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Tolerability , PK/PD and Safety of Dabigatran Etexilate Oral Liquid Formulation in Children < 1 Year of Age

Open-label, Single Dose, Tolerability, Pharmacokinetic/Pharmacodynamics and Safety Study of Dabigatran Etexilate Given at the End of Standard Anticoagulant Therapy in Children Aged Less Than 1 Year Old

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02223260
Enrollment
8
Registered
2014-08-22
Start date
2014-09-30
Completion date
2016-02-29
Last updated
2016-09-20

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Venous Thromboembolism

Brief summary

The aim of the study is to investigate the safety and tolerability of dabigatran etexilate solution in children aged less than 1 year, to demonstrate comparable PK/PD relationship to older children and adults and to confirm dabigatran etexilate dosing algorithm for children aged less than 1 year.

Detailed description

Purpose:

Interventions

DRUGdabigatran

Experimental dose chosen based on age and weight

Sponsors

Boehringer Ingelheim
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
No minimum to 12 Months
Healthy volunteers
No

Inclusion criteria

* Neonates and infants with aged \< 12 months at Visit 1 * Objective diagnosis of VTE * End of planned treatment course with anticoagulant therapy as per standard of care at the investigator site. * Written informed consent provided by the patient's parent(s) (or legal guardian) according to local regulations at Visit 1.

Exclusion criteria

* Weight less than 3 kg at Visit 1 * Conditions associated with an increased risk of bleeding * renal dysfunction * hepatic disease * Anemia or thrombocytopenia at screening

Design outcomes

Primary

MeasureTime frameDescription
Central Measurement: The Mean of dTT Ratio at 2h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.baseline (0.5 h before intake of study medication), 2 h, and 12 h after dosing on day 1Central measurement: The mean of dTT (AntiFactor IIa activity) ratio at 2 h and 12 h (±2 h) post administration of dabigatran etexilate. Standard deviation is actually the Coefficient of Variation. dTT ratio= dTT(post dose)/dTT(baseline). The mean of dTT ratio is presented.
Plasma Concentrations of Total Dabigatran, 2h and 12 h (+/-2h) Post Administration of Dabigatran Etexilate2 hours (h) and 12h after drug administration on day 1Plasma concentrations of total dabigatran, 2h and 12 h (+/-2h) post administration of dabigatran etexilate.
Central Measurement: The Mean aPTT Coagulation Time at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.2 h, and 12 h after dosing on day 1Central measurement: The mean activated partial thromboplastin time (aPTT) coagulation time at 2 h and 12 h (±2 h) post administration of dabigatran etexilate. Standard deviation is actually the Coefficient of Variation.
Central Measurement: The Mean of ECT Coagulation Time at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.2 h, and 12 h after dosing on day 1Central measurement: The mean of Ecarin Clotting Time (ECT) coagulation time at 2 h and 12h (+/-2h) post administration of dabigatran etexilate. Standard deviation is actually the Coefficient of Variation.
Central Measurement: The Mean of Diluted Thrombin Time (dTT) Coagulation Time at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.2 h, and 12 h after dosing on day 1Central measurement: The mean of dTT (AntiFactor IIa activity) coagulation time at 2 h and 12h (+/-2h) post administration of dabigatran etexilate. Standard deviation is actually the Coefficient of Variation.
Central Measurement: The Mean aPTT Ratio at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.baseline (0.5 h before intake of study medication), 2 h, and 12 h after dosing on day 1Central measurement: The mean aPTT (activated partial thromboplastin time) ratio at 2 h and 12 h (±2 h) post administration of dabigatran etexilate. Standard deviation is actually the Coefficient of Variation. aPTT ratio= aPTT (post dose)/aPTT (baseline). The mean of aPTT ratio is presented.
Central Measurement: The Mean ECT Ratio at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.baseline (0.5 h before intake of study medication), 2 h, and 12 h after dosing on day 1Central measurement: The mean Ecarin Clotting Time (ECT) ratio at 2 h and 12h (+/-2h) post administration of dabigatran etexilate. Standard deviation is actually the Coefficient of Variation. ECT ratio= ECT(Post dose)/ECT(baseline), The mean of ECT ratio is presented.

