Deep Vein Thrombosis
Conditions
Keywords
Deep vein thrombosis, Prophylaxis, Sodium enoxaparin
Brief summary
The purpose of the study is to prove equivalence of efficacy and safety of BCD-080 and Clexan for deep vein thrombosis and embolism prophylaxis at orthopedic surgeries.
Detailed description
The study will include 116 patients who are planned for hip or knee replacement. Patients will randomized in 2 groups. 1-st group will receive BCD-080 at dose 30 mg every 12 hours during 14 days after surgery, 2-d group will receive Clexane at the same dose. Efficacy assessment will include frequency of deep vein thrombosis (DVT) (proximal and/or distal; symptomatic or asymptomatic), symptomatic nonlethal thromboembolia of the pulmonary artery (PATE) and venous thromboembolism death. Safety assessment will include frequency of big, small and other bleedings and frequency of heparin induced thrombocytopenia.The assessment of efficacy and safety parameters will be made during the treatment and follow-up period (till 60 day).
Interventions
DRUGSodium Enoxaparine
30 mg (0,3 ml), subcutaneously, twice a day (every 12 h).
Sponsors
Biocad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Written informed consent 2. Age ≥18 years and age ≤80 years 3. Women body mass 50-110kg, men body mass 57-110 kg inclusive 4. Patients who are planned for hip or knee replacement 5. Willingness of patients of both sexes and their sexual partners with preserved reproductive function to use reliable methods of contraception, starting from screening and up to 4 weeks after the last dose of the studied drug. This requirement does not apply to patients who underwent surgical sterilization. Reliable methods of contraception involves a 1-barrier method combined with one of the following: spermicides/oral contraceptive 6. Ability of the patient, in the opinion of the investigator, to meet the Protocol requirements.
Exclusion criteria
1. Hypersensitivity to the components included in the formula of preparation BCD-080 (CJSC BIOCAD) Clexane (Sanofi-Avensis France, France) or medications of the same class 2. Conditions and diseases in which there is a high risk of bleeding: cerebral aneurysm or aortic dissection, hemorrhagic stroke (including in history) 3. Intractable hemorrhage 4. History of documented diseases of blood coagulation (hemophilia A or B, Willebrand disease and other coagulopathies, idiopathic thrombocytopenic purpura, Heparin induced thrombocytopenia associated with thrombosis or without it, thrombohemorrhagic syndrome, etc.) in anamnesis and/or at the moment of examination 5. Gastric or duodenal ulcer or other erosive and ulcerative lesions of gastrointestinal tract 6. Recent ischemic stroke 7. Uncontrolled severe hypertension; that is, all cases of hypertension, in which blood pressure decrease cannot be achieved with the use of combination of 3 antihypertensive drugs, compulsorily including a diuretic, and non-drug methods of correction (salt-free diet, graduated exercise); or if the results of two successive measurements of supine arterial blood pressure with an interval of 15-30 minutes, systolic blood pressure\> 180 mm Hg. or diastolic blood pressure\> 105 mm Hg 8. Diabetic or hemorrhagic retinopathy 9. Decompensated diabetes mellitus, diabetes mellitus complications 10. Recent delivery (during last 90 days) 11. Bacterial endocarditis (acute or subacute) 12. Pericarditis and pericardial effusion 13. Renal and/or hepatic insufficiency 14. Intrauterine contraception 15. Surgeries or injuries of brain/spinal cord, spine, eyes, and major surgeries and injuries within 90 days prior to randomization) 16. Spinal surgeries or its deformation in history of patients who are planned for epidural/spinal anesthesia 17. Active liver diseases 18. Anamnestic information about alcoholism, addiction or drug abuse over the last year 19. Contraindications to