Association Between Genetic Variant Scores and P2Y12 Inhibitor Effects

NCT04580602 | Completed DMC

• 1 other identifier: C03-001 BD002
• Study Type: observational
• Target: 200
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this study is to predict and prevent adverse drug events by investigating the impact of genetic variants, demographics, and environmental factors in subjects status post myocardial infarction and percutaneous coronary insertion who have experienced adverse drug events while on P2Y12 inhibitors.

Conditions

Stent Thrombosis; Ischemic Stroke; Myocardial Infarction; Acute Coronary Syndrome

Outcome Measures

Primary Outcomes (1)

• To assess the predictive accuracy of Cipherome's drug safety score (DSS) in correlating with serious ADRs in subjects on P2Y12 inhibitors.

  The primary endpoint is to assess the predictive accuracy of the DSS compared to actual clinical outcomes of treatment failure (major adverse cardiovascular events or MACE) or bleeding (per BARC criteria) in subjects on P2Y12 inhibitors. The DSS is calculated on a scale of 0 to 1, with preliminary studies demonstrating that scores below 0.3 correlated with a higher chance of an ADR and scores above 0.7 correlated with a lower chance of an ADR.

  Within 24 months of clopidogrel therapy initiation

Secondary Outcomes (2)

• To assess the predictive accuracy of the DSS in correlating with serious ADRs compared to clinical guidelines (e.g., Clinical Pharmacogenetics Implementation Consortium (CPIC)) in subjects on P2Y12 inhibitors.

  Within 24 months of clopidogrel therapy initiation

• To assess the predictive accuracy of the DSS in correlating with major bleeding compared to clinical guidelines (CPIC) in subjects on P2Y12 inhibitors.

  Within 24 months of clopidogrel therapy initiation

Other Outcomes (1)

• To discover novel pharmacogenetic variants associated with P2Y12 metabolism.

  Within 24 months of clopidogrel therapy initiation

Study Arms (3)

ADR Group

Major Bleeding BARC Bleeding Criteria Type 2,3,5

Control Group

No ADR or treatment failure, case-control matched to experimental groups

Treatment Failure Group

Major Adverse Cardiovascular Events (MACE)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Subjects (status post myocardial infarction and percutaneous coronary insertion) who have experienced adverse drug events while on P2Y12 inhibitors in order to improve future prediction and prevention of adverse events.

You may qualify if:

• Patients 18 years and older, who are on P2Y12 inhibitors (clopidogrel, prasugrel, or ticagrelor).
• Ability to provide informed consent.

You may not qualify if:

• \. Lack of informed consent

Sponsors & Collaborators

• Cipherome, Inc.: lead
• Seoul National University Bundang Hospital: collaborator

Study Sites (1)

SNUBH

Seongnam-si, Gyonggi-do, South Korea

Location

Related Publications (11)

• Pereira NL, Rihal CS, So DYF, Rosenberg Y, Lennon RJ, Mathew V, Goodman SG, Weinshilboum RM, Wang L, Baudhuin LM, Lerman A, Hasan A, Iturriaga E, Fu YP, Geller N, Bailey K, Farkouh ME. Clopidogrel Pharmacogenetics. Circ Cardiovasc Interv. 2019 Apr;12(4):e007811. doi: 10.1161/CIRCINTERVENTIONS.119.007811.

  PMID: 30998396 BACKGROUND

• Pan Y, Chen W, Xu Y, Yi X, Han Y, Yang Q, Li X, Huang L, Johnston SC, Zhao X, Liu L, Zhang Q, Wang G, Wang Y, Wang Y. Genetic Polymorphisms and Clopidogrel Efficacy for Acute Ischemic Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis. Circulation. 2017 Jan 3;135(1):21-33. doi: 10.1161/CIRCULATIONAHA.116.024913. Epub 2016 Nov 2.

  PMID: 27806998 BACKGROUND

• Simon T, Verstuyft C, Mary-Krause M, Quteineh L, Drouet E, Meneveau N, Steg PG, Ferrieres J, Danchin N, Becquemont L; French Registry of Acute ST-Elevation and Non-ST-Elevation Myocardial Infarction (FAST-MI) Investigators. Genetic determinants of response to clopidogrel and cardiovascular events. N Engl J Med. 2009 Jan 22;360(4):363-75. doi: 10.1056/NEJMoa0808227. Epub 2008 Dec 22.

  PMID: 19106083 BACKGROUND

• Jeong YH, Tantry US, Kim IS, Koh JS, Kwon TJ, Park Y, Hwang SJ, Bliden KP, Kwak CH, Hwang JY, Gurbel PA. Effect of CYP2C19*2 and *3 loss-of-function alleles on platelet reactivity and adverse clinical events in East Asian acute myocardial infarction survivors treated with clopidogrel and aspirin. Circ Cardiovasc Interv. 2011 Dec 1;4(6):585-94. doi: 10.1161/CIRCINTERVENTIONS.111.962555. Epub 2011 Nov 1.

