A Global, Phase 2, Randomized, Double-Blind, Placebo-Controlled, Dose-Ranging Study of BMS-986177, an Oral Factor XIa Inhibitor, for the Prevention of New Ischemic Stroke or New Covert Brain Infarction in Patients Receiving Aspirin and Clopidogrel Following Acute Ischemic Stroke or Transient Ischemic Attack (TIA)
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 发起方
- 入组人数
- 2,366
- 试验地点
- 361
- 主要终点
- Percent of Participants With Model Based Assessment of Composite of New Ischemic Stroke During Treatment and New Covert Brain Infarction (FLAIR + DWI) Detected by MRI by Day 90
研究概览
简要总结
The purpose of this clinical study is to determine whether the addition of an oral Factor XIa Inhibitor to Aspirin and Clopidogrel is more effective than standard therapy in secondary stroke prevention.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 40 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Male and Female ≥40 years of age
- •Acute Ischemic Stroke or Transient Ischemic Attack
- •Intracranial or Extracranial Atherosclerotic Plaque proximal to the affected brain area
排除标准
- •Predicted inability to swallow study medication
- •Any condition that, in the opinion of the Investigator, contraindicates anticoagulant therapy or would have an unacceptable risk of bleeding
- •Use of thrombolytic therapy or mechanical thrombectomy for treatment of index stroke
- •Other protocol defined inclusion/exclusion criteria could apply
研究组 & 干预措施
Dose 6: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Aspirin (Drug)
BMS-986177 Placebo
Specified Dose on Specified Days
干预措施: Placebo (Other)
BMS-986177 Placebo
Specified Dose on Specified Days
干预措施: Clopidogrel (Drug)
BMS-986177 Placebo
Specified Dose on Specified Days
干预措施: Aspirin (Drug)
Dose 1: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: BMS-986177 (Drug)
Dose 1: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Clopidogrel (Drug)
Dose 2: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Aspirin (Drug)
Dose 1: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Aspirin (Drug)
Dose 2: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: BMS-986177 (Drug)
Dose 2: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Clopidogrel (Drug)
Dose 3: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: BMS-986177 (Drug)
Dose 5: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Clopidogrel (Drug)
Dose 3: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Clopidogrel (Drug)
Dose 3: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Aspirin (Drug)
Dose 4: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: BMS-986177 (Drug)
Dose 4: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Clopidogrel (Drug)
Dose 4: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Aspirin (Drug)
Dose 5: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: BMS-986177 (Drug)
Dose 5: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Aspirin (Drug)
Dose 6: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: BMS-986177 (Drug)
Dose 6: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Clopidogrel (Drug)
Dose 7: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: BMS-986177 (Drug)
Dose 7: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Clopidogrel (Drug)
Dose 7: BMS-986177 + Aspirin + Clopidogrel
Specified Dose on Specified Days
干预措施: Aspirin (Drug)
结局指标
主要结局
Percent of Participants With Model Based Assessment of Composite of New Ischemic Stroke During Treatment and New Covert Brain Infarction (FLAIR + DWI) Detected by MRI by Day 90
时间窗: From randomization to up to 90 days after randomization
Model based assessment estimate for composite event is a customized statistical analysis called MCP-MOD (Multiple Comparison Procedures, MODel) estimation, which is used to check for dose-response relationship. 95% confidence interval (CI) for composite event based on bootstrap (10000 samples).
次要结局
- Percent of Participants With Descriptive Assessment of Composite of New Ischemic Stroke During Treatment and New Covert Brain Infarction (FLAIR + DWI) Detected by MRI by Day 90(From randomization to up to 90 days after randomization)
- Composite of Percent of Participants With New Ischemic Stroke, MI and All Cause Death(From randomization to up to 90 days after randomization)
- Modified Rankin Scale (mRS)(At baseline, on Days 21 and 90, and at the time of a new stroke event)
- Number of Participants With Clinically Significant Vital Sign Abnormalities(From first dose to up to 90 days after first dose)
- Number of Participants With Bleeding Based on ISTH-Defined Criteria(From first dose to up to 107 days after first dose)
- Percent of Participants With Major Bleeding According to BARC Type 3 and 5(From first dose to up to 107 days after first dose)
- Number of Participants With Bleeding Based on BARC Types 1-5(From first dose to up to 107 days after first dose)
- Number of Participants With Clinically Significant Electrocardiogram (ECG) Abnormalities(From first dose to up to 90 days after first dose)
- Pharmacokinetic Parameter - Estimated Clearance (CL)(From first dose to up to 90 days after first dose)
- Number of Participants With Bleeding Based on PLATO-Defined Criteria(From first dose to up to 107 days after first dose)
- Montreal Cognitive Assessment (MoCA)(At baseline, on Days 21 and 90, and at the time of a new stroke event)
- Percent Change From Baseline in Factor XI Clotting Activity(Baseline and day 90)
- Digit Symbol Substitution Test (DSST)(At baseline, on Days 21 and 90, and at the time of a new stroke event)
- Number of Participants With Adverse Events (AEs)(From first dose to 2 days after last dose of study therapy (up to approximately 107 days))
- National Institutes of Health Stroke Scale (NIHSS)(At baseline, on Days 21 and 90, and at the time of a new stroke event)
- Number of Participants With Clinically Significant Physical Examination Abnormalities(From first dose to up to 90 days after first dose)
- Number of Participants With Clinically Significant Laboratory Abnormalities - Liver(From first dose to up to approximately 38 months)
- Percent Change From Baseline in aPTT Activity(Baseline and day 90)
- Volume of Incident Infarcts (New DWI+ or DWI- Lesions) by Participant on Day 90 MRI(At day 90)
- Pharmacokinetic Parameter - Volume of the Central Compartment (VC)(From first dose to up to 90 days after first dose)
- Number of Incident Infarcts (New DWI+ or DWI- Lesions) by Participant on Day 90 MRI(At day 90)