Secondary

MeasureTime frameDescription
PK-PD Relationship: Relationship Between Total Dabigatran Plasma Concentration and Coagulation Parameters ECT Values.baseline (0.5 h before intake of study medication), 2 h, and 12 h after dosing on day 1Linear regression models were used for modeling the relationship between total dabigatran plasma concentration and coagulation parameters ECT values. For our simple regression model, R-squared is equal to the square of Pearson's coefficient of correlation. The R-squared can be between 0 and 1. R-squared =1 means a perfect fit.
PK-PD Relationship: Relationship Between Total Dabigatran Plasma Concentration and Coagulation Parameters dTT Values.baseline (0.5 h before intake of study medication), 2 h, and 12 h after dosing on day 1Linear regression models were used for modeling the relationship between total dabigatran plasma concentration and coagulation parameters dTT (AntiFactor IIa activity) values. For our simple regression model, R-squared is equal to the square of Pearson's coefficient of correlation. The R-squared can be between 0 and 1. R-squared =1 means a perfect fit.
Incidence of All Bleeding Events (Major, CRNM and Minor) During the Treatment Period.Within two days after the administration of trial medication, up to 3 daysPercentage of patients with Incidence of all bleeding events(major, clinically relevant non-major (CRNM) & minor) during the treatment period (including the residual effect period).Bleeding events were classified as follow: Major bleeding: 1) Fatal bleeding 2) Clinically overt bleeding associated with decrease in haemoglobin of at least 2 g/dL (20 g/L) in 24-h-period 3) Bleeding that was retroperitoneal, pulmonary, intracranial, or otherwise involved the central nervous system 4) Bleeding that required surgical intervention in an operating suite. CRNM bleeding: 1) Overt bleeding for which a blood product was administered & which was not directly attributable to the patient's underlying medical condition 2) Bleeding that required medical or surgical intervention to restore haemostasis, other than in an operating suite. Minor bleeding defined as any overt or macroscopic evidence of bleeding that did not fulfil the criteria for either major bleeding or CRNM bleeding.
Incidence of All AEs During the Treatment PeriodWithin two days after the administration of trial medication, up to 3 daysPercentage of patients with all adverse events (AEs) during the treatment period (including REP).
Global Assessment of Acceptability and Tolerability of Study MedicationDay 1 (immediately after dosing)The investigator was to provide a global clinical assessment of tolerability and acceptability of study medication by the patient.This assessment was based on 5-point scale (good, satisfactory, not satisfactory, bad, not assessable).
PK-PD Relationship: Relationship Between Total Dabigatran Plasma Concentration and Coagulation Parameters APTT Values.baseline (0.5 h before intake of study medication), 2 h, and 12 h after dosing on day 1Linear regression models were used for modeling the relationship between total dabigatran plasma concentration and coagulation parameters APTT values. For our simple regression model, R-squared is equal to the square of Pearson's coefficient of correlation. The R-squared can be between 0 and 1. R-squared =1 means a perfect fit.

Countries

Canada, France, Russia

Participant flow

Pre-assignment details

This was an open-label, multicentre, multinational, non-randomised, uncontrolled, single dose, single arm Phase IIa study.

Participants by arm

ArmCount
Dabigatran Etexilate
The patients were orally administered a single dose of liquid formulation of dabigatran etexilate. The dose were adjusted based on an age and weight (equivalent to a 150 mg dose in adults). In case the patient could not take the full dose at once, the assigned dose could have been given as divided doses.
8
Total8

Baseline characteristics

CharacteristicDabigatran Etexilate
Age, Continuous2.912 Months
STANDARD_DEVIATION 1.694
Sex: Female, Male
Female
5 Participants
Sex: Female, Male
Male
3 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
0 / 8
serious
Total, serious adverse events
0 / 8

Outcome results

Primary

Central Measurement: The Mean aPTT Coagulation Time at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.

Central measurement: The mean activated partial thromboplastin time (aPTT) coagulation time at 2 h and 12 h (±2 h) post administration of dabigatran etexilate. Standard deviation is actually the Coefficient of Variation.

Time frame: 2 h, and 12 h after dosing on day 1

Population: PKS

ArmMeasureGroupValue (MEAN)Dispersion
Dabigatran EtexilateCentral Measurement: The Mean aPTT Coagulation Time at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.E278.9 secondStandard Deviation 26.7
Dabigatran EtexilateCentral Measurement: The Mean aPTT Coagulation Time at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.E1262.8 secondStandard Deviation 27.7
Primary

Central Measurement: The Mean aPTT Ratio at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.

Central measurement: The mean aPTT (activated partial thromboplastin time) ratio at 2 h and 12 h (±2 h) post administration of dabigatran etexilate. Standard deviation is actually the Coefficient of Variation. aPTT ratio= aPTT (post dose)/aPTT (baseline). The mean of aPTT ratio is presented.

Time frame: baseline (0.5 h before intake of study medication), 2 h, and 12 h after dosing on day 1

Population: PKS

ArmMeasureGroupValue (MEAN)Dispersion
Dabigatran EtexilateCentral Measurement: The Mean aPTT Ratio at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.ER21.86 ratioStandard Deviation 19.5
Dabigatran EtexilateCentral Measurement: The Mean aPTT Ratio at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.ER121.47 ratioStandard Deviation 17.7
Primary

Central Measurement: The Mean ECT Ratio at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.

