NCT03083704

Brief Summary

This is a randomized, double-blind, study in healthy volunteers dosed to steady state with fXa inhibitors, designed to (1) demonstrate PK/PD comparability between andexanet manufactured by the Generation 1 and Generation 2 processes, (2) evaluate the degree to which the Generation 2 andexanet reverses fXa-inhibitor-induced anticoagulation in comparison to placebo, and (3) evaluate safety of Generation 2 andexanet.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
153

participants targeted

Target at P75+ for phase_1

Timeline
Completed

Started Feb 2017

Shorter than P25 for phase_1

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 26, 2017

Completed
9 days until next milestone

First Submitted

Initial submission to the registry

March 7, 2017

Completed
13 days until next milestone

First Posted

Study publicly available on registry

March 20, 2017

Completed
6 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 28, 2017

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 28, 2017

Completed
Last Updated

August 8, 2023

Status Verified

August 1, 2023

Enrollment Period

7 months

First QC Date

March 7, 2017

Last Update Submit

August 7, 2023

Conditions

Outcome Measures

Primary Outcomes (7)

  • Pharmacokinetics

    To evaluate the pharmacokinetics of Generation 2 process andexanet, as measured by AUC(0-∞)

    Day 1 through Day 7

  • Reversal

    To evaluate reversal of fXa-inhibitor-mediated anticoagulation, as measured by anti-fXa activity

    Day 1 through Day 7

  • Safety will be evaluated by assessment of adverse events, venous thromboembolic events, physical exam findings, vital signs, oxygen saturation, fecal occult blood testing, and 12-lead ECGs.

    Non-laboratory-based Endpoints

    Day 1 through Day 32

  • Safety will be evaluated by analyzing the following: • Hematology, chemistry & urinalysis.

    Laboratory-based Endpoints

    Day 1 through Day 32

  • Safety will be evaluated by analyzing the following: • Antibodies to andexanet, fX, & fXa, and neutralizing antibodies

    Laboratory-based Endpoints

    Day 1 through Day 32

  • Safety will be evaluated by analyzing the following: • TFPI, D-dimer, F1+2, thrombin-antithrombin III, and Russell's viper venom time

    Laboratory-based Endpoints

    Day 1 through Day 32

  • Safety will be evaluated by analyzing the following: fX, fibrinogen, tissue-type plasminogen activator, plasmin-alpha2-antiplasmin complexes, thrombin activatable fibrinolysis inhibitor, beta-thromboglobulin, platelet factor 4 & soluble thrombomodulin

    Laboratory-based Endpoints

    Day 1 through Day 32

Secondary Outcomes (9)

  • To evaluate the pharmacokinetics of Generation 2 process andexanet, as measured by the following PK parameter: Total area under the plasma concentration-time curve from time 0 to infinity (AUC(0 ∞)

    Day 1 through Day 7

  • Reversal

    Day 1 through Day 7

  • Reversal

    Day 1 through Day 7

  • To evaluate the pharmacokinetics of Generation 2 process andexanet, as measured by the following PK parameter: Cmax - Maximum Observed Concentration

    Day 1 through Day 7

  • To evaluate the pharmacokinetics of Generation 2 process andexanet, as measured by the following PK parameter: Tmax - Time to maximum observed plasma concentration (Tmax)

    Day 1 through Day 7

  • +4 more secondary outcomes

Study Arms (11)

Cohort 1

EXPERIMENTAL
Drug: Apixaban 5 MGBiological: Andexanet alfa (Gen 1 Process 3)

Cohort 2

EXPERIMENTAL
Drug: Rivaroxaban 20 MGBiological: Andexanet alfa (Gen 1 Process 3)

Cohort 3

EXPERIMENTAL
Biological: Andexanet alfa (Gen 1 Process 2)Drug: Apixaban 5 MG

Cohort 4

EXPERIMENTAL
Drug: Apixaban 5 MGBiological: Andexanet alfa (Gen 2)

