A Study in Patients With Acute Major Bleeding to Evaluate the Ability of Andexanet Alfa to Reverse the Anticoagulation Effect of Direct and Indirect Oral Anticoagulants (Extension Study)
Status: | Recruiting |
---|---|
Healthy: | No |
Age Range: | 18 - Any |
Updated: | 3/14/2019 |
Start Date: | January 2015 |
End Date: | November 2022 |
Contact: | Patrick Yue, M.D. |
Email: | ClinicalTrials@portola.com |
Phone: | 650.246.7000 |
Prospective, Open-Label Study of Andexanet Alfa in Patients Receiving a Factor Xa Inhibitor Who Have Acute Major Bleeding (ANNEXA-4)
The purpose of this study is to evaluate the hemostatic efficacy of andexanet alfa in
patients receiving a factor Xa inhibitor who are experiencing an acute major bleed. The
safety of andexanet will also be studied.
patients receiving a factor Xa inhibitor who are experiencing an acute major bleed. The
safety of andexanet will also be studied.
Inclusion:
1. Acute major bleeding episode requiring urgent reversal of anticoagulation; defined by
at least one of the following:
- Acute bleeding that is potentially life-threatening, OR
- Acute bleeding associated with a fall in hemoglobin level by ≥2 g/dL, OR
- Acute bleeding associated with a hemoglobin level of ≤8 g/dL if no baseline
hemoglobin is available, OR
- Acute bleeding in a critical area or organ such as intraspinal, pericardial, or
intracranial.
2. If bleeding is intracranial or intraspinal, the patient must have undergone a head CT
or MRI scan demonstrating the bleeding.
3. Patient received or is believed to have received one of the following within 18 hours
prior to andexanet administration: apixaban, rivaroxaban, edoxaban or enoxaparin.
4. For patients with intracranial bleeding, there must be a reasonable expectation that
andexanet treatment will commence within 2 hours of the baseline imaging evaluation.
Exclusion:
1. The patient is scheduled to undergo surgery in less than 12 hours, with the exception
of minimally invasive surgery/procedures.
2. A patient with an intracerebral hemorrhage has any of the following:
- Glasgow coma score < 7, OR
- Intracerebral hematoma > 60 cc as assessed by CT or MRI
3. Patients with visible, musculoskeletal or intra-articular bleeding as their qualifying
bleed.
4. Expected survival of less than 1 month
5. Recent history (within 2 weeks) of a diagnosed thrombotic event (TE) as follows:
venous thromboembolism, myocardial infarction, disseminated intravascular coagulation
(DIC), cerebral vascular accident, transient ischemic attack, unstable angina pectoris
hospitalization or severe peripheral vascular disease within 2 weeks prior to
screening.
6. Severe sepsis or septic shock at the time of Screening.
7. Pregnant or a lactating female.
8. Patient has received any of the following drugs or blood products within 7 days of
Screening:
- Vitamin K antagonist (VKA)
- Dabigatran
- Prothrombin Complex Concentrate products (PCC) or recombinant factor VIIa
(rfVIIa)
- Whole blood, plasma fractions
9. Treated with an investigational drug <30 days prior to Screening
10. Planned administration of PCC, fresh frozen plasma (FFP) or rfVIIa from Screening
until within 12 hours after the end of the andexanet infusion.
We found this trial at
24
sites
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