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Study to Gather Information About the Proper Dosing of the Oral FXIa Inhibitor BAY 2433334 and to Compare the Safety of the Study Drug to Apixaban, a Non-vitamin K Oral Anticoagulant (NOAC) in Patients With Irregular Heartbeat (Atrial Fibrillation) That Can Lead to Heart-related Complications.

Phase 2
Completed
Conditions
Atrial Fibrillation (AF)
Interventions
Other: Apixaban matching placebo
Other: BAY2433334 matching placebo
Registration Number
NCT04218266
Lead Sponsor
Bayer
Brief Summary

The purpose of this study is to try to find the best dose of the new drug BAY 2433334 to give to participants and to look at how well BAY 2433334 works in patients with irregular heartbeat (atrial fibrillation) that can lead to blood clots, stroke and other heart-related complications. In addition researchers want to compare the safety of the study drug to apixaban, a non-vitamin K oral anticoagulant (NOAC) in patients with atrial fibrillation. This study is also done to learn how the drug in this study moves into, through and out of the body. BAY 2433334, works by blocking a step of the blood clotting process in our body and thins the blood and is a so called oral FXIa inhibitor.

Apixaban, works by reducing the production of blood clotting factors in our body and thins the blood and is a so called non-vitamin K oral anticoagulant (NOAC). Thinning the blood can prevent you from blood clots which can cause a stroke.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
755
Inclusion Criteria
  • Participant must be 45 years of age or older at the time of signing the informed consent.

  • Participant with AF documented by ECG evidence with

    • CHA2DS2-VASc score ≥ 2 if male or CHA2DS2-VASc score ≥ 3 if female

    • Indication for treatment with an oral anticoagulant in

      • any participant currently not treated with an oral anticoagulant (e.g. treatment naïve) or alternatively,
      • participant on a NOAC in case of at least one bleeding risk feature (history of a prior bleed within the last 12 months requiring medical attention and / or moderate renal dysfunction with eGFR 30-50 ml/min and / or current clinically indicated antiplatelet therapy with Acetylsalicylic acid(ASA) ≤ 100 mg)
  • Written informed consent

Exclusion Criteria
  • Mechanical heart valve prosthesis
  • Any degree of rheumatic mitral stenosis or moderate-to-severe, non-rheumatic mitral stenosis
  • Atrial fibrillation due to a reversible cause, participants in sinus rhythm after successful ablation, or plan for cardioversion or ablation during study conduct
  • Requirement for chronic anticoagulation (for a different indication than AF) or antiplatelet therapy (up to 100 mg ASA is allowed). Anticipated need for chronic therapy with Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Treated with a Vitamin K antagonist in the 30 days prior to screening

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
BAY2433334 50mg+Apixaban matching placeboApixaban matching placebo-
BAY2433334 20mg+Apixaban matching placeboBAY2433334-
BAY2433334 20mg+Apixaban matching placeboApixaban matching placebo-
BAY2433334 matching placebo+ApixabanBAY2433334 matching placeboApixaban usual dose is 5 mg, reduced to 2.5 mg for participants with any 2 of the following criteria: age 80 years or older, body weight less than 60 kg, or serum creatinine level of 1.5 mg per dL or more.
BAY2433334 50mg+Apixaban matching placeboBAY2433334-
BAY2433334 matching placebo+ApixabanApixabanApixaban usual dose is 5 mg, reduced to 2.5 mg for participants with any 2 of the following criteria: age 80 years or older, body weight less than 60 kg, or serum creatinine level of 1.5 mg per dL or more.
Primary Outcome Measures
NameTimeMethod
Number of Participants With Composite of International Society on Thrombosis and Hemostasis (ISTH) Major Bleeding or Clinically Relevant Non-major (CRNM) BleedingAfter the first administration of study intervention with an average administration of 12 weeks (but not starting after more than 2 days after the last administration)

ISTH Major Bleeding criteria: 1. Fatal bleeding, and/or 2. Symptomatic bleeding in a critical area or organ (intracranial, intraocular, intraspinal, pericardial, retroperitoneal, intraarticular, or intramuscular with compartment syndrome), and/or 3. Clinically overt bleeding associated with a recent decrease in the hemoglobin level of ≥ 2 g/dL (20 g/L; 1.24 mmol/L) compared to the most recent hemoglobin value available before the event, and/or 4. Clinically overt bleeding leading to transfusion of 2 or more units of packed red blood cells or whole blood.

ISTH Clinically Relevant Non-Major Bleeding is considered any sign or symptom of hemorrhage that does not fit the criteria for the ISTH definition of major bleeding, but does meet at least one of the following criteria 1. requiring medical intervention by a healthcare professional. 2. leading to hospitalization or increased level of care. 3. prompting a face to face (i.e. not just a telephone or electronic communication) evaluation.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With All BleedingAfter the first administration of study intervention with an average administration of 12 weeks (but not starting after more than 2 days after the last administration)

Adjudication of all bleeding events was performed by members of the Clinical events committee (CEC) who reviewed events in a blinded fashion and adjudicated and classified the following events in a consistent and unbiased manner according to the following classifications: ISTH (major, clinically relevant non-major and minor); Thrombolysis in myocardial infarction (TIMI major, minor, requiring medical attention, minimal); Bleeding Academic Research Consortium (BARC type 1, 2, 3, 5).