surgeries 20. Hemoglobin \<100 g/l 21. Platelet count \<100х10\*9/l 22. Creatine clearance \<30 ml/min 23. Biochemical blood assay indexes: AST/ALT \> UNLх3; total bilirubin \> UNLх1,5 (unless other causal factors provided, such as Gilbert's syndrome) 24. Necessity for continued treatment with anticoagulants (except for planned under this study), antiaggregant and fibrinolytics (eg, patients with artificial cardiac valve, atrial fibrillation patients receiving warfarin, etc.) 25. The use of dextrans or fibrinolytic therapy or other drugs affecting hemostasis; 26. Necessity for use of systemic glucocorticosteroids and non-steroidal anti-inflammatory drugs (except for the use of the latter with the purpose of anaesthesia in the early postoperative period - during 3 days after the planned hip or knee replacement) 27. Impossibility of contrast venography: contrast allergy, inability to install an intravenous catheter, etc 28. Pregnancy, lactation period 29. Donation of 450 ml or more of blood or plasma within 60 calendar days before inclusion enrolment 30. Participation in clinical trials no less than 30 days before enrolment into this study or previous participation in this clinical study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of Symptomatic Nonlethal Thromboembolia of the Pulmonary Artery (PATE) | During the treatment period (14 days) | — |
| Frequency of Venous Thromboembolism Death | During the treatment period (14 days) | — |
| Frequency of DVT. | During the treatment period (14 days) | Frequency of deep vein thrombosis (DVT) (proximal and/or distal; symptomatic or asymptomatic). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of Clinically Significant Small Bleedings | During the treatment period (14 days) | — |
| Frequency of Clinically Significant Bleedings | During the treatment period (14 days) | — |
| Frequency of Death From Other Causes | During the treatment period (14 days) and follow-up period (till 60-th day) | — |
| Frequency of DTV | During the treatment period (14 days) and follow-up period (till 60-th day) | Frequency of DTV (proximal and/or distal; symptomatic or asymptomatic) |
| Frequency of Proximal DVT | During the treatment period (14 days) and follow-up period (till 60-th day) | Frequency of proximal DVT (symptomatic or asymptomatic) |
| Frequency of Distal DVT | During the treatment period (14 days) and follow-up period (till 60-th day) | Frequency of distal DVT (symptomatic or asymptomatic) |
| Frequency of Venous Thromboembolism (PATE and/or DTV) | During the treatment period (14 days) and follow-up period (till 60-th day) | — |
| Frequency of Venous Thromboembolism Death | During the treatment period (14 days) and follow-up period (till 60-th day) | — |
| Frequency of Other Small Bleedings | During the treatment period (14 days) | — |
| Frequency of All Bleedings | During the treatment period (14 days) | — |
| Frequency of Heparin Induced Thrombocytopenia | During the treatment period (14 days) | — |
| Frequency of Strokes, Myocardial Infarction, Unstable Angina and Cardiovascular Death | During the treatment period (14 days) and follow-up period (till 60-th day) | — |
| Frequency of Other AE SAE | During the treatment period (14 days) and follow-up period (till 60-th day) | — |
| Frequency of Symptomatic Nonlethal PATE | During the treatment period (14 days) and follow-up period (till 60-th day) | — |
| Frequency of Big and Clinically Significant Small Bleedings | During the treatment period (14 days) | — |
| Frequency of Big Bleedings | During the treatment period (14 days) | — |
Countries
Russia
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| BCD-080 Sodium enoxaparine 40 mg (4 000 anti-Xa IU / 0,4 ml) at pre-filled syringe. Administration of BCD-080 30 mg (0,3 ml) every 12 hours during 14 days after surgery for preventing venous thromboembolic complications after surgery.