Central measurement: The mean Ecarin Clotting Time (ECT) ratio at 2 h and 12h (+/-2h) post administration of dabigatran etexilate. Standard deviation is actually the Coefficient of Variation. ECT ratio= ECT(Post dose)/ECT(baseline), The mean of ECT ratio is presented.

Time frame: baseline (0.5 h before intake of study medication), 2 h, and 12 h after dosing on day 1

Population: PKS

ArmMeasureGroupValue (MEAN)Dispersion
Dabigatran EtexilateCentral Measurement: The Mean ECT Ratio at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.ER22.42 RatioStandard Deviation 34.2
Dabigatran EtexilateCentral Measurement: The Mean ECT Ratio at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.ER121.63 RatioStandard Deviation 13.8
Primary

Central Measurement: The Mean of Diluted Thrombin Time (dTT) Coagulation Time at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.

Central measurement: The mean of dTT (AntiFactor IIa activity) coagulation time at 2 h and 12h (+/-2h) post administration of dabigatran etexilate. Standard deviation is actually the Coefficient of Variation.

Time frame: 2 h, and 12 h after dosing on day 1

Population: PKS

ArmMeasureGroupValue (MEAN)Dispersion
Dabigatran EtexilateCentral Measurement: The Mean of Diluted Thrombin Time (dTT) Coagulation Time at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.E248.7 secondStandard Deviation 24
Dabigatran EtexilateCentral Measurement: The Mean of Diluted Thrombin Time (dTT) Coagulation Time at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.E1238.6 secondStandard Deviation 8.12
Primary

Central Measurement: The Mean of dTT Ratio at 2h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.

Central measurement: The mean of dTT (AntiFactor IIa activity) ratio at 2 h and 12 h (±2 h) post administration of dabigatran etexilate. Standard deviation is actually the Coefficient of Variation. dTT ratio= dTT(post dose)/dTT(baseline). The mean of dTT ratio is presented.

Time frame: baseline (0.5 h before intake of study medication), 2 h, and 12 h after dosing on day 1

Population: PKS

ArmMeasureGroupValue (MEAN)Dispersion
Dabigatran EtexilateCentral Measurement: The Mean of dTT Ratio at 2h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.ER121.26 ratioStandard Deviation 5.67
Dabigatran EtexilateCentral Measurement: The Mean of dTT Ratio at 2h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.ER21.59 ratioStandard Deviation 25.4
Primary

Central Measurement: The Mean of ECT Coagulation Time at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.

Central measurement: The mean of Ecarin Clotting Time (ECT) coagulation time at 2 h and 12h (+/-2h) post administration of dabigatran etexilate. Standard deviation is actually the Coefficient of Variation.

Time frame: 2 h, and 12 h after dosing on day 1

Population: PKS

ArmMeasureGroupValue (MEAN)Dispersion
Dabigatran EtexilateCentral Measurement: The Mean of ECT Coagulation Time at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.E2101 secondStandard Deviation 44.3
Dabigatran EtexilateCentral Measurement: The Mean of ECT Coagulation Time at 2 h and 12h (+/-2h) Post Administration of Dabigatran Etexilate.E1266.9 secondStandard Deviation 23.5
Primary

Plasma Concentrations of Total Dabigatran, 2h and 12 h (+/-2h) Post Administration of Dabigatran Etexilate

Plasma concentrations of total dabigatran, 2h and 12 h (+/-2h) post administration of dabigatran etexilate.

Time frame: 2 hours (h) and 12h after drug administration on day 1

Population: Pharmacokinetic set (PKS): This patient set included all treated patients who provided at least 1 PK/PD observation and had no important Protocol violations (PVs) with respect to statistical analysis of Pharmacokinetic (PK) or Pharmacodynamic (PD ) endpoints.

ArmMeasureGroupValue (GEOMETRIC_MEAN)Dispersion
Dabigatran EtexilatePlasma Concentrations of Total Dabigatran, 2h and 12 h (+/-2h) Post Administration of Dabigatran Etexilate12h60.4 ng/mLGeometric Coefficient of Variation 30
Dabigatran EtexilatePlasma Concentrations of Total Dabigatran, 2h and 12 h (+/-2h) Post Administration of Dabigatran Etexilate2h120.0 ng/mLGeometric Coefficient of Variation 62.1
Secondary

Global Assessment of Acceptability and Tolerability of Study Medication

The investigator was to provide a global clinical assessment of tolerability and acceptability of study medication by the patient.This assessment was based on 5-point scale (good, satisfactory, not satisfactory, bad, not assessable).