Number of Participants With ISTH Minor BleedingAfter the first administration of study intervention with an average administration of 12 weeks (but not starting after more than 2 days after the last administration)

All other overt bleeding episodes not meeting ISTH Major Bleeding criteria or clinically relevant non major bleeding were classified as minor bleeding.

Number of Participants With ISTH Major BleedingAfter the first administration of study intervention with an average administration of 12 weeks (but not starting after more than 2 days after the last administration)

ISTH Major Bleeding criteria: 1. Fatal bleeding, and/or 2. Symptomatic bleeding in a critical area or organ (intracranial, intraocular, intraspinal, pericardial, retroperitoneal, intraarticular, or intramuscular with compartment syndrome), and/or 3. Clinically overt bleeding associated with a recent decrease in the hemoglobin level of ≥ 2 g/dL (20 g/L; 1.24 mmol/L) compared to the most recent hemoglobin value available before the event, and/or 4. Clinically overt bleeding leading to transfusion of 2 or more units of packed red blood cells or whole blood.

Number of Participants of ISTH Clinically Relevant Non-major (CRNM) BleedingAfter the first administration of study intervention with an average administration of 12 weeks (but not starting after more than 2 days after the last administration)

ISTH Clinically Relevant Non-Major Bleeding is considered any sign or symptom of hemorrhage that does not fit the criteria for the ISTH definition of major bleeding, but does meet at least one of the following criteria 1. requiring medical intervention by a healthcare professional. 2. leading to hospitalization or increased level of care. 3. prompting a face to face (i.e. not just a telephone or electronic communication) evaluation.

Trial Locations

Locations (92)

Hôpital de Rangueil - Toulouse

🇫🇷

Toulouse, France

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Danderyds sjukhus

🇸🇪

Stockholm, Sweden

A.O. di Perugia

🇮🇹

Perugia, Umbria, Italy

Universitätsspital Basel

🇨🇭

Basel, Basel-Stadt, Switzerland

Jessa Ziekenhuis

🇧🇪

Hasselt, Belgium

UZ Antwerpen

🇧🇪

Edegem, Belgium

Ordensklinikum Linz GmbH Elisabethinen

🇦🇹

Linz, Oberösterreich, Austria

AZ St-Jan Brugge Oostende AV

🇧🇪

Brugge, Belgium

Montreal Heart Institute

🇨🇦

Montreal, Quebec, Canada

Medifarma-98 Egeszsegugyi, Kereskedelmi es Szolgaltato Kft.

🇭🇺

Nyiregyhaza, Hungary

Landeskrankenhaus Feldkirch

🇦🇹

Feldkirch, Vorarlberg, Austria

Krankenhaus St. Josef Braunau

🇦🇹

Braunau, Oberösterreich, Austria

Medizinische Universität Graz

🇦🇹

Graz, Steiermark, Austria

Imeldaziekenhuis - St-Elisabethkliniek

🇧🇪

Bonheiden, Belgium

Tagore Medical Center

🇭🇺

Balatonfured, Hungary

Kanizsai Dorottya Hospital

🇭🇺

Nagykanizsa, Hungary

Kishiwada Tokushukai Hospital

🇯🇵

Kishiwada, Osaka, Japan

Minamino Cardiovascular Hospital

🇯🇵

Hachioji, Tokyo, Japan

Riga East Clinical University Hospital "Gailezers"

🇱🇻

Riga, Latvia

Academisch Medisch Centrum (AMC)

