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臨床試驗計畫

計劃書編號DU176b-C-U301

2009-02-15 - 2012-09-15

Phase III

終止收納16

A Phase 3, Randomized, Double-Blind, Double-Dummy, Parallel Group, Multi-Center, Multi-National Study for Evaluation of Efficacy and Safety of DU-176b Versus Warfarin In Subjects with Atrial Fibrillation – Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation (ENGAGE – AF TIMI - 48)

  • 試驗申請者

    艾昆緯股份有限公司

  • 試驗委託 / 贊助單位名稱

    Daiichi Sankyo Pharma Development

  • 臨床試驗規模

    多國多中心

  • 更新日期

    2025/08/20

試驗主持人及試驗醫院

試驗主持人

協同主持人

實際收案人數

0 終止收納

試驗主持人 葉宏一 心臟血管內科

協同主持人

實際收案人數

0 終止收納

試驗主持人 夏建勳 心臟血管內科

協同主持人

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0 終止收納

試驗主持人 王志鴻 心臟血管內科

協同主持人

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0 終止收納

試驗主持人 黃金隆 心臟血管內科

協同主持人

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0 終止收納

試驗主持人 郭啟泰 心臟血管內科

協同主持人

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0 終止收納

試驗主持人 賴文德 心臟血管內科

協同主持人

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0 終止收納

試驗主持人 韓志陸 心臟血管內科

協同主持人

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0 終止收納

試驗主持人 鄭成泉 心臟血管內科

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0 終止收納

試驗主持人 邱春旺 心臟血管內科

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0 終止收納

試驗主持人 曾維功 心臟血管內科

協同主持人

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0 終止收納

試驗主持人 江福田 心臟血管內科

協同主持人

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0 終止收納

試驗主持人 白培英 心臟血管內科

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0 終止收納

試驗主持人 徐國基 心臟血管內科

協同主持人

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0 終止收納

試驗主持人 翁國昌 心臟血管內科

協同主持人

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0 終止收納

試驗主持人 葉宏一 心臟血管內科

協同主持人

實際收案人數

0 終止收納

適應症

Prevention of Stroke in Patients with AF.

試驗目的

主要目的: 主要目的是在中風和 SEE 的綜合主要指標方面,比較 DU-176b 與 warfarin。將比較每種 DU-176b 治療方法對warfarin 之非劣效性。任何非劣效性之 DU-176b 治療方法將拿來與warfarin 作優越性的比較。 次要目的: 1.比較 DU-176b 與 warfarin 的中風、SEE 和所有病因死亡率之綜合臨床結果,以及其中每項單獨的結果。 2.比較 DU-176b 與 warfarin 的重大心血管不良事件 (MACE),而本第 3 期研究將重大心血管不良事件定義為綜合非致命性心肌梗塞 (MI)、非致命性中風、非致命性 SEE 和心血管 (CV) 病因或出血造成的死亡。 3.為DU-176b 與 warfarin 在重大出血( major bleeding)上的比較,並為其在重大出血加上臨床相關的非重大出血( non-major bleeding)上的比較。

藥品名稱

DU176b

主成份

DU176b

劑型

Oral

劑量

15mg /30mg

評估指標

主要目的:主要目的是在中風和 SEE 的綜合主要指標方面,比較 DU-176b 與 warfarin。將比較每種 DU-176b 治療方法對warfarin 之非劣效性。任何非劣效性之 DU-176b 治療方法將拿來與warfarin 作優越性的比較。
次要目的:
1.比較 DU-176b 與 warfarin 的中風、SEE 和所有病因死亡率之綜合臨床結果,以及其中每項單獨的結果。
2.比較 DU-176b 與 warfarin 的重大心血管不良事件 (MACE),而本第 3 期研究將重大心血管不良事件定義為綜合非致命性心肌梗塞 (MI)、非致命性中風、非致命性 SEE 和心血管 (CV) 病因或出血造成的死亡。
3.為DU-176b 與 warfarin 在重大出血( major bleeding)上的比較,並為其在重大出血加上臨床相關的非重大出血( non-major bleeding)上的比較。

主要納入條件

Inclusion Criteria:
1.Male or female subjects with age ≥ 21 years;
2.Able to provide written informed consent;
3.History of AF documented by a 12-lead electrocardiographic reading and/or continuous electrocardiogram (ECG) (e.g., Holter monitoring) consistent with AF (notation of AF as the abnormal rhythm on the local ECG report with evidence of irregularly irregular rhythm and an absence of P-waves on the ECG for diagnosis of AF) within the prior 12 months and for which anticoagulation therapy is indicated and planned for the duration of the study, including subjects with paroxysmal, persistent, or permanent AF and subjects with or without previous vitamin K antagonist (VKA) (including warfarin) experience (it is anticipated that approximately 40% of subjects will be VKA-naive);
4.A moderate to high risk of stroke, as defined by CHADS2 index score of at least 2, is required to be eligible for the study. The CHADS2 scoring is performed by assigning 1 point each for a history of congestive heart failure, hypertension, age 75 years, or diabetes mellitus; and by assigning 2 points for history of stroke or TIA.