  PMID: 22045970 BACKGROUND

• Wiviott SD, Braunwald E, McCabe CH, Montalescot G, Ruzyllo W, Gottlieb S, Neumann FJ, Ardissino D, De Servi S, Murphy SA, Riesmeyer J, Weerakkody G, Gibson CM, Antman EM; TRITON-TIMI 38 Investigators. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007 Nov 15;357(20):2001-15. doi: 10.1056/NEJMoa0706482. Epub 2007 Nov 4.

  PMID: 17982182 BACKGROUND

• Park KH, Jeong MH, Kim HK, Ahn TH, Seung KB, Oh DJ, Choi DJ, Kim HS, Gwon HC, Seong IW, Hwang KK, Chae SC, Kim KB, Kim YJ, Cha KS, Oh SK, Chae JK; KAMIR-NIH Registry Investigators. Comparison of prasugrel versus clopidogrel in Korean patients with acute myocardial infarction undergoing successful revascularization. J Cardiol. 2018 Jan;71(1):36-43. doi: 10.1016/j.jjcc.2017.05.003. Epub 2017 Jun 30.

  PMID: 28673508 BACKGROUND

• Park DW, Kwon O, Jang JS, Yun SC, Park H, Kang DY, Ahn JM, Lee PH, Lee SW, Park SW, Choi SW, Lee SG, Yoon HJ, Ahn T, Kim MH, Nah DY, Lee SY, Chae JK, Park SJ; TICAKOREA Investigators. Clinically Significant Bleeding With Ticagrelor Versus Clopidogrel in Korean Patients With Acute Coronary Syndromes Intended for Invasive Management: A Randomized Clinical Trial. Circulation. 2019 Dec 3;140(23):1865-1877. doi: 10.1161/CIRCULATIONAHA.119.041766. Epub 2019 Sep 25.

  PMID: 31553203 BACKGROUND

• Parks AL, Fang MC. Scoring Systems for Estimating the Risk of Anticoagulant-Associated Bleeding. Semin Thromb Hemost. 2017 Jul;43(5):514-524. doi: 10.1055/s-0037-1598061. Epub 2017 Mar 30.

  PMID: 28359135 BACKGROUND

• Kang J, Park KW, Ki YJ, Park J, Rhee T, Kim CH, Han JK, Yang HM, Kang HJ, Koo BK, Nakamura M, Hamasaki T, Yokoi H, Cohen D, Kim HS. Development and Validation of an Ischemic and Bleeding Risk Evaluation Tool in East Asian Patients Receiving Percutaneous Coronary Intervention. Thromb Haemost. 2019 Jul;119(7):1182-1193. doi: 10.1055/s-0039-1688792. Epub 2019 May 12.

  PMID: 31079414 BACKGROUND

• Claassens DMF, Vos GJA, Bergmeijer TO, Hermanides RS, van 't Hof AWJ, van der Harst P, Barbato E, Morisco C, Tjon Joe Gin RM, Asselbergs FW, Mosterd A, Herrman JR, Dewilde WJM, Janssen PWA, Kelder JC, Postma MJ, de Boer A, Boersma C, Deneer VHM, Ten Berg JM. A Genotype-Guided Strategy for Oral P2Y12 Inhibitors in Primary PCI. N Engl J Med. 2019 Oct 24;381(17):1621-1631. doi: 10.1056/NEJMoa1907096. Epub 2019 Sep 3.

  PMID: 31479209 BACKGROUND

• Urban P, Mehran R, Colleran R, Angiolillo DJ, Byrne RA, Capodanno D, Cuisset T, Cutlip D, Eerdmans P, Eikelboom J, Farb A, Gibson CM, Gregson J, Haude M, James SK, Kim HS, Kimura T, Konishi A, Laschinger J, Leon MB, Magee PFA, Mitsutake Y, Mylotte D, Pocock S, Price MJ, Rao SV, Spitzer E, Stockbridge N, Valgimigli M, Varenne O, Windhoevel U, Yeh RW, Krucoff MW, Morice MC. Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the Academic Research Consortium for High Bleeding Risk. Eur Heart J. 2019 Aug 14;40(31):2632-2653. doi: 10.1093/eurheartj/ehz372.

  PMID: 31116395 BACKGROUND

Related Links

• Plavix package insert. (accessed March 26, 2020)

Biospecimen

Retention: SAMPLES WITH DNA

Laboratory blood draw

MeSH Terms

Conditions

Ischemic Stroke; Myocardial Infarction; Acute Coronary Syndrome

Condition Hierarchy (Ancestors)

Stroke; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Myocardial Ischemia; Heart Diseases; Infarction; Ischemia; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Necrosis

Study Officials

• Jungwon Suh, MD

  SNUBH

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 2, 2020
• First Posted: October 8, 2020
• Study Start: October 7, 2020
• Primary Completion: June 9, 2022
• Study Completion: June 9, 2022
• Last Updated: February 16, 2023

Record last verified: 2023-02

Locations

KR (1)