prothrombin complex concentrate (4F-PCC) as part of standard treatment other than Prothromplex Total for anticoagulation reversal in participants treated with Factor Xa inhibitors who require urgent surgery/invasive procedure.

The participant will be assigned by chance to either TAK-330 or SOC 4F-PCC as part of standard treatment before surgery.

Patients participating in this study will need to be hospitalized. They will also be contacted (via telehealth/phone call) 30 days after the surgery.

Official Title

A Phase 3, Prospective, Randomized, Open-label, Adaptive Group Sequential, Multicenter Trial With Blinded Endpoint Assessment to Evaluate the Efficacy and Safety of TAK-330 for the Reversal of Direct Oral Factor Xa Inhibitor-induced Anticoagulation in Patients Requiring Urgent Surgery/Invasive Procedure

Keywords

Coagulation Disorder, Reversal of Factor Xa inhibitors, Hemostatic Disorders, Blood Coagulation Disorders, TAK-330, SOC 4F-PCC, TAK-330 25 IU/kg

Eligibility

You can join if…

Open to people ages 18 years and up

  • Participant or legally authorized representative willing to sign e-consent/written informed consent form.
  • Participants at least 18 years of age at enrollment.
  • Participant currently on treatment with oral Factor Xa inhibitor (rivaroxaban, apixaban, edoxaban).
  • In the opinion of the surgeon, the participant requires an urgent surgery/procedure that is associated with high-risk of intraoperative bleeding within 15 hours from the last dose of Factor Xa inhibitor and requires a reversal agent for suspected direct oral Factor Xa inhibitor-related coagulopathy. For participants who are beyond the 15-hour window, eligibility requires proof of elevated plasma anti Factor Xa (FXa) levels using either specific direct oral anti-coagulant (DOAC)-calibrated (apixaban, rivaroxaban or edoxaban) anti-FXa levels of greater than (>) 75 nanograms per milliliter (ng/mL), or heparin calibrated anti-FXa assay levels of >0.5 international unit per milliliter (IU/mL) at screening.
  • Women of childbearing potential should have a negative pregnancy test documented prior to enrollment.

You CAN'T join if...

  • The participant has an expected survival of less than 30 days, even with best available medical and surgical care.
  • Recent history (within 90 days prior to screening) of venous thromboembolism, myocardial infarction (MI), disseminated intravascular coagulation (DIC), ischemic stroke, transient ischemic attack, hospitalization for unstable angina pectoris or severe or critical coronavirus 2 (SARS-CoV-2) infection.
  • Active major bleeding defined as bleeding that requires surgery or transfusion of >2 units of packed red blood cell (PRBC) or intracranial hemorrhage with the exception of subacute and chronic subdural hemorrhages with a Glasgow Coma Score (GCS) greater than or equal to (>=) 9.
  • Polytrauma for which reversal of Factor Xa-inhibition alone would not be sufficient to achieve hemostasis.
  • Known prothrombotic disorder including primary antiphospholipid syndrome, antithrombin-3 deficiency, homozygous protein C deficiency, homozygous protein S deficiency, and homozygous factor V Leiden.
  • Known bleeding disorder (eg, platelet function disorders, hemophilia, Von Willebrand disease, or coagulation factor deficiency).
  • Platelet count less than (<) 50,000 per microliter (/mcL).
  • History of heparin-induced thrombocytopenia.
  • Administration of procoagulant drugs (eg, non-study prothrombin complex concentrates (PCCs), recombinant Factor VIIa) or blood products (transfusion of whole blood, fresh frozen plasma, cryoglobulins, plasma fractions, or platelets) within 7 days before enrollment. (Note: administration of PRBCs for hemoglobin correction, tranexamic acid or aminocaproic acid are not exclusion criteria).
  • Planned use of procoagulant drugs (eg, Vitamin K, non-study PCCs, recombinant Factor VIIa) or blood products (transfusion of whole blood, fresh frozen plasma, cryoglobulins, plasma fractions, or platelets) after enrollment but before the investigational product infusion is initiated (Note: administration of PRBCs for hemoglobin correction, tranexamic acid or aminocaproic acid are not exclusion criteria).
  • Administration of unfractionated heparin within 2 hours before randomization or low molecular weight heparin within 6 hours before randomization.
  • Hypersensitivity to PCC constituents or any excipient of TAK-330.
  • Participants with history of confirmed immunoglobulin A (IgA) deficiency with hypersensitivity reaction and antibodies to IgA.
  • Septic shock as defined by persistent hypotension requiring vasopressors to maintain mean arterial pressure (MAP) >=65 millimeters of mercury (mmHg) and having blood lactate >2 millimole (mmol) despite adequate volume resuscitation.
  • Acute or chronic liver failure (hepatic cirrhosis Child-PUGH score C)
  • Renal failure requiring dialysis
  • Any other condition that could, in the opinion of the investigator, put the participant at undue risk of harm if the participant were to participate in the study.
  • Participation in another clinical study involving an investigational product or device within 30 days prior to study enrollment, or planned participation in another clinical study involving an investigational product or device during the course of this study.
  • The use of PROTHROMPLEX TOTAL as SOC 4F-PCC.
  • Women who are breastfeeding at the time of enrollment .

Locations

  • UC Davis Health Dept of Orthopaedic Surgery accepting new patients
    Sacramento California 95817 United States
  • Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center accepting new patients
    Torrance California 90502 United States

Lead Scientists at University of California Health

  • Sean Campbell, MD (ucdavis)
    Assistant Professor, Orthopaedic Surgery, School of Medicine. Authored (or co-authored) 34 research publications
  • Brant Putnam, MD (ucla)
    HS Clinical Professor, Surgery, Medicine. Authored (or co-authored) 65 research publications

Details

Status
accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
Takeda
ID
NCT05156983
Phase
Phase 3 research study
Study Type
Interventional
Participants
Expecting 328 study participants
Last Updated