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Comparison of the Effects of Apixaban on Thrombin Generation in Patients With de Novo Multiple Myeloma

Not Applicable
Not yet recruiting
Conditions
Multiple Myeloma
Total Knee Replacement
Interventions
Procedure: Blood sampling
Registration Number
NCT06474182
Lead Sponsor
Centre Hospitalier Universitaire de Saint Etienne
Brief Summary

Patients with multiple myeloma (MM) are at high risk of venous thromboembolism (VTE) and these patients require adequate thromboprophylaxis. Following the publication of the AVERT clinical study, Apixaban is strongly recommended as a prophylactic treatment option for patients with cancer, based on high quality of evidence and a favorable efficacy/safety profile. A multicenter and ancillary study - APIXABOR - that measured the plasmatic concentration of Apixaban in patients with MM and treated with preventive dose has been conducted. The peak drug concentration was superior in MM plasma, as compared to non-myeloma patients under prophylaxis. Therefore, the present study evaluated whether differences in pharmacokinetics have an impact on pharmacodynamics (i.e. decrease in coagulability in MM patients as compared to non-MM patients undergoing a surgery for total knee replacement who also have VTE prophylaxis). In fine, this study may inform to better manage thromboprophylaxis in MM patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
32
Inclusion Criteria
  • Age ≥ 18 years old,
  • Signed informed consent,
  • Patient covered by a social security scheme.
  • Group 1 : patient with a diagnosis of de novo multiple myeloma, with an indication of thromboprophylaxis with Apixaban,
  • Group 2 : patient requiring a surgery for total knee replacement, , with an indication of thromboprophylaxis with Apixaban.
Exclusion Criteria
  • Curative doses of anticoagulation treatment,
  • Contra-indication to Apixaban,
  • Pregnant or breastfeeding woman,
  • Refusal to sign consent,
  • Patient under legal protection.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Blood sampling of patients with de novo multiple myelomaApixabanDescription: Blood sampling of patients with de novo multiple myeloma
Blood sampling of patients undergoing total knee replacementBlood samplingDescription: Blood sampling of patients undergoing total knee replacement
Blood sampling of patients undergoing total knee replacementApixabanDescription: Blood sampling of patients undergoing total knee replacement
Blood sampling of patients with de novo multiple myelomaBlood samplingDescription: Blood sampling of patients with de novo multiple myeloma
Primary Outcome Measures
NameTimeMethod
Endogenous Thrombin potential (nM.min)2 hours after Apixaban Treatment

Endogenous Thrombin potential (nM.min) as measured with MidiCAT method at the concentration peak 2 hours after 2.5mg Apixaban treatment

Secondary Outcome Measures
NameTimeMethod
Apixaban concentration (ng/mL)Kinetics of 12 hours following Apixaban treatment in both groups

Apixaban concentration (ng/mL) as measured by mass spectrometry during 12 hours following Apixaban treatment (2.5mg) in both groups

Pharmacodynamics' kinetics of Endogenous Thrombin PotentialKinetics of 12 hours following Apixaban treatment in both groups

MidiCAT method measure : Endogenous Thrombin Potential (nM.min)

Pharmacodynamics' kinetics of LagtimeKinetics of 12 hours following Apixaban treatment in both groups

MidiCAT method measure : Lagtime (min)

Pharmacodynamics' kinetics of Time to peakKinetics of 12 hours following Apixaban treatment in both groups

MidiCAT method measure : Time to peak (min)

Pharmacodynamics' kinetics of Thrombin peakKinetics of 12 hours following Apixaban treatment in both groups

MidiCAT method measure : Thrombin peak (M, Thrombin)

Trial Locations

Locations (1)

CHU de Saint-Etienne

🇫🇷

Saint-Étienne, France

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