Cohort 5

EXPERIMENTAL
Drug: Rivaroxaban 20 MGBiological: Andexanet alfa (Gen 2)

Cohort 6

EXPERIMENTAL
Drug: Enoxaparin sodiumBiological: Andexanet alfa (Gen 2)

Cohort 7

EXPERIMENTAL
Drug: Edoxaban 60 MGBiological: Andexanet alfa (Gen 2)

Cohort 8

EXPERIMENTAL
Biological: Andexanet alfa (Gen 2)Drug: Apixaban 10 MG

Cohort 9

EXPERIMENTAL
Biological: Andexanet alfa (Gen 2)Drug: Rivaroxaban 10 MG

Cohort 10

EXPERIMENTAL
Drug: Enoxaparin sodiumBiological: Andexanet alfa (Gen 2)

Cohort 11

EXPERIMENTAL
Drug: Edoxaban 60 MGBiological: Andexanet alfa (Gen 2)

Interventions

factor Xa inhibitor antidote

Cohort 3

factor Xa inhibitor

Cohort 1Cohort 3Cohort 4

factor Xa inhibitor

Cohort 2Cohort 5

low molecular weight heparin

Cohort 10Cohort 6

factor Xa inhibitor

Cohort 11Cohort 7

factor Xa inhibitor antidote

Cohort 10Cohort 11Cohort 4Cohort 5Cohort 6Cohort 7Cohort 8Cohort 9

factor Xa inhibitor antidote

Cohort 1Cohort 2

factor Xa inhibitor

Cohort 8

factor Xa inhibitor

Cohort 9

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Must be in reasonably good health as determined by the Investigator based on medical history, full physical examination (including blood pressure and pulse rate measurement), 12-lead ECG, and clinical laboratory tests. Subjects with well-controlled, chronic, stable conditions (e.g., controlled hypertension, non-insulin dependent diabetes, osteoarthritis, hypothyroidism) may be enrolled based on the clinical judgment of the Investigator and if approved by the Medical Monitor.
  • Must be between the ages of 18 and 75 years, inclusive, at the time of signing of the informed consent form (ICF).
  • Agrees to have any dietary or nutritional supplements reviewed by the Investigator and potentially be withheld during the study if advised by the Investigator. Standard multivitamin and mineral supplementation will be permitted.
  • Agrees to comply with the contraception and reproduction restrictions of the study:
  • Men whose sexual partner is of childbearing potential and/or who are not monogamous must be using two acceptable methods of contraception, at least one of which must be a barrier method (e.g., spermicidal gel plus condom), for the entire duration of the study and for at least 1 month following study-drug administration; and men must refrain from attempting to father a child or donating sperm in the 1 month following the study-drug administration. Periodic abstinence (e.g., calendar, ovulation, sympto-thermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception;
  • Men who report surgical sterilization (e.g., bilateral vasectomy) must have had the procedure at least 6 months before study drug administration.
  • Surgical sterilization procedures should be supported with clinical documentation and noted in the Relevant Medical History/Current Medical Conditions section of the case report forms (CRFs).
  • Women of childbearing potential must be using two medically acceptable methods of contraception, at least one of which must be a barrier method (e.g., non-hormone containing intra-uterine device plus condom, spermicidal gel plus condom, diaphragm plus condom), from the time of Screening and for the duration of the study, through at least 1 month following study drug administration. NOTE: Oral and topical hormonal contraceptive use, as well as the use of hormone-containing intra-uterine devices, is not permitted due to their increased risk of thromboembolism. Periodic abstinence (e.g., calendar, ovulation, sympto-thermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception; OR
  • Postmenopausal women must have had no regular menstrual bleeding for at least 1 year before initial dosing and either be over the age of 60 years or have an elevated plasma follicle-stimulating hormone (FSH) level (i.e., \> 40 mIU/mL) at Screening; OR
  • Women who report surgical sterilization (i.e., hysterectomy, tubal ligation, and/or bilateral oophorectomy) must have had the procedure at least 6 months before study drug administration. Surgical sterilization procedures should be supported with clinical documentation and noted in the Relevant Medical History/Current Medical Conditions section of the CRF; AND
  • All female subjects must have a documented negative pregnancy test result at Screening and on Study Day 1.
  • Systolic blood pressure \< 160 mmHg and diastolic blood pressure \< 90 mmHg at Screening and Day 1.
  • The following laboratory values must be within the normal laboratory reference range within 28 days of Day 1: prothrombin time (PT), activated partial thromboplastin time (aPTT), and activated clotting time (ACT); hemoglobin, hematocrit, and platelet count.
  • The following laboratory values must be equal to or below 2 times the upper limit of normal (ULN) range within 28 days of Day 1: Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) and total bilirubin.
  • The Screening serum creatinine must be below 1.5 mg/dL within 28 days of Day 1.
  • +3 more criteria

