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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03785080
Registration number
NCT03785080
Ethics application status
Date submitted
20/12/2018
Date registered
24/12/2018
Date last updated
5/05/2020
Titles & IDs
Public title
Non-warfarin Oral AntiCoagulant Resumption After Gastrointestinal Bleeding in Atrial Fibrillation Patients
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Scientific title
Non-warfarin Oral AntiCoagulant Resumption After Gastrointestinal Bleeding in Atrial Fibrillation Patients (NOAC-GAP) - a Randomised Controlled Study
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Secondary ID [1]
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NOAC-GAP
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Universal Trial Number (UTN)
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Trial acronym
NOAC-GAP
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Upper Gastrointestinal Bleeding
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Condition category
Condition code
Oral and Gastrointestinal
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Cardiovascular
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Other interventions - restart NOAC very early
Other interventions - restart NOAC early
Experimental: restart NOAC very early - restart NOAC within 24 hours
Active comparator: restart NOAC early - restart NOAC at 72 - 84 hours
Other interventions: restart NOAC very early
withhold NOAC less than 24 hours Post OGD
Other interventions: restart NOAC early
withhold NOAC for 72 to 84 hours Post OGD
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Intervention code [1]
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Other interventions
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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recurrent gastrointestinal bleeding
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Assessment method [1]
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melaena and/or haematemesis with drop in Hb \>2g/dL and confirmation of bleeding by endoscopy.
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Timepoint [1]
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30 days
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Secondary outcome [1]
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recurrent gastrointestinal bleeding
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Assessment method [1]
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melaena and/or haematemesis with drop in Hb \>2g/dL and confirmation of bleeding by endoscopy.
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Timepoint [1]
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90 days
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Secondary outcome [2]
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Ischemic stroke or transient ischaemic attack
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Assessment method [2]
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an acute episode of neurologic deficit of presumed vascular or cardioembolic origin; its presence will be confirmed by a member of the neurology service
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Timepoint [2]
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30 days
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Secondary outcome [3]
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Systemic thromboembolism
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Assessment method [3]
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any clinical and/or radiographic acute stroke and/or an acute peripheral arterial thromboembolic event including acute limb ischaemia, coronary embolism and arterial thromboembolism
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Timepoint [3]
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30 days
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Secondary outcome [4]
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Death
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Assessment method [4]
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All-cause mortality
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Timepoint [4]
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6 months
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Eligibility
Key inclusion criteria
* Age =18 years
* History of AF
* Taking any kind of NOAC at the time of index acute GIB
* Acute upper GIB (non-variceal bleeding lesions accounting for the GIB) with or without endoscopic treatment confirmed endoscopic haemostasis verified by GI specialist
* Patient or next-of-kin able to provide informed consent
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Minimum age
18
Years
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Maximum age
99
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Concomitant stroke (including TIA) at the time of index GIB
* Requiring bridging IV heparin therapy
* Portal hypertension
* Known bleeding diathesis
* Other conditions precluding use of NOAC at the time of randomisation
* Pregnancy
* Tumour bleeding
* Antidote administration to reverse anticoagulation effect of NOACs
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
11/03/2019
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
30/12/2025
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Actual
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Sample size
Target
552
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Blacktown Hospital - Blacktown
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Recruitment postcode(s) [1]
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- Blacktown
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Recruitment outside Australia
Country [1]
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Hong Kong
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State/province [1]
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Hong Kong
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Country [2]
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Singapore
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State/province [2]
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Singapore
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Funding & Sponsors
Primary sponsor type
Other
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Name
Chinese University of Hong Kong
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
Current clinical society guidelines and statements are non-specific and relatively open-ended regarding the optimal timing to restart non-warfarin oral anticoagulant (NOAC) after gastrointestinal bleeding (GIB) in patients with atrial fibrillation (AF) who require the prophylactic medication for stroke prevention. These patients are at increased risk for devastating future thromboembolic events including stroke if NOAC is not resumed promptly, whilst premature resumption of anticoagulants can result in recurrent GIB, haemorrhage, anaemia, myocardial ischaemia and infarction in those with ischaemic heart disease, and even death. However, the question as to how early a NOAC can be safely restarted after acute GIB has not been previously answered, and there remains an important knowledge gap.
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Trial website
https://clinicaltrials.gov/study/NCT03785080
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Joseph SUNG, MD
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Address
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CUHK
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Bing Yee SUEN, BSN
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Address
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Country
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Phone
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+852 3505 2640
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Fax
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Email
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[email protected]
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03785080
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