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A Trial to Learn How Well REGN9933 Works for Preventing Blood Clots After Knee Replacement Surgery in Adult Participants

Phase 2
Completed
Conditions
Venous Thromboembolism
Interventions
Registration Number
NCT05618808
Lead Sponsor
Regeneron Pharmaceuticals
Brief Summary

The primary objective of the study is to evaluate the efficacy of REGN9933 for the prevention of venous thromboembolism (VTE) after unilateral total knee arthroplasty (TKA), compared to enoxaparin

The secondary objectives of the study are:

* To evaluate the bleeding risk (ie, major and clinically relevant non-major \[CRNM\] bleeding) of REGN9933 after unilateral TKA through time of venography, compared to enoxaparin

* To assess overall safety and tolerability of REGN9933 in participants undergoing TKA

* To evaluate the efficacy of REGN9933 in prevention of clinically relevant VTE, compared to enoxaparin

* To evaluate the efficacy of REGN9933 in prevention of deep venous thrombosis (DVT) detected by venography, compared to enoxaparin

* To evaluate the pharmacokinetics (PK) of REGN9933 after single intravenous (IV) administration

* To assess pharmacodynamic (PD) effects of REGN9933 on intrinsic and extrinsic coagulation pathways

* To assess immunogenicity following a single dose of REGN9933 over time

* To compare the efficacy of enoxaparin and apixaban in prevention of VTE after unilateral TKA

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
373
Inclusion Criteria
  1. Undergoing elective unilateral TKA
  2. Has a body weight ≤130 kg at screening visit
  3. Is judged by the investigator to be in good health based on medical history, physical examination, vital sign measurements, and Electrocardiograms (ECG) performed at screening and/or prior to administration of initial dose of study drug
  4. Is in good health based on laboratory safety testing obtained during the screening period as described in the protocol

Key

Exclusion Criteria
  1. History of bleeding in the past 6 months requiring hospitalization or transfusion; history of intracranial or intraocular bleeding, excessive operative or post-operative bleeding, and traumatic spinal or epidural anesthesia; history of bleeding diathesis.
  2. History of thromboembolic disease or thrombophilia
  3. History of major surgery, including brain, spinal, or ocular, within approximately the past 6 months.
  4. History of major trauma within approximately the past 6 months.
  5. Hospitalized (>24 hours) for any reason within 30 days of the screening visit
  6. Using the Modification of Diet in Renal Disease equation, has an estimated glomerular filtration rate as described in the protocol

Note: Other protocol-defined Inclusion/ Exclusion Criteria apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ApixabanApixibanApixaban will be administered orally twice a day
REGN9933REGN9933REGN9933 will be administered by intravenous (IV) infusion
EnoxaparinEnoxaparinEnoxaparin will be administered by subcutaneous (SC) administration
Primary Outcome Measures
NameTimeMethod
Incidence of confirmed, adjudicated venous thromboembolism (VTE)Through Day 12

Asymptomatic deep DVT detected by unilateral venography of the operated leg; confirmed symptomatic DVT of either leg; confirmed fatal or nonfatal pulmonary embolism (PE) including unexplained death for which PE cannot be ruled out (REGN9933 vs enoxaparin)

Secondary Outcome Measures
NameTimeMethod
Incidence of major bleedingUp to approximately Day 12

International Society on Thrombosis and Hemostasis (ISTH) criteria for Major Bleeding as described in the protocol

Incidence of major VTEThrough Day 12

Major VTE is defined as: proximal DVT; confirmed symptomatic DVT of either leg; confirmed fatal or nonfatal PE including unexplained death for which PE cannot be ruled out

Incidence of DVTApproximately Day 12

DVT will be measured by venography of the operated leg

Incidence of clinically relevant non-major (CRNM) bleedingUp to approximately Day 12

International Society on Thrombosis and Hemostasis (ISTH) criteria for Clinically Relevant Non-Major Bleeding as described in the protocol

Incidence of treatment emergent adverse events (TEAEs)Through end of study; approximately Day 75

A TEAE is any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment

Concentrations of REGN9933 in serumThrough end of study; approximately Day 75

The concentrations of REGN9933 over time will be summarized by descriptive statistics by study arm for the overall population

Change in activated partial thromboplastin time (aPTT)Baseline to end of study; approximately Day 75

aPTT will be used to measure the anticipated anticoagulant effect of REGN9933

Change in prothrombin time (PT)Baseline to end of study; approximately Day 75

PT is a measure of extrinsic and/or common pathway function.

Incidence of anti-drug antibodies (ADA) to REGN9933Through end of study; approximately Day 75

Immunogenicity will be characterized per drug molecule by ADA status

Titer of anti-drug antibodies to REGN9933Through end of study; approximately Day 75

Immunogenicity will be characterized per drug molecule by ADA status.

Incidence of confirmed, adjudicated VTEBaseline through Day 12

Asymptomatic deep DVT detected by unilateral venography of the operated leg; confirmed symptomatic DVT of either leg; confirmed fatal or nonfatal pulmonary embolism (PE) including unexplained death for which PE cannot be ruled out (enoxaparin vs apixaban)

Trial Locations

Locations (16)

MBAL Heart and Brain Hospital

🇧🇬

Pleven, Bulgaria

Ziekenhuis Oost-Limburg- Campus Sint-Jan

🇧🇪

Genk, Limburg, Belgium

Department of Orthopedics, Somogy County Mór Kaposi Teaching Hospital

🇭🇺

Kaposvar, Hungary

Liepaja Regional Hospital

🇱🇻

Liepaja, Latvia

MAV Korhaz es Rendelointezet Szolnok

🇭🇺

Szolnok, Jász-Nagykun-Szolnok, Hungary

Riga's 2nd Hospital

🇱🇻

Riga, Latvia

Samodzielny Publiczny Szpital Kliniczny nr 4 w Lublinie

🇵🇱

Lublin, Poland

Lietuvos Sveikatos Mokslu Universiteto Ligonine Kauno Klinik

🇱🇹

Kaunas, Kauno Apskritis, Lithuania

Durham Bone and Joint Specialists

🇨🇦

Ajax, Ontario, Canada

Vidzemes Hospital

🇱🇻

Riga, Latvia

Hospital of Traumatology and Orthopaedics

🇱🇻

Riga, Latvia

Lietuvos Sveikatos Mokslu Universiteto Kauno Ligoninė

🇱🇹

Kaunas, Lithuania

SP ZOZ Centralny Szpital Kliniczny UM w Lodzi

🇵🇱

Lodz, Poland

Samodzielny Publiczny Zaklad Opieki Zdrowotnej w Radzyniu Podlaskim

🇵🇱

Radzyn Podlaski, Poland

Klaipeda University Hospital

🇱🇹

Klaipeda, Klaipedos Apskritis, Lithuania

Specjalistyczny Szpital im. E. Szczeklika w Tarnowie

🇵🇱

Tarnow, Malopolskie, Poland

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