Sodium Enoxaparine: 30 mg (0,3 ml), subcutaneously, twice a day (every 12 h). | 64 |
| Clexane Sodium enoxaparine 40 mg (4 000 anti-Xa IU / 0,4 ml) at pre-filled syringe. Administration of Clexane 30 mg (0,3 ml) every 12 hours during 14 days after surgery for preventing venous thromboembolic complications after surgery/
Sodium Enoxaparine: 30 mg (0,3 ml), subcutaneously, twice a day (every 12 h). | 59 |
| Total | 123 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 1 | 2 |
| Overall Study | Withdrawal by Subject | 2 | 1 |
Baseline characteristics
| Characteristic | BCD-080 | Clexane | Total |
|---|---|---|---|
| Age, Continuous | 57.50 years | 60.00 years | 58.00 years |
| Sex: Female, Male Female | 35 Participants | 35 Participants | 70 Participants |
| Sex: Female, Male Male | 29 Participants | 24 Participants | 53 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 53 / 64 | 56 / 59 |
| serious Total, serious adverse events | 2 / 64 | 5 / 59 |
Outcome results
Primary
Frequency of DVT.
Frequency of deep vein thrombosis (DVT) (proximal and/or distal; symptomatic or asymptomatic).
Time frame: During the treatment period (14 days)
Population: Patient who finished the study as per protocol and had contrast venography results for efficacy evaluation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| BCD-080 | Frequency of DVT. | 0 participants |
| Clexane | Frequency of DVT. | 2 participants |
p-value: 0.226Fisher Exact
Primary
Frequency of Symptomatic Nonlethal Thromboembolia of the Pulmonary Artery (PATE)
Time frame: During the treatment period (14 days)
Population: Patient who finished the study as per protocol and had contrast venography results for efficacy evaluation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| BCD-080 | Frequency of Symptomatic Nonlethal Thromboembolia of the Pulmonary Artery (PATE) | 0 participants |
| Clexane | Frequency of Symptomatic Nonlethal Thromboembolia of the Pulmonary Artery (PATE) | 0 participants |
Primary
Frequency of Venous Thromboembolism Death
Time frame: During the treatment period (14 days)
Population: Patient who finished the study as per protocol and had contrast venography results for efficacy evaluation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| BCD-080 | Frequency of Venous Thromboembolism Death | 0 participants |
| Clexane | Frequency of Venous Thromboembolism Death | 0 participants |
Secondary
Frequency of All Bleedings
Time frame: During the treatment period (14 days)
Secondary
Frequency of Big and Clinically Significant Small Bleedings
Time frame: During the treatment period (14 days)
Secondary
Frequency of Big Bleedings
Time frame: During the treatment period (14 days)
Secondary
Frequency of Clinically Significant Bleedings
Time frame: During the treatment period (14 days)
Secondary
Frequency of Clinically Significant Small Bleedings
Time frame: During the treatment period (14 days)
Secondary
Frequency of Death From Other Causes
Time frame: During the treatment period (14 days) and follow-up period (till 60-th day)
Secondary
Frequency of Distal DVT
Frequency of distal DVT (symptomatic or asymptomatic)
Time frame: During the treatment period (14 days) and follow-up period (till 60-th day)
Secondary
Frequency of DTV
Frequency of DTV (proximal and/or distal; symptomatic or asymptomatic)
Time frame: During the treatment period (14 days) and follow-up period (till 60-th day)
Secondary
Frequency of Heparin Induced Thrombocytopenia
Time frame: During the treatment period (14 days)
Secondary
Frequency of Other AE SAE
Time frame: During the treatment period (14 days) and follow-up period (till 60-th day)
Secondary
Frequency of Other Small Bleedings
Time frame: During the treatment period (14 days)
Secondary
Frequency of Proximal DVT
Frequency of proximal DVT (symptomatic or asymptomatic)
Time frame: During the treatment period (14 days) and follow-up period (till 60-th day)
Secondary
Frequency of Strokes, Myocardial Infarction, Unstable Angina and Cardiovascular Death
Time frame: During the treatment period (14 days) and follow-up period (till 60-th day)
Secondary
Frequency of Symptomatic Nonlethal PATE
Time frame: During the treatment period (14 days) and follow-up period (till 60-th day)
Secondary
Frequency of Venous Thromboembolism Death
Time frame: During the treatment period (14 days) and follow-up period (till 60-th day)
Secondary
Frequency of Venous Thromboembolism (PATE and/or DTV)
Time frame: During the treatment period (14 days) and follow-up period (till 60-th day)