Exclusion Criteria:
1.Transient AF secondary to other reversible disorders (e.g., thyrotoxicosis, cardiac or thoracic surgery, pneumonia, severe anemia);
2.Subjects with moderate or severe mitral stenosis, unresected atrial myxoma, or a mechanical heart valve (subjects with bioprosthetic heart valves and/or valve repair can be included);
3.Subjects for whom the AF management plan is rhythm control with subsequent discontinuation of oral anticoagulation if sinus rhythm is restored or maintained, including subjects in whom successful electrical or surgical ablation has been performed or is planned during the course of the study;
4.Subjects with any contraindication for anticoagulant agents;
5.Subjects with conditions associated with high risk of bleeding such as past history of spontaneous intracranial, intraocular, spinal, retroperitoneal, or intra-articular bleeding; overt gastrointestinal (GI) bleeding or active ulcer within the previous year; recent severe trauma, major surgery, or deep organ biopsy within the previous 10 days; active infective endocarditis; uncontrolled hypertension (blood pressure [BP] above 170/100 mmHg); or hemorrhagic disorder including known or suspected hereditary or acquired bleeding or coagulation disorder;
6.Subjects receiving thienopyridines (such as ticlopidine or clopidogrel) or other non-aspirin antiplatelet agents that cannot be stopped at randomization, or who are anticipated to receive non-aspirin antiplatelet agents as chronic therapy during the study;
7.Subjects receiving chronic cyclosporine for organ transplant, rheumatoid arthristis, or psoriasis;
8.Subjects receiving prohibited concomitant medications (fibrinolytics, non-study anticoagulants other than those used as a bridge to/from study drug, chronic non-aspirin non-steroidal anti-inflammatory drug [NSAID] use for > 4 days/week or for a chronic condition, potent P-glycoprotein (P-gp) inhibitors [ritonavir, cyclosporine, ketoconazole, itraconazole, erythromycin, clarithromycin];
9.Subjects with acute MI, stroke, acute coronary syndrome (ACS), or percutaneous coronary intervention (PCI) within the previous 30 days;
10.Subjects with active liver disease or persistent (confirmed by repeat assessment within a week) elevation of liver enzymes/bilirubin:
•Alanine transaminase (ALT) or aspartate transaminase (AST) ≥ 2 times the upper limit of normal (ULN),
•Total bilirubin (TBL)  1.5 times the ULN,
•Alkaline phosphatase (ALP)  2 times the ULN;
11.Subjects with severe renal insufficiency (calculated CrCL <30 cc/min);
12.History of positive Hepatitis B antigen or Hepatitis C antibody;
13.Any other clinically relevant laboratory abnormality as judged by the Investigator;
14.Subjects receiving antiretroviral therapy for human immunodeficiency virus (HIV) infection or likely to receive such therapy during the study;
15.Subjects with hemoglobin < 10 g/dL or platelet count < 100,000 cells/L or white blood cell count (WBC) < 3000 cells/L;
16.Subjects with pre-planned invasive procedures (other than routine endoscopy) or surgeries in which bleeding is anticipated during the study period;
17.Subjects who received any investigational drug or device within 30 days prior to randomization, or plan to receive such investigational therapy during the study period;
18.Subjects previously randomized in a DU-176b study;
19.Females of childbearing potential including including the following:
•Females with a history of tubal ligation;
•Females less than 2 years postmenopausal;
20.Subjects with the following diagnoses or situations:
•Active malignancy (diagnosed within 5 years) except for adequately treated non-melanoma skin cancer or other non-invasive or in-situ neoplasm (e.g., cervical cancer);
•Concurrent treatment with anti-cancer therapy (drug and/or radiation);
•Significant active concurrent medical illness or infection;
•Life expectancy < 12 months;
21.Subjects who are unlikely to comply with the protocol (e.g., uncooperative attitude, inability to return for subsequent visits, and/or otherwise considered by the Investigator to be unlikely to complete the study);
22.Subjects with a known drug or alcohol dependence within the past 12 months as judged by the Investigator.

試驗計畫預計收納受試者人數

  • 台灣人數

    240 人

  • 全球人數

    16500 人