Outcomes and Safety Trial Investigating Ecallantide's Effect on Reducing Surgical Blood Loss Volume in Subjects at High Risk of Bleeding Exposed to Cardio-pulmonary Bypass During Cardiac Surgery

Phase 2

Completed

Conditions: Surgical Procedures, Operative
Bloodloss

Interventions: Drug: Cyklokapron(R)
Drug: Ecallantide

Registration Number: NCT00888940

Lead Sponsor: Cubist Pharmaceuticals LLC, a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USA)

Brief Summary: A Phase 2 Randomized Double-Blind Active-Controlled Study in Subjects Exposed to Cardio-pulmonary Bypass During Cardiac Surgery at High Risk of Bleeding

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 243

Inclusion Criteria

Written informed consent (by study subject) prior to any study-related procedure not part of normal medical care;
Male or female between the ages of 18 and 85 years old, inclusive; and
Planned cardiac surgery using cardio-pulmonary bypass, for one of the following procedures: any repeat sternotomy; surgery to repair or replace more than one valve; combined CABG plus repair or replacement of at least one valve
If female, subject is non-lactating, and is either:Not of childbearing potential, defined as postmenopausal for at least one year or surgically sterile due to bilateral tubal ligation, bilateral oophorectomy, or hysterectomy;Of childbearing potential but is not pregnant as confirmed by negative pregnancy test at time of screening (based on the β-subunit of HCG), and is practicing the barrier method of birth control along with one of the following methods: oral or parenteral contraceptives for three months prior to study drug administration, a vasectomized partner, or abstinence from sexual intercourse.

Exclusion Criteria

Planned primary CABG, single valve repair or replacement surgery, or any off pump procedure;
Body weight <55 kg;
Planned hypothermia (<28ºC);
Planned transfusion in the peri-operative or post-operative periods;
Planned transfusion of pre-operatively donated autologous blood;
Female subjects who are pregnant or lactating;
Planned use of desmopressin, lysine analogs (other than study medication), atrial natriuretic hormone or recombinant activated Factor VII;
Planned use of corticosteroids in the pump prime solution;
Ejection fraction <30% within 90 days prior to surgery;
Evidence of a myocardial infarction within 5 days prior to surgery;
History of stroke or transient ischemic attack within 3 months prior to surgery;
Hypotension or heart failure requiring the use of inotropes or mechanical devices within 24 hours prior to surgery;
Serum creatinine >2.0 mg/dL within 48 hours prior to surgery;
Serum hepatic enzymes (aspartate aminotransferase or alanine aminotransferase) above 2.5 times the upper limit of normal for the applicable laboratory;
Hematocrit <32% within 48 hours prior to surgery;
Platelet count below the normal range for the applicable laboratory within 14 days prior to surgery;
History of, or family history of, bleeding or clotting disorder (e.g. von Willebrand's Disease, idiopathic thrombocytopenia purpura) or thrombophilia such as anti-thrombin III deficiency or Factor V Leiden mutation;
History of heparin-induced thrombocytopenia;
Prothrombin time (PT) and/or activated partial thromboplastin time (aPTT) >1.5 X normal range unless subject received heparin within 24 hours of test;
Serious intercurrent illness or active infection (e.g. endocarditis, sepsis, active malignancy requiring treatment);
Any previous exposure to ecallantide;
Receipt of an investigational drug or device 30 days prior to participation in the current study;
Any other condition that, in the opinion of the investigator, may compromise the safety or compliance of the subject or would preclude the subject from successful completion of the study;
Inability to comply with the protocol for the duration of the study;
Known allergy to any agent expected to be used in the intra-operative or post-operative periods; and
Administration of: Eptifibatide within 6 hours prior to surgery, Tirofiban hydrochloride within 6 hours prior to surgery, (Enoxaparin sodium or other low-molecular-weight heparin <24 hours prior to surgery), Prasugrel within 10 days prior to surgery, Clopidogrel within 3 days prior to surgery, Ticlopidine within 7 days prior to surgery, Abciximab within 5 days prior to surgery, (Bivalirudin, argatroban or lepirudin within 6 hours prior to surgery), (Fondaparinux within 72 hours prior to surgery), Chlorpromazine within 7 days prior to surgery (Prophylactic use permitted for the prevention of deep vein thrombosis.)
Planned use of heparin bonded bypass circuits;
Known allergy or hypersensitivity to tranexamic acid or any of the other ingredients;
Disturbance of color sense;
Evidence of hematuria or any acute thromboses or thromboembolic diseases such as deep vein thrombosis, pulmonary embolism, or vertebral vein thrombosis.

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Cyklokapron(R)	Cyklokapron(R)	-
ecallantide	Ecallantide	-

Primary Outcome Measures

Name	Time	Method
Cumulative Volume of Packed Red Blood Cells Transfused	12 hours after the end of surgery

Secondary Outcome Measures

Name	Time	Method
Treatment-emergent Adverse Events.	Over the duration of the study.

Trial Locations

Locations (34): Cardio-Thoracic Surgeons PC
🇺🇸
Birmingham, Alabama, United States
Universitaetsklinikum Aachen AoeR
🇩🇪
Aachen, Germany
Klinikum Augsburg
🇩🇪
Augsburg, Germany
Herz- und Gefaesszentrum Bad Bevensen
🇩🇪
Bad Bevensen, Germany
Universitaetsklinikum Bonn
🇩🇪
Bonn, Germany
Klinik und Poliklinik fuer Herz- und Thoraxchirurgie der Universitaet zu Koeln
🇩🇪
Cologne, Germany
St. Johannes Hospital
🇩🇪
Dortmund, Germany
Herzzentrum Dresden GmbH Universitaetsklinik
🇩🇪
Dresden, Germany
Universitaetsklinikum Erlangen
🇩🇪
Erlangen, Germany
Universitaetsklinikum Frankfurt
🇩🇪
Frankfurt, Germany
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Cardio-Thoracic Surgeons PC
🇺🇸Birmingham, Alabama, United States