Clinical Study Assessing Idrabiotaparinux Sodium Injections Once-weekly in Pulmonary Embolism Therapeutic Approach (CASSIOPEA)

Sanofi

Status and phase: Completed; Phase 3

Conditions: Embolism; Thrombosis

Treatments: Drug: Placebo (for idrabiotaparinux sodium); Drug: Avidin; Drug: Enoxaparin; Drug: Warfarin; Drug: Placebo (for warfarin); Drug: Idrabiotaparinux sodium

Study type: Interventional

Funder types: Industry

Identifiers

NCT00345618

EFC6034

EudraCT:2006-001786-42

Details and patient eligibility

About

Objectives are to evaluate whether idrabiotaparinux sodium (SSR126517E) is as least as effective as a standard warfarin treatment to prevent recurrence of venous thromboembolic events (VTE) in patients with symptomatic pulmonary embolism (PE) with or without symptomatic deep venous thrombosis (DVT) and to assess its safety (bleedings) versus warfarin.

Full description

Treatment with a therapeutic dose of any low molecular weight heparin (LMWH) or unfractioned heparin (UFH) or fondaparinux is allowed only within the 36 hours immediately preceding randomization. Randomization is performed as soon as the diagnosis of PE (and DVT if concomitant suspected symptomatic DVT) is confirmed.

Allocation to treatment is done centrally by Interactive Voice Response System (IVRS) and stratified by (1) center, (2) intended treatment duration, ie, 3 months or 6 months. At randomization, the planned duration of treatment (3 or 6 months) is prespecified by the Investigator and determined on the assessment of risk of VTE recurrence. Participants are randomized to either idrabiotaparinux + placebo of warfarin, or warfarin + placebo of idrabiotaparinux, with an initial treatment of at least 5 days with enoxaparin in both treatment groups.

Participants in the 3-month stratum have an additional 13-week observational period after cessation of study treatment. Participants in the 6-month stratum have a 13-week up to 26-week observational period.

Enrollment: 3,202 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Symptomatic pulmonary embolism with or without symptomatic deep vein thrombosis

Exclusion criteria

• End stage renal failure, hepatic failure, uncontrolled hypertension;
• Active bleeding or high risk for bleeding;
• Pregnancy or childbearing potential without proper contraceptive measures, threatened abortion.
• Breastfeeding.
• Known allergy to idraparinux or idrabiotaparinux, avidin or egg proteins;
• hypersensitivity to warfarin, enoxaparin, heparin or pork product; or any other contraindication listed in the labelling of warfarin or enoxaparin;
• Indication of prolonged anticoagulation therapy for other reason than PE;
• Life expectancy < 6 months;

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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3,202 participants in 2 patient groups

Idrabiotaparinux

Experimental group

Description:

Idrabiotaparinux sodium, 3.0 mg, once-weekly for 3 or 6 months depending on the stratum, after enoxaparin, 1.0 mg/kg, every 12 hours for at least 5 days. Avidin, 100 mg, at the discretion of the investigator whenever deemed appropriate and possible (ie, life-threatening bleeding, emergency invasive procedure with the potential of uncontrolled bleeding, or over-dosage).

Treatment:

Drug: Idrabiotaparinux sodium

Drug: Placebo (for warfarin)

Drug: Avidin

Drug: Enoxaparin

Warfarin

Active Comparator group

Description:

Warfarin, INR-adjusted dose, started 24 hours after the start of enoxaparin, 1.0 mg/kg, every 12 hours for at least 5 days, and continued for 3 or 6 months depending on the stratum. Avidin, 100 mg, at the discretion of the investigator whenever deemed appropriate and possible (ie, life-threatening bleeding, emergency invasive procedure with the potential of uncontrolled bleeding, or over-dosage).

Treatment:

Drug: Warfarin

Drug: Placebo (for idrabiotaparinux sodium)

Drug: Avidin

Drug: Enoxaparin