Time frame: Day 1 (immediately after dosing)

Population: Treated set

ArmMeasureGroupValue (NUMBER)
Dabigatran EtexilateGlobal Assessment of Acceptability and Tolerability of Study MedicationGood75.0 percentage of participants
Dabigatran EtexilateGlobal Assessment of Acceptability and Tolerability of Study MedicationSatisfactory12.5 percentage of participants
Dabigatran EtexilateGlobal Assessment of Acceptability and Tolerability of Study MedicationNot satisfactory0.0 percentage of participants
Dabigatran EtexilateGlobal Assessment of Acceptability and Tolerability of Study MedicationBad12.5 percentage of participants
Dabigatran EtexilateGlobal Assessment of Acceptability and Tolerability of Study MedicationNot assessable0.0 percentage of participants
Secondary

Incidence of All AEs During the Treatment Period

Percentage of patients with all adverse events (AEs) during the treatment period (including REP).

Time frame: Within two days after the administration of trial medication, up to 3 days

Population: Treated set

ArmMeasureValue (NUMBER)
Dabigatran EtexilateIncidence of All AEs During the Treatment Period0.0 percentage of participants
Secondary

Incidence of All Bleeding Events (Major, CRNM and Minor) During the Treatment Period.

Percentage of patients with Incidence of all bleeding events(major, clinically relevant non-major (CRNM) & minor) during the treatment period (including the residual effect period).Bleeding events were classified as follow: Major bleeding: 1) Fatal bleeding 2) Clinically overt bleeding associated with decrease in haemoglobin of at least 2 g/dL (20 g/L) in 24-h-period 3) Bleeding that was retroperitoneal, pulmonary, intracranial, or otherwise involved the central nervous system 4) Bleeding that required surgical intervention in an operating suite. CRNM bleeding: 1) Overt bleeding for which a blood product was administered & which was not directly attributable to the patient's underlying medical condition 2) Bleeding that required medical or surgical intervention to restore haemostasis, other than in an operating suite. Minor bleeding defined as any overt or macroscopic evidence of bleeding that did not fulfil the criteria for either major bleeding or CRNM bleeding.

Time frame: Within two days after the administration of trial medication, up to 3 days

Population: Treated set

ArmMeasureValue (NUMBER)
Dabigatran EtexilateIncidence of All Bleeding Events (Major, CRNM and Minor) During the Treatment Period.0.0 Percentage of participants
Secondary

PK-PD Relationship: Relationship Between Total Dabigatran Plasma Concentration and Coagulation Parameters APTT Values.

Linear regression models were used for modeling the relationship between total dabigatran plasma concentration and coagulation parameters APTT values. For our simple regression model, R-squared is equal to the square of Pearson's coefficient of correlation. The R-squared can be between 0 and 1. R-squared =1 means a perfect fit.

Time frame: baseline (0.5 h before intake of study medication), 2 h, and 12 h after dosing on day 1

Population: PKS

ArmMeasureValue (NUMBER)
Dabigatran EtexilatePK-PD Relationship: Relationship Between Total Dabigatran Plasma Concentration and Coagulation Parameters APTT Values.0.752 R-Square
Secondary

PK-PD Relationship: Relationship Between Total Dabigatran Plasma Concentration and Coagulation Parameters dTT Values.

Linear regression models were used for modeling the relationship between total dabigatran plasma concentration and coagulation parameters dTT (AntiFactor IIa activity) values. For our simple regression model, R-squared is equal to the square of Pearson's coefficient of correlation. The R-squared can be between 0 and 1. R-squared =1 means a perfect fit.

Time frame: baseline (0.5 h before intake of study medication), 2 h, and 12 h after dosing on day 1

Population: PKS

ArmMeasureValue (NUMBER)
Dabigatran EtexilatePK-PD Relationship: Relationship Between Total Dabigatran Plasma Concentration and Coagulation Parameters dTT Values.0.920 R-Square
Secondary

PK-PD Relationship: Relationship Between Total Dabigatran Plasma Concentration and Coagulation Parameters ECT Values.

Linear regression models were used for modeling the relationship between total dabigatran plasma concentration and coagulation parameters ECT values. For our simple regression model, R-squared is equal to the square of Pearson's coefficient of correlation. The R-squared can be between 0 and 1. R-squared =1 means a perfect fit.

Time frame: baseline (0.5 h before intake of study medication), 2 h, and 12 h after dosing on day 1

Population: PKS

ArmMeasureValue (NUMBER)
Dabigatran EtexilatePK-PD Relationship: Relationship Between Total Dabigatran Plasma Concentration and Coagulation Parameters ECT Values.0.858 R-Square

Source: ClinicalTrials.gov · Data processed: Mar 7, 2026