You may not qualify if:

  • Previous use of andexanet or previous participation in the current study.
  • History of abnormal bleeding, signs or symptoms of active bleeding, or risk factors for bleeding.
  • Has a stool specimen that was positive for occult blood within 6 months of study Screening or during the Screening Period.
  • Past or current medical history of thrombosis, any sign or symptom that suggests an increased risk of a systemic thrombotic condition or thrombotic event, or recent events that may increase risk of thrombosis.
  • a. For example, subjects with a known or suspected hypercoagulable state, history of VTE, DVT, stroke, myocardial infarction \[MI\], cancer \[other than non-melanoma skin cancer\], atrial fibrillation, heart failure, cardiomyopathy, phlebitis, lower extremity edema, major surgery or trauma within 2 months of Study Day 1, airplane travel ≥ 2 hours during the 4 weeks prior to Study Day 1, or general immobility are excluded.
  • Absolute or relative contraindication to anticoagulation or treatment with apixaban, rivaroxaban, enoxaparin, or edoxaban.
  • Prior consumption of (by any route) one or more doses of aspirin (including baby aspirin), salicylate or subsalicylate, other antiplatelet drugs (e.g., ticlopidine, clopidogrel), non-steroidal anti-inflammatory drugs, fibrinolytic, or any anticoagulant within 7 days prior to Day 1 or is anticipated to require such drugs during the study.
  • Receipt of (by any route) hormonal contraception, post-menopausal hormone replacement therapy (HRT) (including over-the-counter products), or testosterone during the 4 weeks prior to Study Day 1 or is anticipated to require such drugs during the study.
  • Family history of or risk factors for a hypercoagulable or thrombotic condition, including one of the following:
  • Factor V Leiden carrier or homozygote.
  • Protein C, S, or ATIII activity below the normal range.
  • History of adult asthma or chronic obstructive pulmonary disease or current regular or as-needed use of inhaled medications.
  • Active HBV, HCV, or HIV-1/2 infection
  • Use of any drugs that are strong dual inhibitors or inducers of CYP3A4 and P-gp within 7 days prior to Study Day 1 or anticipated need for such drugs during the study.
  • Participation in an investigational drug study within 28 days of Day 1 or Day 1 is within 5 half-lives of the investigational compound.
  • +7 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

West Coast Clinical Trials

Cypress, California, 90630, United States

Location

MeSH Terms

Conditions

Hemorrhage

Interventions

PRT064445apixabanRivaroxabanenoxaparin sodiumedoxaban

Condition Hierarchy (Ancestors)

Pathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

ThiophenesSulfur CompoundsOrganic ChemicalsMorpholinesOxazinesHeterocyclic Compounds, 1-RingHeterocyclic Compounds

Study Design

Study Type
interventional
Phase
phase 1
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 7, 2017

First Posted

March 20, 2017

Study Start

February 26, 2017

Primary Completion

September 28, 2017

Study Completion

September 28, 2017

Last Updated

August 8, 2023

Record last verified: 2023-08

Locations