🇳🇱

Amsterdam, Netherlands

Martini Ziekenhuis, Locatie van Swieten

🇳🇱

Groningen, Netherlands

Magyar Honvedseg Egeszsegugyi Kozpont

🇭🇺

Budapest, Hungary

ASUR Marche - Area Vasta 5

🇮🇹

Ascoli Piceno, Marche, Italy

Uniklinikum Salzburg - Landeskrankenhaus

🇦🇹

Salzburg, Austria

VZW Emmaus

🇧🇪

Mechelen, Belgium

Clinique Sante Cardio MC

🇨🇦

Montreal, Quebec, Canada

Tolna Megyei Balassa Janos Korhaz

🇭🇺

Szekszard, Hungary

Nishiarai Heart Central Clinic

🇯🇵

Adachi-ku, Tokyo, Japan

Koto Hospital

🇯🇵

Koto-ku, Tokyo, Japan

Ciutat Sanitària i Universitària de Bellvitge

🇪🇸

L'Hospitalet de Llobregat, Barcelona, Spain

Klinik Floridsdorf - Krankenhaus Nord

🇦🇹

Wien, Austria

UZ Leuven Gasthuisberg

🇧🇪

Leuven, Vlaams Brabant, Belgium

AZ Delta

🇧🇪

Roeselare, Belgium

Pecsi Tudomanyegyetem Klinikai Kozpont

🇭🇺

Pecs, Hungary

Yao Tokushukai General Hospital

🇯🇵

Yao, Osaka, Japan

Maastricht UMC

🇳🇱

Maastricht, Netherlands

University of Semmelweis/ Semmelweis Egyetem

🇭🇺

Budapest, Hungary

A.O.U. Policlinico Umberto I

🇮🇹

Roma, Lazio, Italy

Liepaja Regional Hospital

🇱🇻

Liepaja, Latvia

Ziekenhuis Rijnstate

🇳🇱

Arnhem, Netherlands

Hôpital Cantonal Universitaire de Genève

🇨🇭

Genève, Switzerland

Staploe Medical Centre

🇬🇧

Ely, Cambridgeshire, United Kingdom

Queen Elizabeth II Hospital

🇬🇧

Welwyn Garden City, Hertfordshire, United Kingdom

St Richard's Hospital

🇬🇧

Chichester, West Sussex, United Kingdom

Daugavpils Regional Hospital

🇱🇻

Daugavpils, Latvia

Amphia Ziekenhuis, locatie Molengracht

🇳🇱

Breda, Netherlands

Spaarne Gasthuis - locatie Zuid

🇳🇱

Haarlem, Netherlands

Inselspital Universitätsspital Bern

🇨🇭

Bern, Switzerland

Universitätsklinikum AKH Wien

🇦🇹

Wien, Austria

Fakultni nemocnice Kralovske Vinohrady

🇨🇿

Praha 10, Czechia

Fakultni nemocnice Plzen - Lochotin

🇨🇿

Plzen, Czechia

Institut universitaire de cardiologie et de pneumologie

🇨🇦

Ste-Foy, Quebec, Canada

Institut Klinicke a Experimentalni Mediciny

🇨🇿

Praha 4, Czechia

Fakultni nemocnice v Motole

🇨🇿

Praha 5, Czechia

Nemocnice Slany

🇨🇿

Slany, Czechia

Centre Hospitalier Départemental Vendée

🇫🇷

La Roche Sur Yon Cedex, France

Krajska nemocnice T. Bati, a.s.

🇨🇿

Zlin, Czechia

Hôpital Henri Mondor

🇫🇷

Creteil, France

Centre Hospitalier Louis Pasteur

🇫🇷

Le Coudray, France

Hopital Bichat - Paris

🇫🇷

Paris, France

Centre Hospitalier Régional - Saint Brieuc

🇫🇷

Saint Brieuc, France

Centre Hospitalier - Valenciennes Cedex

🇫🇷

Valenciennes Cedex, France

Csongrad-Csanad Megyei Dr. Bugyi Istvan Korhaz

🇭🇺

Szentes, Hungary

IRCCS Ospedale Policlinico San Martino

🇮🇹

Genova, Liguria, Italy

ASST Spedali Civili di Brescia

🇮🇹

Brescia, Lombardia, Italy

AUSL Toscana Sud-Est

🇮🇹

Arezzo, Toscana, Italy

Nakamura Cardiovascular Clinic

🇯🇵

Itoshima, Fukuoka, Japan

Hyogo Prefectural Harima-Himeji General Medical Center

🇯🇵

Himeji, Hyogo, Japan

Hayama Heart Center

🇯🇵

Miura-gun, Kanagawa, Japan

Tokyo Angel Hospital

🇯🇵

Hachioji, Tokyo, Japan

Doctor's Practice in Cardiology

🇱🇻

Daugavpils, Latvia

P. Stradins Clinical University Hospital

🇱🇻

Riga, Latvia

1st Riga Clinical Hospital

🇱🇻

Riga, Latvia

Albert Schweitzer Ziekenhuis, Dordwijk

🇳🇱

Dordrecht, Netherlands

Medisch Spectrum Twente

🇳🇱

Enschede, Netherlands

Clemenstorget Hjärtmottagning

🇸🇪

Lund, Sweden

Ciutat Sanitària i Universitaria de la Vall d'Hebron

🇪🇸

Barcelona, Spain

Hospital de la Santa Creu i de Sant Pau | Cardiología

🇪🇸

Barcelona, Spain

Falu Lasarett

🇸🇪

Falun, Sweden

Hospital Virgen de la Victoria

🇪🇸

Málaga, Spain

Skellefteå Lasarett

🇸🇪

Skellefteå, Sweden

Södersjukhuset AB

🇸🇪

Stockholm, Sweden

Avdelningen för kliniska prövningar AKP

🇸🇪

Örebro, Sweden

Kantonsspital Aarau

🇨🇭

Aarau, Aargau, Switzerland

Östersunds Sjukhus

🇸🇪

Östersund, Sweden

Kantonsspital St. Gallen

🇨🇭

St. Gallen, Sankt Gallen, Switzerland

Ospedale regionale di Lugano

🇨🇭

Lugano, Switzerland

Northwick Park Hospital

🇬🇧

Harrow, London, United Kingdom

Heart and Chest Hospital

🇬🇧

Liverpool, United Kingdom

Medizinische Universität Innsbruck

🇦🇹

Innsbruck, Tirol, Austria

Queen Elizabeth II Health Sciences Centre

🇨🇦

Halifax, Nova Scotia, Canada

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